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IPAP > Ortho Block 4: Detailed > Flashcards

Ortho Block 4: Detailed Flashcards

1
Q

What causes stress Fxs

Stress Fxs can also be AKA ?

A

Repetitive overloading causing bone failure when fatigue out lass repair processes

Insufficiency Fxs

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2
Q

Why are younger females at higher risk of stress Fxs

Why are older women at higher risk?

A

Female athlete triad: amenorrhea, osteopenia, eating d/os

Osteoporosis

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3
Q

What is the MC site of stress Fxs

Where can they also develop through out the foot and ankle

A

Metatarsals, especially #2

Navicular
Calcaneous
Medial malleolus
Fibula

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4
Q

How do PTs w/ stress Fxs present

What is the most reliable physical sign for these on PE?

A

Inc pain w/ weight bearing
Dec pain w/ rest
Metatarsal Fx= dorsal swelling
Fibula Fx= swollen lateral ankle

Pain/tenderness and swelling localized over area

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5
Q

How long does it take stress Fxs to show on imaging?

What two types of stress Fxs are at risk for malunion/non-union healing if proper rest is not observed?

A

3-4wks on x-ray
5 days on bone scan
MRI can confirm Dx, not routinely used

Jones Fx of 5th metatarsal
Navicular stress Fxs

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6
Q

How are stress Fxs in different locations Tx

How are 5th metatarsal stress Fxs better Tx in an athletic PT?

A

Metatarsal: stiff sole shoe/short leg brace
Calcaneal/fibular: 2-4wks imobilization in short leg cast
Navicular/5th metatarsal: casted, NWB

Internal fixation

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7
Q

Heel varus= ? Fx
Heel valgus= ? Fx

Which stress Fxs are referred w/ red flags?

A

Varus: 5th MT Fx
Valgus: fibula Fx

Navicular, 5th MT, all fibular
Failure to heal in 6wks/Recurrent Fxs= metabolic work up

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8
Q

1st MTP has ? sesamoids and which is more prone to Fx

The plantar aspect of each is surrounded by ? tendon

What does the dorsal aspect of the sesamoids articulate w/?

A

2: lateral, medial*

Flexor hallucis brevis
Plantar plate

Metatarsal head

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9
Q

What are 3 MOIs that can cause a sesamoid Fx

Dancing or running will cause ? types of Fxs

A

MC: direct trauma
Avulsion from MTP hyperdorsiflexion
Stress

Stress or Avulsion

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10
Q

What is the MC site for accessory sesamoids to be found

What type of sesamoid is a normal variant?

What do PTs complain of during PE when sesamoid is Fx?

A

Second MT head on tibial side

Bipartite

Point of pain will move w/ toe flexion/extension
Inc pain w/ dorsiflexion of 1st MTP

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11
Q

How are sesamoids best evaluated w/ imaging?

What imaging is used to differentiate between acute or stress Fxs of bipartite and sesamoids?

What imaging is used to differentiate between a Fx of the bipartite sesamoid or osteonecrosis?

A

Lateral: w/ internal oblique view
AP/Lat/Axial views

Tc-99m bone scan

MRI- marrow edema if Fx is present

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12
Q

How are sesamoid Fxs Tx w/out surgery

When do these types of Fxs have to be Tx w/ surgery

What is the adverse outcome of this injury

A

Short leg brace or stiff sole shoe w/ rocker bottom
When Sxs improve- felt pad x 6mon

Fx w/ plantar plate rupture

6-12mon healing time= limited dorsiflexion of 1st MTP

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13
Q

Phalangeal Fx usually involves ? part and is due to ?

Which toe is MC affected

What is the MC unlikely adverse outcome of this injury

A

Proximal phalynx
Direct trauma

5th toe

Permanent deformity

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14
Q

How are phalangeal Fxs Tx w/out surgery

When do these Fxs need to be reduced

When do they need to be referred?

