Brainscape's Knowledge GenomeTM

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


See full index

5. OITE > Foot & Ankle 2015 > Flashcards

Foot & Ankle 2015 Flashcards

1
Q
  1. Figures 1a and 1b are the radiographs of a 28-year-old woman who has frequent, painless giving-way of her ankle, which is causing her difficulty at work. Examination reveals severe laxity of both the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL). Her hindfoot alignment does not change with Coleman block testing. Surgical treatment should include reconstruction of the ATFL, CFL, and
  2. triple arthrodesis.
  3. in situ subtalar arthrodesis.
  4. realignment subtalar arthrodesis.
  5. dorsiflexion osteotomy of the first metatarsal.
  6. lateralizing osteotomy of the calcaneus tuberosity.
A
  1. lateralizing osteotomy of the calcaneus tuberosity.

RECOMMENDED READINGS

Strauss JE, Forsberg JA, Lippert FG 3rd. Chronic lateral ankle instability and associated conditions: a rationale for treatment. Foot Ankle Int. 2007 Oct;28(10): 1041-4. PubMed PMID: 17923051.

Vienne P, Schцniger R, Helmy N, Espinosa N. Hindfoot instability in cavovarus deformity: static and dynamic balancing. Foot Ankle Int. 2007 Jan;28(1):96-102. PubMed PMID: 17257547.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q
  1. Figures 16a through 16c are the weight-bearing radiographs of an active 34-year-old man with chronic great toe pain who is 6-ft, 5-in tall and weighs 250 pounds. He underwent surgery 8 months ago and reports persistent stiffness and pain with weight-bearing activity despite shoe modifications and a steel shank insert. He denies fevers, chills, and a history of prior wound difficulties. In addition to component explantation, what is the most appropriate treatment method?
  2. Resection arthroplasty
  3. Capsular interposition and phalanx osteotomy
  4. Arthrodesis with structural bone graft
  5. Conversion to total joint arthroplasty
  6. In situ arthrodesi
A
  1. Arthrodesis with structural bone graft

Garras DN, Durinka JB, Bercik M, Miller AG, Raikin SM. Conversion arthrodesis for failed first metatarsophalangeal joint hemiarthroplasty. Foot Ankle Int. 2013 Sep;34(9):1227-32. doi: 10.1177/1071100713488093. Epub 2013 Apr 23. PubMed PMID: 23613329.

Brodsky JW, Ptaszek AJ, Morris SG. Salvage first MTP arthrodesis utilizing ICBG: clinical evaluation and outcome. Foot Ankle Int. 2000 Apr;21(4):290-6. PubMed PMID: 10808968.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q
  1. Figures 31a through 31c are the MR images of an abnormal tendon that is most important during which stage of the gait cycle?
  2. Toe-off
  3. Terminal swing
  4. Heel strike
  5. Midstance
  6. Terminal stance
A
  1. Terminal stance

RECOMMENDED READINGS

Kaye RA, Jahss MH. Tibialis posterior: a review of anatomy and biomechanics in relation to support of the medial longitudinal arch. Foot Ankle. 1991 Feb;11(4):244-7. Review. PubMed PMID: 1855713.

Semple R, Murley GS, Woodburn J, Turner DE. Tibialis posterior in health and disease: a review of structure and function with specific reference to electromyographic studies. J Foot Ankle Res. 2009 Aug 19;2:24. doi: 10.1186/1757-1146-2-24. PubMed PMID: 19691828; PubMed Central PMCID: PMC2739849.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q
  1. Figures 46a and 46b are the current radiographs of a 42-year-old man who has severe left ankle and hindfoot pain after sustaining an open ankle fracture 3 years ago. The pain is aggravated by weight bearing and relieved by rest. He denies paresthesia and has had 7 surgeries on the ankle during the last 3 years, including a tibiotalocalcaneal arthrodesis 15 months ago. What is the best next step?
  2. Observation
  3. Scar revision
  4. Nerve exploration
  5. Revision arthrodesis
  6. Referral to a pain management clinic
A
  1. Revision arthrodesis

RECOMMENDED READINGS

Hammett R, Hepple S, Forster B, Winson I. Tibiotalocalcaneal (hindfoot) arthrodesis by retrograde intramedullary nailing using a curved locking nail. The results of 52 procedures. Foot Ankle Int. 2005 Oct;26(10):810-5. PubMed PMID: 16221452.

