Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

OITE Review Book > Foot & Ankle > Flashcards

Foot & Ankle Flashcards

1
Q

Toe off during terminal stance

A

Posterior tibialis fires causing subtalar inversion, which locks transverse tarsal joints, stabilizing hindfoot/midfoot for push off.

**Posterior tibialis is most important during terminal stance.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Heel strike (early stance)

A

subtalar eversion unlocks transverse tarsal joints –> supple foot acts as shock asbsorber

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

During the gait cycle, the anterior tibialis eccentrically contracts as…

A

ankle plantarflexes, then concentrically contracts as the ankle dorsiflexes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Quadriceps weakness will cause…

A

knee hyperextension during swing phase.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Weakness of hip flexors affects..

A

limb advancement during swing phase.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Risk of anterolateral portal during ankle arthroscopy

A

SPN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Risk of anteromedial portal during ankle arthroscopy

A

saphenous nerve and vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Better healing of ulcers is associated with:

A
  • albumin > 3
  • ABI >.45
  • lymphocyte count > 1500
  • toe pressure > 40
  • transcutaneous oxygen tension > 30
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Treatment of chronic plantar ulcer at the IP joint of the hallux if no sign of infection

A

Keller arthroplasty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Treatment of chronic heel ulcer unresponsive to serial debridement, that probes to bone or osteomyelitis on MRI

A

Adequate perfusion: calcaneal saucerization & TAL

Inadequate perfusion: BKA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

In charcot arthropathy, limb elevation will…

A

reduce hyperemia (not true in infection)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Pathophysiology of charcot arthropathy

A

bone destruction is due to hypervascularity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Advanced imaging of charcot arthropathy

A

-technetium bone scan: positive for charcot and infection

indium WBC scan: positive for infection ONLY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Initial tx of Charcot

A

total contact casting then transition to CROW boot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Hallux valgus deformity

A

Hallux is plantarflexed, pronated and in valgus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Normal hallux angles

A

HVA < 15
IMA < 9
DMAA < 10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Treatment for HVA < 40 and IMA < 13

A

distal MT osteotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Treatment for HVA > 40 and IMA > 13

A

proximal MT osteotomy or combined proximal/distal osteotomies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

If there is increased DMAA, need to treat with…

A

combined proximal and distal MT osteotomies.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Instability of the 1st TMT is characterized by…

A

medial translation and plantar gapping of 1st TMTJ on xrays.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What nerve is at risk with hallux valgus surgery?

A

Dorsomedial cutaneous nerve (branch of SPN)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Modified McBride procedure includes…

A

release of adductor hallucis to help correct the deformity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Treatment of hallux valgus interphalangeus

A

Akin (proximal phalanx) osteotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Treatment of hallux valgus in pts with neuromuscular conditions

A

MTP fusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Excessive resection of the medial eminence can lead to…

A

iatrogenic hallux varus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Treatment of juvenile/adolescent hallux valgus

A

open physis so perform medial cuneiform osteotomy rather than MT osteotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Treatment of mild hallux rigidus (pain only with terminal dorsiflexion)

A

dorsal cheilectomy

dorsiflexion is what is most limited in hallux rigidus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Type I Bunionette

A

enlarged 5th MT head +/- lateral exostosis

Tx: exostectomy of 5th MT head

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Type II Bunionette

A

lateral bowing of 5th MT

Tx: distal chevron osteotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Type III Bunionette

A

widened 4,5 IMA > 12

Tx: rotational diaphyseal osteotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Pathophysiology of cavovarus foot

A

Peroneus longus overpowers tibialis anterior (predominant force) –> cavus

Posterior tibialis overpowers peroneus brevis –> varus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Initial deformity of cavovarus foot is..

A

plantarflexion of 1st ray.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Treatment of flexible cavovarus

A

plantar fascia release, PT transfer to dorsum of foot, PL transfer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Treatment of rigid cavovarus

A

lateralizing calc osteotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Treatment of pediatric flexible flatfoot if fails non-op…

A

varus producing calc osteotomy (lengthening or medializing)

36
Q

Lateral impaction syndrome

A

subluxation of the talocalcaneal joint in flatfoot –> impingement between the talus and calcaneus in the sinus tarsi and/or distal fibula and calc

37
Q

Stage I PTTI

A

no deformity, able to perform single heel raise

normal xray

38
Q

Stage II PTTI

A

flexible planovalgus, unable to perform single limb heel raise

x-rays: flatfoot

tx: FDL transfer to augment PT, medializing calc osteotomy or lateral column lengthening)

39
Q

Stage III PTTI

A

rigid planovalgus

x-rays: subtalar arthritis

tx: triple arthrodesis

40
Q

Stage IV PTTI

A

rigid planovalgus

x-rays: talar tilt

tx: TTC arthrodesis

41
Q

Management of residual forefoot varus deformity in planovalgus is due to…

A

malposition of the transverse tarsal joint and is treated with dorsal opening plantarflexion osteotomy of the medial cuneiform (Cotton).

42
Q

Way to reduce infection in treatment of planovalgus

A

perform subtalar and talonavicular arthrodesis through single medial approach

43
Q

Treatment of acquired flatfoot deformity in those with midfoot arthritis/instability and normal PT function (small subset)

A

midfoot arthrodesis and TAL

44
Q

What nerve is at greatest risk with a TCC fusion with IMN

A

lateral plantar nerve

45
Q

Spastic equinovarus is usually due to…

A

stroke or TBI –> spastic GSC causes equinus and spastic tib ant causes varus

*If non-op (AFO) fails –> TAL and SPLATT to cuboid

46
Q

The interdigital nerve runs…

A

below the transverse intermetatarsal ligament.

