Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Sports Medicine Board > Lower Leg/Ankle/Foot Injuries > Flashcards

Lower Leg/Ankle/Foot Injuries Flashcards

You may prefer our related Brainscape-certified flashcards:
Sports Trivia flashcards
1
Q

List the structures of the anterior compartment of the lower leg.

A

EHL, ED, AT, Peroneus tertius, Deep peroneal N.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Name the lateral structures in the lower lower leg compartment.

A
  1. Peroneus Longus
  2. Peroneus Brevis
  3. Superficial Peroneal nerve
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Name the Deep Posterior structures in the lower lower leg compartment.

A
  1. FHL
  2. FDL
  3. PT
  4. Posterior Tibial N
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Name the superficial posterior structures in the lower lower leg compartment.

A
  1. Gastrocneumius
  2. Soleus
  3. Sural nerve
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are some associated injuries from a tibial plateau fracture?

A

Compartment syndrome

meniscal injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Name the different radiographs views for a supsected tibial plateau injury

A
  1. AP
  2. Lateral
  3. Internal
  4. External Oblique
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Reasons to get ortho involved for a tibial plateau fracture.

A
  1. Compartment Syndrome
  2. Ligamentous injury
  3. Displaced/depressed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

___ > mmHG for diagnosis of Acute Compartment Pressure Syndrome.

A

30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the formula for pressure testing for Acute Compartment Pressure?

A

< 30 = DBP- CP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Pedowitz Formula for Chronic Exertional Compartment Syndrome

A

Pre > 15 mm Hg

1 min post >30 mmHg

5 min post> 20 mm Hg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

RTP following fasiotomy for Chronic Exertional Compartment Syndrome

A

6-12 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Runner comes in with bilateral diffuse medial tibial shaft tenderness. Worst with exertion but can tough it out to comeplete runs. Diffusely tender on along medial tibial shaft.

What is the diagnosis and what is in the differential?

A

Medial Stress Syndrome

Compartment Syndrome should be in differential however once the pain starts while running these patients cannot push through it and must stop.

Tibial Stress Fracture- more localized tenderness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How can an MRI be useful for medial tibial shaft pain in runner who just started training for marathon?

A

MRI can differentiate b/t stress fracture and stress sydnrome.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a vascular condition that can often present like compartment syndrome in usually a male athlete < 40 yr. Provacative pain on exam with passive ankle dorsiflexion and active ankle planterflexion.

A

Popliteal Artery Entrapment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Definite study to confirm popliteal artery Entrapment

A

Arteriography

Doppler US exam with high false positive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Treatment for popliteal artery entrapment

A

surgical release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Where is the most common place for tibial stress fractures?

A

Middle 1/3 posteromedial tibia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Discuss the pros and cons of the following imaging modalities for Tibial stress fractures:

XRAY

Bone Scan

MRI

A
  1. Xray- often normal for 2-3 weeks
  2. Bone Scans are highly sensative with low specificity
  3. MRI good for grading.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

For Popliteal Artery Entrapment give the 3 values of POST ABIs that would

a: be suggestive
b: indicative

A drop of ____ mmHg from baseline is also indicitive and usually correlates between 0.1-0.2 ABI)

A

A- ABI < .75 suggestibve

B- ABI <.50 indicative

Drop of 15 mmHg from baseline = (0.1-.0.2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Describe the Fredericson Grading System for Medial Tibial Stress Syndrome and how it correlates with RTP

A

Grading system based on MRI

  1. Grade 1 - persosteal edema —–> RTP 2-3 weeks
  2. Grade 2- 4a ( progressive marrow edema changes with intracortical signal changes(4a) RTP 6-7 weeks
  3. Grade 4b- linear region of intracorticla signal change—-> RTP 9-10+ weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Is this tibial stress fracture high risk or low risk?

What is the treatment?

A

High risk ( tension side) - the dreaded black line. Anterior tibia

Treatment: NWB, cast vs. pneumatic bracing for 6-12 months. Depending on the level of the athlete this could require bone graft vs. intra-medullary nailing (faster RTP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Catagorize this tibial stress fracture as high or low risk?

A

Low- posteriormedial tibia ( compression side)

Low Risk

Most common stress fx site in athletes

AVOID NSAIDS

Correct training/technique errors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

RTP for low risk tibial stress fractures vs. high risk stress fractures

A

Low Risk (posteriormedial) - 2-6 weeks when sx resolve

High Risk( anteriormedial) 6-12 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Describe the MOI from a fibular fracture?

A

Varus stress at knee

or

ankle in ER ( Maisonneuve fx)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are some Physical Exam findings for a fibular fracture?

