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OCS Cards > Foot & Ankle > Flashcards

Foot & Ankle Flashcards

1
Q

What are the three components of supination?

A

Inversion, adduction and plantar flexion

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2
Q

What plane does inversion of the foot occur in?

A

Frontal

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3
Q

What plane does adduction of the foot occur in?

A

Transverse

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4
Q

What plane does plantar flexion of the foot occur in?

A

Sagittal

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5
Q

What are the three components of pronation?

A

Eversion, abduction and dorsiflexion

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6
Q

What plane does eversion of the foot occur in?

A

Frontal

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7
Q

What plane does abduction of the foot occur in?

A

Transverse

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8
Q

What plane does dorsiflexion of the foot occur in?

A

Sagittal

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9
Q

What is the Chopart joint?

A

Transverse tarsal - talonavicular and calcaneocuboid

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10
Q

What is the LisFranc joint?

A

Tarsal-metatarsal joints

cuneiforms and cuboids - metatarsals

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11
Q

What ligament prevents anterior displacement of the talus relative to the mortise?

A

ATFL

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12
Q

What ligament of the ankle is taut with inversion and adduction of the calcaneus relative to fibula?

A

CFL

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13
Q

What ligament is taut with ER of the talus relative to the ankle mortise?

A

Posterior talofibular ligament

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14
Q

What two ligaments work together to limit supination of the subtalar joint?

A

Calcaneofibular and cervical ligaments

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15
Q

Damage to this ligament can result in excessive supination of the subtalar joint?

A

Interosseous ligament

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16
Q

What bones constitute the midfoot?

A

Cuneiforms, navicular, cuboid

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17
Q

What ligament, with no attachment to the talus, prevents plantar flexion of the talus?

A

Calcaneonavicular or spring ligament

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18
Q

The Chopart joint joins which two parts of the foot?

A

Hind foot -> mid foot

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19
Q

The talonavicular joint is supported on the plantar surface by what ligament?

A

Spring or calcaneonavicular ligament

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20
Q

What bones create the transverse arch of the foot?

A

Intertarsal joints (cuneiforms, navicular, cuboid and navicular)

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21
Q

Which Lisfranc/tarsometatarsal joint is the most commonly injured joint?

A

2nd metatarsal with medial cuneiform - interosseous ligament

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22
Q

What muscle may have role in supporting transverse arch with an attachment at base of 1st metatarsal and medial cuneiform?

A

Fibularis longus

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23
Q

Which muscle is the largest in surface area and strength for supination of the subtalar joint?

A

Posterior tibialis - supporters -> flexor digitorum longus, flexor hallucis longus

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24
Q

Which muscle has larger moment arm for subtalar supination - anterior or posterior tibialis?

A

Posterior tib -

Anterior tib has 1/5 the moment arm

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25
Q

With size/shape of talocrural joint - which motion is joint more congruent?

A

Wider anteriorly than posteriorly -> more congruent in dorsiflexion

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26
Q

What movements occur in weight bearing supination in reference to calcaneus and talus?

A

Calcaneus ->inversion

Talus -> abduction and dorsiflexion (ER of tibfib)

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27
Q

What movements occur in weight bearing pronation in reference to calcaneus and talus?

A

Calcaneus ->eversion

Talus ->adduction and plantar flexion (IR of tibfib)

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28
Q

NWB supination is a combination of: (only calcaneal movement)

A

Inversion, adduction, plantar flexion

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29
Q

NWB pronation is a combination of: (only calcaneal movement)

A

Eversion, abduction and dorsiflexion

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30
Q

What ligament supports calcaneocuboid joint?

A

Long plantar ligament - one of strongest in body = minimal movement

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31
Q

Which joint is more mobile: talonavicular or calcaneocuboid?

A

Talonavicular

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32
Q

A loss of plantar fascial support inc the load on what two ligaments:

A

1) calcaneonavicular - spring

2) long plantar ligament (calcaneocuboid)

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33
Q

At IC of gait cycle: what position is the foot in?

A

Slight dorsiflexion

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34
Q

During gait cycle, when do plantar flexors start to become active? (what phase)

A

Late midstance -> pre-swing

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35
Q

What muscle decelerates tibia after flat foot/midstance?

A

Soleus

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36
Q

What motions does the subtalar joint move from and then to at IC to flat foot and then terminal stance?

A

Pronation (at IC/flat foot) to supination (terminal stance)

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37
Q

What muscle eccentrically lowers MLL at IC and during midstance phase?