Chou LB, Mann RA, Yaszay B, Graves SC, McPeake WT 3rd, Dreeben SM, Horton GA, Katcherian DA, Clanton TO, Miller RA, Van Manen JW. Tibiotalocalcaneal arthrodesis. Foot Ankle Int. 2000 Oct;21(10):804-8. PubMed PMID: 11128009.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q
  1. A 63-year-old man with a 20-year history of noninsulin-dependent diabetes mellitus has a 6-month history of a Wagner grade 1 plantar foot ulcer at the hallux interphalangeal (IP) joint. There is no erythema or drainage. Pulses are palpable. Sensation to a 5.07 Semmes-Weinstein monofilament test is absent. A Silfverskiöld test result is negative, and radiograph findings are normal. Total contact casting has been unsuccessful. Surgical treatment at this point should consist of
  2. Keller arthroplasty.
  3. hallux IP joint fusion.
  4. hallux disarticulation.
  5. hallux metatarsophalangeal fusion.
  6. debridement and skin graft.
A
  1. Keller arthroplasty.

RECOMMENDED READINGS

Pinzur MS, Slovenkai MP, Trepman E, Shields NN; Diabetes Committee of American Orthopaedic Foot and Ankle Society. Guidelines for diabetic foot care: recommendations endorsed by the Diabetes Committee of the American Orthopaedic Foot and Ankle Society. Foot Ankle Int. 2005 Jan;26(1):113-9. PubMed PMID: 15680122.

Lin SS, Bono CM, Lee TH. Total contact casting and Keller arthoplasty for diabetic great toe ulceration under the interphalangeal joint. Foot Ankle Int. 2000 Jul;21(7):588-93. PubMed PMID: 10919626.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q
  1. Figures 69a through 69d are the weight-bearing radiographs and CT scan of a 33-year-old woman with persistent ankle pain 3 years after undergoing total ankle arthroplasty and subtalar arthrodesis. She sustained an open talar neck fracture that was treated with open reduction and internal fixation 6 years ago. She describes constant pain with weight-bearing activity despite supportive bracing and has noticed substantial loss of ankle motion. She denies fevers, chills, and prior wound complications. What is the most appropriate treatment method?
  2. Total ankle arthroplasty revision
  3. Ankle debridement and polyethylene exchange
  4. Revision subtalar arthrodesis and polyethylene exchange
  5. Component explantation, bone debridement, and tibiotalocalcaneal arthrodesis
  6. Lateralizing calcaneal osteotomy and dorsiflexion metatarsal osteotomy
A
  1. Component explantation, bone debridement, and tibiotalocalcaneal arthrodesis

RECOMMENDED READINGS

Berkowitz MJ, Sanders RW, Walling AK. Salvage arthrodesis after failed ankle replacement: surgical decision making. Foot Ankle Clin. 2012 Dec;17(4):725-40.Review. PubMed PMID: 23297436.

Berkowitz MJ, Clare MP, Walling AK, Sanders R. Salvage of failed total ankle arthroplasty with fusion using structural allograft and internal fixation. Foot Ankle Int. 2011 May;32(5):S493-502. doi: 10.3113/ FAI.2011.0493. PubMed PMID: 21733457.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q
  1. Figure 80 is the radiograph of a 58-year-old woman who has a painful hallux. She has pronation of the great toe upon standing, tightness of the adductor halluces, painless first metatarsophalangeal (MTP) range of motion, and pain at the first tarsometatarsal (TMT) joint. In addition to any distal soft-tissue procedure, the recommended surgical treatment should consist of
  2. first TMT arthrodesis.
  3. first MTP arthrodesis.
  4. distal Chevron osteotomy.
  5. proximal first metatarsal osteotomy.
  6. Silastic implant arthroplasty of the first MTP joint.
A
  1. first TMT arthrodesis.

RECOMMENDED READINGS

Thompson IM, Bohay DR, Anderson JG. Fusion rate of first tarsometatarsal arthrodesis in the modified Lapidus procedure and flatfoot reconstruction. Foot Ankle Int. 2005 Sep;26(9):698-703. PubMed PMID: 16174499.

