Foot and Ankle Flashcards
What are Metatarsal Stress Fractures?
Also called a March fracture. Stress or fatigue fracture, most commonly in the second or third metatarsal. Presents with pain but no trauma; initially may be occult. Healing leads to sclerosis visible on imaging. NM bone scan helpful for early detection.
What are 5th Metatarsal Fractures?
Commonly avulsion fractures. Should not be confused with an unfused apophysis in pediatric patients. Apophysis appears as a vertical lucency. Fracture appears as a transverse lucency across the base of the metatarsal.
What are the Midfoot Joints?
Lisfranc Joint: Connects midfoot to forefoot; stabilized by the Lisfranc ligament.
Chopart Joint: Connects midfoot to hindfoot.
What is a Chopart Fracture-Dislocation?
Fracture through the calcaneocuboid and talonavicular joints. High-impact injuries (MVA, falls from height).
What is a Lisfranc Fracture-Dislocation?
Fracture through the tarsal-metatarsal junction. The 2nd metatarsal base fits into a recess formed by the cuneiforms. Causes: MVAs, falls from height, sports injuries, foot lodged and pulled.
What is a Lisfranc Fracture-Dislocation? extended
Caused by hyperplantarflexion along the long axis of the foot. Up to 20% are initially missed. The Lisfranc ligament, the strongest in the joint complex, originates from the medial cuneiform and inserts on the medial aspect of the second metatarsal base.
What characterizes a Divergent Lisfranc Fracture-Dislocation?
Widening of the space between the first and second metatarsals and lateral subluxation of the second metatarsal.
What is a Homolateral Lisfranc Fracture-Dislocation?
Fracture-dislocation in the tarsometatarsal joint with displacement of the first through fifth metatarsals in the same direction.
What defines a Divergent Lisfranc Fracture-Dislocation?
Fracture-dislocation in the tarsometatarsal joint where metatarsals are displaced in different directions.
What are Calcaneal Fractures?
Most commonly fractured tarsal bone, typically impacted fractures or stress fractures.
What is Böhler’s Angle?
The angle between two lines drawn from the anterior and posterior aspects of the calcaneum on a lateral view. Normal range: 20°–40°. A reduced Böhler’s angle indicates a calcaneal fracture.
Weber A Fracture
Below the level of the syndesmosis. Transverse fracture of the distal fibula. Syndesmosis and deltoid ligaments are usually intact.
Weber B Fracture
At the level of the syndesmosis. Usually an oblique fracture of the distal fibula. May be associated with a medial injury (medial malleolus or deltoid ligament). Check for widening of the medial joint space. Syndesmosis is usually intact. Stability varies depending on ligament involvement.
Weber C Fracture
Above the level of the syndesmosis. May involve a proximal fibula fracture (Maisonneuve fracture). Syndesmosis disruption with tibiofibular joint space widening. Medial malleolus and deltoid ligament injury often present. Unstable and usually requires ORIF (Open Reduction and Internal Fixation).
Gravity Stress Views
Used to assess lateral movement of the talus. Helps identify ligamentous rupture.
Böhler’s Angle – Line 1
Drawn from the superior aspect of the posterior tuberosity to the superior aspect of the posterior facet
Böhler’s Angle – Line 2
Drawn from the superior aspect of the posterior facet to the anterior process
Maisonneuve Fracture
Unstable ankle fracture (Weber C)
Proximal fibula fracture associated with ankle injury
May have an associated lateral malleolus fracture
Also called a “high Weber C” fracture
If ankle views show widening without a lateral malleolus fracture, obtain a full-length tibia and fibula X-ray to check for proximal fibula fracture
What is a Jones Fracture?
A fracture of the fifth metatarsal bone, located at the base, approximately 1-2 cm from the tuberosity.
What causes a Jones Fracture?
Often caused by repetitive stress or an acute injury, such as an ankle sprain or a twisting motion.