A

Tibialias anterior

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38
Q

What muscle becomes eccentrically active before flat foot to control for pronation of the MLL?

A

Tibialis posterior

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39
Q

How many degrees of motion occur at the MLL with walking?

A

10 deg

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40
Q

What is normal ROM for great toe/hallux/MTP motion duriing pre-swing?

A

40-60 deg dorsiflexion

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41
Q

During running/sprinting, what percentage of moment energy is contributed by the digits/toes?

A

20-50%

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42
Q

When transferring energy from Achilles to and through the midfoot, what is more problematic: laxity of the midfoot or rigidity?

A

Laxity - excessive plantarflexion of talus results in subluxation of posterior facet of subtalar joint -> inc load on calcaneonavicular/spring ligament which can rupture

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43
Q

A variety of clinical conditions can contribute to excessive pronation(10 listed): what are examples?

A 
Gastroc/soleus tightness
PTT dysfunction
midfoot laxity
abduction of forefoot
ER of hindfoot
subluxation of alus
traumatic deformities
ruptured plantar fascia
Charcot foot
neuromuscular imbalance
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44
Q

Is there a strong correlation between static measurement of foot posture and foot kinematics?

A

Yes - McPoil found measurement of MLL statically and identical measure dynamically at midstance

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45
Q

What are believed to be causes of high arch/pes cavus?

A

Over activity of PTT or tib anterior or both - or ER of tibia with proximal control issue

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46
Q

What is the Coleman block test?

A

Identify foot posture with quiet, static standing and then have pt stand on 1” block with lateral foot and heel on block - does midfoot respond with rigidity or flexibility? (Looking at 1st-3rd metatarsals)

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47
Q

What is the peek a boo sign?

A

Observation of medial heel when looking at a person from the front due to excessive supination

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48
Q

What is the too many toes sign?

A

Observation of lateral toes (digits 3-5) when looking at a person from behind due to excessive pronation - PTT dysfunction

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49
Q

Which outcome measures are validated for ankle instability?

A

Cumberland Ankle Instability Tool (CAIT) and Ankle Instability Index (AII)

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50
Q

Which outcome measure looks at plantar fasciitis, Achilles tendinopathy, CAI?

A

Foot and ankle ability measure (FAAM)

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51
Q

What exam is a valid and reliable assessment tool for foot posture?

A

Foot posture index

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52
Q

What are generalized outcomes for the Foot Posture Index?

A

Neutral = 0
Highly pronated > +10
Highly supinated < -10

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53
Q

In runners with higher arches, what two injuries are more prominent?

A

Ankle sprains, bony injuries to 5th metatarsal

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54
Q

What is the expected average change in height in the Arch height index from NWB to WB?

A

10 mm or 13.4%

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55
Q

In the navicular drop test, what is the cutoff for abnormal findings?

A

Difference of 10 mm between NWB and WB

> 10 mm = risk factor for medial tibial stress syndrome

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56
Q

When assessing the heel raise, what might a lower height indicate in terms of dysfunction? (Normative = 55-65% of length of foot)

A

1) weakness - dec ability to plantar flex body weight
2) dec length of PFs
3) midfoot instability (flat foot deformity)

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57
Q

What is considered to be more severely tight in terms of dorsiflexion AROM? (less than…)

A

5 deg - average is 18 deg

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58
Q

With a tight first MTP joint, where is the center of pressure shifted during walking?

A

Laterally

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59
Q

Is MMT valid for plantar flexors?

A

No - need to do heel raise test

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60
Q

Name the special test: ankle in 10-20 deg of plantar flexion, gentle pull of calcaneus anteriorly and looking at amt of translation (positive outcome?)

A

Anterior drawer test - > 3 mm of translation or pain in region anterior/inferior to malleolus
(questionable reliability)

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61
Q

Name the special test: 20 deg of plantar flexion // 10 deg of dorsiflexion - apply maximal inversion (positive outcome?)