Scranton PE, Coetzee JC, Carreira D. Arthrodesis of the first metatarsocuneiform joint: a comparative study of fixation methods. Foot Ankle Int. 2009 Apr;30(4):341-5. doi: 10.3113/FAI.2009.0341. PubMed PMID: 19356359.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q
  1. Figures 93a and 93b are the radiographs of a 34-year-old woman who has a 2-week history of first metatarsophalangeal (MTP) joint pain after sustaining a hyperextension injury while falling down her stairs. The hallux is stiff and mildly swollen. She has pain with resisted plantar flexion of the first joint. Initial treatment should consist of
  2. physical therapy.
  3. stabilization taping.
  4. a weight-bearing cast.
  5. a corticosteroid injection.
  6. manipulation under anesthesia.
A
  1. stabilization taping.

RECOMMENDED READINGS

George E, Harris AH, Dragoo JL, Hunt KJ. Incidence and risk factors for turf toe injuries in intercollegiate football: data from the national collegiate athletic association injury surveillance system. Foot Ankle Int. 2014 Feb;35(2):108-15. doi: 10.1177/1071100713514038. Epub 2013 Dec 11. PubMed PMID: 24334272.

Anderson RB, Hunt KJ, McCormick JJ. Management of common sports-related injuries about the foot and ankle. J Am Acad Orthop Surg. 2010 Sep;18(9):546-56. Review. PubMed PMID: 20810936.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q
  1. Figures 105a through 105c are the weight-bearing radiographs of a morbidly obese 38-year-old woman with diabetic peripheral neuropathy who has a 1-year history of a neuropathic plantar heel wound measuring 3 cm x 3 cm. There is a positive “probe-to-bone” test result, and peripheral pulses are audible by Doppler examination. The wound has been refractory to serial wound debridements, hyperbaric treatments, and local injection of growth factors. She denies fevers and chills, and her blood glucose levels and insulin requirements have not changed substantially. What is the most appropriate next step?
  2. Hindfoot arthrodesis
  3. Transtibial amputation
  4. Circular frame and fine-wire fixation
  5. Calcaneal saucerization and tendon Achilles lengthening
  6. Percutaneous Achilles lengthening and total contact casting
A
  1. Calcaneal saucerization and tendon Achilles lengthening

RECOMMENDED READINGS

Bollinger M, Thordarson DB. Partial calcanectomy: an alternative to below knee amputation. Foot Ankle Int. 2002 Oct;23(10):927-32. PubMed PMID: 12398145.

Smith DG, Stuck RM, Ketner L, Sage RM, Pinzur MS. Partial calcanectomy for the treatment of large ulcerations of the heel and calcaneal osteomyelitis. An amputation of the back of the foot. J Bone Joint Surg Am. 1992 Apr;74(4):571-6. PubMed PMID: 1583052.

Crandall RC, Wagner FW Jr. Partial and total calcanectomy: a review of thirty-one consecutive cases over a ten-year period. J Bone Joint Surg Am. 1981 Jan;63(1):152-5. PubMed PMID: 7451518.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q
  1. A 57-year-old woman developed flatfoot deformity 2 years ago. She has medial ankle pain and swelling. She also has posterior calf achiness with prolonged walking. What are the pathomechanics of her calf discomfort?
  2. Increased external leg rotation
  3. A more horizontal subtalar joint axis
  4. Plastic deformation of the plantar fascia
  5. Altered kinetics of the foot intrinsic muscles
  6. Inability to “lock” the transverse tarsal joints
A
  1. Inability to “lock” the transverse tarsal joints

RECOMMENDED READINGS

Sarrafian SK. Functional anatomy of the foot and ankle. In: Sarrafian SK, ed. Anatomy of the Foot and Ankle. Descriptive, Topographic, Functional, 2nd ed. Philadelphia, PA:Lippincott;1993:474-602.

