Ankle and Foot Flashcards

1
Q

What are the Ottawa ankle rules?

A
  • If there is pain in malleolar zone

AND

  • Bone pain in the posterior edge or tip of the medial or lateral malleolus
  • Can’t weight bear immediately in clinic
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2
Q

What are the Ottawa foot rules?

A
  • Pain in midfoot

AND

  • Bone pain in base of 5th MT or navicular
  • Can’t weight bear immediately or in clinic
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3
Q

What is the 1 - 2 intermetatarsal angle?

A
  • Bisection of 1st and 2nd MT
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4
Q

What is the Hallux Valgus angle?

A
  • Bisection of 1st MT and proximal phalanx
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5
Q

What is mild, moderate, and severe 1-2 intermetarsal angle?

A

Mild: < 11 degrees
Mod: < 15 degrees
Sev: 15 < degrees

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6
Q

What is a mild, moderate, and severe hallux valgus angle?

A

Mild: < 20 degrees
Mod: 20 - 40 degrees
Sev: 40 < degrees

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7
Q

What is the WB lateral view of the foot used to measure?

A

Longitudinal arch measurements

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8
Q

What is the NWB lateral view of the foot used to assess?

A

Trauma

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9
Q

What is the Boehler angle? What does is its use? What is normal?

A
  • Calcaneal fractures
  • Line joining anterior and posterior calcaneal facets
  • Line through posterior facet and superior posterior process

Normal: 25 - 40 degrees

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10
Q

What is the Talometatarsal angle? What is its use? What is normal?

A

Assesses flat foot

  • Line bisecting the (long-axis) of 1st MT
  • Line bisecting the (long-axis) of the talus

Normal: 0 - 10 degrees

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11
Q

What is Calcaneal Inclination? What is its use? What is normal?

A

Assesses flat foot

  • Line joining inferior limit of distal calcaneal facet and inferior distal tuberosity
  • Plane of support
  • Normal 20 - 30 degrees
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12
Q

What is measured in an inversion or stress view? What is considered abnormal?

A
  • Inversion or eversion applied manually

- > 10 degree for either is considered abnormal

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13
Q

What is assessed in a sesamoid view?

A
  • Position of the sesamoids in the groove
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14
Q

What is a unimalleolar fracture?

A
  • Medial or lateral malleolus is fractured
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15
Q

What is a bimalleolar fracture?

A
  • Medial and lateral are fractured
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16
Q

What is a trimalleolar fracture?

A
  • Medial and lateral malleoli are fractured

- Posterior tibial rim is fractured

17
Q

What is the second most fractured bone in the foot?

A

The talus.

18
Q

Which aspect of the talus is fractured most commonly?

A
  • The neck
19
Q

What is there a high incidence of with respect to talar fractures?

A
  • AVN

- Subtalar and ankle DJD

20
Q

What can help prevent the incidence of AVN in talar fractures?

A
  • Open reduction

- Internal fixation

21
Q

What age and gender are most susceptible to adult acquired flatfoot?

A
  • Women, 45 - 65 y/o
22
Q

What are 4 lifestyle factors that can contribute to adult acquired flatfoot?

A
  • Diabetes
  • Seroneg Arthropathies
  • Overweight
  • Smoking
23
Q

What soft tissue dysfunction is associated with adult acquired flatfoot?

A
  • Posterior tivialis tendonitis/ rupture
24
Q

What is the process of adult acquired flatfoot in relation to posterior tibial dysfunction?

A
  • Loss of dynamic control of medial longitudinal arch

- Stretches static stabilizers

25
Q

During what phases of gait is supination lacking with PTT?

A
  • TSt

- PSw

26
Q

Where will pain be felt with PTT?

A
  • Medial malleolus
27
Q

Which stages of adult acquired flatfoot may be recovered from?

A

Stage I and II

28
Q

What is stage I of adult acquired flat foot?

A
  • Painful synovitis of PTT, tender to palpation

- Tendon length and function maintained, strength may be 5/5`

29
Q

What is stage II of adult acquired flatfoot?

A
  • Progressive tendon dysfunction
  • Weakness and tendon lengthening
  • Flexible flatfoot develops
30
Q

What is stage III of adult acquired flatfoot?

A
  • Deformity becomes rigid

- Stiff/ arthrosis

31
Q

What is stage IV of adult acquired flatfoot?

A
  • Tibiotalar valgus

- Arthritic changes progress

32
Q

What is conservative treatment for stage I and II AAFF?

A
  • Orthosis
  • Inflammation reduction
  • Stretching
  • High repetition plantar flexor training
33
Q

What are 4 surgical options to treat flatfoot?

A
  • Transfer FDL to navicula
  • Implant plug to limit subtalar eversion (subtalar arthroereisis)
  • Calcaneal osteotomy (Reposition 2 halves of calcaneus so that plantar flexors invert during late stance phase
  • Arthrodesis (drill joint, and fuse it)
34
Q

What 3 joints may recieve arthrodesis?

A
  • Talonavicular
  • Calcaneal cuboid
  • Subtalar
35
Q

What are 3 indications for arthrodesis?

A
  • Correct hyperpronantion/ painful flexible flatfoot
  • Severe subtalar DJD
  • Trauma
36
Q

What imaging technique is good for assessing stress fractures?

A

Bone scan

37
Q

How is a bone scan assessed for a stress fracture?

A
  • Look for hot spots where radioisotopes are taken up, indicating high metabolic activity
  • Compare bilaterally as growth plates also show up as hot spots