Foot and ankle disease

Question 1

Management of hallux valgus

Answer 1

Conservative: Change shoes Surgical: Osteotomy

Question 2

ndications for surgery in hallux valgus

Answer 2

Pain, Damage to the second toe

Question 3

Define hallux rigidus

Answer 3

Osteoarthritis of the 1st toe

Question 4

Management of hallux rigidus

Answer 4

Conservative: Insoles Medical: Pain ladder Surgical: Arthrodesis, Arthroplasty

Question 5

Define planovalgus

Answer 5

Flat footedness

Question 6

Causes of planovalgus

Answer 6

Past trauma, Tibialis posterior dysfunction

Question 7

Management of planovalgus

Answer 7

Conservative: Insoles, Physiontherapy Surgical: Reconstruction

Question 8

Symptoms of tibialsis posterior dysfunction

Answer 8

Pain (medial dorsum of the foot)

Question 9

Signs of tibialis posterior dysfunction

Answer 9

Loss of arch, Hindfoot valgus, Unable to single limb heel raise, Reduced inversion

Question 10

Investigations for tibialis posterior dysfunction

Answer 10

MRI, X-ray

Question 11

Management of tibialis posterior dysfunction

Answer 11

Conservative: Insoles, Immobilisation
Surgical: Tenosynoctomy, Osteotomy, FDL transfer, Debridement, Arthrodesis

Question 12

Mechanisms of injury for achilles tendon rupture

Answer 12

Sudden plantarflexion of a fixed foot, Violent dorsiflexion

Question 13

Symptoms of achilles tendon rupture

Answer 13

Pain (heel), Difficulty in walking

Question 14

Signs of achilles tendon rupture

Answer 14

Passive dorsiflexion, Calf atrophy, Palpable gap, Decreased plantarflexion, Positive Thompson test

Question 15

Describe Thompson test

Answer 15

Lack of plantarflexion on squeezing the calf

Question 16

Investigations for achilles tendon rupture

Answer 16

USS, MRI

Question 17

Management of achilles tendon rupture

Answer 17

Conservative: Serial casts
Surgical: Repair, FHL transfer

Question 18

Symptoms of an ankle sprain

Answer 18

Pain (lateral/medial, worse on weight bearing), Instability

Question 19

Signs of ankle sprain

Answer 19

Tenderness over the affected ligament, Positive anterior draw test

Question 20

Investigations for ankle sprain and reasons why they’d be ordered

Answer 20

X-ray (look for associated fractures)

MRI (if pain persists longer than 8 weeks)

Question 21

Management of an ankle sprain

Answer 21

Conservative: RICE, Physiotherapy, Walking boot
Surgical: Arthroscopy, Reconstruction, Tendon transfer

Question 22

Define a high ankle sprain

Answer 22

Damage to the syndesmosis between the tibia and fibula

Question 23

Mechanism of injury for a high ankle sprain

Answer 23

Violent external rotation

Question 24

Symptoms of a high ankle sprain

Answer 24

Pain (Anterolateral ankle), Difficulty weight bearing

Question 25

Signs of high ankle sprain

Answer 25

Medial swelling, Tenderness over syndesmosis, Pain on external rotation, Positive Hopkin’s test, Positive Cotton’s test

Question 26

Describe Hopkin’s test

Answer 26

Pain on squeezing the tibia and fibula - (high ankle sprain)

Question 27

Describe Cotton’s test

Answer 27

Widening of the gap between the tibia and fibula on pulling the fibula

Question 28

Investigations for a high ankle sprain

Answer 28

X-rays, MRI

Question 29

Management of a high ankle sprain

Answer 29

Conservative: Walking boot
Surgical: Fixation