Ringleb SI, Kavros SJ, Kotajarvi BR, Hansen DK, Kitaoka HB, Kaufman KR. Changes in gait associated with acute stage II posterior tibial tendon dysfunction. Gait Posture. 2007 Apr;25(4):555-64. Epub 2006 Jul 28. PubMed PMID: 16876415.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q
  1. Figure 130 is a standing radiograph of a 32-year-old woman with painful hallux valgus who now has pain over her medial eminence but no lesser-toe pain. She has failed nonsurgical treatment with shoe and activity modifications. There is no first-ray instability. The radiograph shows a 1-2 intermetatarsal angle of 17 degrees. What is the most appropriate surgical treatment?
  2. Akin osteotomy
  3. Distal Chevron osteotomy
  4. Keller resection arthroplasty
  5. First metatarsophalangeal (MTP) joint arthrodesis
  6. Proximal first metatarsal osteotomy with distal soft-tissue release
A
  1. Proximal first metatarsal osteotomy with distal soft-tissue release

RECOMMENDED READINGS

Easley ME, Kiebzak GM, Davis WH, Anderson RB. Prospective, randomized comparison of proximal crescentic and proximal Chevron osteotomies for correction of hallux valgus deformity. Foot Ankle Int. 1996 Jun;17(6):307-16. PubMed PMID: 8791076.

Dreeben S, Mann RA. Advanced hallux valgus deformity: long-term results utilizing the distal soft tissue procedure and proximal metatarsal osteotomy. Foot Ankle Int. 1996 Mar;17(3):142-4. PubMed PMID: 8919617.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q
  1. Figure 147 is the standing anteroposterior radiograph of a 22-year-old woman who has forefoot pain that developed 6 weeks ago without any antecedent injury. There is associated swelling; however, she has not had any fevers. Examination reveals tenderness along the third metatarsal shaft. What is the best next step?
  2. Observation
  3. Third-ray resection
  4. Protected weight-bearing
  5. Curettage and bone grafting
  6. 6 weeks of intravenous antibiotics
A
  1. Protected weight-bearing

RECOMMENDED READINGS

Shindle MK, Endo Y, Warren RF, Lane JM, Helfet DL, Schwartz EN, Ellis SJ. Stress fractures about the tibia, foot, and ankle. J Am Acad Orthop Surg. 2012 Mar;20(3):167-76. doi: 10.5435/JAAOS-20-03-167. Review. PubMed PMID: 22382289.

Rongstad KM, Tueting J, Rongstad M, Garrels K, Meis R. Fourth metatarsal base stress fractures in athletes: a case series. Foot Ankle Int. 2013 Jul;34(7): 962-8. doi: 10.1177/1071100713475613. Epub 2013 Feb 5. PubMed PMID: 23386752.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q
  1. Figures 158a and 158b are the weight-bearing radiographs of a 32-year-old woman who has persistent lateral ankle pain 6 months after sustaining a lateral ankle sprain. She attended a course of physical therapy and continues to use a lace-up ankle brace. She has intermittent pain along the anterior ankle with prolonged standing and walking. She has full ankle and hindfoot range of motion, generalized tenderness along the anterior joint line of the ankle, and a symmetric end point with ligamentous testing about the ankle. She has painless 4+ eversion strength when compared to the contralateral side. What is the most appropriate next step?
  2. CT scan
  3. MR imaging
  4. Cavus foot orthotic
  5. Boot immobilization
  6. More physical therapy
A
  1. More physical therapy

RECOMMENDED READINGS

Prado MP, Mendes AA, Amodio DT, Camanho GL, Smyth NA, Fernandes TD. A comparative, prospective, and randomized study of two conservative treatment protocols for first-episode lateral ankle ligament injuries. Foot Ankle Int. 2014 Mar;35(3):201-6. doi: 10.1177/1071100713519776. Epub 2014 Jan 13. PubMed PMID: 24419825.

Kemler E, van de Port I, Backx F, van Dijk CN. A systematic review on the treatment of acute ankle sprain: brace versus other functional treatment types. Sports Med. 2011 Mar 1;41(3):185-97. doi: 10.2165/11584370-000000000-00000. Review. PubMed PMID: 21395362.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q
  1. Figures 179a through 179c are the radiographs of a 61-year-old woman with insulin-dependent diabetes mellitus and peripheral neuropathy who sustained an ankle fracture-dislocation that was treated by open reduction and internal fixation 4 weeks ago. The incision healed uneventfully. There is erythema that decreases with elevation. What would have minimized risk for this complication?
  2. Early ankle mobilization
  3. Delayed internal fixation
  4. Presurgical bisphosphonates
  5. Postsurgical antibiotics for 2 weeks
  6. Additional internal or external fixation
A
  1. Additional internal or external fixation

RECOMMENDED READINGS

Wukich DK, Kline AJ. The management of ankle fractures in patients with diabetes. J Bone Joint Surg Am. 2008 Jul;90(7):1570-8. doi: 10.2106/JBJS.G.01673. Review. PubMed PMID: 18594108.