A

Buddy taped to medial toe w/ gauze pad in between to prevent maceration

Angulated
Articular surface involvement
Interphalangeal joint involvement of great toe

Open/displaced intra-articular Fx

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15
Q

What type of metatarsal Fxs are unique and need extensive immobilization

How long can it take for a stress Fx on a metatarsal to show up?

A

Zone 2 proximal diaphysis of 5th metatarsal (Jones Fx)
Zone 3 of 5th MT, usually stress Fx

2-3wks

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16
Q

Define Zone 1-3 on the 5th MT

How are these Tx w/out surgery

How often are images needed

A

1: articular surface
2: articulation of proximal 4th and 5th MTs
3: extends 1.5cm distal to zone 2

Short leg cast/brace

Repeated @ 1wk and 6wks

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17
Q

A Fx of the 1st MT if often the result of ? injury and requires ? for Tx

What types of Fxs require surgical correction to protect weight bearing function of the foot?

Fx to Zone 3 can resemble ? Fxs

A

High impact injury
Surgery

Multiple Fxs w/ more than 4mm displacement
Apical angulation >10* on lateral view

Stress Fx exacerbated w/ inversion injury

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18
Q

What type of Fx to the 5th MT is more difficult to Tx

What are the 2 bones of the hind foot usually Fx during MVAs or falls

A

Acute Fx to Zone 2- NWB x 6-8wks
Athletes= internal fixation

Calcaneous
Talus

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19
Q

Since compartment syndrome is difficult to identify due to calcaneous/talus Fxs, what finding is indicative

Calcaneous Fxs need to have ? other injury r/o

A

Swelling in area of arch

Spinal Fx on ipsilateral side of injury

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20
Q

What x-ray views are needed to assess calcaneous Fxs

Coronal CT images are needed if suspected nerve entrapment is present

A

AP Lateral Mortise Harris

Evaluate subtalar/calcaneocuboid joints

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21
Q

Fx to ? bone in the ankle frequently leads to osteonecrosis

What are the first two things done during Tx of these injuries

A

Talus

Elevation above heart
Ice q20min

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22
Q

Ankle Fxs include injuries to ? bones

Unstable ankle Fxs involve ?

A

Lateral/Medial/Posterior malleolus
Collateral ligaments
Talar dome

Both sides of joint
Bimalleolar: lat/medial malleolus or distal fibula w/ disrupted deltoid ligament
Trimalleola

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23
Q

Posterior dislocation of the ankle may be present w/ ? Fx

What type of PE finding is assumed to be an unstable bimalleolar injury

A

Trimalleolar

Fx of distal fibular w/ TTP over medial deltoid ligament

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24
Q

Define a Maisonneuve Fx

What type of x-ray view allows for clear evaluation of the tibia, fibula and talus

A

Fx of proximal fibula from unstable external rotation injury including Fx of fibula, tear of medial deltoid and disrupted tibiofibular ligaments

Mortise view

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25
Q

If ankle injury doesn’t show Fx on initial x-rays, how long until repeat x-rays are taken?

What type of Fx may be present in the ankle after a rotational injury?

A

10-14 days

Osteochondral Fx

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26
Q

How are stable, unstable, unstable/not displaced Fx of the ankle Tx

If an osteochondral fragment is present in the joint space, successful pinning and fixation is only successful in ? PTs?

A

Stable: WBAT w/ cast x 4wks
Unstable, not displaced: NWB w/ cast and immobilization
Unstable, displaced: reduction needed

Young

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27
Q

When is rehab indicated after an ankle Fx

Define Lisfranc Fx-dislocation

A

Elder PT
Full ROM/balance not returned by 3mon

Fx-dislocaiton to the midfoot at the tarsometatarsal joints

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28
Q

How can Lisfranc Fx/Dislocations occur in athletes

What does this ‘critical’ injury involve

Where will PTs point their pain to be during PE

A

Tripping

2nd MT, joint wedges into slot in cuneiforms and is key to stabilizing other midfoot joints

Dorsum of midfoot

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29
Q

How can you tell a Lisfranc injury from an ankle sprain

What x-ray findings are indicative of a ‘normal’ foot and no injury

A

Stabilize calcaneous, rotate/abduct forefoot w/ other
+pain= Lisfranc

Medial aspect of cuneiform lines up w/ medial 2nd MT
Medial aspect of 4th MT lines up w/ medial cuboid

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30
Q

What does the Lisfranc ligament join and what does it provide?

