Foot&Ankle Flashcards
Fleck sign
Small avulsion fx of 2nd met bone
XR needed for lisfranc injury
Weight bearing XR
Lisfranc ligament runs from
Medial cuneiform to 2nd met bone (dorsal and plantar lig, strong interos lig)
What must be disrupted for crossover toe
Plantar plate
Tx for mod severe Hallux valgus without arthritic changes
Bunionectomy with prox met osteotomy
Female athlete triad
Osteopenia, anorexia, amenorrhea
Total ankle replacement
Age 60 or older, low demand, minimal deformity
Wound and total ankle 3 weeks compared to 6 weeks out
3 weeks is acute infection: poly exchange
6 weeks is chronic infection: remove total ankle and place abx spacer
Ankle fusion for what patient
End stage arthritis, active patients who have failed nonsx tx
Arthroscopic debridement and cheilectomy of ankle for what patient
Bony impingement as mild arthritis with little articulate cartilage loss
Stress syndesmosis is most important in which ankle fractures
Pronation external rotation
Tx for acute Charcot foot and pathophys of bone destruction
Total contact casting
Bone destruction via hypervascularity
Cause of hammertoe
Contraction of FDL
Severe disease
Calcaneal apophysitis
Activity modificarion
Most common cause or adult acquired flat foot
Post tib tendon dysfunction
Tearing of calcaneonavicular (spring lig) and gastroc contracture
Initial tx and sx tx for flat foot
AFO and PT
Rigid-fusion
Flex-FDL transfer, calf osteotomy, lat column lengthening, medial dorsal opening wedge osteotomy of medial cuneiform
Tx of osteochondral lesions of talar dome
Small less than 1.5cm noncystic-scope debridement and drilling
Cystic with cartilage surface intact-retrograde drilling and bone graft
Small cystic and unstable-malleolar osteotomy and osteochondral graft
Different Tx of hallux valgus for ima and hva angle
Ima less than 15 and hva less than 35: distal osteotomy if joint congruent
Ima greater than 25 and hva greater than 35: prox osteotomy, lapidus bunionectomy if prox osteotomy failed
Ima less than 11 and hva less than 25: soft tissue recon if joint incongruent
Large dmaa angle and normal
Ima: biplanar distal chevron osteotomy
Tx for flatfoot dependent on pain and rigidity
No pain: obs
Initial tx for painful flatfoot: cast
Rigid flatfoot and pain: triple arthrodesis, Arizona brace if not stable
Resection of prox phalanx results in
Floppy toe
Tx for hallux rigidus
Lesser joint destruction: cheilectomy
More destruction: fusion
Chopart joint
What is it and block to reduction
Talonav and calccuboid
Tib post is block to reduction
Most common coalition locations
Treatment of coalitions
Talocalcaneal and calcaneonavicular
Tx: rest and temporary cast
Sx: less than 50% and young: resection and interposition of fatty tissue
Greater than 50: fusion
Severe disease
Kohler disease
Freiberg infarction
Thiemann disease
Traction apophysitis at Achilles’ tendon
Tarsal navicular
Lesser met head
Great toe phalanx
What is the primary stabilizer of the lesser mtp joint
Plantar plate
Neuromas: Most appropriate orthotic Compressions neuropathy from what structure Advantage of plantar approach Complication with steroid injection Type of nerve degeneration
Metatarsal pad Intermet lig Better access to neuroma Hammertoe deformity Perineural Fibrosis of intermet nerve 2nd and 3rd webspace
Complication if lisfranc is ORIF but only ligamentous injury (should have been fused)
Persistent pain and arthritis
Strongest lig in lisfranc
First lig to fail in lisfranc
Oblique interosseous
Dorsal ligaments weakest
