Foot & Ankle Flashcards

1
Q

Where does the bifurcate ligament attach?

A

Originates: Anterior process of the calcaneus; Inserts: dorsal navicular and cuboid

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2
Q

What is the classic characteristic of a subtle cavovarus deformity?

A

mild heel varus and plantar flexed first ray

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3
Q

What are the most common pathologies of subtle cavovarus foot?

A

lateral column overload, stress fractures, and injury to the peroneal tendons and/or the lateral ankle ligaments.

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4
Q

What is the first line treatment for subtle cavovarus foot?

A

first line treatment of subtle cavus foot should include custom full-length orthoses with a recess under the first metatarsal head, post at the lateral forefoot, lowered arch, and a heel cushion.

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5
Q

What is a Stieda process?

A

Extended lateral tubercle of the posterior process of the talus

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6
Q

Neurologic injury is the most common complication of ankle arthroscopy. The nerve most commonly injured is at risk during placement of which portal?

A

The SPN is the most commonly injured nerve; it is at risk with the anterolateral portal

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7
Q

What structure is at risk with placement of an anterior-central portal in ankle arthroscopy?

A

the DPN and DPA

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8
Q

What is the optimal position for ankle arthrodesis?

A

Plantigrade, 10° external rotation, 5° valgus, posterior positioning of the talus on tibial plafond (5 mm posterior)

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9
Q

What is Baxter’s nerve entrapment?

A

Entrapment of the first branch of the lateral plantar nerve; elicited by Tinel’s at origin of abductor hallicus

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10
Q

What is the definition of Lisfranc injury?

A

traumatic disruption between the articulation of the medial cuneiform and base of the second metatarsal.

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11
Q

In a Lisfranc injury, the metatarsals displace in […] direction

A

dorsal/lateral

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12
Q

The Lisfranc ligament is an interosseous ligament that goes from […] to […] on plantar surface

A

medial cuneiform; 2nd metatarsal base

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13
Q

The Lisfranc ligament is an interosseous ligament that goes from medial cuneiform to base of 2nd metatarsal on […] surface of the foot

A

plantar

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14
Q

Lisfranc ligament tightens with […] and […] of forefoot

A

pronation; abduction

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15
Q

Injury of the plantar ligament between the medial cuneiform and the second and third metatarsals along with the Lisfranc ligament is necessary to give […] instability.

A

transverse

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16
Q

What is the most common complication of Lisfranc injury?

A

mid foot osteoarthritis

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17
Q

In patients with a malunited Lisfranc injury, who are not good candidates for surgery, what shoe wear can be used in treatment?

A

rocker bottom with cushioned heel

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18
Q

What percentage of patients who undergo ORIF for Lisfranc have HWR?

A

75%

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19
Q

What percentage of patients who undergo primary arthrodesis for a Lisfranc injury have HWR?

A

20%

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20
Q

What foot deformity is seen in Lisfranc injury treated non operatively (or malreduced ORIF?

A

planovalgus

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21
Q

What is the insertion of the peroneus tertius?

A

dorsal diaphysis of 5th metatarsal

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22
Q

What inserts to the tuberosity/base of the 5th metatarsal?

A

Peroneus brevis and lateral band of the plantar fascia

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23
Q

What is the insertion site for the lateral band of the plantar fascia?

A

Base/tuberosity of the 5th metatarsal

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24
Q

What is the blood supply to the base of the 5th metatarsal?

A

metaphyseal vessels and diaphyseal nutrient artery

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25
Q

Zone 3 Jones fractures are associated with what foot deformity?

A

cavovarus foot (also sensory neuropathies)

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26
Q

In the setting of a 5th metatarsal base fracture, callus forms […] first and progresses […]

A

medially; laterally

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27
Q

In the setting of a 5th metatarsal base fracture, […] fracture gap lends poor prognosis for union with nonoperative treatment

A

plantar

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28
Q

Treatment of a zone 2 Jones fracture non-operatively has a […] non-union rate and […] risk of re-fracture.

A

high; high

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29
Q

What is the risk of re-fracture in a zone 2 jones fracture treated non-operatively?

A

33%

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30
Q

What is the treatment for a Zone 2 Jones fracture in an athlete?

A

intra-medullary screw fixation

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31
Q

A screw size less than […] is a risk factor for non-union in the treatment of intramedullary screw fixation for a Jones fracture.