What is the next step if injury suggests what x-rays don’t show?

A

Base of 2nd MT and medial cuneiform
Stability to tarsometatarsal joints

Sedation w/ stress radiographs of midfoot

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31
Q

What types of deviation is seen during a Lisfranc injury

How are these Tx w/out surgery

A

Fragment at base of 2nd MT
Lateral deviation of 2nd and 3rd MT
Medial deviation of 1st MT

8wks NWB, 3mon of rigid arch support
Any displacement= reduction and fixation

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32
Q

What can be added to a bandage surrounding a Lisfranc injury to reduce edema

What two Dzs are r/o when evaluating idiopathic toe walking

What PT population is toe walking common in?

A

Zinc oxide cream

Cerebral palsy
Muscular dystrophy

Speech/language delays
Autism

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33
Q

When quantifying the degree of dorsiflexion of a toe walker, what PE finding is indicative of an Achillies contracture

How are these cases Tx when Pt is a toddler

A

<10* passive dorsiflexion

Self resolve in 3-6mon
Autistic- PT, OT

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34
Q

When is serial casting for toe walking needed

What are the MC causes of unilateral toe walking?

A

Co-existing Achilles contractures

Limb length discrepancy
Cerebral palsy
Tethering of spinal cord

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35
Q

Define Tarsal Coalition

How is this condition linked w/ FamHx

Which types begins to present w/ Sxs earlier

A

Abnormal connection between two tarsal bones, MC calcaneous and navicular or talus and calcaneous

ASx but no hindfoot motion

Calcaneonavicular @ 9-13y/o w/ lateral pain
Talocalcaneal @ 13-16y/o deep in hind foot

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36
Q

What is seen in PTs w/ tarsal coalition on PE

What x-ray view is best for talocalcaneal bars

A

Rigid flat foot- hind foot valgus, fore foot abduction
No longitudinal arch
Restricted hindfoot motion from spastic peronial muscles

Harris heel view

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37
Q

What is the preferred Tx of tarsal coalitions after non-surgical efforts fail

What procedure is reserved for those who do not respond to resections or who are not candidates due to large coalitions or arthritic changes being present?

A

Resection of coalition w/ interposition of fat/muscle

Hind foot arthrodesis

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38
Q

Osteochondral lesions of the hyaline cartilage and subchondral bone can occur in what two ways?

How does this present?

A

Trauma: osteochondral Fx
Idipathic: subchondral avascularity

Pain, swelling/effusions, giving away
Hx of repeat/chronic sprains
Limited/painful A/PROM

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39
Q

What type of x-ray view is needed for viewing osteochondral lesions of the talus?

What will be seen?

What imaging is used for Dz staging?

A

Mortise views

Articular surface defect w/ halo of lucent bone on weight bearing surface

CT for medial lesion staging
MRI for cartilage/vascular assessment

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40
Q

How are osteochondral lesions Tx

Define Metatarsus Adductus and what causes it

A

If skeletal immature: time/immobilization
Skeletal mature: surgery

Medial deviation/adduction of forefoot
MC form intrauterine positioning issue

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41
Q

Metatarsus adductus usually presents w/ ? other positional deformities

What toe malformity may be observed but usually self resolves?

A

Congenital muscular torticollis
Medial tibial torsion
Hip dysplasia- rare

Atavistic/wandering adduction of great toe

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42
Q

What images are used to track metatarsus adductus

Since most cases self resolve, what parent education piece needs to be followed?

When do these cases need to be referred?

