Foot/Ankle 2 Flashcards
a positive too many toes sign can indicate pathology of either what tendon or ligament?
posterior tibial tendon or spring ligament
the posterior process of the talus consists of what two tubercles?
lateral and medial tubercle
an os navicular can interfere with the attachment of what tendon to the navicular?
posterior tibial tendon
what is a hammertoe deformity?
flexion deformity of the DIP joint
what is a mallet toe deformity?
hyperextension of the MTPJ and fixed flexion of the PIP and DIP joints
t/f a plantar calcaneal enthesophyte is normally the cause of pain in plantar fasciitis
false
a night splint in what direction of ROM is indicated for plantar fasciitis?
dorsiflexion
what is a positive Severs test?
heel pain aggravated by heel rise
a 10 yo male athlete has heel pain and XR demonstrates fragmentation, sclerosis. what is the diagnosis?
Severs disease
what is the treatment for Severs disease?
rest, activity modification, stretching and strengthening
an athlete has pain at the plantar surface of the great toe MTPJ. XR reveals proximal migration of the sesamoids. what is the diagnosis?
plantar plate fupture
a patient with turf toe should wear a walking boot until when?
pain free
what is the hallmark radiographic finding of hallux rigidus?
dorsal exostosis of the first metatarsal
what surgical procedure is appropriate if conservative management fails for hallux rigidus to benefit the running athlete by improving dorsiflexion movement?
proximal phalanx osteotomy
how would you initially treat hallux rigidus conservatively?
shoe modification, nsaids, orthotics, intraarticular steroids
which condition is characterized by overload of the metatarsal head leading to repetitive stress and attritional tear of the MTPJ plantar plate?
lesser MTPJ instability
which metatarsal head is the most common site of lesser MTPJ instability?
second MT head
what are the major 3 components of initial treatment of lesser MTPJ instability?
rest, splint toe, and stiff soled shoes
what is the most hypovascular portion of the navicular?
central one third
what imaging modality is the gold standard for navicular stress fracture?
CT
what is the initial treatment for navicular stress fracture?
short leg cast immobilization for 6-8 weeks
what two criteria should be met prior to a patient with calcaneal stress fracture being allowed to participate in gradual return to activity?
symptoms abate and when radiographs document healing
in what specific portion of the bone does a Jones fracture occur?
metaphyseal - diaphyseal junction
what is the term for stress fracture of the fifth metatarsal?
Jones fracture
if you treat a Jones fracture non operatively, what length of time should you immobilize in cast and then using a walking boot, respectively?
4-6 weeks cast followed by 4-6 weeks walking boot
at which joint is metatarsophalangeal joint synovitis most common:
second MTPJ
a patient complains of medial arch pain and pain with resisted inversion. On exam, they have difficulty with one leg heel raise. what is the most likely diagnosis?
posterior tibial tendinopathy
t/f direct tenderness at the plantar MTPJ of the great toe and pain with resisted plantarflexion can indicate sesamoid pathology
true
if conservative treatment for sesamoiditis with activity modification, rest, nsaids, orthotics, walking boot fails you should perform CT or MRI to rule out presence of what?
stress fracture
what are the two key initial components of management of sesamoid fracture?
immobilization and protected weight bearing with cast or boot
what joint of the ankle allows eversion/inversion of the ankle?
subtalar joint
how should a non displaced or stress fracture of the talus initially be managed?
6 weeks of non weightbearing followed by a walking boot
what two bones are connected by the Lisfranc ligament?
medial cuneiform and 2nd MT base
how is a lisfranc sprain managed?
CAM boot
how is a non displaced lisfranc injury with ligament disruption managed?
non weightbearing cast
how is a displaced lisfranc ligament injury managed?
ORIF
how is an avulsion fracture at the base of the fifth metatarsal typically treated?
non surgically / conservatively
how are second through fourth metatarsal stress fractures usually generally managed?
conservatively - cessation of weightbearing activities, modified rest and immobilization prn for pain control
other than open fracture, what is the only other time surgery is typically required for phalangeal fracture of the foot?
intraarticular fracture of the great toe with displacement
what is the treatment for non displaced phalangeal fracture?
buddy tape and hard soled shoe
which tendon runs just inferior to the sustenaculum tali?
FHL
which metatarsal interspace is most commonly affected by interdigital neuroma?
third