A

4.5 mm

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32
Q

Running and impact activities can commence at 6 weeks in the surgical treatment of Jones fractures, if surgical site pain-free and […]

A

signs of radiographic callus

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33
Q

What foot deformity is a risk factor for re-fracture in a Jones fracture?

A

cavovarus

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34
Q

Which nerve can be injured with intra-medullary screw fixation of a Jones fracture?

A

dorsal lateral branch of the sural nerve

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35
Q

The dorsolateral branch of sural nerve is within […] of the 5th metatarsal tuberosity

A

2-3 mm

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36
Q

The […] nerve is within 2-3 mm of the 5th metatarsal tuberosity

A

dorsolateral branch of sural

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37
Q

Achilles tendon ruptures usually occur […] in hypovascular region

A

4-6 cm above the calcaneal insertion

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38
Q

The achilles tendon receives its blood supply from the […]

A

posterior tibial artery

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39
Q

Achilles tendon ruptures treated with bracing/casting have […] plantar flexion strength compared to operative management

A

equivalent

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40
Q

Achilles tendon ruptures treated with bracing/casting have […] rates of re-rupture if functional rehabilitation used versus operative repair

A

equivalent

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41
Q

Achilles tendon ruptures treated with bracing/casting have […] complications compared to operative treatment

A

fewer

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42
Q

Achilles tendon ruptures treated with open end to end repair have decreased risk of re-rupture after surgical repair when […] protocol used

A

early ROM

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43
Q

Percutaneous achilles tendon repair have increased rates of […] nerve injury compared to open repair

A

sural

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44
Q

Percutaneous achilles tendon repair have […] risk of wound complications/infection compared with open repair

A

lesser

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45
Q

Treatment of chronic achilles tendon ruptures with a VY advancement is indicated when there is less than a […] defect

A

3 cm

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46
Q

Treatment of a chronic achilles tendon rupture with a FHL transfer and VY advancement is indicated when there is a defect measuring greater than […]

A

3 cm

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47
Q

Chronic achilles tendon ruptures with >3 cm defect are surgically treated with […]

A

flexor hallucis longus transfer +/- VY advancement of gastrocnemius

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48
Q

Reconstruction of an achilles tendon rupture with a flexor hallucis longus transfer +/- VY advancement of gastrocnemius requires a functioning […] nerve.

A

tibial

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49
Q

In performing a flexor hallucis longus transfer for a achilles tendon repair, the FHL tendon is released at the […] and transferred through the calcaneus

A

knot of Henry

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50
Q

The knot of Henry is a cross over of what two muscles?

A

FHL and FDL

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51
Q

At the Knot of Henry, which muscle is more plantar?

A

FDL is plantar to FHL at knot of Henry

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52
Q

Which nerve can be entrapped at the Knot of Henry?

A

Medial plantar nerve

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53
Q

What is the most common cause for wound complications in the surgical treatment of the achilles tendon ruptures?

A

Smoking

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54
Q

Sural nerve injury is higher when which surgical approach is used in the treatment of achilles tendon ruptures?

A

Percutaneous repair/approach

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55
Q

The most common pattern of Peroneal tendon tears is a […]

A

longitudinal split tear in the PB

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56
Q

What foot deformity/alignment is associated with peroneal tendon injury?

A

cavovarus hindfoot alignment

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57
Q

What accessory muscle is associated with peroneal tendon injury?

A

accessory peroneus quartus or quintus

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58
Q

Peroneus breves lies […] and […] to the peroneus longus at the level of the lateral malleolus

A

anterior; medial

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59
Q

What nerve root innervates peroneus brevis?

A

S1 (SPN)

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60
Q

What nerve root innervates peroneus longus?

A

S1 (SPN)

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61
Q

What is the origin and insertion of the superior peroneal retinaculum?

A

originates from the posterolateral ridge of the fibula and inserts onto the lateral calcaneus (peroneal tubercle)

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62
Q

What is the primary restraint of the peroneal tendons within the retromalleolar sulcus?

A

superior peroneal retinaculum

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63
Q

At the level of the peroneal tubercle of the calcaneus, the peroneus brevis lies […] to the peroneus longus

A

superior

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64
Q

At the level of the peroneal tubercle of the calcaneus, the peroneus longus lies […] to the peroneus brevis.

A

inferior

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65
Q

What is the blood supply to the peroneal brevis and longus?

A

branches of anterior and posterior tibial arteries via vincula

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66
Q

What is the apprehension test for peroneal tendons?

