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Orthopaedics > Foot Disorders > Flashcards

Foot Disorders Flashcards

1
Q

What is Achilles tendon known as?

A

Calcaneal tendon

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2
Q

What is the Px of achilles tendonitis

A
  1. repetitive action of calcaneal tendon
  2. microtears & inflammation
  3. Tendon thickens > lose elasticity
  4. tendon ruptures on sudden force
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3
Q

What are the RF for achilles tendonitis?

A
  • unfit
  • sudden increase in exercise frequency
  • poor footwear
  • male
  • obesity
  • fluoroquinolone
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4
Q

What are the clinical features of Achilles Tendonitis?

A
  • gradual onset pain
  • stiffness
  • worsens on exertion
  • tenderness on palpatation
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5
Q

What are the clinical features of ruptured achilles tendon?

A
  • sudden onset pain @ posterior calf
  • audible popping sound
  • feeling of somethig went
  • loss of plantarflexion
    • simmonds test
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6
Q

What is Simmonds test

A
  • Pt kneel on chair
  • ankles hang off edge of chair
  • squeeze calf
    • if plantarflexion absent
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7
Q

What are the differentials for achilles tendonitis?

A
  • ankle sprain
  • tibial/calcaneal #
  • OA
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8
Q

What Ix would you order for achilles tendonitis/rupture?

A
  • clinically diagnosed
  • USS - test severity of tear
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9
Q

What is the Mx for Achilles tendonitis?

A
  • Stop exercise
  • Ice
  • NSAIDs
  • Physiotherapy
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10
Q

What is the Mx for ruptured Achilles tendon?

A

If < 2 weeks

  • Analgesia
  • Splinted in plaster or aircast boot
  • Crutches

If > 2 weeks

  • Surgical fixation c end to end tendon repair
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11
Q

Which tarsal bone is most commonly fractured?

A

Calcaneal bone

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12
Q

What causes calcaneal #?

A
  • Fall from height / significant axial loading
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13
Q

What are the classifications for calcaneal #

A

Intra-articular (Most common)

  • Involve articular surface of subtalar joint

Extra-articular

  • caused by avulsion injury
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14
Q

What classification is used for intra-articular calcaneal #?

A

Sanders classification

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15
Q

There are 4 types in the Sander’s clssifictaion. Describe them

A

Type I

  • Nondisplaced posterior facet (regardless of number of fracture lines)

Type II

  • One fracture line in the posterior facet (two fragments)

Type III

  • Two fracture lines in the posterior facet (three fragments)

Type IV

  • Comminuted with more than three fracture lines in the posterior facet (four or more fragments)
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16
Q

What are the clinical features of calcaneal #?

A
  • pain
  • tenderness
  • inability of bear weight on calcaneal region
17
Q

What will you find on Ex for calcaneal #?

A
  • Swollen
  • bruising
  • Varus deformity
18
Q

What are the differentials for calcaneal #?

A
  • Talar #
  • Ankle #
  • Ankle sprain
19
Q

What Ix would you order for clacaneal #?

A
  • Radiograph (AP, Lat, oblique)
    • dec Bohler’s angle
    • calcaneal shortening
    • varus tuberosity deformity
20
Q

How would you Mx calcaneal #?

A

Intra-articular (majority require surgery)

  • if <2mm displacement / near normal Bohler’s angle, do for conservative mx

Extra-articular (majority conservative)

  • cast immobilisation
  • non weight bearing 10-12 weeks
21
Q

What are the surgical interventions for calcaneal #?

A
  • Closed reduction with percutaneous pinning
  • ORIF (most cases)
22
Q

What is the Cx for calcaneal #?

A
  • Subtalar arthritis
23
Q

What is Bohler’s angle?

A
  • posterior angle formed between one line from the anterior to middle facet, and one line from the posterior to middle facet;
  • normally 20-40
  • reduced Böhler’s angle can indicate a calcaneal fracture
24
Q

What is the second most common tarsal bone #?

A
  • Talar bone
25
Q

What type of trauma causes talar #?

A
  • HIgh energy trauma
  • Ankle is forced into dorsiflexion
26
Q

Which part of the Talus is commonly affected in a talar#?

A
  • Talar neck

Less common

  • body
  • lateral process
  • posterior process
27
Q
A
28
Q

What is the blood supply to Talus?

A
  • Posterior Tibial Artery
    • artery of tarsal canal
    • deltoid artery
  • Anterior Tibial Artery
    • artery of tarsal sinus
  • Perforating Peroneal Artery
29
Q

What is the talus bone highly at risk of?

A
  • Avascular necrosis
    • extraosseous arterial supply highly susceptible to interruption in #
30
Q

What are the clinical features of Talar #?

A
  • Swelling around ankle
  • Clear deformity
  • Unable to plantarflex and dorsiflex
31
Q

What are the differentials for Talar #?

A
  • Ankle #
  • Pilon # (distal tibia #)
32
Q

What Ix would you order for Talar #?

A
  • Plain radiograph
    • AP
    • Lat
    • Plantar & Dorsiflex - to differentiate between type 1/2 injusries
  • CT - for complex injuries
33
Q

What classification is used for talar neck #? What is it for?

A
  • Hawkins classification
  • Determine risk of AVN
34
Q

Describe the Hawkins classification

A

I

Undisplaced

0-15%

II

Subtalar dislocation

20-50%

III

Subtalar and tibiotalar dislocation

90-100%

IV

Subtalar, tibiotalar and talonavicular dislocation

100%

35
Q

Mx of talar # based on Hawkins classification. How would you treat undisplaced talar #?

A
  • Plaster
  • non-weight bearing crutches - 3months
  • assess for nonunion or AVN
36
Q

How would you Mx type 2-4 Hawkins classification?

A
  • Closed reduction - emergency setting
  • ORIF
  • Cast
  • non weight bearing
37
Q

What are the Cx of talar #?

A
  • AVN - 17%
  • OA

Orthopaedics (13 decks)

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