Jani MM, Ricci WM, Borrelli J Jr, Barrett SE, Johnson JE. A protocol for treatment of unstable ankle fractures using transarticular fixation in patients with diabetes mellitus and loss of protective sensibility. Foot Ankle Int. 2003 Nov;24(11):838-44. PubMed PMID: 14655888.

Perry MD, Taranow WS, Manoli A 2nd, Carr JB. Salvage of failed neuropathic ankle fractures: use of large-fragment fibular plating and multiple syndesmotic screws. J Surg Orthop Adv. 2005 Summer;14(2):85-91. PubMed PMID: 16115434.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q
  1. Figures 193a through 193c are the radiographs of a 53-year-old woman with diabetic peripheral neuropathy who had surgical treatment of an ankle fracture 3 months ago. She has noticed increased swelling and deformity during the last 3 weeks after initiation of weight-bearing activity despite boot immobilization. She denies major shifts in insulin requirements. Previous incisions are healed, and there are no wounds or areas of skin breakdown. What is the most appropriate next step?
  2. Arthrodesis
  3. Transtibial amputation
  4. Circular frame stabilization
  5. Revision open reduction and internal fixation (ORIF)
  6. Surgical debridement and intravenous antibiotics
A
  1. Arthrodesis

RECOMMENDED READINGS

Rammelt S, Pyrc J, Agren PH, Hartsock LA, Cronier P, Friscia DA, Hansen ST, Schaser K, Ljungqvist J, Sands AK. Tibiotalocalcaneal fusion using the hindfoot arthrodesis nail: a multicenter study. Foot Ankle Int. 2013 Sep;34(9):1245-55. doi: 10.1177/1071100713487526. Epub 2013 Apr 23. PubMed PMID: 23613330.

Thomas RL, Sathe V, Habib SI. The use of intramedullary nails in tibiotalocalcaneal arthrodesis. J Am Acad Orthop Surg. 2012 Jan;20(1):1-7. doi: 10.5435/JAAOS-20-01-001. PubMed PMID: 22207513.

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

Figures 200a and 200b are the radiographs of a 63-year-old woman with a long-standing bunion deformity that has become painful during the last year. Wide-toe-box shoes no longer provide relief, and she desires surgical correction. In addition to possible distal soft-tissue release, which procedure most effectively achieves correction?

  1. Distal metatarsal osteotomy and soft-tissue release
  2. Distal metatarsal and proximal phalanx osteotomies
  3. Proximal metatarsal osteotomy and soft-tissue release
  4. Proximal metatarsal and proximal phalanx osteotomies
  5. First tarsometatarsal realignment arthrodesis and soft-tissue release
A
  1. Distal metatarsal and proximal phalanx osteotomies

RECOMMENDED READINGS

Coughlin MJ, Saltzman CL, Anderson RB: Mann’s Surgery of the Foot and Ankle, 9th ed. Philadelphia, PA: Saunders 2014;155-321.

Jung HG, Kim TH, Park JT, Shin MH, Lee SH. Proximal reverse chevron metatarsal osteotomy, lateral soft tissue release, and akin osteotomy through a single medial incision for hallux valgus. Foot Ankle Int. 2014 Apr;35(4):368-73. doi: 10.1177/1071100713517099. Epub 2013 Dec 18. PubMed PMID: 24351657.

17
Q

211.

A 46-year-old woman has an 18-month history of plantar heel pain. She describes start-up symptoms that persist with activity throughout the day. She has failed night splinting, custom inserts, cortisone injections, and physical therapy. She has neutral-slight valgus hindfoot alignment. There is point tenderness over the plantar medial heel, a negative Tinel sign result, and a plantar heel spur as seen on radiographs. Ankle dorsiflexion is 15 degrees less than neutral with the knee in extension and 10 degrees with the knee in flexion. In addition to treatment of the plantar fascia, what is the most appropriate next step?