A

Foot photocopies
Hip US

Don’t place baby prone w/ feet turned in

Residual after 3-6mon old
Rigid adductus

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43
Q

An abnormally low or absent arch of the foot that in most cases is a normal variant commonly seen in infants and kids

What is the MC Dx of this variant

A

Flat foot

Flexible flatfoot

44
Q

What are the etiologies of flat foot?

When is idiopathic rigid flatfoot commonly seen?

A

Congenital: tarsal coaltion, vertical talus
Neuromuscular: cerebral palsy, hypotonia
Inflammatory: juvenile idiopathic arthritis

Obesity

45
Q

What PE test is used to assess flatfoot?

How is hindfoot flexibility assessed in these PTs?

A

Jack test: great toe extension test, re-creates arch during weight bearing in a flexible flatfoot

Tiptoe standing

46
Q

What parental education needs to happen for kids w/ flat feet?

What is the exception to Peds needing surgical Tx for their flexible flatfoot?

A

Orthotics have no bearing on self resolving cases
People w/ high arcs are usually in pain while flat feet are ASx

Sxs persist despite stretching, orthosis, and shoe modificaitons= Osteotomy to lengthen lateral foot columns

47
Q

Define Talipes Equinovarus

What is the acronym for this conditions?

A

Club foot

Cavus, midfoot (high arch)
Adduction, forefoot (
Varus, heel (adduction)
Equinus, ankle (plantar flexion)

48
Q

How are positional club foots differentiated from inherent flexibility of a deformity

What congenital d/os are associated with club foot?

A

Spontaneous/rapid resolution
Absence of calf atrophy/foot size difference

Myelomeningocele
Arthrogryposis

49
Q

What PE finding is common in congenital club foot and may even remain after Tx?

What social concern needs to be present when Tx this condition abroad?

What is the TxOC in the US?

A

Calf atrophy

Many of these PTs are ostracized due to belief condition is cursed

Ponseti method: all components of CAVE are Tx except hind foot equinus

50
Q

What causes a Cavus Foot deformity

Define Cavovarus

Define Equinocavovarus

A

Abnormally high arch from equinus (plantar flexion)

Forefoot equinus

Hind foot equinus

51
Q

Unilateral cavus foot is usually due to ? while bilateral cavus feet are due to ?

Define the Meary angle

A

Tethered spinal cord
CMTooth Dz

Cavus foot deformity causing 1st MTP is plantar flexed compared to talus causing increased angle

52
Q

What causes Calcaneal Apophysitis

What ages does this normally self resolve?

A

Activity related pain in posterior heel from stress/microtrauma

9y/o in girls
11y/o in boys

53
Q

What is a common variant seen on x-rays of calcaneal apophysitis

This issue can AKA ?

A

Calcaneous sclerosis

Sever’s Dz

54
Q

Define Accessory Navicular

What may be seen on PE of this issue

A

Secondary ossification center develops on medial portion of tarsal naviular bone at attachment site of tibialis posterior tendon

TTP medial aspect of navicular
Pain w/ inversion resistance
Flexible pes planus

55
Q

What is the TxOC for PTs w/ persistent accessory navicular Sxs

Define Os Trigonum

What causes pain w/ this d/o

A

Excision of navicular portion

Secondary ossification center on posterior talus that is Sx on soccer/ballet

Impingement between talus and tibia w/ plantar flexion

56
Q

Osteochondritis dissecans of the talus may result in ? 3 issues

What is a common cause of rigid flat feet in kids?

A

Pain w/ activity
Locking of joint
Swelling

Tarsal coalition

57
Q

Osteonecrosis of navicular bone is AKA ?

How do these PTs present

How is it best Tx

A

Kohler Dz

Male 4-8y/o w/ limp and out-toeing of foot during walk

Short leg walking cast x 4-8wks

58
Q

Define a Freiberg infarction

How does it present?

A

Osteonecrosis of head of 2nd MT

Adolescents after trauma
TTP on MT head w/ movement

59
Q

How are ASx Hallux Valgus cases Tx

What is the adverse outcome when this presents in Peds?