A

Talar tilt - plantar flexion looks more at ATFL // dorsiflexion looks more at CFL - but unable to distinguish which is injured - positive test is pain in region inferior to lateral malleolus, >15 deg or empty end feel

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62
Q

Name the special test: knee is flexed at 90 deg, flexion of ankle maximally in dorsiflexion and passive ER (positive outcome)

A

Dorsiflexion-ER test - positive is anterolateral pain in area of syndesmosis

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63
Q

Name the special test: squeeze fibula and tibia together (NWB) above midpoint of calf (positive outcome)

A

Squeeze test - positive test pain in area of syndesmosis (good specificity)

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64
Q

Name the special test: stabilize distal tibia and grasp rear foot, move talus and calcaneus medially/laterally (positive outcome)

A

Cotton test - positive test is translation of talus in mortise - syndesmotic injury

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65
Q

Name the special test: stabilize distal tibia and move lateral malleolus anterior to posterior (positive outcome)

A

Fibula translation test - positive is pain reproduced along syndesmosis

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66
Q

Name the special test: pt in prone, knee flexed to 90 deg, compress gastroc/soleus complex at middle third (positive outcome)

A

Thompson test - positive no associated ankle motion = Achilles tendon rupture - high sensitivity and specificity (90+)

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67
Q

Name the special test: pt in prone, palpation for most significant tender portion of Achilles, have pt actively dorsiflex ankle (positive outcome)

A

Royal London Hospital Test - positive test is repeated palpation of tender spot has decreased or absent pain in dorsiflexion = Achilles tendinopathy - highly specific

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68
Q

Name the special test: pt in prone, active pf/df with watching for area of maximal swelling (positive outcome)

A

Arc sign - positive is edema moves proximal to distal during motion = tendinopathy - high specificity

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69
Q

Name the special test: pt in prone, knee flexed to 90 deg - AROM for pf then df and follow with resisted eversion (positive test)

A

Fibularis subluxation - subluxation/dislocation of fibularis tendons - indicative of instability

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70
Q

Name the special test: observe foot/calcaneal position during stance -> have pt stnad with calcaneus and lateral foot (4/5) on one in step (positive outcome)

A

Coleman block test - looking at rigidity or flexibility of rear and forefoot deformity

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71
Q

Name the special test: pt standing with equal weight between feet, toes off edge of step -> passively extend 1st MTP until reproduction of sxs or end range df (positive outcome)

A

Winlass test - positive test reproduces sxs along plantar fascia - indicative of plantar fasciitis (high specificity)

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72
Q

Name the special test: palpate for mass between 2nd/3rd or 3rd/4th metatarsals - push mass between met head and then grasp around forefoot compressing heads together (positive outcome)

A

Mulder click test - pt experiences pain with pressing mass to plantar surface coupled with examiner feeling palpable click - mass is likely neuroma

73
Q

Name the special test: foot/ankle in neutral position - tap along pathway of posterior tibial nerve (MLL to above medial malleolus) (positive outcome)

A

Tinels sign - pt sxs are reproduced at site of tapping or referred into foot

74
Q

Name the special test: with the knee extended, passively dorsiflex the ankle (positive outcome)

A

Homan sign: pain in the calf may indicate DVT - LOW specificity and sensitivity

75
Q

Are pitch angles in a radiograph high for supinated feet or pronated feet?

A

High in supinated feet - low in pronated feet

76
Q

In an ultrasound, what do hypoechoic (dark) regions within the tendon indicate?

A

Abnormal tendon structure / tendinopathy

77
Q

In an ultrasound, what does fluid around the tendon indicate?

A

Peritendinitis

78
Q

In an ultrasound, what does fluid adjacent to the tendons indicate?

A

Bursitis

79
Q

At what age do children develop normal footprints with set arch height?

A

12-13 y.o.

80
Q

What is the most common cause for acquired flat foot in adults?

A

Tib posterior tendon dysfunction

81
Q

Pes cavus foot deformity can be associated with two different conditions of the foot: (2)

A

1) Charcot foot

2) spastic neurological conditions

82
Q

Pes cavus is associated with high rates of what common foot ailment:

A

Plantar fasciitis

83
Q

Which foot deformity is characterized by lateral deviation of great toe corresponding to medial deviation of the 1st metatarsal (bunion)?

A

Hallux valgus

84
Q

Does hallux valgus have a genetic component?

A

Yes - >60% have family hx

85
Q

Is hallux valgus more common in women or men?

A

Women - 2-3x more

Women with lower BMI
Men with higher BMI

86
Q

Does hallux valgus result in inc fall risk?

A

Yes

87
Q

How is halux valgus defined:

A

> 15 deg of deviation of hallux from first metatarsal

88
Q

What joint does a hammer toe affect?

A

IP flexion deformity - most commonly 2nd due to being longer

89
Q

What joint does a claw toe affect?

A

Both IP flexion and MTP extension - typically all toes due to neuromuscular disorder

90
Q

Is the extensor digitorum able to correct/extend the PIP joint with the MTP in neutral, flexed or extended positions?