A

active dorsiflexion and resisted eversion

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67
Q

Proximal migration of the os peroneum is indicative of a […] rupture

A

peroneus longus

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68
Q

What is the treatment for acute peroneal brevis/longus instability in nonprofessional athletes?

A

short leg cast with PWB x 6 weeks; activity modification; PT

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69
Q

In treatment of peroneal tendon instability, the addition of […] shows higher rate of return to sport than SPR repair alone

A

groove deepening

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70
Q

Tenosynovectomy and tendon debridement with tubularization is indicated with recalcitrant and symptomatic PB/PL tears less than […] of the tendon width

A

50-60%

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71
Q

Tenodesis of distal and proximal ends of the brevis tendon to the peroneus longus is indicated when greater than […] percent of the peroneus brevis tendon is involved

A

50%

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72
Q

In the treatment of peroneal tendon tears, debridement with graft placement is indicated when >50% of the tendons are involved with preserved […]

A

muscle excursion

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73
Q

In the treatment of peroneal tendon tears, debridement with FDL or FHL transfer is indicated when >50% of the tendons are involved and there is no […]

A

muscle excursion

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74
Q

What is the most common complication following surgery for peroneal tendons?

A

Sural nerve neuroma

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75
Q

What is the most common cause of adult acquired flat foot deformity?

A

Posterior tibial tendon insufficiency

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76
Q

Posterior tibial tendon insufficiency contributes to attritional failure of […] stabilizers and collapse of the […]

A

static hindfoot; medial longitudinal arch

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77
Q

What is the origin of the posterior tibialis muscle?

A

posterior fibular, tibia, and interosseous membrane

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78
Q

What nerve root innervates the posterior tibialis?

A

L4-5

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79
Q

The anterior limb of the posterior tibialis tendon inserts where?

A

navicular tuberosity and medial cuneiform

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80
Q

The middle limb of the posterior tibialis tendon inserts where?

A

second and third cuneiforms, cuboid, and metatarsals 2-4

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81
Q

The posterior limb of the posterior tibialis tendon inserts where?

A

sustentaculum tali

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82
Q

What is the primary dynamic support for the arch of the foot?

A

Posterior tibialis tendon

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83
Q

Posterior tibialis tendon […] and […] the forefoot during stance phase of gait

A

adducts; supinates

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84
Q

What is the major antagonist to the posterior tibialis tendon?

A

Peroneus brevis

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85
Q

Activation of posterior tibialis tendon allows locking of the […] joints creating a rigid lever arm for the toe-off phase of gait.

A

transverse tarsal

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86
Q

Activation of posterior tibialis tendon allows locking of the transverse tarsal joints creating a rigid lever arm for the […] phase of gait.

A

toe-off

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87
Q

A Meary angle of greater than […] degrees indicate pes planus

A

4

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88
Q

What is a normal degree of calcaneal pitch on a lateral foot XR?

A

17-32 degrees

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89
Q

What is the primary static stabilizer of the talonavicular joint?

A

Spring ligament

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90
Q

In treating PTTI with an AFO, a […] orthotic post is utilized to support valgus collapse

A

medial

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91
Q

What is the first line treatment for stage I of PTTI?

A

Walking cast/boot FOR 3-4 months

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92
Q

In treating PTTI with a custom orthotic, a […] heel post with longitudinal arch support is utilized.

A

medial

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93
Q

In treating PTTI with a custom orthotic, a medial forefoot post is indicated if […] is present

A

fixed forefoot varus

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94
Q

What tendon can be transferred in the treatment of posterior tibialis tendon insufficiency?

A

FDL

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95
Q

A triple arthrodesis includes which joints?

A

Calcaneocuboid, talonavicular, subtalar

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96
Q

What is a Haglund deformity?

A

an enlargement of the posterosuperior tuberosity of the calcaneus

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97
Q

Histology of achilles tendonitis shows what?

A

disorganized collagen with mucoid degeneration

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98
Q

In the treatment of achilles tendonitis, tendon transfer or augmentation with FDL, FHL or PB, is indicated what greater that […] percent of the achilles tendon must be debrided

A

50

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99
Q

In the treatment of achilles tendonitis which tendon transfer is associated with greater ankle plantar flexion strength post op?

A

FHL

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100
Q

Which three muscles share a common origin on the medial calcaneal tubercle and may be inflamed in plantar fasciits?

