The Lower Leg, Ankle and Foot

Question 1

What is Compartment syndrome in the leg?

Which area is it most common in ?

Answer 1

Acute rapid Increase in pressure within a close fascia

MC is the anterior compartment

Question 2

What are some causes of Compartment syndrome of the leg?

Answer 2

Direct blow

Crushing injuries

Question 3

What ranges of motion are now deficient in someone with anterior compartment syndrome

Answer 3

Weak Dorsiflexion
Weak Toe flexion
Decreased sensation over dorsum of foot

Question 4

What are the 5 P’s associated with compartment syndrome?

Answer 4

Pain
Parasthesia
Pulselessness
Pallor
Paralysis

Question 5

What appearance will someone have with anterior compartment syndrome

Answer 5

Skin is under high tension ==> Shiny appearance

Question 6

A delta pressure of ________ warrants a fasciotomy

Answer 6

<30 mmHg

Diastolic - Compartment = Delta pressure

Question 7

In someone with an overused Achilles/Achilles Tendonitis what movements would you expect to be weakened and painfull

Answer 7

Passive stretching of the achilles (dorsiflexion)

Pain with resisted plantar flexion

Question 8

Treatment for Achilles tendonitis?

Answer 8

Rest 
Ice
NSAiDS
stretching 
Correct footware

Question 9

What are signs and symptoms that would lead to believe an achilles rupture has occurred?

What movement would be diminished?

Answer 9

Snap/Pop
Obvious gap
Swelling

Plantar flexion

Question 10

What test can be used to assess a possible TORN achilles

What is a positive test?

Answer 10

Thompson Test

Squeezing on the calf does not cause plantar flexion

Question 11

Non surgical treatment for torn achilles

Answer 11

Imobilization

Walking boot

Question 12

Describe the injury to structures in a Grade I, II, III Ankle sprain

Answer 12

Grade I = mild stretch of ATFL

Grade II = Partial tear of ATFL and/or CFL

Grade III= Complete tear of ATFL and CFL

Question 13

What is the most common MOI of injury for an ankle sprain inversion or eversion?

Answer 13

Inversion

8:1

Question 14

What ligament is is stretched/torn in an eversion ankle sprain?

Answer 14

Deltoid ligament

Question 15

What are the Ottawa Ankle Rules for an ankle sprain

Answer 15

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

Question 16

What are the Ottawa ankle rules for an ankle sprain?

Answer 16

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

Question 17

What are view ordered for most ankle injuries

Answer 17

AP “Mortise” view

Question 18

Describe an Avulsion/Pull off fracture

Answer 18

Horizontal line

Question 19

Describe a pull off fracture?

Answer 19

Oblique or vertical line fracture

Question 20

Describe the MOI for a Maisonneuve’s Fracture?

Answer 20

Rotational stress placed on the medial malleous that makes its way up the upper portion of the fibula

Question 21

What part of the leg does a Salter harris fracture apply to? Who is the most common in?

Answer 21

Growth plates of the leg

Need to have high suspicion in pediatrics

Question 22

What areas involve a Lisfranc fracture?

Answer 22

Bases 1st and 2nd metatarsal

The articulation between the 3 cunieforms

Question 23

What are some signs that will indicate and Lisfranc injury?

Answer 23

Pain and swelling over the tarsometatarsal joint

Echymossis at the base of the foot

Question 24

What imagine test us used to confirm a Lisfranc injury?

Answer 24

MRI

Question 25

How is a Lisfrance injury treated?

Answer 25

6-8 weeks of NWB cast + arch support for 3 months