lower limb trauma

Question 1

achilles tendon rupture will cause rapid dorsiflexion - will the foot move upwards/downwards? where does this usually occur?
thomas test used for achilles tendon rupture - outline.

Answer 1

upwards (unbalanced tendons)
2-6cm from insertion

thomas test - squeeze calf - this will usually cause plantar flexion, wont in ruptrue.

if acute = brace
chronic = surgery

Question 2

plantar fasciitis will have pain where? outline treatment

Answer 2

pain at bottom of foot, towards heel

physio, anti-inflam, ICE, night splints, steroid injections

Question 3

RED, HOT swollen foot, but elevation reduces this. what is this? why does is occur? which patients are susceptible? possible complication

Answer 3

charcots foot
neuropathy
diabetics
bone breakdown ‘bag of bones’

Question 4

hallux valgus is a bunion on side of big toe, where does hallux rigidus occur? what causes it

Answer 4

on top of big toe

arhritis of 1st MTP

Question 5

tibial plateau fracture- most common area

Answer 5

proximal lateral tibia (can be medial/both)

Question 6

tibial plateau vs shaft fracture

Answer 6

plateau - involves knee joint

shaft - usually proximal 3rd, most common long bone fracture, no Joints involved

Question 7

unable to stand on leg with knee pain and swelling, which fracture more likely? what treatment

Answer 7

plateau (joint)

ORIF - plates nd screws

Question 8

which fracture is the commonest cause of compartment syndrome

Answer 8

tibial shaft fracture

Question 9

in tibial shaft fracture, if fibula not fractured, tibia drifts into __, if fibula is also fractured, this causes __ alignment

Answer 9

TIBIA + NO FIB = VARUS

TIB + FIB = Valgus

Question 10

for tibia shaft fracture, would you need an over knee cast?

Answer 10

yes

Question 11

tenderness over medial retiniculum of the knee would suggest

Answer 11

patellar dislocation

Question 12

femoral neck fracture is likely to cause

Answer 12

AVN

Question 13

pilon fracture

Answer 13

intra-articular fracture of distal tibia (ORIF)

Question 14

another cause of a femoral shaft fracture, other than traum

Answer 14

pagets

Question 15

both tibial and femoral shaft fractures are usually treated with

Answer 15

IM nail

Question 16

fibula fracture usually occurs with __ and external rotation. how does it attach to foot/tibia?

Answer 16

supination
foot - ATFL + CFL
tibia - syndemosis

Question 17

deltoid ligament attaches the __ __ (part of tibia) to foot

Answer 17

medial malleolus

Question 18

fibula fracture is stable if:

Answer 18

isolated - no tibia fractur or ruptured deltoid ligament

Question 19

talar shift is decreased space around tauls t.f

Answer 19

false

incr asymmetrical medial clear space

Question 20

talar tilt is when which to bones are not aligned

Answer 20

talus and tibial

Question 21

talar shift or tilt - which will have a ruptured deltoid

Answer 21

both

Question 22

lis franc fracture - wwhat is, whrre would the pain be?

Answer 22

twisting foot when stepping off curb
midfoot
2nd MTP +/- other dislocations

Question 23

femoral shaft fracture happens in children when fall onto flexed knee. outline treatment for 2-6, 12+ yrs

if under 2, likely cause

Answer 23

2-6 = thomas s[plint + hip spica cast

12+ IM nail

<2 cannot walk -> NAI