The Foot and Ankle Lecture Powerpoint Flashcards

1
Q

Distal fibula makes up the ___ malleolus, distal tibia makes up the ___ malleolus

A

lateral, medial

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2
Q

Anterior talofibular ligament function

A

Stabilizes the foot from moving forward

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3
Q

Calcaneofibular ligament function

A

Stabilizes the foot from inverting, often injured in rolling of ankle

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4
Q

Deltoid ligament of the ankle function

A

Multiple ligaments that support the medial malleolus and help limit how common pathology is seen here opposed to other parts

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5
Q

Sprains grading (3)

A

I - stretching or partial tear, minimal to no functional loss, no laxity on stress test
II - incomplete tear, some loss of motion and function, some laxity at end points, some swelling and bruising
III - complete tear and loss of integrity, loss of function and motion (no weight bearing or ambulation), mechanical instability, complete laxity

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6
Q

Anterior drawer test assesses this ligament’s integrity, talar tilt assesses these 2

A
  • anterior talofibular ligament

- calcaneofibular ligament (inversion), deltoid ligament (eversion)

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7
Q

High ankle sprain/syndesmosis injury

A

Injury of the interosseous ligament and associated ligaments between the tibia and fibula, most often mechanism of injury is dorsiflexion and external rotation, will see widening of the syndesmosis space on x ray

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8
Q

Squeeze test

A

Test for syndesmosis injury that tests to see if pain is elicited upon sqeezing the calf together from the sides

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9
Q

Syndesmosis injury treatment options (4)

A
  • rule out associated fractures
  • surgical repair if complete
  • support/stabilization
  • crutches, PT
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10
Q

Achilles tendonitis

A

Overuse inflammation injury seeing pain and swelling along tendon or at heel,

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11
Q

Achilles tendonitis treatment options (3)

A
  • rest for months and NSAIDS
  • avoid steroid injection
  • stretching
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12
Q

Achilles tendon rupture mech of action (3 and sequelae)

A
  • Most often forceful plantarflexion while the knee is extended
  • sudden unexpected dorsiflexion
  • going from plantar to sudden dorsiflex position
  • frequently describe popping sensation followed by pain, inability to bear weight, and inability to plantar flex the ankle
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13
Q

Achilles tendon rupture treatment options

A
  • surgery internal or external fixation in complete tear

- immobilization in plantarflexion for partial tear

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14
Q

Bimalleolar fracture

A

Affects both the tibia and fibula (medial and lateral malleolus), causes loss of ankle mortise

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15
Q

Trimalleolar fracture

A

Affects the distal fibula, distal tibia, and posterior tibia, recommended to be treated by ORIF in many cases

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16
Q

Ankle mortise

A

Bony arch formed between the malleoli forming a rectangular socket in which the foot articulates with the leg

17
Q

Ankle fracture treatment options (2)

A
  • casting in stable cases

- unstable need surgical ORIF

18
Q

Lisfranc injury

A

Injury of the 2nd metatarsal which is already in a lisfranc position (wedged between talar bones) pops dorsally upon a sudden axial load send thru the plantar flexed foot upward

19
Q

Lisfranc injury treatment options (3)

A
  • immobilize
  • nonweight bearing
  • surgical repair
20
Q

Stress fractures diagnostic studies (3)

A
  • initial radiographs not helpful!!!
  • MRI
  • Bone scan to see increased metabolic activity
21
Q

Jones fractures

A

Occurs distal to the tuberosity of the base of the 5th metatarsal (different from avulsion), due to poor blood flow requires long time for healing, can be casted or surgically repaired

22
Q

Dosriflexion eversion test

A

Used to reproduce symptoms of tarsal tunnel syndrome in a patient by dorsiflexing and everting the foot and watching for response

23
Q

Plantar fasciitis definition

A

Caused by collagen degeneration from repetitive microtears of the plantar fascias, often from overuse, pes lanus or cavus at increased risk, first steps of day tend to produce excruciating pain, treated with massage, stretching, strengthening

24
Q

Heel spur (osteophyte)

A

Extremely painful for some osteophyte formation from chronic overuse/inflammation

25
Q

Morton’s neuroma definition and diagnosis (2)

A
  • inflamed nerve due to chronic trauma and repeptitve stress or tight fitting shoes, sees pain and paresthesias in distribution of the nerve involved, lateral compression often elicits symptoms
  • Injection of anesthetic and MRI
26
Q

Callus vs corn

A

Callus is thickened skin that is not painful and has no central core, corn’s central core extends deep into skin and presses on nerve endings resulting in increased sensitivity and pain unlike calluses,

27
Q

Callus and corn treatment options (4)

A
  • padding
  • sharp debridement to reduce tissue
  • changing shoes
  • surgery in extreme cases to fix anatomic predisposition
28
Q

Ingrown toenails treatment

A

-administer digital anesthesia (1% lidocaine no epi), complete or partial nail avulsion or wedge resection

29
Q

Cellulitis treatment options (2)

A
  • fluorquinolone

- non weight bearing, elevation, warm compress