Define Turf Toe and what causes it

A

Night brace

Post-operative recurrence rate is higher

Sprain of 1st MTP from hyperextension/forced ROM

60
Q

What are two unique facts about Turf Toe

How are these injuries graded

A

Significant morbidity association
Account for more missed game time than ankle sprains

1: stretch injury of the capusle
2: partial tear of plantar ligament
3: complete tear of MTEP ligament; no playing, can’t walk normally

61
Q

What are two adverse outcome from a Turf Toe injury

How are these injuries Tx

A

Hallux Rigidus
Instability

1, 2: stiff/rocker sole shoe
3: protected weight bearing/immobilization x 2wks, 6wk rest period from sports

62
Q

What is the MC cause of lesser toe deformities

A

Improperly fitting shoes
Intrinsic (foot) muscle imbalance
Extrinsic (leg) muscle imbalance

63
Q

Define Claw Toe

This d/o affects ? toes

This can be due to ? issues

A

Fixed extension of MTP, flexion of PIP, +/- DIP contraction

All lesser toes

Charcto Tooth Dz, RA

64
Q

What PT population frequently develops claw toes?

Define Hammer Toe

What is the difference in appearance w/ weight/non-weight bearing

A

DM w/ peripheral neuropathy

Correctable extension deformity of MTP, flexion deformity of PIP, no DIP deformity

Passive extension w/ standing
Neutral w/ non-weight bearing

65
Q

Define Mallet Toe

Which toe is MC affected by hammer/mallet toe?

What has been shown to be the primary cause of a MTP deformity w/ hammer toe

A

Flexion deformity of DIP, normal PIP, MTP

2nd toe due to tight shoes

Plantar plate rupture

66
Q

PTs w/ toe deformities can develop corns ?

PTs w/ hyper extension of the MTP joint, ? bone is displaced plantarly causing inc of pressure on plantar side

A

Dorsum of PIP or tip of toe

Metatarsal head

67
Q

When assessing toe deformities, ? issue needs to be searched for?

When would a neuro work up be indicated for PTs w/ toe deformities

A

Cavus foot

Claw toe w/ high arch

68
Q

How is the presence of a plantar plate rupture assessed for duing a toe deformity PE?

What is the mainstay of Tx for these deformities

A

Anterior drawer/Shock test

Roomy box shoe

69
Q

Sesamoiditis is AKA ?

D/os of these bones include ? 4

A

Dancer’s Toe

Fx
Osteonecrosis
Arthritis
Inflammation

70
Q

What would be seen on PE in sesamoiditis cases

How would normal variants be differentiated from Fxs on x-ray?

A

Pain under 1st MT head and w/ dorsiflexion
ROM restricted

Normal variants- smooth edges
Fx- rough/irregular edges

71
Q

Fungal infections of the nail are called ?

What are the two MC microbes that cause this

What PO meds can be used

A

Onychomycosis

Trichophyton rubrum/mentagrophytes

I/F/K-azole, Terbinafine

72
Q

When are nail fungal infections referred to Ortho?

What are clusters of plantar warts called?

How are warts differentiated from calluses on exam?

A

Old/liver can’t tolerate PO anti-fungals

Mosaic warts

Warts are painful when pinched from sides

73
Q

How are plantar warts managed

What are some causes of metatarsalgia

If these lead to calluses on the sole, the callus is called ?

A

Paring, keratolytic agents (salicyclic acid)

Abnormal metatarsal length
Claw/hammer toes

Intactable plantar keratosis

74
Q

When assessing metatarsalgia, the discovery of a callus in a line formation indicates ?

What test will be positive during PE if there is MTP joint instability

A

Overload of metatarsal head

Anterior drawer (shock test)

75
Q

How are calluses located under a metatarsal head T when associated w/ metatarsalgia

Define an Interdigital Neuroma

A

Plantar condylectomy

Morton’s neuroma/Plantar interdigital neuroma
Perineural fibrosis of common digitalis nerve passing between metatarsal heads
Fibrosis occurs from repetitive irritation of nerves

76
Q

Where do Norton’s Fibromas MC show?