A

Neutral and flexed - only if deformity is flexible; tenodesis of the extensors

91
Q

What deformity is abnormal flexion of the DIP?

A

Mallet toe

92
Q

What toe does mallet toe typically occur at?

A

2nd (poorly fitting shoes)

93
Q

What are the main ligamentous supports of the distal tibiofibular joint?

A

Anterior inferior tibiofibular ligament - posterior inferior tibiofibular ligament - syndesmosis between tib/fib

94
Q

What is the primary MOI for a high ankle sprain/

A

ER with dorsiflexion of tibia on planted foot

95
Q

What are two indicators with syndesmotic special testing that may help confirm high ankle sprain?

A

1) pain out of proportion to the injury
2) pain at the knee or shank during injury
- also pain with forceful DF/passive ER

96
Q

What grade syndesmosis injury requires immobilization or internal fixation?

A

Grade 2-3 - significant gapping, screw fixation 1-3 cm proximal to ankle

97
Q

What percentage of pt’s have objective mechanical laxity after lateral ankle sprain?

A

30%

98
Q

Ottawa ankle rules:

A

1) bone tenderness in malleolar zone along medial or lateral malleoli, talar neck/head
2) bone tenderness at posterior edge or tip of lateral malleolus / posterior edeg or tip of lateral malleolus - base of 5th metatarsal - navicular
3) inability to bear weight immediately following injury and during exam

99
Q

What are the three Bernese rules added to the Ottawa ankle rules to inc specificity and dec false positives?

A

1) indirect fibular stress - compress fibula,tibia together approx 10 cm proximal to fibular tip
2) direct medial malleolar stress - thumb pressed flat on medial malloelus
3) compression stress on mid/hindfoot - stabilized calcaneus in neutral, apply sagittal load on forefoot to compress mid/hind foot

100
Q

Typical characteristics of Grade I ankle sprain:

A

No loss of function, no ligamentous instability, little to no ecchymosis, less than 5 deg ROM loss, less than 0.5 cm selling

101
Q

Typical characteristics of Grade II ankle sprain:

A

Some loss of function, positive anterior drawer/negative talar tilt, ecchymosis, swelling and point tenderness, dec ROM between 5-10 deg, swelling 0.5 cm to 2 cm

102
Q

Typical characteristics of Grade III ankle sprain:

A

Near total loss of function, positive talar tilt and anterior drawer tests, ecchymosis, extreme point tenderness, decreased ROM >10 deg, swelling > 2 cm, loss of ability to bear weight

103
Q

What are two factors are the current best evidence of indicators for reinjury with lateral ankle sprain?

A

1) exposure to court sports / indoor sports

2) poor balance

104
Q

What is a good prognostic indicator for lateral ankle sprain?

A

Lack of WB pain with dorsiflexion

105
Q

What is a negative prognostic indicator for lateral ankle sprain?

A

Limited dorsiflexion is factor for re-injury

106
Q

What are 5 factors for high risk of reinjury with lateral ankle sprains?

A

1) hx of previous ankle sprain
2) failure to use external support
3) failure to warm up with static stretch/dynamic movement
4) lacking normal ankle DF
5) failure to participate in balance prevention program after injury

107
Q

Do pts always demonstrate ankle joint laxity with side/side comparisons with injury?

A

No - functional ankle instability is used to distinguish lack of mechanical instability

108
Q

Does joint laxity or mechanical instability after an ankle sprain contribute to development of Chronic Ankle Instability (CAI)?

A

No - contributes little - more a perceived instability due to sensorimotor theory (dec joint position sense, impaired sensory pathway)

109
Q

What targeted manual therapy mobilization had immediate effect and maintained effect for 6 months with improved dynamic balance and perception of instability?

A

Specifically addressing dorsiflexion

110
Q

Is clinical evaluation sensitive enough to detect ankle mechanical laxity?

A

May not be - may require stress radiographs; > 7 deg talar tilt - anterior displacement of 4 mm

111
Q

Besides manual therapy, what else can be done to aid with anterior impingement?

A

Heel lift

112
Q

When is OA of the ankle common?

A

Post-traumatically - 62% associated with fracture

113
Q

What is a common prognostic factor leading to ankle OA?

A

Osteochondral defect of talar dome

114
Q

Where is a heel spur common in plantar fasciopathy?

A

Medial calcaneal tubercle

115
Q

What are factors for developing plantar fasciopathy?

A

Obesity
DM
decreased DF ** strongest predictor
Time spent on feet

116
Q

What ROM for AROM dorsiflexion is 23x more likely to develop plantar fasciopathy?

A

0 deg or less

117
Q

Does taping have a short term or long term improvement for plantar fasciopathy?

A

Short term

118
Q

Which has greater improvement: pre-fab or custom orthotics for plantar fasciopathy?

A

Marginal improvement in custom compared to pre-fab -> cost?

119
Q

What foot position may benefit more from custom foot orthoses for plantar fasciopathy?

A

Rigid and fixed flat foot deformity

120
Q

True / false: The Achilles tendon is directly attached to the plantar fascia.

A

True - need neutral arch position to adequately stretch Achilles/PF combo

121
Q

What proximal limitation in the hip contributes to the lowering of the MLL and thus plantar fasciopathy?

A

Limitations in ER

122
Q

What has better outcomes in plantar fasciopathy: plantar fasciotomy or gastroc lengthening procedure?

A

Gastroc lengthening/recession -

123
Q

Where is the sustentaculum tali located?

A

Inferior to and slightly anterior to the medial malleolus, where calcaneus articulates with talus

124
Q

Where is the sinus tarsi located?

A

Slightly inferior and anterior to lateral malleolus, tunnel between calcaneus and talus.

125
Q

Is a flat foot, neutral foot or supinated foot more likely to develop Sinus Tarsi Syndrome?

A

Flat foot due to compression of anatomy in the tunnel

126
Q

Where is the Lis Franc ligament?

A

Medial aspect of first cuneiform attaching to base of second metatarsal

127
Q

What injury is diagnosed based on the degree of separation between 1st and 2nd metatarsals?

A

Lis Franc injury
Stage 1 - no change in
separation; no loss MLL height
Stage 2 - 1-5 mm separation; no loss MLL height
Stage 3 - >5 mm separation; loss of MLL height

128
Q

What disease is characterized by calcaneal apophysitis caused by inflammation of secondary calcaneal ossification open in childhood due to Achilles tendon traction on bone fragment?

A

Sever’s disease

129
Q

Severe’s disease affects which gender more predominantly?

A

Boys > girls

130
Q

Sever’s disease typically impacts children/adolescents playing what type of sports?

A

Higher impact (running, soccer)

131
Q

Why would a growth spurt contribute to development of Sever’s disease?

A

Greater tension on Achilles tendon -> greater deg of traction on ossification center

132
Q

What two special tests in combination are very specific (100%) in diagnosing Sever’s disease?

A

1) one leg heel raise

2) squeeze test: compress lateral sides of calcaneus just anterior and on either side of Achilles to reproduce pain

133
Q

What disease is a rare and uncommon childhood disease consisting of osteochondrosis of the navicular bone?

A

Kohler’s disease

134
Q

Typically, how long does it take the navicular to reconstitute itself with Kohler’s disease?

A

8 months - tx: soft arch support, activity modification - severe cases may require casting

135
Q

What disease is characterized by disturbance in the dorsalis pedis or medial plantar artery supplying the navicular?

A

Kohler’s disease

136
Q

What disease is classified by degenerative arthritis of the first MTP joint?

A

Hallux rigidus

137
Q

Does hallux rigidus affect males or females more often?

A

Females

138
Q

What is the grading system for Hallux Rigidus:

A

Grade 0: df 40-60, normal xray
Grade 1: 30-40 df, minimal joint change
Grade 2: 10-30 df, mild-mod joint narrowing, sclerosis
Grade 3: <10 df, < 10 pf, severe xray changes, constant pain
Grade 4: same as 3, but pain with any ROM

139
Q

What metatarsals are the common sites for metatarsalgia?

A

1st and 3rd

140
Q

What other anatomical feature is affected with 1st MTP metatarsalgia?

A

Sesamoid bones -> sesamoiditis

141
Q

Where in the foot is the most common place to develop Morton’s neuroma?

A

Between 3rd-4th metatarsals - 3rd webspace

142
Q

What may develop due to excessive dorsiflexion of the metatarsals as a result of flat foot deformity?

A

Morton’s neuroma

143
Q

What is one of the most common overuse injuries in the foot in terms of tendinopathy?

A

Noninsertional Achilles tendinopathy

144
Q

What is one of the most important factors in development of noninsertional Achilles tendinopahty?

A

Age - most common in 41-60 y.o.; also sedentary, obese

145
Q

What technique with landing inc risk for noninsertional Achilles tendinopathy?

A

Forefoot landing / toe landing strategy

146
Q

Does noninsertional Achilles tendinopathy have intermittent or constant sxs?

