Flashcards in Ankle and Foot Deck (37):
What are the Ottawa ankle rules?
- If there is pain in malleolar zone
- Bone pain in the posterior edge or tip of the medial or lateral malleolus
- Can't weight bear immediately in clinic
What are the Ottawa foot rules?
- Pain in midfoot
- Bone pain in base of 5th MT or navicular
- Can't weight bear immediately or in clinic
What is the 1 - 2 intermetatarsal angle?
- Bisection of 1st and 2nd MT
What is the Hallux Valgus angle?
- Bisection of 1st MT and proximal phalanx
What is mild, moderate, and severe 1-2 intermetarsal angle?
Mild: < 11 degrees
Mod: < 15 degrees
Sev: 15 < degrees
What is a mild, moderate, and severe hallux valgus angle?
Mild: < 20 degrees
Mod: 20 - 40 degrees
Sev: 40 < degrees
What is the WB lateral view of the foot used to measure?
Longitudinal arch measurements
What is the NWB lateral view of the foot used to assess?
What is the Boehler angle? What does is its use? What is normal?
- Calcaneal fractures
- Line joining anterior and posterior calcaneal facets
- Line through posterior facet and superior posterior process
Normal: 25 - 40 degrees
What is the Talometatarsal angle? What is its use? What is normal?
Assesses flat foot
- Line bisecting the (long-axis) of 1st MT
- Line bisecting the (long-axis) of the talus
Normal: 0 - 10 degrees
What is Calcaneal Inclination? What is its use? What is normal?
Assesses flat foot
- Line joining inferior limit of distal calcaneal facet and inferior distal tuberosity
- Plane of support
- Normal 20 - 30 degrees
What is measured in an inversion or stress view? What is considered abnormal?
- Inversion or eversion applied manually
- > 10 degree for either is considered abnormal
What is assessed in a sesamoid view?
- Position of the sesamoids in the groove
What is a unimalleolar fracture?
- Medial or lateral malleolus is fractured
What is a bimalleolar fracture?
- Medial and lateral are fractured
What is a trimalleolar fracture?
- Medial and lateral malleoli are fractured
- Posterior tibial rim is fractured
What is the second most fractured bone in the foot?
Which aspect of the talus is fractured most commonly?
- The neck
What is there a high incidence of with respect to talar fractures?
- Subtalar and ankle DJD
What can help prevent the incidence of AVN in talar fractures?
- Open reduction
- Internal fixation
What age and gender are most susceptible to adult acquired flatfoot?
- Women, 45 - 65 y/o
What are 4 lifestyle factors that can contribute to adult acquired flatfoot?
- Seroneg Arthropathies
What soft tissue dysfunction is associated with adult acquired flatfoot?
- Posterior tivialis tendonitis/ rupture
What is the process of adult acquired flatfoot in relation to posterior tibial dysfunction?
- Loss of dynamic control of medial longitudinal arch
- Stretches static stabilizers
During what phases of gait is supination lacking with PTT?
Where will pain be felt with PTT?
- Medial malleolus
Which stages of adult acquired flatfoot may be recovered from?
Stage I and II
What is stage I of adult acquired flat foot?
- Painful synovitis of PTT, tender to palpation
- Tendon length and function maintained, strength may be 5/5`
What is stage II of adult acquired flatfoot?
- Progressive tendon dysfunction
- Weakness and tendon lengthening
- Flexible flatfoot develops
What is stage III of adult acquired flatfoot?
- Deformity becomes rigid
- Stiff/ arthrosis
What is stage IV of adult acquired flatfoot?
- Tibiotalar valgus
- Arthritic changes progress
What is conservative treatment for stage I and II AAFF?
- Inflammation reduction
- High repetition plantar flexor training
What are 4 surgical options to treat flatfoot?
- Transfer FDL to navicula
- Implant plug to limit subtalar eversion (subtalar arthroereisis)
- Calcaneal osteotomy (Reposition 2 halves of calcaneus so that plantar flexors invert during late stance phase
- Arthrodesis (drill joint, and fuse it)
What 3 joints may recieve arthrodesis?
- Calcaneal cuboid
What are 3 indications for arthrodesis?
- Correct hyperpronantion/ painful flexible flatfoot
- Severe subtalar DJD
What imaging technique is good for assessing stress fractures?