The Lower Leg, Ankle and Foot Flashcards
What is Compartment syndrome in the leg?
Which area is it most common in ?
Acute rapid Increase in pressure within a close fascia
MC is the anterior compartment
What are some causes of Compartment syndrome of the leg?
Direct blow
Crushing injuries
What ranges of motion are now deficient in someone with anterior compartment syndrome
Weak Dorsiflexion
Weak Toe flexion
Decreased sensation over dorsum of foot
What are the 5 P’s associated with compartment syndrome?
Pain Parasthesia Pulselessness Pallor Paralysis
What appearance will someone have with anterior compartment syndrome
Skin is under high tension ==> Shiny appearance
A delta pressure of ________ warrants a fasciotomy
<30 mmHg
Diastolic - Compartment = Delta pressure
In someone with an overused Achilles/Achilles Tendonitis what movements would you expect to be weakened and painfull
Passive stretching of the achilles (dorsiflexion)
Pain with resisted plantar flexion
Treatment for Achilles tendonitis?
Rest Ice NSAiDS stretching Correct footware
What are signs and symptoms that would lead to believe an achilles rupture has occurred?
What movement would be diminished?
Snap/Pop
Obvious gap
Swelling
Plantar flexion
What test can be used to assess a possible TORN achilles
What is a positive test?
Thompson Test
Squeezing on the calf does not cause plantar flexion
Non surgical treatment for torn achilles
Imobilization
Walking boot
Describe the injury to structures in a Grade I, II, III Ankle sprain
Grade I = mild stretch of ATFL
Grade II = Partial tear of ATFL and/or CFL
Grade III= Complete tear of ATFL and CFL
What is the most common MOI of injury for an ankle sprain inversion or eversion?
Inversion
8:1
What ligament is is stretched/torn in an eversion ankle sprain?
Deltoid ligament
What are the Ottawa Ankle Rules for an ankle sprain
Inability to bear weight for more than 4 steps both immediately and at time of evaluation and…
Pain at the malleolar zone
Pain at the distal posterior edge of the fibula or tip of the medial/lateral maleolus
What are the Ottawa ankle rules for an ankle sprain?
Inability to bear weight for more than 4 steps immediately and at time of evaluation and
Pain in midfoot zone and
Boney tenderness at the base of the fifth metatarsal OR
Boney tenderness at the navicular
What are view ordered for most ankle injuries
AP “Mortise” view
Describe an Avulsion/Pull off fracture
Horizontal line
Describe a pull off fracture?
Oblique or vertical line fracture
Describe the MOI for a Maisonneuve’s Fracture?
Rotational stress placed on the medial malleous that makes its way up the upper portion of the fibula
What part of the leg does a Salter harris fracture apply to? Who is the most common in?
Growth plates of the leg
Need to have high suspicion in pediatrics
What areas involve a Lisfranc fracture?
Bases 1st and 2nd metatarsal
The articulation between the 3 cunieforms
What are some signs that will indicate and Lisfranc injury?
Pain and swelling over the tarsometatarsal joint
Echymossis at the base of the foot
What imagine test us used to confirm a Lisfranc injury?
MRI
How is a Lisfrance injury treated?
6-8 weeks of NWB cast + arch support for 3 months
