Foot and Ankle

Question 1

Intrinsic causes of Hallux Valgus

Answer 1

Genetic
Increased DMAA (distal metaphyseal articular angle)
Rheumatoid arthritis
Ligamentous laxity
2nd toe amputation / deformity
Convex metatarsal head
Pes planus
Cerebral palsy

Question 2

Hallux Valgus Angle

Answer 2

Between MT and proximal phalanx

< 15 degrees is normal

Question 3

Intermetatarsal Angle

Answer 3

Between 1st MT and 2nd MT

< 9 degrees is normal

Question 4

Distal Metatarsal Articular Angle

Answer 4

Between 1st MT articular surface vs. Perpendicular line to long axis 1st MT
< 10 degrees is normal

Question 5

Hallux Valgus Interphalangeus Angle

Answer 5

Between proximal phalanx and distal phalanx

< 10 degrees is normal

Question 6

Normal Ankle radiographic parameters

Answer 6

Tibiofibular Overlap > 6mm on AP
Tibiofibular Overlap > 1mm on Mortise
Medial clear space < 4mm on Mortise
Tibiofibular clear space <6mm on AP and Mortise (1cm above the joint)
Talocrural angle (tips of malleoli vs tibial axis) 83 degrees

Question 7

Bohler’s angle

Answer 7

Highest point of anterior process (front) to
Highest point of posterior facet (middle) to
Highest point of superior tuberosity (back)

Normal = 20-40

Question 8

Gissane angle

Answer 8

Line along lateral margin of posterior facet to
Line anterior to beak of calcaneus

Normal = 120-145

Question 9

Causes of CavoVarus foot

Answer 9

CMT - Bilateral
Tethered spinal cord - Unilateral
Tumor of spinal cord - Unilateral
Cerebral palsy
Freidreich's ataxia
Polio
Malunion - Talus
Compartment syndrome

Neurologic
Idiopathic
Traumatic

CMT
T
F
CCP

Question 10

Calcaneal pitch

Answer 10

Angle between ground and the antero-inferior border of calcaneus
Should be 20
Less = planus
More = cavus

Question 11

Steindler stripping

Answer 11

Release of short flexors off the calcaneus in cases of Cavus foot. Often done with plantar release.

Question 12

Anteater sign - what does it represent?

Answer 12

Calcaneo-Navicular coalition

Question 13

Talar beaking and C-sign - what do they represent

Answer 13

Talo-Calcaneal coalition

Question 14

3 principles when doing Sesamoidectomy

Answer 14

Both - never excise both
Incision - never directly over the sesamoid
Adductor - alway repair adductor if excising lateral sesamoid

Question 15

4 predictors of poor outcome with tarsal coalition takedown

Answer 15

Age > 15
Area > 50 %
TaloCalcaneal
Valgus excessive