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Recon > MIDTERM Classifications > Flashcards

MIDTERM Classifications Flashcards

1
Q

PHASE 1 of Luck classification

A

PROLIFERATIVE phase

fibroblasts, cellular activity

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2
Q

PHASE 2 of Luck classification

A

ACTIVE phase

nodules form

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3
Q

PHASE 3 of Luck classification

A

RESIDUAL phase

collagen maturation

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4
Q

plantar fasciitis versus fasciosis

A
  • fasciitis: more acute, INFLAMMATORY process
  • fasciosis: more chronic, DEGENERATION of the fascia
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5
Q

pirani classification:

purpose and total possible score

A
  • assesses the severity by using a 6-point scoring system and 6 different physical exam findings.
  • 3 points assess the midfoot deformity and 3 points assess the hindfoot deformity
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6
Q

when performing the 6 Pirani physical exam findings,

what would be 0 points?

A

no abnormality

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7
Q

when performing the 6 Pirani physical exam findings,

what would be 0.5 points?

A

moderate abnormality

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8
Q

when performing the 6 Pirani physical exam findings,

what would be 1 point?

A

severe abnormality

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9
Q

Tx for Pirani hindfoot score > 2

A

>83% requiring Achilles tenotomy

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10
Q

Treatment for total Pirani score: 2-4

A

required a mean of 4 biweekly casts

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11
Q

Treatment for total Pirani score of 4-6

A

required a mean of 7 biweekly casts

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12
Q

dimeglio classification:

purpose and scoring system

A
  • significant equinus indicates significant deformity/pathology,
    • more equinus = more points,
    • more plantarflexion of medial column = more points,
    • more varus = more points,
    • more internally rotated = more points
  • 20-point scoring system after applying gentle corrective maneuver
  • Rated I - IV based on total points
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13
Q

dimeglio stage I

A

benign (<5 points),

soft-soft, resolving

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14
Q

dimeglio stage II

A

moderate (5-9 points)

soft-stiff, reducible, partly resistant

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15
Q

dimeglio stage III

A

severe (10-14 points), stiff-soft, resistant, partly reducible

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16
Q

dimeglio stage IV

A

very severe (15-19 points),

stiff-stiff, resistant

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17
Q

seddon classification: overview

A
  • classification of nerve injury
  • describes into:
    1. Neurapraxia
    2. Axonotmesis
    3. Neurotmesis
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18
Q

neurapraxia

(seddon)

A
  • conduction deficit without damage to the axon
  • Least severe (contusion/compression)
19
Q

axonotmesis

(seddon)

A
  • axon damage without endoneurial tube damage
    • Wallerian degeneration – degeneration of the axon distal to the injury
    • May cause muscle atrophy
20
Q

neurotmesis

(seddon)

A
  • nerve severance with complete disruption of the endoneurial tube
  • Most severe – irreversible with muscle atrophy
21
Q

sunderland classification:

purpose and overview

A
  • classify peripheral nerve injuries PRODUCING LOSS OF FUNCTION
  • 1st Degree - 5th Degree
22
Q

1st degree

(sunderland)

A

axon is preserved with temporary conduction block

23
Q

2nd degree

(sunderland)

A

axon is (reversibly) damaged,

but the endoneurial sheath is preserved

24
Q

3rd degree

(sunderland)

A

axon and endoneurial sheath are damaged,

but fasciculi (perineurium) are intact

25
Q

4th degree

(sunderland)

A

nerve fascicule is destroyed and only held together by connective tissue

26
Q

5th degree

(sunderland)

A

complete loss of nerve trunk continuity

27
Q

Johnson & Strom/Myerson Classification:

purpose and scale

A
  • classify severity of Tibialis Posterior Dysfunction (adult acquired flatfoot)
  • levels of severity
    • stage I
    • stage II
      • IIa - IIe
    • stage III
    • stage IV (added by myerson)
28
Q

stage 1

(Johnson & Strom/Myerson)

A
  • tenosynovitis with mild tendon degeneration (normal length and function)
  • without osseous deformity and with flexible rearfoot,
  • mild weakness of single heel raise
29
Q

stage II

(Johnson & Strom/Myerson)

A
  • tendonitis (elongated with degeneration),
  • flexible rearfoot,
  • weak heel rise + too many toes sign
30
Q

stage III

(Johnson & Strom/Myerson)

A
  • longstanding deformity,
  • elongated and ruptured tendon,
  • rigid valgus rearfoot,
  • marked weakness of single heel raise + too many toes sign
31
Q

stage IV

(Johnson & Strom/Myerson)

A
  • same as stage III + rigid ankle valgus,
  • rigid deformity of the hindfoot with valgus tilt secondary to deltoid insufficiency and spring ligament attenuation
32
Q

stage IIA

(Johnson & Strom/Myerson)

A

stage II tendonitis + hindfoot valgus

33
Q

stage IIB

(Johnson & Strom/Myerson)

A

stage II tendonitis + flexible forefoot supination

34
Q

stage IIC

(Johnson & Strom/Myerson)

A

stage II tendonitis + fixed forefoot supination

35
Q

stage IID

(Johnson & Strom/Myerson)

A

stage II tendonitis + forefoot abduction

36
Q

stage IIE

(Johnson & Strom/Myerson)

A

stage II tendonitis + medial ray instability

37
Q

type I

(MRI classification of TP Dysfunction)

A

hypertrophic,

as tendon responds to injury

38
Q

type II

(MRI classification of TP Dysfunction)

A

candle wicking,

narrowing at point of injury as tendon stretches

39
Q

type III

(MRI classification of TP Dysfunction)

A

full rupture (less common)

40
Q

Stage I

  • (Johnson & Strom/Myerson)*
  • Recommended Tx*
A
  • conservative treatment, tenosynovectomy, tendon debridement
    • Generally wouldn’t inject tendon with steroids
41
Q

Stage II

  • (Johnson & Strom/Myerson)*
  • Recommended Tx*
A
  • tendon transfer, calcaneal osteotomies, arthroeresis, medial column procedures, isolated rearfoot fusions
  • MC tx: medial calcaneal slide (Kouts) and either a FDL transfer (or some other type of medial procedure, ex: Hoke)
42
Q

Stage III

  • (Johnson & Strom/Myerson)*
  • Recommended Tx*
A
  • isolated rearfoot arthrodesis, double arthrodesis, triple arthrodesis
43
Q

Stage IV

  • (Johnson & Strom/Myerson)*
  • Recommended Tx*
A

TTC arthrodesis, pantalar arthrodesis

Recon (11 decks)

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