A

Usually associated with other injures and sometimes missed

Can Bear Weight

TTP at fracture site and distal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Treatment for a fibular fracture

A

Short walking boot 3-4 weeks

Crutches PRN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

RTP for a fibular shaft fracture (that is not an ortho referal)

A

6-8 weeks/normal WB and ROM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Name 2 groups of athletes that are proned to fibular stress fractures?

A

Runners and ballet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Middle age women who just started to train for marathon presents with latera leg pain that is worse when running. If you suspected a fibular stress fracture where would you expet her to more tender?

If it was a young male runner where would the fracture/tenderness be?

A

3-4 cm proximal to lat mal

6-8 cm prox to lat mal- runners fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

All though rare, name the 4 classifications of tibio-fibular joint dislocations

Most common?

Occurs in sliding?

Peroneal nerve or LCL inj

A

Trauma, popping sound, fibular head TTP, unstable and may lack knee extension

  1. Subluxation - generalized hypermobility
  2. Anterior Dislocation- sliding (most common)
  3. Posterior Dislocation- direct trauma or twisting, LCL or peroneal nerve inj

4 Superior Dislocation- rare, trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

If you are suspcious of a tibio-fibula dislocation what is the best xray to get?

A

Lower leg with IR

This maximize distance between fibula and tibia.

compare contralateral side.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the treatment for Tibio-fibular dislocation?

A

Closed reduction and 3x weeks of immobilization

33
Q

What is another name for tennis leg?

Where does it usually occur?

Who is it more common in?

What do they complain of?
What do you see on PE?

A

Gastrocnemius Tear

M>>L

Middle aged recreational athletes

Sharp posterior calf pain

TTP at MT junction with swelling and tracking echymosis

34
Q

What is the treatment for tennis leg?

A

RICE

rehab

aspirate hematoma if present

RTP- 2-3 weeks

35
Q

What is the weber classifcation of this fracture?

Treatment?

A

Weber TYPE A

ORTHO REFERAL ( FOR B AND C)

36
Q

WHAT IS WEBER TYPE C

A

FIBULAR FRACTURE ABOVE MORTISE

37
Q

WHAT IS A WEBER TYPE A?

A

FIBULAR FRACTURE BELOW THE MORTISE

38
Q

Indication for ortho referral for ankle fracture

A

Weber B and C

Bi or tri malleolar fx

Posterior malleolar fx

>25% articular involvment and/or >2mm

39
Q

How would you manage this?

A

Isolated malleloar avulsion fracture

Treat like ankle sprain

early mobilization

40
Q

How would you treat an oblique nondisplaced malleolar fracture?

A

4-6 weeks walking boot/cast

RTP-normal range of motion and strenth

6-10 weeks

41
Q

Which type of ankle dislocation ( ant, post, lateral) is the most common?

A

anterior

42
Q

Which type of ankle dislocation ( ant, post, lateral) is always assoicated with fracture?

A

Lateral

43
Q

Which type of ankle dislocation ( ant, post, lateral) is the least common?

A

posterior

44
Q

The most common sports injury?

A

Lateral ankle sprain

45
Q

Name the most common to least common ligament injuried in ankle sprain?

A

ATFL> CF>PTFL

46
Q

How long should an ankle brace be worn following sprain?

A

6-12 months

47
Q

What is an assoicated injury to suspect for a medial ankle sprain?

A

associated medial malleolus fx

48
Q

What is the MOA for a high ankle sprain?

What is the name of the ligament?

A

AITiboFib Lig

Dorsaflexion/ER

49
Q

What kind of fracture does a high ankle sprain predispose someone to?

A

Maisonneuve fx

50
Q

What are some physical exam test that would make you concerned about a high ankle sprain?

A

Positive squeeze test

Positive ER test

Tenderness length

fibula translation test

stabilization test

https: //youtu.be/ANgWSz0UoDg
https: //youtu.be/W3SHqKqkK14

51
Q

XRAY views to evaluate for high ankle sprain

A

entire tibia fibia

STANDING

AP, lateral, mortise, gravity stress views

52
Q

What are you looking for on xray when suspecting high ankle sprain?

A
53
Q

You diagnose patient with Grade 1 high ankle sprain.

XRAY

Physical Exam

Treatment

RTP

A

XRAY- negative

Physical Exam- stable

Treatment- PRICE with immobalization 2-4 weeks followed by functional brace

54
Q

When examing an ankle for chronic instability what is a high yield physical exam finding?

A

Poor proprioception

55
Q

MOI for calcaneus fracture

A

Fall (axial load) with or without plantar or dorsiflexion, twisting

Inability to bear weight

56
Q

Indications for ortho referral with calcaneal fracture

A

displaced

intra-articular ( most common 70%)

Persistant pain (non union)

57
Q

Discuss the non surgical treatment options of calcaneal fractures

a. Ant, med, or lateral processes
b. Tuberosity

C. Sustentaclum tali

d. Body (extra articular)

A

a. short-leg walking cast x 4 weeks
b. short leg NWB cast x 6 weeks
c. Short leg NWB cast 6-8 weeks
d. No immobilization, active rehab

Rehab following immobilzation 6-12 weeks RTP

58
Q

Is a calcaneus stress fracture considered high or low risk?

