Foot and Ankle

Question 1

what are the factors important in deciding a treatment plan in Diabetic Foot Ulcers?

Answer 1

1. angiopathic vs. neuropathic
2. deep vs. superficial
3. +/- osteomyelitis, antibiotics based on bone biopsy culture sensitivities
4. +/- pyarthrosis

Question 2

what is the Triple C osteotomy?

Answer 2

1. sliding-closing medial calcaneal osteotomy
2. plantar-closing wedge osteotomy of the medial cuneiform
3. opening wedge osteotomy of the cuboid

Question 3

what are the indications of Tibiotalocalcaneal (TTC) fusion with retrograde intramedullary nail ?

Answer 3

Indications:

1. End-stage ankle and subtalar arthritis
2. Charcot neuroarthropathy
3. Significant hindfoot bone loss (failed total ankle arthroplasty, failed arthrodesis)
4. Osteonecrosis of the talus
5. Severe acute trauma

Contraindications:

1. Active infection
2. Profound vascular disease
3. Severe tibia malalignment

Question 4

what are the Non-operative rx for low ankle sprain?

Answer 4

1. RICE
2. elastic wrap to minimize swelling +/- walking cast or boot for 1 week only then early mobilization.
3. physical therapy

Question 5

what is the physical therapy treatment for low ankle sprain?

Answer 5

once swelling and pain have subsided

+

patient has full range of motion

1. begin neuromuscular training with a focus on peroneal muscles strength
2. proprioception training
3. functional brace that controls inversion and eversion
4. early functional rehabilitation allows for quickest return to physical activity

Question 6

what are the Achilles tendonitis family conditions?

Answer 6

1. insertional Achilles tendonitis
2. retrocalcaneal bursitis & Haglund deformity
3. Achilles tendonitis

Question 7

in treating transfer metatarsalgia comparing (Weil osteotomy) to (Helal osteotomy)

Answer 7

Weil Osteotomy:

1. Higher patient satisfaction rates
2. Lower incidence of recurrent metatarsalgia
3. Fewer transfer lesions
4. Higher percentage of radiographic reduction and maintenance of the MTP joint reduction

Question 8

what are the type of orthotics in Hallux Rigidus?

Answer 8

1. Morton’s extension
2. stiff foot plate
3. stiff sole shoe
4. shoe box stretching

Question 9

What is the non-operative treatment of MTP joint dislocation?

Answer 9

1. taping
2. shoe modification
3. metatarsal pads
4. Budin splint
5. NSAIDS

Question 10

What is the operative treatment of MTP dislocation?

Answer 10

1. distal oblique shortening MT osteotomy (Weil procedure)
2. plantar plate repair
3. flexor to extensor tendon transfer
4. EDB transfer under intermetatarsal ligament

Question 11

what are the indications of syndesmosis screw fixation?

Answer 11

1. syndesmotic sprain (without fracture) with instability on stress radiographs
2. syndesmotic sprain refractory to conservative treatment
3. syndesmotic injury with associated fracture that remains unstable after fixation of fracture

Question 12

what is the none operative treatent of claw toe?

Answer 12

1. taping
2. shoe modification
3. plantar padding
4. high toe box
5. sling to hold the proximal phalanx parallel to the ground

Question 13

What is the operative treatment of claw toe?

Answer 13

1. EDB tenotomy
2. EDL lengthening
3. FDL flexor-to-extensor transfer (Girdlestone)
4. MTP capsulectomy
5. proximal phalanx head and neck resection
6. distal MT shortening osteotomy (Weil lesser MT osteotomy)

Question 14

What are the common technical errors In TAA

Answer 14

1. placing the prosthesis too lateral
2. using too small a prosthesis, which subsides
3. failing to solve preoperative varus or valgus malalignment and attempting to replace an ankle that is too anteriorly subluxated

Question 15

what is the Cavus Foot Deformity pathoanatomy?

Answer 15

1. plantar flexed 1st ray is initial deformity
2. cavus caused by peroneus longus (normal) overpower weak tibialis anterior
3. varus caused by tibialis posterior (normal) overpowering weak peroneus brevis