  1. Heel spur removal
  2. Gastrocnemius recession
  3. Tarsal tunnel release
  4. Achilles tendon lengthening
  5. Anterior ankle decompression
A
  1. Gastrocnemius recession

RECOMMENDED READINGS

Anderson JG, Bohay DR, Eller EB, Witt BL. Gastrocnemius recession. Foot Ankle Clin. 2014 Dec;19(4):767-86. doi: 10.1016/j.fcl.2014.09.001. Epub 2014 Nov 25. Review. PubMed PMID: 25456721.

Maskill JD, Bohay DR, Anderson JG. Gastrocnemius recession to treat isolated foot pain. Foot Ankle Int. 2010 Jan;31(1):19-23. doi: 10.3113/FAI.2010.0019. PubMed PMID: 20067718.

18
Q
  1. (Deleted)

The initial nonsurgical treatment of posterior tibialis tendon insufficiency with flexible pes planovalgus deformity and forefoot adduction consists of

  1. physical therapy.
  2. cast immobilization.
  3. an ankle-foot orthosis.
  4. a custom foot orthoses with lateral hindfoot posting.
  5. a custom foot orthoses with medial hindfoot posting.
A
  1. an ankle-foot orthosis.

RECOMMENDED READINGS

Chao W, Wapner KL, Lee TH, Adams J, Hecht PJ. Nonoperative management of posterior tibial tendon dysfunction. Foot Ankle Int. 1996 Dec;17(12):736-41. PubMed PMID: 8973895.

Augustin JF, Lin SS, Berberian WS, Johnson JE. Nonoperative treatment of adult acquired flat foot with the Arizona brace. Foot Ankle Clin. 2003 Sep;8(3):491-502. PubMed PMID: 14560901.

19
Q
  1. Figures 222a through 222c are the weight-bearing radiographs of a 57-year-old man with a history of flatfoot who has persistent foot pain. He underwent a subtalar arthrodesis 1 year ago. He states that his foot still “feels flat” compared to the contralateral foot. He is tender in the lateral subfibular area but is nontender in the sinus tarsi. What is the most appropriate next step?
  2. Lateral wall exostectomy
  3. Medial column arthrodesis
  4. Medializing calcaneal osteotomy and lateral column lengthening
  5. Extension of arthrodesis to triple arthrodesis
  6. Arthrodesis takedown with revision arthrodesis
A
  1. Arthrodesis takedown with revision arthrodesis

RECOMMENDED READINGS

Johnson JE, Yu JR. Arthrodesis techniques in the management of stage II and III acquired adult flatfoot deformity. Instr Course Lect. 2006;55:531-42. Review. PubMed PMID: 16958486.

Kadakia AR, Haddad SL. Hindfoot arthrodesis for the adult acquired flat foot. Foot Ankle Clin. 2003 Sep;8(3):569-94, x. Review. PubMed PMID: 14560906.

20
Q
  1. A 57-year-old man with diabetes mellitus has a plantar foot ulcer at the fifth metatarsal head. He has experienced no healing after 3 months of total contact casting. There is no erythema or drainage and his pedal pulses are palpable. Laboratory results reveal his white blood cell (WBC) count is within defined limits. His erythrocyte sedimentation rate is 21 mm/h (reference range [rr], 0-20 mm/h), and his C-reactive protein level is 2.9 mg/L (rr, 0.08-3.1 mg/L). Plain radiographs suggest only decreased mineralization of the metatarsal heads. Which diagnostic test is most appropriate at this time to help guide treatment?
  2. MR imaging
  3. CT scan
  4. Gallium scan
  5. Indium-111 WBC scan
  6. Technetium-99m bone scan
A
  1. MR imaging

RECOMMENDED READINGS

Ertugrul BM, Lipsky BA, Savk O. Osteomyelitis or Charcot neuro-osteoarthropathy? Differentiating these disorders in diabetic patients with a foot problem. Diabet Foot Ankle. 2013 Nov 5;4. doi: 10.3402/dfa. v4i0.21855. Review. PubMed PMID: 24205433; PubMed Central PMCID: PMC3819473.

