Adult Foot and Ankle Disorders

Question 1

what is the most common foot and ankle pathology?

Answer 1

Hallux Valgus

Question 2

the eye doesn’t see what…

Answer 2

the mind doesn’t know

Question 3

name the 3 rockers in the gait of the foot

Answer 3

1st Rocker - Heel strike to flat foot
2nd Rocker - Mid stance
3rd Rocker - Heel rise

Question 4

Pes Planus is a normal varient associated with ligamentous laxity

true or false?

Answer 4

true

Question 5

what is the most common cause of acquired flatfoot deformity in adults?

Answer 5

tibialis posterior dysfunction

Question 6

what is the course of tibialis posterior dysfunction?

Answer 6

immediately posterior to medial malleolus

attaches on to navicular tuberosity and plantar aspect of medial and middle cuneiforms

primary dynamic stabiliser of medial longitudinal arch – elevates arch

invertor & plantar-flexor

Question 7

in whom is tibialis posterior dysfunction common in?

Answer 7

obese
middle aged
female
flat foot
hypertension
diabetes
steroids

Question 8

what is sign of tibialis posterior dysfunction?

Answer 8

Pain and/or swelling posterior to medial malleolus – very specific

Question 9

how many types of TPD are there?

Answer 9

I, II, III, IV

Question 10

what is the treatment in TPD?

Answer 10

physiotherapy
insole
footwear
surgery

Question 11

what is Pes Cavus?

Answer 11

claw foot

Question 12

what is plantar fasciitis?

Answer 12

tenderness over plantar aspect of heel and/or plantarmedial aspect of heel

fullness or swelling plantarmedial aspect of heel

Question 13

plantar fasciitis is worse after ________.

Answer 13

exercise

pain after rest also

Question 14

what are the causes of plantar fasciitis?

Answer 14

physical overload - exercise or weight
seronegative arthropathy
diabetes
abnormal foot shape
improper footwear?

Question 15

what is the treatment in plantar fasciitis?

Answer 15

NSAIDs
night splints
taping
heel cups
physiotherapy
injection steroid
surgery - 50/50

Question 16

the best treatment of plantar fasciitis is…

Answer 16

self management

self limiting over 18-24 months

Question 17

what is Hallus Valgus?

Answer 17

deformity of 1st MTPJ - bunion

Question 18

what is the incidence of Hallus Valgus?

Answer 18

increases with age
bilateral
3F > 1M
adolescence
RA

Question 19

what is Hallux Rigidus?

Answer 19

osteoarthritis of 1st MTPJ

Question 20

what is the management in Hallux Rigidus?

Answer 20

Non-operative

Operative:

• Joint replacement
• Fusion (arthrodesis)

great success rates

Question 21

RA effects the feet in __% or cases

Answer 21

90%

Question 22

what foot condition is seen in diabetic patients?

Answer 22

Charcot’s

Question 23

what does Charcot’s do?

Answer 23

melts the bone

Question 24

what is Mortons’s neuroma?

Answer 24

degenerative fibrosis of digital nerve near it’s bifurcation

Question 25

what is the most common part of the foot where pain is experienced in Mortons's neuroma?

Answer 25

forefoot (metatarsalgia)

Question 26

what is the mean age of Mortons's neuroma? what sex?

Answer 26

45-50 female

Question 27

what is the management in Mortons's neuroma?

Answer 27

non-operative = insoles and injections operative = excise

Question 28

what is tendon-achilles tendinosis?

Answer 28

repetitive microtrauma, failure of collagen repair with loss of fibre alignment/structure

Question 29

in what age does tendo-achilles rupture occur in?

Answer 29

over 40 with pre existing tendiosis

Question 30

what are the clinical signs of tendo-achilles rupture?

Answer 30

unable to bear weight weak plantar flexion positive calf squeeze (Simmonds) test

Question 31

what causes ankle sprains?

Answer 31

twisting forces - inversion on planted foot

Question 32

ankle sprains take ______ to resolve than fracture

Answer 32

longer

Question 33

Brostrum Gould and Chrisman Snook are the _________ management of ankle sprains

Answer 33

operative

Question 34

what is the classification of ankle fractures?

Answer 34

Weber A, B, C

Question 35

Distal fibula fracture with no medial malleolus fracture or deltoid ligament rupture stable or unstable ankle fracture?

Answer 35

stable

Question 36

Distal fibula fracture WITH medial malleolus fracture or deltoid ligament rupture stable or unstable ankle fracture?

Answer 36

unstable

Question 37

what are Pilon fractures and what causes them?

Answer 37

a fracture of the distal part of the tibia, involving its articular surface at the ankle joint high energy like falls and road traffic accidents

Question 38

a Jones fracture is a fracture of what?

Answer 38

the base and middle part of the fifth metatarsal of the foot

Question 39

what is a Lisfranc injury?

Answer 39

injury of the foot in which one or more of the metatarsal bones are displaced from the tarsus

Question 40

calcaneus fractures are caused by that?

Answer 40

fall from height on feet