A

Intermittent - stiffness with NWB (sleeping)

147
Q

What questionnaire is valid and reliable for Achilles tendinopathy?

A

VISA-A: Victorian Institute of Sports Assessment-Achilles

148
Q

Does an athletic or non-athletic individual respond better to eccentric loading for Achilles tendinopathy?

A

Athletic - does have positive results either way - non-athletic is perform as tolerated, not through pain

149
Q

What is the typical duration of sxs with noninsertional Achilles tendinopathy?

A

3-6 months; 40-65% report complete resolution within this time

150
Q

What is the key characteristic of insertional Achilles tendinopathy?

A

Swelling within 2 cm of bony insertion

151
Q

Which has a poorer prognosis; insertional or noninsertional Achilles tendinopathy?

A

Insertional - 50% success rate

152
Q

Do bone spurs, Haglunds deformities impact long term outcome for insertional Achilles tendinopathy?

A

No - improve despite this involvement

153
Q

What recommendation on eccentric heel lowering is recommended for those with Haglunds deformity / impingement of superior aspect of calcaneus?

A

Limiting the movement to 0 deg for lowering

154
Q

At what age does the incidence of Achilles rupture increase?

A

> 50 y.o.

155
Q

What gender is more greatly affected by Achilles tendon rupture?

A

Males, 3-4x greater

156
Q

Do operative and non-operative approaches have similar rates of re-rupture and/or DVT?

A

Yes

157
Q

Is research trending toward immediate WB or immobilization for Achilles tendon rupture (surgical or non-surgical route)?

A

Immediate WB -> earlier return to work, greater satisfaction

Brumann states immediate full WB with immobilization in plantar flexion

158
Q

What is the leading cause of acquired flat foot deformity?

A

PTT dysfunction

159
Q

Are males or females more greatly affected by PTT dysfunction?

A

Females (80%) - obesity /overweight is also key factor

160
Q

What ligament is highly affected by PTT dysfunction?

A

Spring (calcaneonavicular) ligament

161
Q

What three muscles work synergistically to contribute to subtalar inversion/supination?

A

Flexor hallucis longus, flexor digitorum, posterior tibialis

162
Q

At what stage does PTT dysfunction become rigid?

A

Stage III

163
Q

What distinguishes between Stage 1 and 2 for PTT?

A

Flat foot deformity - flexible

164
Q

What are key exam findings distinguishing lateral ankle sprain from fibularis tendon subluxation?

A

Pain along lateral and posterior region of foot, 2-3 cm distal to lateral malleolus - occurs in cuboid tunnel or at insertion of base of 1st metatarsal

165
Q

What is the most common treatment for fibularis muscle subluxation?

A

Due to anatomical incongruities - most often is surgical

166
Q

Is osteoporosis a risk factor for ankle fractures?

A

No, but is factor in healing time

167
Q

What is the golden time frame for recovery of strength, ROM, function for an ankle fracture?

A

6 months - after 6 months, varied and slow recovery

168
Q

What is mallolar tertius?

A

The lateral and posterior aspect of the tibia

169
Q

Which of the Weber ankle fractures are more severe?

A

B and C due to involvement of syndesmosis and malleolar tertius

170
Q

What defines trimalleolar fracture?

A

Medial, lateral and malleolar tertius

171
Q

What are negative prognostic factors affecting long term outcomes for ankle fractures (5)?

A

1) osteoporosis
2) skin problems
3) PVD
4) DM
5) age related comorbidities

172
Q

Which metatarsal is the least commonly fractured metatarsal?

A

1st

173
Q

Which metatarsal fracture has the propensity to not heal and result in non-union?

A

5th - Jone’s fracture

174
Q

Which bone type does a stress fracture occur in?

A

Compact or cortical bone - slower healing than cancellous bone

175
Q

What is the female athlete triad often associated with stress fractures?

A

Amenorrhea - osteoporosis - eating disorder

176
Q

What are subjective factors important leading to diagnosis of stress fractures?

A

1) sharp inc in LE load/inc in training
2) walking on hard surfaces
3) pain at specific distance in run
4) focal tenderness along bone = key sign

177
Q

What bone developing a stress fracture may have high risk for complication?

A

Navicular - found in sprinters, hurdlers, middle distance runners

178
Q

Who is at greater risk for MTSS - males / females?

A

Females - esp higher BMI, below average activity, previous LE injury

179
Q

What are key risk factors for MTSS?

A

Inc BMI, inc navicular drop, foot pronation, limited ankle df NOT a factor

OCS Cards (23 decks)

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