Ankle & Foot Injuries Flashcards
What is the timeframe that Ottawa Ankle Rules are applied to?
ankle injuries <7 days old
If there are no positive criteria on Ottawa Ankle Rules, what is the chance of significant fracture?
<2.5%
What are the Ottawa Ankle Rules?
Radiographs indicated if any of the following:
(ANKLE)
- bone tenderness along distal 6cm of post edge of tibia or tip of medial malleolus
- bone tenderness along distal 6cm of post edge of fibula or tip of lateral malleolus
(FOOT)
- bone tenderness at base of 5th metatarsal
- bone tenderness at navicular
- inability to bear weight both immediately & in clinic for 4 steps (regardless of limping)
What is the rule for determining stability of an ankle injury?
2 or more injuries to the ankle mortise = unstable
What is a trimalleolar fracture?
bimalleolar fx + post. malleolar fx of tibia
What is a Maisonneuve fracture?
ankle inj w/ proximal fibular fx
What is the mechanism of a Maisonneuve fracture?
inversion-external rotation of ankle
What injuries are associated with a Maisonneuve fracture?
- ruptured tibiofibular syndesmosis / distal tibiofibular lig widening
- medial malleolus fx or deltoid lig inj
What is a toddler fracture?
undisplaced spiral fx of tibia, which occurs in children 9 mo to 3 yrs
What is the mechanism of a toddler fracture?
fall out of crib, leg caught in slats
What is a boot-top fracture?
fracture of tibia & fibula in adults
What is another name for a boot-top fracture?
skiing injury
What is the clinical significance of avulsion fractures of the ankle?
none
If you see a cystic lucency of the talar dome on an AP radiograph, what are your next steps?
- AP plantarflex & dorsiflex
- if Fx found, need MRI arthrogram
Where do osteochondral fractures occur in the ankle?
anterolateral or posteromedial corners of talar dome
What is the mechanism of osteochondral fractures of the talar dome?
inversion injury
What soft tissue structures are associated with osteochondral fractures of the talar dome?
lateral ligamentous inj
What is another name for osteochondral fracture?
osteochondritis dissecans (OCD)
What is the most common tarsal bone to fracture?
calcaneus
What is a Don Juan fracture?
intra-articular (subtalar jt) compression fracture of calcaneus, often comminuted
What is a common location of calcaneal avulsion fractures?
at site of calcaneofibular lig
What is the 2nd most common tarsal to fracture?
talus
What is the most common type of fracture of the talus?
avulsion of anterior process by talonavicular lig
What is the term for a fracture through the talar neck?
Aviators fx
What is the clinical significance of an Aviators fracture?
concern for AVN
What is a Jones/Dancer fracture?
transverse fx of base of 5th metatarsal
(perpendicular to long axis)
What is the mechanism of a Jones/Dancer fracture?
inversion + plantarflexion
What is the most common bony injury of the foot?
Jones/Dancer fx
What is the most common fracture associated with inversion injuries?
Jones/Dancer Fx
What is a potential outcome of a Jones/Dancer fracture?
non-union
What is a march fracture?
fatigue fx of metatarsal
What is a LisFranc injury?
tarsometatarsal dislocation of 1st & 2nd metatarsal bases d/t rupture of ligament from 1st cuneiform to 2nd metatarsal base
