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MSK SB > Foot + Ankle Problems > Flashcards

Foot + Ankle Problems Flashcards

1
Q

what ligament in the foot is most commonly sprained

A

anterior talofibular ligament

ATFL

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2
Q

muscle power in the ankle/foot

A 
Tibialis Posterior
Tibialis Anterior
Peroneus Longus
Peroneus Brevis
EHL, FHL
EDL, FDL
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3
Q

what is pes planus

A

flat feet

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4
Q

what is pen planus associated with and what is the difference between flexible and fixed flat feet

A

associated with ligamentous laxity

flexible flat feet form an arch when patients goes on tip-toes

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5
Q

what is the most common cause of acquired flat foot in adults

A

tibialis posterior dysfunction

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6
Q

Features of tibias posterior dysfunction

A 
obese, middle age, female
increases with age
hypertension/diabetes
steroid injection
seronegative arthropathies
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7
Q

symptoms/signs of TPD

A

pain and/or swelling posterior to medial malleolus
change in foot shape
diminished walking ability

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8
Q

Tx of TPD

A

physiotherapy
insole to support medial longitudinal arch
surgery

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9
Q

what is not recommended in TPD Tx

A

NO steroid injections

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10
Q

what is pes cavus

A

high arched foot

often with clawing of toes

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11
Q

what causes pes cavus

A 
most common idiopathic
CP
Polio
Spina bifida
Club foot
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12
Q

what is plantar fasciitis

A

thickening of the plantar fascia

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13
Q

what are signs/symptoms of PF

A

start-up pain after rest
worse after exercise
swelling of plantar medial aspect of heel
tenderness over plantar aspect of heel

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14
Q

where is pain felt in PF

A

heel and bottom of the foot

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15
Q

what test is positive of PF

A

Tinel’s test positive for Baxter’s nerve

lightly tap over nerve to cause pins and needles sensation

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16
Q

causes of PF

A

physical overload
seronegative arthropathy
diabetes
abnormal foot shape

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17
Q

Tx of plantar fasciitis

A

Usually self-limiting, 18-24 months

NSAIDs
Night splints
Taping 
Physio
Steroid injection
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18
Q

what is hallux valgus

A

lateral deviation of the big toes and the subsequent affect it has on the forefoot

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19
Q

incidence of Hallux valgus

A

increases with age
usually bilateral
F > M

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20
Q

who commonly gets Hallux valgus

A

RA

CTDs

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21
Q

what are indications for hallux valgus operative Mx

A 
failure of non-op 
pain
lesser toe deformities
overlapping
ulceration
22
Q

what is the aim of surgery of HV

A

aim to realign the hallux
decrease the HV angle

correct any lesser toes deformities at the same time

23
Q

what is hallux rigidus

A

OA of 1st MTPJ

24
Q

Mx of HR

A

Non-op

Op

  • joint replacement
  • fusion (arthrodesis)
25
Q

what are features of the Rheumatoid foot

A

subluxed MTPJs
Hallux valgus
Clawed toes
Painful plantar calluses

26
Q

problems in the hindfoot in RA

A

Unstable subtalar joint, calcaneus drifts into valgus

Medial arch collapses, flat feet

27
Q

what is Morton’s neuroma

A

Degenerative fibrosis of digital nerve near it’s bifurcation

28
Q

what signs and symptoms of Morton’s neuroma

A

get forefoot pain (metatarsalgia)

burning and tingling in toes

29
Q

what Ix is first line for Morton’s neuroma

A

USS

30
Q

Mx of Morton’s neuroma

A

Non-op - insoles, injections

Op - excise nerve but gives them numbness between toes

31
Q

what causes pain, morning stiffness in (most commonly) men feet/ankles and eases with heat/walking

A

Tendo-Achilles Tendinosis

32
Q

what is Tendo-Achilles Tendinosis

A

Repetitive microtrauma, failure of collagen repair with loss of fibre alignment/structure

33
Q

what can cause Tendo-Achilles Tendinosis

A

over training
steroids
ciprofloxacin
CTDs

34
Q

Ix for Tendo-Achilles Tendinosis

A

Clinical

USS

35
Q

Mx for Tendo-Achilles Tendinosis

A 
Analgesia
NSAIDs
Shockwave therapy 
Physio
Surgery
36
Q

what is features of Tendo-Achilles rupture

A

Usually over 40s
Often pre-existing tendinosis
very painful - patient thinks they’ve been hit

37
Q

clinical appearance of tendo-achilles rupture

A 
unable to bear weight
weak plantar flexion
cannot stand on toes
palpable painful gap
sudden deceleration with resisted calf contraction
38
Q

what test will be positive in tendon-achilles rupture

A

Simmonds test

i.e. positive calf squeeze

39
Q

what causes claw/hammer/mallet toes

A

acquired imbalance between flexors and extensors

40
Q

what can claw/hammer/mallet toes cause

A

painful callus/corns with skin breakdown

41
Q

surgical options of claw/hammer/mallet toes

A

tenotomies (division of tendons), tendon transfer, fusions (PIP) or amputation

42
Q

MOI of ankle sprains

A

Twisting forces (commonly inversion or twisting forces on a planted foot)

43
Q

ankle sprains heal quicker than ankle fractures - true or false

A

false

fractures heal quicker

44
Q

Mx of ankle sprains

A

Non-op

  • RICE
  • Physio

Op

  • Brostrum Gould
  • Chrisman Snook
45
Q

what classification is used Ankle Fracture

A

Weber Classification

Weber A/B/C

46
Q

what type of fracture in the foot are very common

A

5th metatarsal fractures

inversion injury

47
Q

what are the 3 MOI of 5th metatarsal fracture

A
  1. Avulsion by peroneus brevis tendon (heal predictably in moonboot, do well)
  2. Jones fracture, poor blood supply, 25% risk non-union
  3. Proximal shaft (common site for stress fracture)
48
Q

what is Jones fracture

A

fracture in the meta-diaphyseal junction of the fifth metatarsal of the foot

49
Q

what is Lisfranc fracture

A

injury of the foot in which one or more of the metatarsal bones are displaced from the tarsus

50
Q

MOI of calcaneus fracture

A

Fall from height, look for other injuries esp spinal, often intra-articular, significant swelling, risk compartment syndrome

51
Q

MOI of Talus fracture

A

Forced dorsiflexion/rapid deceleration

52
Q

what are possible complications of a Talus fracture

A

Talus has reverse blood supply

risk of AVN and OA

MSK SB (15 decks)

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