47
Q

Treatment of Morton’s neuroma

A

Non-op: wide shoe box, MT pad, injection

Op: dorsal neurectomy

48
Q

In Morton’s neuroma, multiple cortisone injections can lead to…

A

hammertoe deformity.

49
Q

Histology of Morton’s neuroma

A

perineural fibrosis

50
Q

Deficiency of the plantar plate can lead to…

A

cross-over toe deformity

51
Q

2nd MTP synovitis

A
  • walking on a “marble”
  • callus under 2nd MT head
  • subluxation w/ drawer test (dorsal subluxation of MTP joint)
52
Q

Initial tx of 2nd MTP synovitis

A

MT pad

53
Q

Tx of fixed dorsal MTP dislocation

A

distal oblique MT shortening osteotomy (Weil)

54
Q

Hammertoe

A

overpull of EDL and contracture of FDL –> PIP flexion and DIP extension

tx: flexible –> FDL to EDL transfer
rigid –> PIP resection arthroplasty

55
Q

Mallet toe

A

DIP hyperflexion from FDL contracture

tx: flexible –> FDL to EDL transfer
rigid –> DIP fusion or resection arthroplasty

56
Q

Claw toe

A

intrinsic minus foot deformity: MTP hyperextension, PIP/DIP flexion

usually due to MTP synovitis and attenuation of the plantar plate

57
Q

Treatment of claw toe

A

non-op: taping

op:
flexible –> EDB tentomy, EDL lengthening, FDL to extensor trasnfer
rigid: resection arhtorplasty of proximal phalanx or weil osteotomy

58
Q

Most common complication of Weil osteotomy is…

A

floating toe (dorsiflexion deformity of MTP)

59
Q

Turf toe

A

hyperextension injury of 1st MTP joint resulting in injury to the plantar plate and sesamoid complex

Tx with taping (or repair in an athlete)

60
Q

Imaging for turf toe

A

Weight bearing or forced dorsiflexion x-rays but if too painful can get MRI

61
Q

The sesamoids are embedded in the…

A

FHB tendon.

62
Q

Tibial sesamoidectomy can lead to…

A

hallux valgus deformity.

63
Q

Fibular sesamoidectomy can lead to…

A

hallux varus deformity.

64
Q

Sesamoidectomy of both can lead to…

A

cock up hallux due to FHB weakness.

65
Q

Treatment of Kohler dz (AVN of the naviuclar)

A

immobilization in short leg walking cast

66
Q

Baxter neuropraxia (1st branch of lateral plantar nerve)

A

Symptoms: pain in plantar medial heel and base of 5th MT

Overview: innervates abductor digit quinti; compression between abductor hallucis longus and quadratus plantae

Tx: release fascia of AHL

67
Q

Plantar fasciitis

A

Symptoms: tight GSC, TTP over medial process of calc tuberosity

Overview: pain is worse when getting out of bed, better after a few steps and worse again at end of day; BMI > 30 is risk factor

Tx: eccentric stretching of plantar fascia & achilles, night splint, shock wave, plantar fasciotomy/TAL

68
Q

Tarsal tunnel syndrome

A

Exam: tinel sign with percussion of tibial nerve

overview: paresthesias in plantar foot with compression of tunnel
tx: if fails non-op, tarsal tunnel release

69
Q

anterior tarsal tunnel syndrome

A

entrapment of the DPN at the level of the inferior extensor retinaculum –> pain/paresthesias in 1st webspace; tenderness to palaption over 1st and 2nd MT bases

*Often due to tight shoe/ski boot

**If fails non-op, treat with inferior extensor retinaculum release.

70
Q

For achilles tendinosis, if > 50% of the achilles insertion or tendon is debrided, then…

A

augment with FHL or FDL transfer.

71
Q

Tx of achilles tendinosis w/ chronic attritional rupture

A

calc ostectomy & insertional repair

72
Q

After achilles rupture tx, early motion will…

A

decrease rerupture rate.

73
Q

Treatment of chronic achilles rupture w/ gap > 5 cm

A

gastroc turndown reconstruction +/- FHL tendon transfer.

74
Q

Posterior ankle arthroscopy puts what nerve at risk?

A

sural

75
Q

Most common tarsal coalition

A

calcaneonavicular

76
Q

Approach for tarsal coalition excision

A

calcaneonavicular: lateral incision over sinus tarsi
talocalcaneal: medial incision between FDL/FHL

77
Q

In a high ankle sprain, the initial ligament to be injured is…

A

AITFL

78
Q

ATFL sprain

A

injured during plantarflexion and inversion

laxity to anterior drawer testing in plantarflexion

79
Q

CFL sprain

A

injured during dorsiflexion and inversion

laxity to anterior drawer test in dorsiflexion

80
Q

Osteochondral lesion of the talus, lateral lesions are…

A

usually traumatic and less common.

81
Q

SPR is injured with…

A

forced ankle dorsiflexion and inversion

82
Q

SPR apprehension test

A

subluxation w/ ankle dorsiflexed and everted

83
Q

Treatment of peroneal tendon tears

A

small: debride, core repair and tubularzie
large irreparable one tendon: tenodesis to intact tendon
large irreparable both tendons: FHL transfer or allograft reconstruction

84
Q

Allograft reconstruction of peroneal tendon tear requires…

A

proximal muscle excursion.

85
Q

Fusion angle for ankle

A

5-10 degrees ER
5 degrees valgus
neutral dorsiflexion

86
Q

Total ankle replacement increases…

A

stride length, cadence and velocity compared to fusion.

OITE Review Book (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions