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ms 1 - 2nd shift > Conditions affecting the Ankle joint > Flashcards

Conditions affecting the Ankle joint Flashcards

1
Q

Excessive prominence of the posterosuperior aspect of the calcaneus (where achilles tendon is inserted)

Symptoms are due to rubbing against the calcaneal prominence of the heel counter of the shoe
- Chronic inflammation of the adventitious superficial pretendinous Achilles bursa
- Coexists with retrocalcaneal bursitis

A

Haglund deformity

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2
Q

Developmental and aggravated by shoe wear

has gout

A

etiology of hugland deformity

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3
Q

Pain on the posterior heel

Signs of skin irritation like skin erythema and focal swelling

If there is retrocalcaneal bursitis, sign & symptoms of this symptoms will be seen

A

Signs and symptoms of haglund’s deformity

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4
Q

Radiographs

There is an extra bone formation at the prominence of the heel

A

Dx of Haglund deformity

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5
Q

Ice, heel lift, open back shoe (wear wedged shoes)
NSAID
Steroid injection
Surgical – excision of bony prominence and retrocalcaneal bursitis

A

Treatment of Haglund deformity

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6
Q

Failure of the lateral tubercle of the posterior process to unit with the body of the talus during ossification (8-10 for girl, 11-13 for boys) producing impingement with extreme plantar flexion

Present in 10% of patients

A

Os Trigonum

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7
Q

Persistent separation of the secondary center of the lateral tubercle from the remainder of the posterior talus secondary to the microtrauma during development

A

Congenital cause of Os Trigonum

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8
Q

Secondary to an actual fracture that did not unite

Common in young athletes who actively plantar flexes the foot such as gymnasts, ice skaters, ballet dancers, soccer players

A

Acquired cause of Os Trigonum

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9
Q

Pain on the posterolateral of the ankle due to impingement of the posterior talus between posterior tibial and calcaneus

Hypertrophic capsulitis

Concurrent posteromedial due to flexor hallucis tendonitis

A

Signs and symptoms of Os Trigonum

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10
Q

Conservative – Rest, NSAID

Surgery if it doesn’t go away

A

Management of Os Trigonum

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11
Q

Disruption of the Achilles tendon

Due to degeneration and repeated microtrauma/microstress

A

Achilles Tendon Rupture

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12
Q

Antecedent non insertional Achilles tendinitis

Sedentary lifestyle

Use of steroids (oral or injection)

Systemic disease such as gout

A

Risk factors of Achilles Tendon Rupture

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13
Q

Non surgical with cast

pt foot in plantarflexion,

Surgical reconstruction for chronic rupture

A

treatment for achilles tendon rupture

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14
Q

Higher re-rupture rate

Incomplete return of function and performance (no extreme activities)

Surgical

Infection

Wound dehiscence (infection at the wound and it opens again)

A

complications of achilles tendon rupture

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15
Q

classification of achilles tendon rupture

A

acute, chronic

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16
Q

Delay of 2 months as chronic or neglected while other consider 3 months as chronic

A

Chronic achilles tendon rupture

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17
Q

Painful pop on the distal aspect of the heel cord

Weak ankle plantarflexion

+ Simon’s sign (palpable defect in the tendon)

Thomson’s test – squeezing the calf

A

Symptoms of achilles tendon rupture

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18
Q

squeezing the calf

A

Thomson’s test

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19
Q

palpable defect in the tendon

A

+ Simon’s sign

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20
Q

Lateral Ligaments complex of the ankle

A

The anterior talofibular ligament (ATFL)
The calcaneofibular ligament (CFL)
The posterior talofibular ligament (PTFL)

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21
Q

is a strong, flat, triangular band, attached, above, to the apex and anterior and posterior borders of the medial malleolus.

A

The deltoid ligament (or medial ligament of talocrural joint)

22
Q

Components of ankle deltoid ligament

A

Anterior tibiotalar ligament
Tibiocalcaneal ligament
Posterior tibiotalar ligament
Tibionavicular ligament.

