Ankle Disorders

Question 1

define Achilles tendonitis

Answer 1

an inflammation of the Achilles tendon sheath

Question 2

define Achilles tendon rupture

Answer 2

a rupturing/tearing of the Achilles tendon

Question 3

risk factors of Achilles tendonitis/rupture

Answer 3

sports overuse
systemic steroid use
fluoroquinolones (e.g. ciprofloxacin)

Question 4

clinical features of achilles tendonitis

Answer 4

posterior ankle pain
pain of palpation of achilles tendon
swelling and thickening of achilles tendon

Question 5

clinical features and signs of achilles tendon rupture

Answer 5

loud ‘popping’ sensation
tenderness and swelling over area
loss of ability to stand on tiptoes
Simmonds test +ve = absence of foot plantar flexion on squeezing calf

Question 6

investigations of Achilles tendon rupture

Answer 6

US scan of tendon

Question 7

management of Achilles tendonitis

Answer 7

rest and analgesia (e.g. NSAIDs)

Question 8

management of Achilles tendon rupture

Answer 8

non-op: serial plasters by starting foot in full equnis

op: tendon repair

Question 9

describe a Type A Danis-Weber ankle fracture

Answer 9

lateral malleolar fracture below syndemosis level
usually a stable fracture
can be treated conservatively with support brace

Question 10

describe a Type B Danis-Weber ankle fractured

Answer 10

lateral malleolar fracture AT the level of syndemosis
can be stable or unstable
can be treated conservatively if NO talar shift
if talar shift: operative fixation

Question 11

describe a Type C Danis-Weber ankle fracture

Answer 11

lateral malleolar fracture above the level of syndemosis
medial malleolus may also be fractures due to deltoid ligament tearing
unstable
requires open reduction and internal fixation