Fujii M, Armstrong DG, Terashi H. Efficacy of magnetic resonance imaging in diagnosing diabetic foot osteomyelitis in the presence of ischemia. J Foot Ankle Surg. 2013 Nov-Dec;52(6):717-23. doi: 10.1053/j. jfas.2013.07.009. Erratum in: J Foot Ankle Surg. 2015 May-Jun;54(3):520. Armsrong, David G [corrected to Armstrong, David G]. PubMed PMID: 24160720.

21
Q
  1. Figures 245a and 245b are radiographs taken 4 weeks after a total ankle arthroplasty performed through an anteromedial approach. Which technical consideration may have most effectively prevented the complication shown here?
  2. Deltoid ligament lengthening
  3. A thinner polyethylene component
  4. A smaller press-fit tibial component
  5. A more proximal tibial cut
  6. A more lateral position of the tibial jig
A
  1. A more lateral position of the tibial jig

RECOMMENDED READINGS

Manegold S, Haas NP, Tsitsilonis S, Springer A, Märdian S, Schaser KD. Periprosthetic fractures in total ankle replacement: classification system and treatment algorithm. J Bone Joint Surg Am. 2013 May 1;95(9):815-20, S1-3. doi: 10.2106/JBJS.L.00572. PubMed PMID: 23636188.

McGarvey WC, Clanton TO, Lunz D. Malleolar fracture after total ankle arthroplasty: a comparison of two designs. Clin Orthop Relat Res. 2004 Jul;(424):104-10. Review. PubMed PMID: 15241150.

22
Q
  1. Which soft-tissue procedure is necessary to prevent deformity after partial foot amputation through the transverse tarsal joints?
  2. Achilles tendon lengthening
  3. Anterior tibialis transfer to the talar head
  4. Peroneus brevis transfer to the calcaneus
  5. Posterior tibialis transfer to the cuboid
  6. Extensor hallucis longus transfer to the cuboid
A
  1. Achilles tendon lengthening

RECOMMENDED READINGS

Dillon MP, Barker TM. Preservation of residual foot length in partial foot amputation: a biomechanical analysis. Foot Ankle Int. 2006 Feb;27(2):110-6.PubMed PMID: 16487463.

Chang BB, Jacobs RL, Darling RC 3rd, Leather RP, Shah DM. Foot amputations. Surg Clin North Am. 1995 Aug;75(4):773-82. Review. PubMed PMID: 7638721.

23
Q
  1. Which type of strengthening exercise is most successful in the setting of Achilles tendinopathy?
  2. Isometric open-chain
  3. Eccentric open-chain
  4. Eccentric closed-chain
  5. Concentric open-chain
  6. Concentric closed-chain
A
  1. Eccentric closed-chain

RECOMMENDED READINGS

Verrall G, Schofield S, Brustad T. Chronic Achilles tendinopathy treated with eccentric stretching program. Foot Ankle Int. 2011 Sep;32(9):843-9. PubMed PMID: 22097158.

Shalabi A, Kristoffersen-Wilberg M, Svensson L, Aspelin P, Movin T. Eccentric training of the gastrocnemius-soleus complex in chronic Achilles tendinopathy results in decreased tendon volume and intratendinous signal as evaluated by MRI. Am J Sports Med. 2004 Jul-Aug;32(5):1286-96. Epub 2004 May 18. PubMed PMID: 15262655.

24
Q
  1. What is the most common complication associated with ankle arthroscopy?
  2. Neurapraxia
  3. Arterial injury
  4. Deep infection
  5. Superficial wound infection
  6. Stiffness from joint distraction
A
  1. Neurapraxia

RECOMMENDED READINGS

Carlson MJ, Ferkel RD. Complications in ankle and foot arthroscopy. Sports Med Arthrosc. 2013 Jun;21(2):135-9. doi: 10.1097/JSA.0b013e31828e5c6c. Review. PubMed PMID: 23649162.

Zengerink M, van Dijk CN. Complications in ankle arthroscopy. Knee Surg Sports Traumatol Arthrosc. 2012 Aug;20(8):1420-31. doi: 10.1007/s00167-012-2063-x. Epub 2012 Jun 5. PubMed PMID: 22669362; PubMed Central PMCID: PMC3402678.

5. OITE (41 decks)

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