Foot and Ankle

Question 1

parts of the deltoid ligament

Answer 1

posterior tibiotalar
tibionavicular
tibiocalcaneal

Question 2

anterior drawer test

Answer 2

Anterior Talofibular Ligament (ATFL)

Question 3

talar tilt test

Answer 3

Calcaneofibular ligament (inversion)	
Deltoid ligament (eversion)

Question 4

what does the ottowa ankle and foot rules help to differntiate

Answer 4

fracture from a sprain

Question 5

Ottawa Ankle rules

Answer 5

An ankle radiographic series is indicated if a patient has pain in the malleolar zone and any one of these findings:
1. Bone tenderness at posterior edge or tip of lateral
mallelous
2. Bone tenderness at posterior edge or tip of medial
mallelous OR
3. Inability to bear weight immediately

Question 6

Ottowa Foot rules

Answer 6

A foot radiographic series is indicated if a patient has pain in the mid-foot zone and any one of these findings:

1. Bone tenderness at base of 5th metatarsal 
2. Bone tenderness at navicular bone or 
3. Inability to bear weight immediately

Question 7

what is a high ankle sprain/syndesmosis injury

Answer 7

injury to the ligament that is in between tib/fib

Question 8

what is included in the syndesmosis

Answer 8

interosseous ligament
anterior-inferior tibiofibular ligament
posterior-inferior fibular ligaments, and
inferior transversetibiofibular ligament

Question 9

syndesmosis MOI

Answer 9

Dorsiflexion & external rotation

Question 10

Maisonneuve fracture

Answer 10

proximal fibular fx associated with medial malleolus injury

Question 11

tests for syndesmosis injury

Answer 11

“Squeeze Test”

Kleiger’s Test

Question 12

bimalleolar fracture

Answer 12

Fracture involving distal fibula and distal tibia

Question 13

trimalleolar fracture

Answer 13

Fracture involving distal fibula, distal tibia, & posterior tibia

Question 14

when is ORIF w/ trimalleolar fracture indicated

Answer 14

• > 25% of posterior articular surface is involved;
• fracture is displaced more than 2 mm;
• there is posterior subluxation of talus;
• if fracture prevents reduction of fibula

Question 15

achilles tenodnitis vs rupture

Answer 15

tendonitis –> overuse, pain/swelling

rupture –> usually acute, inability to bear weight, LOF

Question 16

Lisfranc Injury

Answer 16

“keystone” wedging of the second metatarsal into the cuneiforms

Dorsal dislocation of the proximal base of the second metatarsal

Question 17

what do you order if there is persistent pain with the lisfranc injury

Answer 17

MRI

Question 18

Lisfranc MOI

Answer 18

Foot is placed in extreme plantar flexion (extension) with an axial load

Question 19

avulsion vs jones fracture

Answer 19

look at pic of red and purple pic on slide 48, avulsion is posterior to the jones fracture

Question 20

plantar fasciits presentation

Answer 20

First few steps of the day and end of day produce excruciating pain – feels like stepping on glass.

Question 21

plantar fascitits tx

Answer 21

Splints/orthotics
Massage/stretching
Spike massage balls
Frozen water bottle
Correct underlying problem

Question 22

corns vs calluses

Answer 22

corn- painful, central core

calluses- not painful