Foot and Ankle

Question 1

5th metatarsal fractures?

Answer 1

shaft: diaphyseal
metadiaphyseal fracture: Jones
avulsion: peroneal brevis

Question 2

Treatment for 5th metatasral base avulsion?

Answer 2

conservative, boot

peroneus brevis and plantar aponeurosis attachment

Question 3

treatment for metaphyeal/diaphyeal junction fracture

Answer 3

variable; surgery

Question 4

Freiberg infraction?

Answer 4

avascular necrosis of the second metatarsal head; stress from high heels/young women

Question 5

sesamoid fracture mechanism of injury?

Answer 5

great toe sesamoid bone fracture from hyperextension/dorsal dislocation of the first MTP joint

Question 6

what attaches to sesamoid bones?

Answer 6

flexor hallucis brevis (tibial/fibular heads attach to medial/lateral sesamoid)

Question 7

turf toe injury?

Answer 7

MTP injury

Question 8

Lisfranc joint?

Answer 8

interosseous ligament complex attached to medial cuneiform at second metatarsal

Question 9

most sensitive study for Lisfranc issues?

Answer 9

weightbearing

Question 10

Kohler disease? Mueller Weiss?

Answer 10

osteonecrosis of the navicular bone; more common in boys and adult women

Question 11

Classification of Lisfranc injuries

Answer 11

homolateral or divergent

Question 12

Chopart fracture dislocation? mechanism?

Answer 12

talonavicular/calcaneocuboid joint; high impact trauma

Question 13

Classification system for talar neck fractures?

Answer 13

Hawkins

Question 14

Classification system for calcaneal fractures?

Answer 14

Essex Lopresti and Sanders (CT)

Question 15

Most frequently fractured tarsal bone?

Answer 15

calcaneus

Question 16

associated injuries with calcaneus fractures?

Answer 16

lumbar spine fractures, traumatic aortic rupture, renal vascular pedicle avulsions

Question 17

findings diagnositc of calcaneal fractures?

Answer 17

Boehler angle <20

Question 18

Essex lopresti classification

Answer 18

sparing subtalar joint or extending into subtalar joint

Question 19

Sanders classification system

Answer 19

number of comminuted fragments on coronal CT

Question 20

calcaneal stress fracture findings?

Answer 20

fluffy band of sclerosis; intact cortex

Question 21

Hawkins sign in talus?

Answer 21

subchondral lucent band on frontal ankle radiograph after immobilzation; bone resorption from hyperemia ; good prognosis

Question 22

Talar fracture types

Answer 22

lateral process, posterior process, head, body, neck fractures

Question 23

talar osteochondral lesions

Answer 23

osteochondrosis dessicans from chronic repetitive trauma

acute traumatic osteochondral fracture

Question 24

MRI appearance of osteochondral lesions of the talus

Answer 24

crescentic lucnecy of talar dome

Question 25

tarsal coalition?

Answer 25

fibrous, cartilaginous, osseous; talocalcaneal or calcaneonavicular ; common in adolescence and then ossify

Question 26

C sign on lateral radiograph foot

Answer 26

C shaped contour of fused middle subtalar facet with sustentaculum tail; not sensitive for talocalcaneal coalition

Question 27

talar beak sign?

Answer 27

triangular shaped beaking at anteriosuperior aspect of talus

Question 28

anteater sign

Answer 28

elongated process of calcaneus which looks like anteaters nose; fusion of calcaneus and navicular

Question 29

tom, dick, harry?

Answer 29

anterior extensor tendons, medial to lateral tibialis anterior extensor hallicus longus extensor digitorum longus also runs with anterior tibial artery

Question 30

Danis Weber classification

Answer 30

level of fibular fracture; syndesmotic injury

Question 31

Weber A

Answer 31

distal fibular fracture with intact syndesmosis

Question 32

Weber B

Answer 32

proximal transsyndesmotic fracture, partial syndesmotic rupture

Question 33

Weber C

Answer 33

high fibular fracture above syndesmosis; total rupture and ankle mortise instability

Question 34

Lauge Hansen classification system. Weber A-C?

Answer 34

A: supination/adduction B: supination/external rotation C: pronation/external rotation

Question 35

Tillaux fracture?

Answer 35

peds; Salter III of lateral tibial epiphysis

Question 36

Triplane/Marmor Lynn

Answer 36

fracture through tibia involving vertical epiphyseal, horizontal physeal, oblique metaphyseal

Question 37

Waggstaff-Lefort fracture

Answer 37

avulsion of anterior distal fibula at site of insertion of the anterior tibiofibular ligament

Question 38

Maisonneuve fracture

Answer 38

proximal fibular fracture with interosseous membrane tear or medial malleolar fracture

Question 39

Pilon fracture

Answer 39

comminuted fracture of distal tibia with disruption of tibial plafond; caused by axial loading

Question 40

boundaries of kager fat pad?

Answer 40

FHL, calcaneus, and achilles tendon

Question 41

achilles tendinosis on XR?

Answer 41

thickening of tendon; may also represent xanthomas in hyperlipidemic patients

Question 42

Ddx for increased soft tissue in kagers fat pad?

Answer 42

achilles tendon injury, accessory soleus, Haglund disease (pump bumps)