What is the MC presenting issue

A

3rd web space, between 3 and 4th MT heads
2nd then 1st are lower

Plantar pain in forefoot
Dysesthesia/paresthesia
Rarely night pain

77
Q

What PE test is conducted for interdigital neuromas

What may be felt and is indicative of a positive test

A

Piano key test
Compression test

Mulder sign- clicking/grinding MT heads

78
Q

What procedure can be Dx and therapeutic of interdigital neuromas?

If these are persistent and need surgery, what ligament is released to provide comfort?

A

Lidocaine/CCS injection proximal to neuroma

Division of transverse metatarsal ligament to release plantar nerve

79
Q

What are the 3 stages of an ingrown toe nail

Why would x-rays be obtained for Grades 2 or 3

A

Infalmmation
Abscess
Granulation- less painful than stage 2

R/o subungual exotosis and osteomyelitis

80
Q

How are each grades of ingrown nails Tx

Hallux valgus can cause the great to to shift which direction?

What is a common secondary complication seen on PE?

A

1: warm soak, trimming, socks
2: warm soaks w/ Cephalosporin PO
3: partial/complete nail plate excision

Pronate- inward rotation causing medial callus formation

2nd toe over rides that lateral pointing big toe

81
Q

What angles are measured on weight bearing x-rays to assess bunions

What is the initial Tx in adults

A

Hallux valgus angle
Intermetatarsal angle

Education, shoe modification

82
Q

? is AKA for degernerative arthritis of the MTP in great toe

This Dz is the MC ? of the foot and MC ? of the toe

A

Hallux rigidus

Arthritis manifestation
2nd malady, 1st= hallux valgus

83
Q

What do PTs w/ hallux rigidus complain of?

What is the hallmark finding of this issue

What PE finding indicates a severe problem

A

Pain from lateral/dorsal osteophytes
Pain w/ toe off phase of gait

Stiff great toe w/ loss of extension

Pain @ mid range of motion

84
Q

How is Hallux Rigidus Tx w/ surgery

What procedure is reserved for older and lower demand PTs

? procedure is not recommended

A

Cheilectomy
Arthrodesis

Keller procedure

Artificial joint

85
Q

Bunionette is sometimes AKA ?

This is analogous to a ?

What are the common Sxs of Tarsal Tunnel Syndrome

A

Tailor’s bunion

Hallux valgus

Paresthesia/Dysethesia along medial ankle and is worse after walking

86
Q

How can Tarsal Tunnel be managed

If surgery is an option, where is the nerve release done at?

A

Flat foot + pronation= orthotics can relieve Sxs

Distal tunnel released at bifurcation deep to abductor hallucis fascia

87
Q

PTs w/ tarsal tunnel syndrome and pain radiating above the knee or severe pain to light touch need further work up for possible ?

What is the MC cause of medial ankle pain of middle aged PTs?

A

Herniated disk
CRPS

Posterior tibial tendon dysfunction

88
Q

What are preceding risk factors of posterior tendon dysfunction

What are the MC Sxs at presentation

A 
Flexible flatfoot
CCS injection
DM
HTN
Hx of trauma

Pain/swelling at medial ankle

89
Q

What PE finding is seen in posterior tendon dysfunction

What would cause Sxs to get better and change the location of the pain?

A

Too many toe sign- due to forefoot abduction, hindfoot valgus
Inability to stand on toes/ball of foot

Tendon rupture
Lateral ankle pain

90
Q

Posterior tendon dysfunction w/out flat foot is Tx ?

What Tx is recommended if flexible flatfoot it present?

What Tx is recommended if rigid flatfoot is present?

A

Cast/brace x 4wks Activity modification NSAID

Tendon transfer w/ osteotomy realignment

Arthrodesis of hindfoot

91
Q

When are PTs w/ posterior tendon dysfunction referred to Ortho?

