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ABOS Part 1 > Foot and Ankle > Flashcards

Foot and Ankle Flashcards

1
Q

The spring ligament origin and insertion?

A

Medial aspect of the foot originating from the sustentaculum tail and inserts on the navicular

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2
Q

Is the plantar or dorsal lisfranc ligament the primary stabilizer?

A

Plantar

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3
Q

Blood supply to the talus?

A

Artery of tarsal canal

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4
Q

Pathophysiology of acquired hallux valgus

A

-Proximal phalanx drifts lateral
-medial MTP joint capsule attenuates
-abductor hallucis migrates plantar to metatarsal head which acted as medial restraint
-EHL migrates laterally and acts as deforming force
-hallux pronates
- Sesamoids migrate laterally and erode crusts to allow further progression

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5
Q

Normal hallux valgus angle

A

<15 deg

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6
Q

Normal intermetatarsal angle

A

<9 deg

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7
Q

Normal Hallux valgus inter phalange is angle

A

<10 deg

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8
Q

Normal distal metatarsal articular angle (DMAA)?

A

<10 deg

Measures joint congruency

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9
Q

Bunion correction for low IMA and HVA? Joint is incongruent

A

Distal metatarsal osteotomy
(Can make osteotomy biplanar to correct incongruity)

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10
Q

Bunion correction for high IMA and high HVA? Joint is incongruent

A

Proximal (more powerful) metatarsal osteotomy to correct IMA and HVA

Distal metatarsal osteotomy to correct joint incongruity

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11
Q

Indications for lapidus (1st metatarsal cuneiform arthrodesis)?

A

Generalizes ligamentous laxity
Degenerative 1st metatarsal cuneiform arthritis

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12
Q

Treatment of arthritic 1st MTP Bunnion?

A

MTP fusion

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13
Q

Footwear insert for hallux rigidis

A

Carbon fiber foot plate with Morton’s extension to eliminate 1St MTP motion

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14
Q

Sideline criteria for return to play for turf toe?

A

Can return to play if can dorsi flex toe 60 deg without pain.

Use stiff insole to help with sx

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15
Q

Indications for turf toe surgery?

A

Complete tear of hallux MTP plantar plate with >3 mm proximal retraction of sesamoids

On imaging the sesamoids contract and do not dynamically move with the FHB during MTP motion.

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16
Q

Reason for this deformity ?

A

Cock up deformity

Unrecognized and unrepaires grade 3 turf toe injury (complete tear of plantar plate)

17
Q

Most common location of Morton’s neuroma?

A

3rd interspace

Note injx don’t work, need to excise nerve proximal to metatarsal heads

18
Q

Orthotics for midfoot arthritis

A

Plastazote orthotic (soft)

Do this in combination with stiff shoe

19
Q

Treatment of pure ligamentous injury of lis franc injury?

A

PrimRy arthrodesis of 2nd MTC

20
Q

Vague dorsal foot pain in an athlete
Diagnosis?
Imaging test?

A

Navicular stress fracture
CT is needed to assess if fracture displacement and assess the plane of the fracture

If any displacement do surgery, if not conservative treatment NWB x6-8 weeks, then repeat CT prior to reinitiating return to play

21
Q

Injury to this structure is responsible for flat foot deformity?

A

Spring ligament

22
Q

Conservative treatment of flat foot deformity….

A

Flat foot: medial wedge/post insole to correct flexible hindfoot valgus to varus

Subfibular impingement: UCBL orthosis to better correct heel valgus

Arthritic hindfoot: custom molded lace up Arizona brace

AFO: when ankle becomes involved and there is incompetency of deltoid ligament

23
Q

Flat foot deformity operative treatments

A

FLEXIBLE DEFORMITY

Tenosynovectomy of post tib: only if no structural problems with tendon.

FDL transfer to navicular: once structural issues to the post tib are seen and there’s still flexibility of the deformity

Medial slide calcaneal osteotomy recruits achilles to use as inverter (<40% talonavicular uncoverage) to help create mechanical advantage and maintain heel varus position

Evans procedure/lateral column lengthening (>40% talonavicular uncoverage)

Medial column dorsal opening osteotomy to create plantarflexed position of medial column to correct supination deformity

RIGID DEFORMITY

triple arthrodesis + medial column procedure if needed

RIGID DEFORMITY + DELTOID INCOMPETENCE

TTC fusion


***Likely add gastroc recession

24
Q

Cavovarus foot orthotic?

A

Lateral heel and sole wedge (like correction with Coleman block test)

25
Q

Monofilament size for peripheral neuropathy

A

5.07

26
Q

Hallux valgus:
Indications for isolated distal first metatarsal osteotomy

A

HVA <30
IMA <13

27
Q

Achilles tendon rupture management of residual defect…

A

<2 cm = direct end to end repair
2-5 cm = V-Y advancement
>5 cm = turndown reconstruction

28
Q

Most common complication after talar neck fracture

A

Sub talar arthritis

29
Q

Risk of deformity after lis franc injury?

A

Ped planovalgus

30
Q

Hallux MTP arthrodesis position?

A

5-15 deg dorsiflexion relative to the ground

5-15 deg valgus

Neutral rotation

31
Q

Exam of ATFL stability

A

Anterior drawer with ankle plantarflexed

32
Q

Best test of CFL

A

Anterior drawer test with ankle dorsi flexed

ABOS Part 1 (11 decks)

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