Foot and Ankle

Question 1

Oblique/Mortise view

Answer 1

o Modified AP view: foot/leg IR 15-30
o To view mortise and distal tibiofibular joint
o Need to see gap (2mm around the ankle)

Question 2

Most common ankle fx

Answer 2

• Lateral or medial malleolus

Question 3

Ottawa ankle rules

Answer 3

• Pain in malleolar zone AND 1 of the following
  o Bone tenderness in posterior half of distal tibia/fibula pr tip of malleolus
  o Unable to WB 4 steps (Limp doesn’t count)

Question 4

Ottawa foot rules

Answer 4

• Pain in midfoot zone and any following
  o Bone tenderness over navicular or base of 5th MT
  o Unable to bear weight for 4 steps immediately after injury and during exam

Question 5

Danis-Weber classification

Answer 5

• A fx below ankle
• B fx at level of joint with tibiofibular ligaments
• C fx above joint level which tears the syndesmotic ligaments

Question 6

Laugue Hansen Classification

Answer 6

-	2 word descriptors 
o	Position of foot – 1st 
o	Motin of foot (talus) – 2nd 
	Supination-adduction
	Pronation-Abduction

Question 7

Maisonneuve Fracture

Answer 7

• ER force to ankle and travels through interosseous membrane (2 Fx points)
  o Proximal fibular Fx
  o Medial Malleolus Fx

Question 8

Jones Fx

Answer 8

Base of the 5th

Question 9

Lisfranc Fx

Answer 9

Fx 2 3 4 5 MT w/ lateral dislocation

MOI: Foot in stirrup

Question 10

March Fx

Answer 10

Stress fx 2 3 4 MT

- See in dancers, athletes, new recruits

Question 11

Gout

Answer 11

usually 1st MCP joint

- Inability to WB

Question 12

Bone and joint infection

Answer 12

• Periosteal reaction – thickening of periosteum (White on xray_
  o Seen with normal healing fx, osteomyelitis, benign and malignant tumors
• A radiating periosteal reaction (sunburst) – worry some for malignancy