Foot/Ankle Flashcards
Foot bone at risk of AVN and why?
Talus, retrograde blood supply
Which tendon passes through groove on cuboid bone?
Peroneus longus
Which muscle inserts on the tuberosity of naviular
Posterior tibialis
Which muscle inserts on base of 5th MT?
Peroneus brevis
Contents of tarsal tunnel?
Within medial malleolus Tibialis posterior FDH Posterior tibial A, V, N FHL
2nd MT aligns with which bone?
medial cuneiform
Weber/AO classification
Ankle fx (fibula) based on relation to plafond
A: distal to plafond (tibial plane)
B: at plafond
C: proximal to plafond (torn syndesmosis common)
Lange-Hansen classification
Ankle fx based on foot position and mechanism SA: supination/adduction I-II SER: supination/ER I-IV PER: pronation/ER I-IV PA: pronation/abduction I-III
Essex-Lopresti fx
Fx of calcaneus
Either tongue-type or joint depression
Sanders fx
Calcaneus based on coronal CT findings
I-IV: how many fragments/fracture lines
A-C: lateral to medial
Rule out with ankle fx?
Spine injury
Bohler’s angle
Lines drawn tangential to anterior and posterior aspects of the calcaneus. May indicate fx if
Hawkins classification
Talus neck fx. Predicts AVN risk
I: nondisplaced (
Hawkin’s sign
Resorption of subchondral bone in talus (lucency on XR) indicates fracture healing
Fleck sign
Avulsion of lisfranc ligament from 2nd MT base
Lisfranc (TMT joint) classification
Isolated, homolateral, divergent
MT base fx classification
Zone 1: avulsion fx
Zone 2: metadiaphyseal jxn (Jones fx)
Zone 3: proximal diaphysis (stress fx)
Jones fx?
Zone 2 fx of MT base (metadiaphysial)
1 and # 2 injured ligaments in ankle sprains
ATFL #1, CFL #2
Action of ATFL?
Resists anterior motion
Action of CFL?
Resists inversion
Action of deltoid ligament?
Resists eversion
Ankle relocation blocked by which tendons?
EDB (medial) or PT (lateral)
Morning foot pain?
Plantar faciitis
Thompson test
Squeeze calf, absent foot plantarflexion = achillies tendon rupture
Ankle anterior drawer
Stabilize tibia, PF foot, anterior force. Tests lateral ligament (esp. ATFL)
Talar tilt
Stabilize tibia, DF foot, invert foot. Tests lateral ligaments (esp. CFL)
Ext. rotation stress
Stabilize tibia, ER foot. Tests deep deltoid and syndesmotic ligaments
Eversion stress
Stabilize tibiam evert foot. tests superficial deltoid ligament
Squeeze test
Compress distal tibia/fibula. Pain may indicate syndesmosis injury
Heel rise
Standing, rise onto toes. Heel should go into varus. No varus in PTTD.
Coleman block
Lateral foot and heel on block; 1st ray hands free. Flexible hind foot varus: ankle will go into valgus or neutral on block. Fixed hind foot varus: ankle will stay in varus on the block.
Tinel’s sign (ankle)
Tap nerve posterior to MM. Tingling may indicate tibial nerve entrapment in tarsal tunnel.
Compression test ankle
Squeeze foot at MT heads. Pain or numbness/tingling may indicated interdigital (Morton’s) neuroma
Phases of gait (8) and important muscles
1: heel strike (TA)
2: Foot flat (gastroc)
3: Midstance
4: Heel off (PT+gastroc)
5: Toe off
6: preswing
7: midswing
8: terminal swing
1st layer of foot and innervation
Abductor hallucis (MP)
Flexor digitorum brevis (MP)
Adbuctor digiti minimi (LP 1st branch)
2nd layer of foot and innervation
Quadratus plantae (LP) Lumbricals (1 - MP, 2-4 - LP) FHL, FDL tendons
3rd layer of foot and innervation
Flexor hallucis brevis (MP)
Adductor hallucis (LP)
Flexor digiti minimi brevis (LP)
4th layer of foot an innervation
Plantar interossei (3) (LP) Dorsal interossei (4) (LP) PL and TP tendons
Possible entrapment of lateral plantar n?
Abductor DM fascia
What artery supplies talar head and neck?
Direct talar branches from dorsalis pedis
What decreases achilles tendon rerupture?
Surgical repair
1 musculoskeletal injury?
Ankle sprain
Gout findings PE and lab
1st MTPJ, negatively birefringent crystals (yellow when parallel)
Hallux rigidus findings on XR?
Dorsal osteophyte or OA
Hallux Valgus angle?
> 15°
Morton neuroma locations?
2nd and 3rd interdigital space
Acquired hindfoot cause and stages?
PT tendon failure
Stage 1: tenosynovitis, no deformity
Stage 2: Pes planus, flexible hindfoot, no single heel raise
Stage 3: rigid hindfoot,
Haglund’s disease
Retrocalcaneal bursitis
Baxter’s nerve?
1st branch of LP nerve
Seronegative spondyloarthropathy, findings?
Psoriasis: Sausage ditit, pencil in cup deformity
Neg RF
Deformity of clubfoot?
CAVE Cavus midfoot forefoot Adductus subtalar Varus hindfoot Equinus
Rigid flatfoot types
1) Tarsal coalition: fusion of two tarsal bones
Calcaneonavicular #1, Talocalcaneal #2.
2) Congenital vertical talus
Anterolateral approach to ankle
IN planes, dangers
IN planes - peroneals (superficial peroneals)
EDL (deep peroneal)
Dangers: Deep peroneal n, anterior tibial artery
Arthroscopy portals ankle (3)
Anteromedial - Saphenous nerve and vein
Anterolateral - superficial peroneal nerve
Posterolateral - sural nerve, lesser saphenous vein
