2) Foot & Ankle Pathologies

Question 1

What are some causes of foot/ankle pathologies?

Answer 1

Fx
OA & Deformities
Tendon/Ligament Disorders
Nerve Problems
Neuromuscular Disorders
Heel Pain
Tumors
Infections
Sensory Deficits

Question 2

What is the tx for isolated lateral malleolus fx?

Answer 2

Immobilization for 6wks, WBAT

Question 3

What is the tx for bimalleolar & trimalleolar fx’s?

Answer 3

ORIF

Question 4

What is the tx for bimalleolar equivalent fx w/ruptured deltoid ligament?

Answer 4

ORIF

Question 5

What is the tx for pilon (distal tib-fib) fx or shattered ankle?

Answer 5

ORIF

Question 6

What is the tx for open fx’s?

Answer 6

1) Pulsed lavage to sanitize
2) Test for dead muscle
3) IV antibiotics

Question 7

What are the 4 C’s?

Answer 7

Color, Consistency, Contractility, & Capacity to bleed

Question 8

Why are syndesmotic screws not the best?

Answer 8

They’re left in place, so during movement they can heat up & break

Question 9

What is osteochondral defect (OCD) & how is it tx’ed?

Answer 9

Divot that can form in the ankle after injury

Tx’ed w/arthroscopy or OATS to transplant cartilage

Question 10

What is a Hoffman Procedure?

Answer 10

Standard procedure for RA where met head is removed

Question 11

Seronegative Arthritis

Answer 11

Lupus, Soriatic Arthritis, Chrohn’s Disease

Question 12

Septic Arthritis

Answer 12

Infection in the jt

Question 13

UCBL Brace

Answer 13

Controls hindfoot motion

Question 14

What is hallux rigidis & what is the tx?

Answer 14

Bone spur on the dorsal aspect of the foot

Tx: Put pt in a rigid sneaker or carbon fiber insole w/morton’s extension

Question 15

Are total ankle arthroplasties a thing?

Answer 15

Yes, but they come w/a lot of complications

Question 16

Halux Valgus

Answer 16

Abn prominence at the medial aspect of the MTP of the big toe

Question 17

Who is more likely to get hallux valgus and why?

Answer 17

Women; Their footwear

Question 18

Normal 1st MTP Angle

Normal 1st & 2nd Intermetatarsal Angle

Answer 18

MTP=<15°

InterMet>9°

Question 19

How is hallux valgus tx’ed?

Answer 19

Pt ed about proper footwear
Shoe Modification
Silicon Pads
Bunion Splints

Question 20

Shoe Fitting Guidelines

Answer 20

• Stand while being fitted
• Don’t buy shoes that are too tight
• Limit heel height to 2”
• Don’t assume the shoe will fit
• Get a shoe that conforms to the shape of your foot
• Fit shoes to the larger foot
• Buy shoes at the end of the day when feet are largest

Question 21

Peroneal Nerve Palsy

Answer 21

Foot drop as the result of knicking the peroneal nerve during surgery

Question 22

Reflex Sympathetic Dystrophy (CRPS)

Answer 22

Extreme sensitivity to even light touch

Question 23

Plantar Fasciitis

Answer 23

Inflammation of the plantar fascia, especially right off the origin; Typically occurs in middle-aged pt’s

Question 24

What is the most common foot & ankle problem?

Answer 24

Plantar Fasciitis

Question 25

Risk factors for plantar fasciitis

Answer 25

Obesity Prolonged Standing Distance runners w/cavus feet Systemic Diseases

Question 26

What does a physical exam that's (+) for plantar fasciitis show?

Answer 26

Tenderness over plantar fascia origin

Question 27

How is plantar fasciitis tx'ed?

Answer 27

``` Stretching Relative Rest Well-cushioned shoes Silicon heel cushion NSAIDS Night Splints Casting ```

Question 28

What are cortisone shots not recommended for plantar fasciitis?

Answer 28

It can cause fat pad atrophy which can lead to plantar fascia tear

Question 29

When is surgical release for plantar fasciitis done?

Answer 29

After 6mo of failed tx

Question 30

Complications of plantar fasciitis release surgery:

Answer 30

* Loss of arch * Lateral foot pain * Nerve injury * Recurrent heel pain

Question 31

Risk factors of insensate foot:

Answer 31

* Alcoholism * Syphilis * Leprosy * Syringomyelia * Beriberi * Pesticides * Meds * Heavy Metals * Endocrine Disorders