Acute Foot and Ankle Pain Flashcards Preview

Med School Year 2 Flash Cards > Acute Foot and Ankle Pain > Flashcards

Flashcards in Acute Foot and Ankle Pain Deck (21):
1

Where are the malleoli of the ankle?

Medial: tibia
Lateral: fibula
Posterior: posterior distal tibia

2

What are the ligaments of the ankle?

ATFL: anterior talofibular ligaments (inversion)
PTFL: posterior talofibular ligament
CFL: calcaneal fibular ligaments (dorsiflexion)
PTTL: posterior tibiotalar ligament
TCL: tibiocalcanela ligament
ATTL: anterior tibiotalar ligament
TNL: tibionavicular ligament

3

Ankle sprain history

Rolled
Felt pop
Swelled quickly
Hurts to walk
Stepped off curb wrong
Twisted rounding a base
Stepped on players foot

4

Ankle sprain PE

Swollen, bruised, limping, pain along ligaments
Posterior lateral malleolus, posterior medial malleolus pain and inability to bear weight

5

Ankle sprain test

Anterior Drawer: tibia forward
Talar Tilt: adduct and invert calcaneous to a varus position
Syndesmosis: squeeze tibia and fibula

6

Ankle sprain imaging

X-rays: AP, Lateral, Mortise
MRI usually not done

7

Ankle sprain classification

I: ATFL
II: ATFL and CFL, mild laxity in one or both
III: ATFL and CFL, significant laxity in both
ALL NONOPERATIVE unless recurrent sprains in ADLs

8

Ankle fracture history

Twisting/rotation of ankle
Low energy
Pop
Swelling
Inability to bear weight
Bruising

9

Ankle fracture PE

Swelling, bruising, crepitus to palpation of malleoli, deformity

10

Ankle fracture imaging

x-rays

11

Ankle fracture treatment

nonop in isolated lateral malleolus fracture with joint congruent - cast or walking boot
op in bimalleolar or trimalleolar - ORIF

12

Base of the 5th Metatarsal Fracture is what kind of fracture and usually occur after what

Avulsion fractures that occur after adduction injury to the forefoot (twisting of foot)

13

5th metatarsal fracture treatment

hard soled shoe (avulsion or transverse diaphysis), nonweightbearing for 6 to 8 weeks in a jones, hardly ever results in nonunion but that would be treated with ORIF

14

5th MT fracture PE

pain lateral foot, midfoot swelling, bruising

15

5th MT fracture imaging

x-rays: AP, lateral, oblique

16

Three types of 5th MT fractures

1. Avulsion fracture of a variably sized portion of tuberosity (can involve joint between cuboid and 5th)
2. JONES fracture, intermetatarsal joint (MD jxn)
3. transverse fracture of the proximal metatarsal diaphysis

17

why must you not miss a Jones fracture?

lack of blood supply can cause it not to heal and need for surgery

18

achilles tendon rupture hx

active men/women that are weekend warrior
sudden forced dorsiflexion while gastroc is contracting
sudden pain after push off or changing direction
immediate weakness
fall to ground

19

achilles rupture PE

weak plantar flexion
thompson test: examiner squeeze calf and foot doesnt move = + test
bruising
gap in back of leg

20

achilles rupture imaging

x-rays to make sure no bony injury
MRI confirmatory (esp for partial tears)

21

achilles rupture treatment

nonop: sedentary, diabetics, high chance of re-rupture so use plantar flexed cast
op: younger, re ruptured, HEALING PROBLEMS