Pain around the Achilles tendon can arise from what structures?

A

PTs w/ medial ankle pain

Insertional Achilles tendinosis
Retrocalcaneal bursitis
Haglund syndrome
Pre-Achilles bursitis

92
Q

How is a pump bump in posterior heel pain differentiated from Haglund deformity

What is the MC cause of posterior heel pain in older PTs?

A

Prominent calcaneous processes develop bursa irritated by shoes= bump pump on posterolateral aspect of heel

Insertion tendonosis w/ enthesopathy, calcification and degeneration tears of tendon

93
Q

How is Achilles tendinosis confirmed w/ PE

If it is a retrocalcaneal bursitis, what will be seen on PE?

A

Squeezing tendon inc pain

Swelling, redness and pain anterior to tendon increased w/ squeeze/lateral movement of bursa

94
Q

When should PTs w/ posterior heel pain begin Achilles stretch routines

What non-surgical option may alleviate all Sxs in 6wks

A

After inflammation phase

Casting

95
Q

Where does the plantar fascia originate and insert

Define the Windlass mechanism

A

O: medial tuberosity of calcaneous
I: proximal phalanges

Tightens fascia, Inversion of hindfoot, External leg rotation, Elevates arch

96
Q

What is the MC cause of heel pain in adults

What passive movement can inc pain of plantar fasciitis

When are x-rays needed?

A

Plantar Fasciitis

Dorsiflexion of toes activates windlass mechanism

Systemic Sxs
Pain at rest

97
Q

Half of PTs w/ plantar fasciitis develop ? ortho anomoly sen on x-ray

If a bone scan were to be done, where would increased uptake be seen?

How long can it take for this condition to resolve

A

Enthesophyte at origin of flexor brevis superior to plantar fascia

Medial calcaneal tuberosity

6-12mon

98
Q

What non-surgical Tx is considered for plantar fasciitis after 12mon of non-surgical relief

What are the lateral ligaments of the ankle

What ligamentous structure holds the distal tibial and fibula together

A

Focal shock wave Tx

ATFL, CFL

Anterior tibiofibular syndesmosis

99
Q

What is the MC injury to the subtalar joint

What ligament is on the medial side of the ankle

What PE finding suggests an injury to the tibiofibular syndesomosis

A

Inversion injury tearing ligaments

Deltoid ligament

Squeeze test
External rotation test

100
Q

What is the MC adverse outcome of ankle sprains

What are the 3 phases of rehab

A

Joint instability from incomplete rehab

1: NSAIDs, RICE
2: when PT can bear weight w/out pain/swelling, until full ROM and normal strength
3: agility, proprioception, endurance

101
Q

When does the Thompson test hold the most validity for Dx Achilles tears

How are these Tx w/out surgery

What Tx is recommended for minor and major tears

A

Within 48hrs of injury

Casting/bracing until ankle returns to neutral

RICE, immobilization x 5 days

102
Q

Achilles tears need to be evaluated w/in ? time frame

What predisposing factor increases DM PTs to ulcerations

A

24hrs

Autonomic dysfunction: dry, scaly, cracking skin on feet/legs

103
Q

If PT w/ ulcer on foot can be probed to the bone, what is the Dx

What imaging is used for difficult cases to differentiate between osteomyelitis or Charcot foot?

A

Osteomylelitis

Tech-99 scan

104
Q

If callus develops on the sole of the forefoot, its AKA ?

Usually calluses in this location present w/ ?

A

Intractable plantar keratosis

Metarsalgia

105
Q

Where do heloma molle form

Where do periungual corn develop

A

Toe webs

Painful lesions at edge of nail, usually w/ mallet toe or improper fitting shoes

106
Q

What procedure is reserved for callues that fail non-surgical Tx?

What is a benign thickening of the plantar fascia

A

Plantar condylectomy

Plantar fibroma

IPAP (212 decks)

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