Foot and Cankles Flashcards

1
Q

describe the GAIT cycle

A
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2
Q

Describe anatomical changes with Halgus Valgus:

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3
Q

Describe the normal angular measurments for Halgus Valgus:

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4
Q

what are the three main presenting types of bunion deformity?

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5
Q

How do you treat a degenerative bunion?

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6
Q

What are some options to treat Halux Varus complication after bunion surgery?

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7
Q

Is avascular necrosis a complication of bunion surgery?

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8
Q

What are the three radiology grades of Halgus Rigidus?

A

Grade 1: Stiff ROM, maintained joint space, minimal osteophytes

Grade II: large osteophytes, narrowed joint space

Grade III: severe osteophytes, loss of joint space

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9
Q

What are the treatment options for Halgus Ridigus?

A

CONSERVATIVE: extra depth shoe to accomodate osteophyte, carbon fiber footplate with Morton’s extension.

OPERATIVE GRADE 1,2: Chielectomy (up to 30% metatarsal head), +/- moberg dorsiflexion osteotomy

OPERATIVE GRADE 3: Joint Fusion: neutral, 5 deg valgus, 10-15 dorsiflexion, keller resection arthoplasty only medical ill, frail.

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10
Q

Define the three lesser toe deformities

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11
Q

What is the anatomic definition of lesser toe deformities?

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12
Q

Describe the surgical treatment for hammer and mallet toe:

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13
Q

Describe the surgical treatment for claw toe deformity:

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14
Q

What is a Frieberg infarction of the toe?

A

Treatment options are:

Orthotics limited benefit

Joint Debridement

No evidence for core decompression

Dorsal closing wedge osteotomy

excision of metatarsal head not supported

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15
Q

Bunionnette Deformities:

A

Types

type 1: elarged metatarsal head

Type II- Bowing of the diaphysis of the 5th metatarsal

Type III: greater than 8 degrees IMA

TREATMENT:

Type 1-distal chevron osteomtomy 1mm for 1 degree

Type II, III- obligue diaphyseal metatarsal osteotomy

avoid proximal metatarsal osteotomy

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16
Q

Name some key facts about the seasamoids:

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17
Q

Describe Turf Toe

A

Forced Dorsiflexion injury

Avulsion of plantar plate

Proximal migration of seasamoids

seasamoids do not move with fluroscopic ROM

GRADE 1: (Capsule Strain) Stiff insole, toe taping

GRADE II-(partial tear) stiff insole, no sports 2wks/ rtp painless dorsiflexion greater than 60 degrees

Grade III-(Complete tear)-surgical repair, RTP 6 weeks

Mandatory with 3mm or more proximal retraction

18
Q

Pearls on Seasamoid pathology

A

all recalcitrant seasamoid pathology best treated by removal of the seasamoid.

seasamoid removal complications are:

halgus valgus, halgus varus, cock-up deformity

nerve injury

19
Q

Morton’s Neuroma Diagnosis Pearls

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20
Q

Non-operative treatments for Morton’s Neuroma

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21
Q

Operative treatment for Morton’s Neuroma

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22
Q

What to do with a recurrent Morton Neuroma?

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23
Q

How to diagnosis and treat 5th metatarsal fractures

A

Zone 1: Peroneus Brevus avulsion fracture vs inversion injury– Boot

Zone 2: metaphyseal/diaphyseal watershed area (Jones)

operative in an elite athlete/ NWB Boot x 6 weeks

Zone 3: Diaphyseal

33% refracture risk with non-op, consider ORIF with bone grafting

24
Q

What is the best operative treatment for purely ligamentous lisfranc injuries?

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25
Q

What are some common ways to diagnose a Lisfranc Injury?

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26
Q

Describe the anatomy considerations of a Lisfranc injury:

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27
Q

Key Points to an Accessory Navicular

A

Type 1: small accessory bone with no attachment

type 2: tuberosity separated by 2mm fibrous cartilage

Type 3: accessory bone united by bony bridge

KEY RADIOGRAPH:EXTERNAL OBLIQUE FOOT

operative treatment: modified Kidner–(os excision with advancement of posterior tibial tendon

28
Q

Navicular Stress Fractures

A

tx- nwb in boot 6-8 weeks, ct scan prior to activity:

need to operate on any fracture displacement (>2mm)

single or multiple screws

add bone graft if any sclerotic edges

CT scan required prior to return to play

29
Q
A