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Orthopaedics > Feet problems > Flashcards

Feet problems Flashcards

1
Q

What bones make up the tarsals? (superior -> inferior, medial -> lateral)

A 
Talus
Calcaneus
Navicular 
Cuneiforms 
Cuboid
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2
Q

What bones form the ankle joint?

A

Tibia, fibula and talus

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3
Q

What type of joint is the ankle joint?

A

hinge

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4
Q

What is the function of the medial ligament?

A

resists over eversion of the foot

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5
Q

What is the function of the lateral ligament?

A

resists over inversion

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6
Q

What ligaments does the lateral ligament consist of?

A

i. anterior talofibular
ii. posterior talofibular
iii. calcaneofibular

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7
Q

what ligament is commonly strained and by what mechanism? what are the signs of this?

A

anterior talofibular of lateral ligament by twisting inversion
stiffness, tenderness over lateral ligament
pain on inversion

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8
Q

What is the Rx of ankle ligament strain

A 
RICE
Rest 
Ice 
Compression
Elevation 
Rule out fracture - XR or signs (tenderness at malleolus or inability to walk)
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9
Q

What is a maissoneuve fracture?

A

proximal fibular fracture and syndesmosis rupture, medial malleolus fracture or deltoid ligament rupture

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10
Q

What is the syndesmosis?

A

slightly moveable fibrous joint joined together by connective tissue

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11
Q

What rules can be used to rule out the need for an XR in case of a clinically significant ankle fracture?explain them

A 
Ottawa ankle rules
Pain in malleolar zone and:
1. unable to weight bear for 4 steps
2. tenderness over distal tibia
3. bone tenderness over fibula
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12
Q

What is the Weber classification?

A

classification of lateral malleolar fractures, relating to the level of the fracture in relation to the ankle joint.

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13
Q

What are the symptoms of achilles tendinopathy?

A

gradual onset
posterior heel pain
morning pain and stiffness

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14
Q

What is the treatment for achilles tendinopathy

A

analgesia

stop activities that cause it

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15
Q

What are the clinical features of an achilles tendon rupture?

A
  1. pop in ankle
  2. sudden significant pain in calf or ankle or inability to walk
  3. occurs during running or sport
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16
Q

How can you diagnose an achilles tendon rupture?

A

Simmonds triad:
- pt lies face down, feet hanging off the bed
+ve if there is no plantar flexion (pushing foot down) on squeezing the calf
can also feel gap in the tendon

17
Q

what is the management of achilles tendon rupture?

A

refer acutely to orthopaedic specialist

18
Q

What are the RFs for achilles tendon disorderS?

A

quinolone e.g. ciprofloxacin

hypercholesterolaemia

19
Q

What is the management of ankle fractures in young and elderly ppl?

A

young - surgical repair (often compression plate)

elderly - conservative as the thin bone doesn’t hold metal work well

20
Q

What is hallux valgus?

A

bunion

the big toe deviates laterally at the metatarsophalangeal j

21
Q

What is hallux valgus associated w?

A 
genetics
f>m
age
footwear
BMI
commonly secondary to arthritis
22
Q

What is the rx of hallux valgus

A
  • bunion pads
  • wedges between toes
  • surgery if severe
  • metatarsal osteotomy
23
Q

What is pes planus? why does it occur?

A

flat foot

dysfunction of the posterior tibias tendon

24
Q

How does pes planus present?

A 
mostly asymptomatic 
w progression: 
- pain
- forefoot abduction 
- hindfoot valgus deformity
25
Q

What is pes cavus?

A

elevated arch of the foot

26
Q

What are the associations of pes cavus?

A

usually idiopathic
spina bifida
Cerebral palsy
Polio

27
Q

What is plantar fasciitis?

A

inflammation of the aponeurosis (flat sheet of tendon material) at its origin on the calcaneus

28
Q

What is the plantar fascia?

A

connective tissue connecting the calcaneus (heel bone) to the toes and creates the arch of the foot

29
Q

What is the presentation of plantar fasciitis?

A

pain worse around medial calcineal tuberosity

30
Q

What is the treatment of plantar fasciitis?

A

rest feet
shoes w good arch support and cushioned heels
insoles + heel pads can be helpful

31
Q

What are the RFs for plantar fasciitis?

A 
excessive running
high arches 
standing on hard surfaces for long periods
leg length inequality 
flat feet
32
Q

What is the treatment of ingrowing toenails?

A

tuck cotton wool soaked in surgical spirit under proudflesh
abx?
nail avulsion + chemical matrixectomy (phenol, sodium bicarbonate)

Orthopaedics (11 decks)

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