A

abductor hallucis, flexor digitorum brevis, and quadratus plantae

101
Q

Corticosteroid injections for plantar fasciitis can lead to […] atrophy or […] rupture

A

fat pad; plantar fascia

102
Q

Pre-fabricated shoe inserts shown to be […] effective than custom orthotics in relieving symptoms of plantar fasciitis when used in conjunction with achilles and plantar fascia stretching

103
Q

A non-weight bearing, plantar fascia specific stretching program is […] effective than weight bearing Achilles tendon stretching programs in the treatment of plantar fasciitis.

104
Q

Complete release of the plantar fascia should be avoided as it may result in destabilization of the […], overload of the […], and […] foot pain

A

longitudinal arch, lateral column, dorsolateral

105
Q

Which treatment modality allows for quicker return to play in athletes with a type II jones fracture?

A

Intramedullary screw fixation

106
Q

Which vein often lies just lateral to the sural nerve?

A

small saphenous vein

107
Q

FHL transfer for the treatment of insertional achilles tendinopathy results in […] plantar flexion strength and […] great toe flexion strength.

A

increased; no difference

108
Q

What is a Cotton osteotomy?

A

Plantarflexion opening wedge medial cuneiform osteotomy

109
Q

In the setting of calcaneal malunion, what is the indication for bone block arthrodesis?

A

The classic indication for bone block arthrodesis is ANTERIOR ankle pain and limited dorsiflexion

110
Q

The spring ligament complex is comprised of what two ligament?

A

inferior calcaneonavicular and superomedial calcaneonavicular (CNL) ligaments

111
Q

In chronic peroneal tendinopathy, the pathology often occurs near the […] tunnel.

112
Q

What hind foot alignment is seen in peroneal tendinopathy?

113
Q

In treatment of achilles tendinopathy, Achilles tendon debridement greater than […] percent indicates FHL/tendon transfer

114
Q

Posterior tibialis tendon insufficiency primarily affects which joint?

A

Transverse tarsal joint; unable to lock transverse tarsal joint during gait

115
Q

Posterior tibialis tendon insufficiency affects which stage of gait?

A

late stance / toe-off

116
Q

What is the insertion of FHL?

A

plantar aspect of the great toe distal phalanx

117
Q

What is the insertion of FDL?

A

plantar aspect of the distal phalanges of the lesser toes

118
Q

In midfoot-driven AAFD, the cuneiform subluxates […] on the navicular.

119
Q

Are medial or lateral talar dome osteochondral lesions more common?

120
Q

Do medial or lateral talar dome injuries usually have a history of trauma?

121
Q

Is the anterior or posterior portion of the talus more broad?

A

anterior portion broader than posterior

122
Q

What artery provides the majority of the blood supply to the talus?

A

The deltoid artery

123
Q

[…] hind foot alignment is associated with talar dome injuries.

124
Q

MRI findings will show […] in unstable talar dome injuries

A

fluid deep to the subchondral bone

125
Q

What is the treatment for an acute, non-displaced fragment of the the talar dome with incomplete fracture?

A

immobilization & non-weightbearing

126
Q

Arthroscopy with debridement and marrow stimulation can be a treatment option for talar dome lesions less than […] in size.

127
Q

Operative treatment of talar dome fractures with retrograde drilling and/or bone grafting is indicated in lesions greater than […] in size with an intact cartilage cap.

128
Q

Operative treatment of talar dome lesions with osteochondral grafting is indicated in displaced lesions greater than […] in size.

129
Q

[…] percent of the gait cycle is spent in stance phase

130
Q

During […] phase of gait, the leg accepts body weight and provides single limb support

131
Q

What are the two phases of gait?

A

Stance phase and swing phase

132
Q

In the gait cycle, during initial heel strike, the […] contract to stabilize the hip.

A

hip extensors

133
Q

Toe flexors and tibialis posterior contract and are the most active during the […] phase of the gait cycle

A

terminal stance

134
Q

The gluteus medius and calf muscles undergo eccentric contraction during which phase of the gait cycle?

A

Mid-stance

135
Q

In Hallux valgus, valgus deviation of phalanx promotes […] position of metatarsal

136
Q

In hallux valgus, the metatarsal heads translate […]

137
Q

Sesamoids of the great toe are embodied in what muscle tendon?