23
Q

2 types of ankle sprain

A

high ankle sprain

low ankle sprain

24
Q

syndesmosis injury
1-10% of all ankle sprains

nasa distal tibi-fibular jt

A

high ankle sprain

25
Q

ATFL and CFL injury
>90% of all ankle sprains

A

low ankle sprain

26
Q

most commonly involved ligament in low ankle sprains

mechanism is plantar flexion and inversion

physical exam shows + drawer’s test

A

ATFL (anterior talofibular ligament)

27
Q

2nd most common ligament injury in lateral ankle sprains

mechanism is dorsiflexion and inversion

physical exam shows drawer laxity in dorsiflexion

subtalar instability can be difficult to differentiate from posterior ankle instability because the CFL contributes to both

A

CFL (calcaneo fibular ligament)

28
Q

less commonly involved ligament

A

PTFL (posterior talofibular ligament)

29
Q

clinical features of ankle sprain

A

pain w weight bearing

recurrent instability

catch or popping sensation may occur following recurrent sprains

30
Q

focal tenderness and swelling over involved ligament

anterior drawer test

pain and tenderness and swelling on lateral aspect of foot

A

physical exam for ankle sprain

31
Q

The examiner then places the patient’s foot into 10-15 degrees of plantar flexion and translates the rear foot anteriorly.

A positive test results if the talus translates forward. Positive test results are often graded on a “0 to 3 scale”, with 0 indicating no laxity & 3 indicating gross laxity

A

Drawer’s test

32
Q

ATFL best tested in

A

plantarflexion

33
Q

CFL best tested in

A

dorsiflexion

34
Q

With the ankle in neutral, gentle inversion force is applied to the affected ankle and is compared to the opposite ankle (invert/evert)

A

Talar tilt test

35
Q

+ talar tilt test indicates injury to

A

ATFL and CFL

36
Q

no ligament disruption

minimal swelling

normal weight bearing

A

grade I ankle sprain

37
Q

stretch without tear

moderate swelling

mild pain w weight bearing

A

grade II ankle sprain

38
Q

complete tear of ligament

severe swelling

severe pain w weight bearing

A

grade III ankle sprain

39
Q

Also known as a “high ankle sprain”

A

Syndesmosis ankle sprain

40
Q

most commonly associated with external rotation injuries

A

mechanism of injury of syndesmosis ankle sprain

41
Q

Foot is planted on the ground and then an excessive outwards twisting of foot occurs

A

pathoanatomy of syndesmosis ankle sprain

42
Q

incidence 0.5% of all ankle sprains without fracture
13% of all ankle fractures

A

Syndesmosis ankle sprain

43
Q

distal tibiofibular syndesmosis includes

A

anterior-inferior tibiofibular ligaments (AITFL)

posterior-inferior tibiofibular ligament (PITFL)

interosseous membrane

44
Q

originates from anterolateral tubercle of tibia

inserts on anterior tubercle of fibula

A

anterior-inferior tibiofibular ligaments (AITFL)

45
Q

riginates from posterior tubercle of tibia

inserts on posterior part of lateral malleolus

strongest component of syndesmosis

A

posterior-inferior tibiofibular ligament (PITFL)

46
Q

maintains integrity between tibia and fibula

resists axial, rotational, and translational forces

A

function of distal tibiofibular ligaments

47
Q

syndesmosis widens 1mm during gait

A

normal gait of syndesmosis ankle sprain

48
Q

anterolateral ankle pain proximal to AITFL

may have medial sided ankle tenderness/swelling
difficulty bearing weight

A

Sx of Syndesmosis Ankle Sprain

49
Q

palpation
syndesmosis tenderness is the single best predictor for return to play
+ squeeze test

A

Physical exam of Syndesmosis ankle sprain

50
Q

Examiner grasps the patient’s leg midway up the calf and perform a compress and release motion

+ test if patient experiences pain in the syndesmosis

A

Squeeze test

51
Q

non-weight-bearing CAM (control ankle motion) boot or cast for 2 to 3 weeks

indications

A

non operative treatment of syndesmosis ankle sprain

52
Q

Syndesmosis screw fixation

fiberwire suture with two buttons tensioned around the syndesmosis

A

operative treatment of syndesmosis ankle sprain

ms 1 - 2nd shift (13 decks)

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