Foot and Ankle Pathology

Question 1

Big toe

Answer 1

Most commonly injured digit

Mechanism

• crush injury = results in comminuted fracture
• stunning injury = oblique fracture

Treatment
- splinting or surgery (ORIF) open reduction internal fixation

Question 2

ORIF

Answer 2

Open reduction internal fixation

Question 3

Dislocation toe

Answer 3

Mechanism = hyperextension / hyperflexion injury

Treatment = closed reduction

Question 4

Fracture base of 5th metatarsal

Answer 4

Mechanism = forced inversion e.g a type of twisting injury

Base of 5th metatarsal = attachment of tendon of Petronius brevis muscle = avulsion fracture

Question 5

Jones fracture

Answer 5

• bottom of 5th metatarsal
• differs from avulsion fracture = does not involve brevis muscle
• fractures fragments often don’t unite without help & surgical intervention

Question 6

Normal variant

Answer 6

• area of normal radiographic anatomy that may stimulate disease

Question 7

Unfused apophysis

Answer 7

Normal variant

Base of 5th metatarsal

Certain type of growth plate that occurs end of bone when no other bone on that side

E.g heel bone (edge of bone looks like extra piece of bone)

Question 8

Stress/ March fracture

Answer 8

Occurs because of repeated stress to bone

Bony callus formation (fussiness around bone)

Symptoms = pain, tenderness associated with weight bearing, running pain increases

Question 9

Lisfranc fracture

Answer 9

Midfoot fracture

Loss of normal alignment at base of metatarsal ( metatarsal look pushed to one side and squashed)

Caused by trauma

Question 10

Ankle inversion

Answer 10

Inversion force avulses the lateral malleolus

Continued force = oblique fracture of distal tibia

(Moving to left side)

Question 11

Ankle eversion

Answer 11

Eversion force avulses distal medial malleolus

Continued force = fracture of distal filbula

(Move to the right)

Question 12

Bi malleolar fracture

Answer 12

Unstable fracture, needs stabilisation

On fib

Surgically fixated = ORIF

Question 13

OS trigonom

Answer 13

Common accessory bone

8-14y/o = ossification centre forms posterior to talus

• normally ossification centre fused with talus in 1 year
• 7% of population remains separate = referred to as os trigonum

( looks like a circular ball bone )

Question 14

Open reduction fracture

Answer 14

Risk = infection, contamination

Treatment= antibiotic, surgical removal, would closure skin graft

Question 15

Calcaneum

Brodie’s abscess

Answer 15

Chronic abscess of bone

Surrounded by dense fibrous tissue & sclerotic bone

(Black huge oval hole in calcaneum)

Question 16

Calcaneal fractures

Answer 16

Calcaneus most common fractures tarsal bone

Mechanism = fall from height

Question 17

Bohlers angle

Answer 17

And angle less than 30 degrees = indicates fracture