Miller's F&A

Question 1

What is resected in Keller Arthroplasty

Answer 1

proximal phalanx great toe (nothing to metatarsal head)

Question 2

Freiberg Infraction

Answer 2

traumatic event leads to ischemic 2nd metatarsal head

• rigid sole
• closing wedge osteotomy b’c the plantar cartilage is usually preserved

Question 3

Operative for Bunionette

type 1

Answer 3

1- distal chevron osteotomy and lateral capsule release (displace 3-4 mm)
2/3- oblique diaphyseal osteotomy of the shaft

Question 4

What ligament pulls off base of 5th in pseudo-jones fx?

Answer 4

lateral band of the plantar fascia

Question 5

Hindfoot pathology that can make base of 5th metatarsal fx recurrent or nonunion

Answer 5

varus hindfoot

Question 6

Midfoot column that is most rigid

Answer 6

middle - 2/3 metatarsal/cuneiform

Question 7

Midfoot fusion success is related to

Answer 7

correction of deformity

Question 8

Indication for nonop Lisfranc

Answer 8

NO displacement on weight bearing or stress view and NO bone injury
NWB x6wks

Question 9

Pure ligament Lisfranc (without fleck)

Answer 9

Arthrodesis over screw fixation b’c outcomes are better (apparently found from a RCT)

Question 10

Key xray view for accessory navicular

Answer 10

external oblique

Question 11

Modified Kidner procedure

Answer 11

excision of accessory navicular and advancement of posterior tib tendon

Question 12

When to operate on navicular stress fx

- how are they fixed

Answer 12

displaced > 2mm

- screws must be placed lateral to medial

Question 13

Best view to see talocalc coalition?

- calcaneonavicular?

Answer 13

Harris heel

internal oblique

Question 14

What is procedure for tarsal tunnel syndrome

Answer 14

decompress entire tunnel 5cm proximal to flexor retinaculum and distal to deep fascia of abductor hallucis
- best results with mass that is removed, poorer when no mass found

Question 15

Inciting event of adult acquired flat foot

Answer 15

spring ligament fails

Question 16

Cotton osteotomy

Answer 16

dorsal opening wedge medial cuneiform osteotomy

Question 17

Strayer vs Hoke

Answer 17

Strayer-> gastroc release

Hoke -> triple step cut Achilles lengthening

Question 18

Possibel causes of unilateral cavocarus

Answer 18

tethered spina cord (spina bifida)
compartment syndrome
poliomyelitis

Question 19

Transfer for incompetent peroneus longus and brevis

Answer 19

FHL to base of 5th

Question 20

If it comes to operative intervention for plantar fascia, what is released

Answer 20

medial 1/4 plantar fascia

- also release Baxter’s nerve by release deep fascia of abductor hallucis

Question 21

Reconstruction of recurrent ankle instability in large athletes or hypermobility syndromes

Answer 21

Chrisman- Snook

Question 22

Poor healing potential

- important predictive factors

Answer 22

total protein < 6
WBC count < 1500
albumin < 2.5