A

flexor hallucis brevis tendon

138
Q

Sesamoids of the great toes are within the respective head of the flexor hallucis brevis tendon and are attached to the base of the proximal phalanx via the […] ligament

A

sesamoid-phalangeal

139
Q

What muscle/tendon is the deforming force in hallux valgus?

A

adductor hallucis

140
Q

Which muscle causes plantarflexion and pronation of the first phalanx in hallux valgus?

A

Abductor hallucis

141
Q

What foot deformity is associated with progression of hallux valgus?

A

Pes planus

142
Q

In Juvenile and Adolescent Hallux valgus, which angles are usually increased and can help differentiate from adult hallux valgus?

A

IMA widened and DMAA usually increased

143
Q

What is the most common complication of adolescent hallux valgus?

A

recurrence is most common complication (>50%)

144
Q

In hallux valgus, sesamoids displace […] to metatarsal head

145
Q

What is the insertion of the adductor hallux muscle?

A

lateral aspect of the proximal phalanx of the great toe

146
Q

What is the innervation of adductor hallux?

A

Lateral plantar nerve

147
Q

What is the insertion of the abductor hallux muscle?

A

medial aspect of proximal phalanx of great toe

148
Q

What is the innervation of the abductor hallux?

A

medial plantar nerve

149
Q

What is a normal hallux valgus angle?

A

<15 degrees

150
Q

What is a normal intermetatarsal angle?

A

< 10 degrees

151
Q

What is a normal distal metatarsal articular angle?

A

<15 degrees

152
Q

Which radiographic measurement/angle identifies MTP joint incongruity?

153
Q

A hallux valgus interphalangeus (HVI) angle great than […] is a predisposing risk factor for hallux valgus?

A

10 degrees

154
Q

What is the modified McBride procedure?

A

adductor release from proximal phalanx/lateral sesamoid, lateral capsulotomy, medial capsular imbrication

155
Q

What is a Chevron osteotomy?

A

Distal metatarsal osteotomy

156
Q

What is a crescentic osteotomy?

A

Proximal metatarsal osteotomy

157
Q

What is a Scarf osteotomy?

A

Proximal metatarsal osteotomy

158
Q

What is an Akin osteotomy?

A

A medial closing wedge proximal phalanx osteotomy of the great toe

159
Q

Lapidus procedure, in isolation, can fail to correct […] of the first ray

160
Q

What is a Lapidus procedure?

A

1st metatarsal to cuneiform arthrodesis with modified McBride

161
Q

In a hallux MTP arthrodesis, the toe should be positioned in […] degrees of valgus, neutral rotation, and […] degrees of dorsiflexion

A

5-10 degrees; 5-10 degrees

162
Q

Cock up toe deformity is a complication of which Hallux valgus procedure?

A

Keller resection osteotomy

163
Q

Failure to perform a lateral release of the adductor hallucis tendon in a hallux valgus surgery can lead to what complication?

A

Recurrence

164
Q

Incomplete reduction of sesamoids during hallux valgus corrective surgery can lead to what complication?

A

Recurrence; transfer metatarsalgia

165
Q

In the treatment of hallux valgus, a lateral sesamoidectomy increases the risk for what complication?

A

Hallux varus

166
Q

What is the treatment for transfer metatarsalgia in the setting of hallux valgus post op complications?

A

Weil osteotomy

167
Q

The medial dorsal cutaneous nerve is a terminal branch of the […] nerve

A

superficial peroneal

168
Q

Which nerve is at risk in the surgical treatment of hallux valgus?

A

medial dorsal cutaneous nerve

169
Q

Hallux rigidis affects which joint?

170
Q

Which nerve overlies the 1st MTP joint?

A

Medial branch of medial dorsal cutaneous nerve

171
Q

The first MTPJ carries up to […] percent of an individual’s body weight with each step

172
Q

What orthotic is firstline treatment for hallux rigidus?

A

Morton’s extension orthotic

173
Q

Pain with terminal dorsiflexion is an indicator of […] results with dorsal cheilectomy in treatment of hallux rigidis

174
Q

What is the Moberg osteotomy in the foot?

A

dorsal closing wedge osteotomy of the proximal phalanx

175
Q

Runner’s with hallux rigidus and decreased dorsiflexion can benefit from which procedure?

A

Moberg osteotomy (dorsal closing wedge of proximal phalanx) with dorsal cheilectomy

176
Q

Arthroplasties for hallux rigidus requiring secondary fusions have […] outcomes than primary fusion.

177
Q

Morton’s extension orthotic provides pain relief and allows for minimal […]-flexion

178
Q

When performing a dorsal cheilectomy for hallux rigidus, resection greater than […] percent may lead to joint subluxation

179
Q

In performing a Keller resection arthroplasty, transfer metatarsalgia can be decreased with […] interposition

180
Q

In performing arthrodesis for hallux rigidus, […] degrees of valgus and […] degrees of dorsiflexion is preferred

181
Q

In treatment of diabetic Charcot neuropathy, a […] orthotic can be used after total contact casting

A

CROW (Charcot restraint orthotic walker) boot

182
Q

A Hb A1C greater than […] is associated with decreased healing potential of a diabetic ulcer.

183
Q

An albumin greater than […] and an absolute lymphocyte count greater than […] is associated with increased healing potential of a diabetic ulcer.

184
Q

What is the primary risk factor for diabetic ulcer development?

A

sensory dysfunction

185
Q

What is the most common pathogen associated with infection of diabetic foot ulcers?

A

aerobic gram positive cocci (s. aureus)

186
Q

TCO2 greater than […] is a sign of good healing potential.

A

30-40 mmHg

187
Q

ABI greater than […] is needed to heal am amputation.

188
Q

In the treatment of diabetic foot ulcers, of the available shoe only modifications, […] shoes best reduce the plantar pressure on the forefoot

A

rocker sole

189
Q

For diabetic foot ulcers, medicare will cover modifications and custom shoes/insoles […]

190
Q

What is the absolute contraindication to treating diabetic ulcers with total contact casting?

191
Q

If ulcers recur after TCC for diabetic ulcers, it usually occurs […] weeks after cast removal

192
Q

Tendoachilles lengthening is associated with a […] risk of recurrent ulceration in plantar forefoot ulcerations

193
Q

In the treatment of diabetic foot ulcers, total contact casting is often necessary for up to […] months

194
Q

[…] is considered the most likely predictor of eventual lower extremity amputation in patients with diabetes mellitus

A

Diabetic foot ulceration

195
Q

What is the most common etiology for ankle arthritis?

A

Post-traumatic; ankle fractures > ligamentous

196
Q

In patient undergoing supramalleolar osteotomy for ankle arthritis, patients with […] degree of preoperative talar tilt have five-year survival rates of 85% while those with greater than […] degrees of talar tilt have five-year survival rates of 65%

197
Q

Patients with ankle arthritis who have undergone total ankle arthroplasty have […] gait speed and […] stride length compared with arthrodesis

A

increased; increased

198
Q

The optimal position for ankle arthrodesis is […] dorsiflexion, […] external rotation, […] hind foot valgus, […] posterior talar translation

A

neutral; 5-10 degrees; 5 degrees, 5 mm

199
Q

In ankle arthrodesis, concomitant fusion of the talonavicular joint decreases hindfoot ROM greater than […] percent

200
Q

The risk of nonunion following ankle arthrodesis is […] times higher risk in tobacco users.

201
Q

[…] is greatest risk factor for persistent nonunion with revision of nonunion of ankle arthrodesis

A

neuropathy

202
Q

Total ankle arthroplasty has […] performance on uneven surfaces compared to ankle arthrodesis

203
Q

Total ankle arthroplasty is done via an anterior approach to the ankle in the interval between […]

A

tibialis anterior and EHL

204
Q

What is the most common complication following total ankle arthroplasty?

A

Delayed wound healing

205
Q

Following an infection of a total ankle arthroplasty, studies have shown a […] success rate of component reimplantation

206
Q

Is a medial or lateral malleolus intra-operative fracture more common in total ankle arthroplasty?

207
Q

In a total ankle arthroplasty, does the talar or tibial component fail more commonly?

208
Q

What is the most common foot deformity following a stroke?

A

Equinovarus

209
Q

What tendon transfer can be utilized in a chronic foot drop?

A

Posterior tibialis transfer to lateral cuneiform

210
Q

Loss of ankle eversion is an injury to which nerve?

211
Q

A positive Silverskiold test is indicative of what?

A

Isolated gastroc tightness (NOT gastrocsoleus/achilles tightness)

212
Q

What is a useful salvage procedure for plantar IP diabetic ulceration with a rigid forefoot in a low demand patient?

A

Keller resection arthroplasty (resection of base of proximal phalanx)

213
Q

What are the requirements to perform a Syme amputation in non healing ulcer/diabetic patient?

