Ankle Blabla

Question 1

Cause of recurrent lateral ankle instability

Answer 1

1. Non-healing previous acute ankle ligament injury
2. Peroneal tenosynovitis
3. Peroneal tendon tear/rupture
4. Avulsion fracture of lateral malleolus
5. Superior extensor retinaculum tear
   * look for tendon subluxation during foot eversion or dorsiflexion with resistance
6. Osteochondral lesion
7. Ankle arthritis
8. Fracture
   - lateral process of talus
   - anterior process of calcaneus
   - jones fracture (base of 5th metatarsal)

Question 2

Medial ankle injury

Answer 2

1. Posterior tibial tendinitis/rupture
2. Tarsal tunnel syndrome
3. Flexor hallucis tendinitis

Question 3

Posterior tibial tendinitis/rupture diagnosis

Answer 3

Hx:

• pain
• swelling (posteromedial aspect of ankle)

Pe:

• flat foot deformity
• single toe raise
• too many toes sign (valgus ankle)
• tenderness behind medial malleolus

Question 4

Tarsal tunnel syndrome

Answer 4

Hx:

• pain medial side of foot (worse with dorsiflexion)
• numbness

Pe:
- positive tinel’s sign behind medial malleolus

Question 5

Flexor hallucis tendinitis diagnosis

Answer 5

Hx:

• pain (posterior to medial malleolus)
• swelling “”

Pe:
- reduced toe dorsiflexion (put ankle in dorsiflexion first)