Foot and Ankle Fractures

Question 1

the sustentaculum tali is a portion of what bone?

Answer 1

calcaneus

Question 2

what is the only bone in the body without a musculotendinous attachment?

Answer 2

talus

Question 3

describe the relative motion of the subtalar joint during heel strike and toe off

Answer 3

heel strike - everts
toe off - inverts

Question 4

what type of XR imaging would you consider for acute injury and tenderness of the navicular or fifth MT?

Answer 4

foot XR

Question 5

what type of XR would you consider if there is pain along the posterior aspect of lateral or medial malleolus?

Answer 5

ankle xR

Question 6

widening of the medial clear space indicates incompetency of what ligament?

Answer 6

deltoid

Question 7

you diagnose ankle fracture that is stable. for how long would you consider casting initially?

Answer 7

4-6 weeks

Question 8

t/f medial malleolus stress fractures are inherently unstable and prone to nonunion

Answer 8

true

Question 9

for a Salter Harris I or II fracture of the ankle, how long do you typically cast?

Answer 9

2-3 weeks

Question 10

what should you do for a Salter Harris III-V fracture of the ankle?

Answer 10

refer to ortho to consider surgery

Question 11

what ddx should you consider for posterior process talar fracture?

Answer 11

os trigonum

Question 12

what is the initial treatment and treatment length for posterior talus and anterior calcaneus fracture?

Answer 12

short leg non weightbearing cast x 6 weeks

Question 13

you can try conservative treatment for a calcaneal acute fracture if less than what percentage of the calcaneo-cuboid joint is involved?

Answer 13

<25%

Question 14

if you choose conservative treatment for acute calcaneal fracture, what is the initial management and length of management?

Answer 14

6 weeks non weightbearing cast

Question 15

what is the average return to play time for calcaneal stress fracture with conservative management?

Answer 15

3-4 weeks

Question 16

what is the next step in management for a displaced navicular tuberosity avulsion?

Answer 16

refer for ortho surgery

Question 17

what is the MOI of a navicular tuberosity avulsion fracture?

Answer 17

eversion of the ankle

Question 18

what is the initial conservative treatment for navicular stress fracture?

Answer 18

non weightbearing cast x 6-8 weeks

Question 19

what ligament is the keystone for the transverse arch of the foot?

Answer 19

Lis Franc ligament

Question 20

what is the fleck sign of the midfoot?

Answer 20

avulsion of the lis franc ligament from the 2nd MT base

Question 21

for a zone 1 avulsion injury of the peroneus brevis from the 5th MT base, you can treat with conservative management if less than how many mm displaced?

Answer 21

<3mm displaced

Question 22

for a zone 3, shaft fracture of the 5th MT, if choosing conservative management, when should you refer to ortho if nonunion occurs?

Answer 22

6 months

Question 23

if you choose conservative management for a zone 2 Jones fracture, what is the total recovery time?

Answer 23

12 weeks: 6 weeks non weightbearing followed by 6 weeks protected weight bearing

Question 24

t/f XR will usually be negative initially for navicular stress fracture

Answer 24

true

Question 25

fracture of the first metatarsal and calcaneus have what unique complication compared to other foot fractures?

Answer 25

compartment syndrome

Question 26

dancers have unique predisposition to fracture of what portion of what metatarsal?

Answer 26

proximal 2nd MT