EBM Forefoot Flashcards by Rachel Egdorf

What are risk factors for DVT

Prior DCT, birthcontrol, smoking, immobilized etc

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What is anticoagulant for surgery? dose?

Lovenox 30mg/BID or 40mg/day. Start night after surg. can’t use NSAIDS w

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Why do bunion patients have tingling of medial 1st met?

nerve damage, before and after surg

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What happens to foot if take out fibula sesmoid

hallux varus

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what is included in a lateral release?

adductor hallux, fib sesmoid lig, flexor hal brev

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size of screws for osteotomy?

2.7-3.0 headless

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what do you inflate ankle tourniquet to?

250 or 100 above systolic

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what sizes are ankle tourniquet?

12-18

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thigh tourniquet size? inflate to?

24-42 300-350

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Whats go to preop antibiotic?

2g Ancef

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When are most likely times to clot?

2 wk 4 wks

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what is nicotine test

cotinine

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normal IMA

<10

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norm Hallux abductus

<15

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Normal pasa? dasa?

<8 for both

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Norm sesmoid position?

1-3

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Austin

IM 9-15, long plantar arm

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Akin

corrects DASA, medial closing wedge

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Reverdin

Medial wedge for PASA

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Silver

bumpectomy

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McBride

silver + release/transfer of add H tendon and removal of fib sesmoid

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when do post op infection start? causes?

7 days wind water wound walk wonder

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axis guide for austin

parallel to wt bearing surface

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axis guide for lateral wedge

perpendicular to wt bearing surface

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Long acting insulin day of surg

1/2 dose before 1/2 after

short acting insulin day of surg

hold

shellfish allergy

iodine allergy

inverted scarf->

causes dorsiflexion

Scarf

rotation allows fix higher IMA

crescentric

transverse cut

ludloff

oblique cut. proximal dorsal-> plantar distal

causes of hallux limitus

long first met, elevated first, trauma, genetic hypermobile

Drago oloff and Jacobs classification

1- functional limitus, pain at end of ROM 2- joint adaption, flattening of 1st met head, OCD, dorsal exostosis 3- joint destruction, narrowing 4-ankylosis no joint space. < 10 degrees dorsiflex

When do you do what type of surgery?

class 1 or 2 joint sparing, class 3 or 4 joint destruction

Keller

resect base of proximal phalanx, decompresses first MTP

Joint sparing=

cheilectomy, osteotomy, arthrodiastasis

what angles is 1st MPJ fused in

10-15 abduction 10-20 dorsiflex

youngswick

dorsal wedge removal of austin to plantarflex

waterman

dorsal wedge of austin

lambrinudi

plantarflex osteotomy

Kessel bonney

phalangeal osteotomy in kids

moberg

phalangeal osteotomy in adults

dosage of hydrocodone/Percocet?

5-325

arthrodiastasis

joint distraction .5mm/day 2 wks

flexor stabilization

most common, excessive gripping, pronation, flexors fire early

flexor substitution

flexors have advantage over interossei, weak gastroc

extensor substitution

pes cavus, neuromuscular, equinus,

normal 5th met IMA? bunionette?

6, 8

normal Lateral deviation angle? bunionette?

2.64, 8

normal mtpj angle 5th? bunionette

10, 16

why do you do a syndactly?

prevent floppy toe

foot type of RA patient?

pes planus

Methotrexate

leave on, increases infection

prednisone

if >20mg stress dose 50mg, 25mg every 8 hours

infliximab

hold 2 weeks prior, increases neuropathy

simavastatin

hold day of surg, rhabdomyolysis and muscle aches

TNFa

hold 2 weeks before and after

RA have increased chance for

kidney and liver failure

what size k wires?

.45 or .62

incisions can't be closer than

1cm

colchicine dosage

1.2mg than .6

long term gout med

uloric (flaboxistat) better for renal

goal uric acid for gout patients?

what responds quicker SED or CRP?

CRP

what is gout sign?

martels

dose for allopurinol

100-300 mg

optimal vit d?

30-50

dosage vit D

2000 IU daily, 6000 per day to get there

where is most common for neuroma

3rd met space

alcohol injection for neuroma

if neuroma reoccurs

plantar approach

brachymet callus distraction

1mm/day due to neurovascular

brachymet timeline

7 days latent, 3-4 wk extraction, ossification= latent+ extraction

freibergs

immobilize acute, 2nd met, smillies stages (1-3=cresecent 4=body)

epiphyodisis

stop lateral growth allow medial growth for juvenile HAV

causes of Hallux varus

medial staking, lat release, sesamoidectomy

complication of sesmoiditis

decrease plantarflex strength after surgery

bipartite sesmoid

differentiate from fracture