A

Stable heel pad and palpable PT pulse

214
Q

What foot deformity is associated with increased risk of ankle sprain?

A

subtle cavovarus

215
Q

The deep deltoid limits talus […] and the superficial deltoid limits talus […]

A

external rotation; abduction

216
Q

Which ligament is most commonly involved in low ankle sprains?

217
Q

Injury to ATFL physical exam shows drawer laxity in […] flexion

218
Q

Injury to CFL physical exam shows drawer laxity in […]-flexion

A

dorsiflexion

219
Q

In patients with Charcot arthropathy, the most sensitive test to diagnose soft tissue (and bone) infection is […].

220
Q

The abductor digiti minimi is supplied by what nerve?

A

Baxter’s nerve (first branch of the lateral plantar nerve)

221
Q

Tinels and pain just proximal to the origin of abductor hallicus that radiates to the 5th metatarsal is indicative of entrapment of which nerve?

A

first branch of lateral plantar nerve (Baxter’s nerve)

222
Q

The first branch of the lateral plantar nerve travels […] to the fascia of abductor hallucis and […] to the quadratus plantae

A

dorsal; plantar

223
Q

Where does the AITFL originate?

A

anterolateral tubercle of tibia (Chaput’s)

224
Q

Where does the AITFL insert?

A

anterior tubercle of fibula (Wagstaffe’s)

225
Q

Where does the PITFL originate?

A

posterior tubercle of tibia (Volkmann’s)

226
Q

Where does the PITFL insert?

A

posterior part of lateral malleolus

227
Q

What is the strongest component of the ankle syndesmosis?

228
Q

In the ankle syndesmosis, what is the main restraint to proximal migration of the talus

A

Interosseous ligament

229
Q

During dorsiflexion, the distal fibula […] rotates and translates […] and […]

A

externally; proximally; posterolaterally

230
Q

During normal gait, the syndesmosis widens […]

231
Q

What is the Hopkin’s test?

A

squeeze test; compression of tibia and fibula at midcalf level causes pain at syndesmosis

232
Q

What is a normal tib/fib overlap on an AP ankle?

233
Q

What is a normal tib/fib overlap on an ankle mortise?

234
Q

Bilateral cavovarus foot is due to what disease?

A

Charcot Marie Tooth

235
Q

In unilateral cavovarus foot, what neurologic condition(s) need to be ruled out?

A

Tethered cord and spinal cord tumor

236
Q

Which muscles are weak in a cavovarus foot?

A

Tibialis anterior and peroneus brevis

237
Q

Which muscles are strong in cavovarus?

A

Posterior tibialis and peroneus longus

238
Q

What are the foot deformities in cavovarus foot?

A
  • plantar flexed 1st ray
  • forefoot pronation
  • hindfoot varus
239
Q

Talonavicular angle greater than […] degrees indicates forefoot adduction

240
Q

Are medial or lateral malleolar stress fractures more common in a cavovarus foot?

241
Q

What are the anatomic borders of the posterior tarsal tunnel?

A

calcaneus & talus (medially), abductor hallucis muscle (inferiorly), flexor retinaculum (laciniate ligament)

242
Q

What are the three branches of the tibial nerve?

A

medial plantar, lateral plantar, medial calcaneal

243
Q

In surgical release of the tarsal tunnel, which layers must be release?

A

Flexor retinaculum, deep investing fascia of leg, superficial and deep fascia of abductor hallucis

244
Q

During surgical treatment of metatarsus primus varus (hallux valgus) and hypermobility with metatarsocuneiform arthrodesis anatomic […]-flexion of the first metatarsal is crucial to prevent loading of the lesser metatarsals following surgery.

245
Q

Chevron osteotomy can be used for a congruent or incongruent deformity that have hallux valgus angles less than […] degrees and intermetatarsal angles less than […] degrees.

246
Q

Biplanar Chevron metatarsal osteotomy can correct which angle?

247
Q

In MTP arthrodesis for hallux rigidus, the toe should be fused in […] degrees of valgus in relation to the metatarsal shaft and […] degrees of dorsiflexion in relation to the floor.

248
Q

What is the most common cause of hallux varus following hallux valgus surgery?

A

Resection of the fibular sesamoid

249
Q

Resection of the fibular sesamoind in hallux valgus surgery can lead to what complication?

A

Hallux varus