Where do they commonly occur?

What is a positve test?

Best imaging?

Treatment?

RTP

A

Low risk

Body, post. to talus

Squeeze

XRAY delayed 3-4 weeks–> MRI

relative rest

RTP 4-6 weeks

59
Q

Talus fracture MOI

A

Dorsiflexion, axial load, and twisting

60
Q

What are the classifications of Talus fractures

A

1 and 2- stable

3 and 4- unstable

61
Q

Indciations for ortho for talus fracture

A

displaced or comminuted

Intra-articular

Large avulsions

Unstable talar dome fx( III, IV) or persistent pain for 4-6 mo for stable I and II

62
Q

List the following non op treatments for talus fx

a. Avulsion
b. Neck
c. Body
d. Head
e. Talar Dome

A

a. Short leg walking cast x 4wks
b. Short leg NWB cast x 4-6 weeks,then walkign cast x4 wks
c. Short leg NWB cast x6-8weeks
d. Short-leg walking cast x 6-8wks then longitudinal arch support x 3-6mon
e. Activity restriction or short leg walking cast (Type 1-2)

63
Q

Snow border comes in with symtpoms of an ankle sprain. What fracture is commonly mistaken for an ankle sprain?

A

Talus (lateral process ) fracture

Usually TTP 1 cm from tip of lat mal.

Best seen on mortise view

Get CT if xray negative

64
Q

How would you manage a “Snow borders fx”?

Criteria for ortho referral

A

Ortho referral: comminuted or >2mm displacement

Non displaced: NWB short leg cast x4 weeks

then walking cast for 2weeks

65
Q

Indications for ortho for navicular fractures

A

Large displaced dorsal avulsion (>20% aritcular surface )

tuberosity fx > 1 cm prox displacement

Displaced body fx

Non-union/delayed union stress fracture

66
Q

Discuss nonortho managment for Navicular fracture:

a. Dorsal Avulsion
b. Tuberosity
c. Body

A

a. short leg walking cast x 4-6wks
b. same as above
c. below- knee walking cast x 6-8wks

67
Q

Navicular stress fractures are considered (high/low) risk

A

high

68
Q

What type of athlete are prone to navicular stress fractures?

Why are navicular stress fx high risk?

A

track and field

central 1/3 has poor vascular supply and that is where compressive forces the highest.

69
Q

Treatment for navicular stress fx

A

NWB cast x 6weeks

Can consider surgery

70
Q

Sprain of the 1st/2nd T-MT joint, base of MT

A

Lisfranc

71
Q

Lisfranc MOI

A

Direct- Crush injury

Indirect- axial load to heel with ankle planterflexed and toes dorisflexed

( Football lineman, stepping off curve)

72
Q

Football lineman presents with midfoot pain dorsally . TTP at dorsal mid foot. Pain with eversion and abduction of forefoot. Pain with passive pronation/supination of TMT joint and positive shuck test

A

Lisfranc injury

73
Q

What kind of XRAY and findings for Lisfranc injury?

A

Weight bearing AP

  1. > 2mm displacement b/t 1st and 2nd MT bases
  2. Avulsion fracutre “Fleck sign” - near base of the 2nd MT or medial cuniform
  3. Medial cortex of 2nd MT base line up with medial border of intermediate cuniform

Lateral

  1. Dorsal cortex of 1st MT and medial cuneiform line up

30 degree Oblique

  1. Medial cortex of 4th MT base line up with medial border of cuboid
74
Q

What are the 3 classifications of Lis frranc injury

A
75
Q

What is the treatment of Lisfranc injury (Stage 1, Stage 2, and Stage 3)

A

Stage 1- NWB cast 2 weeks and repeat xrays. If radiographic stable clinical assesment determines contnued immobilization ( up to 10 weeks)

STAGE 2 and 3 considered unstable = ORIF

76
Q

What is the general treatment for nondisplaced MT fractures?

A

Short walking boot or post op shoe for 4-6 weeks

WBAT

77
Q

What is the general managment for displaced MT fracture

A

Short leg NWB cast 2-3 wks

f/u Xray 1 wk

Transition to walking boot 3-4x weeks

78
Q

Which MT fracture is considered high risk?

TX

A

2nd MT “ Ballet Dancers”

Involves volar and medial aspect of Lis Franc

Short- leg NWB cast x 4wks

79
Q

Name the 3 types of 5th MT fratures

A

Styloid avulsion

Metaphyseal -Diaphyseal Junction ( Jones)

Diaphyseal Stress

Sports Medicine Board (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions