Foot & Ankle Flashcards
(251 cards)
1
Q
Where does the bifurcate ligament attach?
A
Originates: Anterior process of the calcaneus; Inserts: dorsal navicular and cuboid
2
Q
What is the classic characteristic of a subtle cavovarus deformity?
A
mild heel varus and plantar flexed first ray
3
Q
What are the most common pathologies of subtle cavovarus foot?
A
lateral column overload, stress fractures, and injury to the peroneal tendons and/or the lateral ankle ligaments.
4
Q
What is the first line treatment for subtle cavovarus foot?
A
first line treatment of subtle cavus foot should include custom full-length orthoses with a recess under the first metatarsal head, post at the lateral forefoot, lowered arch, and a heel cushion.
5
Q
What is a Stieda process?
A
Extended lateral tubercle of the posterior process of the talus
6
Q
Neurologic injury is the most common complication of ankle arthroscopy. The nerve most commonly injured is at risk during placement of which portal?
A
The SPN is the most commonly injured nerve; it is at risk with the anterolateral portal
7
Q
What structure is at risk with placement of an anterior-central portal in ankle arthroscopy?
A
the DPN and DPA
8
Q
What is the optimal position for ankle arthrodesis?
A
Plantigrade, 10° external rotation, 5° valgus, posterior positioning of the talus on tibial plafond (5 mm posterior)
9
Q
What is Baxter’s nerve entrapment?
A
Entrapment of the first branch of the lateral plantar nerve; elicited by Tinel’s at origin of abductor hallicus
10
Q
What is the definition of Lisfranc injury?
A
traumatic disruption between the articulation of the medial cuneiform and base of the second metatarsal.
11
Q
In a Lisfranc injury, the metatarsals displace in […] direction
A
dorsal/lateral
12
Q
The Lisfranc ligament is an interosseous ligament that goes from […] to […] on plantar surface
A
medial cuneiform; 2nd metatarsal base
13
Q
The Lisfranc ligament is an interosseous ligament that goes from medial cuneiform to base of 2nd metatarsal on […] surface of the foot
A
plantar
14
Q
Lisfranc ligament tightens with […] and […] of forefoot
A
pronation; abduction
15
Q
Injury of the plantar ligament between the medial cuneiform and the second and third metatarsals along with the Lisfranc ligament is necessary to give […] instability.
A
transverse
16
Q
What is the most common complication of Lisfranc injury?
A
mid foot osteoarthritis
17
Q
In patients with a malunited Lisfranc injury, who are not good candidates for surgery, what shoe wear can be used in treatment?
A
rocker bottom with cushioned heel
18
Q
What percentage of patients who undergo ORIF for Lisfranc have HWR?
A
75%
19
Q
What percentage of patients who undergo primary arthrodesis for a Lisfranc injury have HWR?
A
20%
20
Q
What foot deformity is seen in Lisfranc injury treated non operatively (or malreduced ORIF?
A
planovalgus
21
Q
What is the insertion of the peroneus tertius?
A
dorsal diaphysis of 5th metatarsal
22
Q
What inserts to the tuberosity/base of the 5th metatarsal?
A
Peroneus brevis and lateral band of the plantar fascia
23
Q
What is the insertion site for the lateral band of the plantar fascia?
A
Base/tuberosity of the 5th metatarsal
24
Q
What is the blood supply to the base of the 5th metatarsal?
A
metaphyseal vessels and diaphyseal nutrient artery
25
Zone 3 Jones fractures are associated with what foot deformity?
cavovarus foot (also sensory neuropathies)
26
In the setting of a 5th metatarsal base fracture, callus forms [...] first and progresses [...]
medially; laterally
27
In the setting of a 5th metatarsal base fracture, [...] fracture gap lends poor prognosis for union with nonoperative treatment
plantar
28
Treatment of a zone 2 Jones fracture non-operatively has a [...] non-union rate and [...] risk of re-fracture.
high; high
29
What is the risk of re-fracture in a zone 2 jones fracture treated non-operatively?
33%
30
What is the treatment for a Zone 2 Jones fracture in an athlete?
intra-medullary screw fixation
31
A screw size less than [...] is a risk factor for non-union in the treatment of intramedullary screw fixation for a Jones fracture.
4.5 mm
32
Running and impact activities can commence at 6 weeks in the surgical treatment of Jones fractures, if surgical site pain-free and [...]
signs of radiographic callus
33
What foot deformity is a risk factor for re-fracture in a Jones fracture?
cavovarus
34
Which nerve can be injured with intra-medullary screw fixation of a Jones fracture?
dorsal lateral branch of the sural nerve
35
The dorsolateral branch of sural nerve is within [...] of the 5th metatarsal tuberosity
2-3 mm
36
The [...] nerve is within 2-3 mm of the 5th metatarsal tuberosity
dorsolateral branch of sural
37
Achilles tendon ruptures usually occur [...] in hypovascular region
4-6 cm above the calcaneal insertion
38
The achilles tendon receives its blood supply from the [...]
posterior tibial artery
39
Achilles tendon ruptures treated with bracing/casting have [...] plantar flexion strength compared to operative management
equivalent
40
Achilles tendon ruptures treated with bracing/casting have [...] rates of re-rupture if functional rehabilitation used versus operative repair
equivalent
41
Achilles tendon ruptures treated with bracing/casting have [...] complications compared to operative treatment
fewer
42
Achilles tendon ruptures treated with open end to end repair have decreased risk of re-rupture after surgical repair when [...] protocol used
early ROM
43
Percutaneous achilles tendon repair have increased rates of [...] nerve injury compared to open repair
sural
44
Percutaneous achilles tendon repair have [...] risk of wound complications/infection compared with open repair
lesser
45
Treatment of chronic achilles tendon ruptures with a VY advancement is indicated when there is less than a [...] defect
3 cm
46
Treatment of a chronic achilles tendon rupture with a FHL transfer and VY advancement is indicated when there is a defect measuring greater than [...]
3 cm
47
Chronic achilles tendon ruptures with >3 cm defect are surgically treated with [...]
flexor hallucis longus transfer +/- VY advancement of gastrocnemius
48
Reconstruction of an achilles tendon rupture with a flexor hallucis longus transfer +/- VY advancement of gastrocnemius requires a functioning [...] nerve.
tibial
49
In performing a flexor hallucis longus transfer for a achilles tendon repair, the FHL tendon is released at the [...] and transferred through the calcaneus
knot of Henry
50
The knot of Henry is a cross over of what two muscles?
FHL and FDL
51
At the Knot of Henry, which muscle is more plantar?
FDL is plantar to FHL at knot of Henry
52
Which nerve can be entrapped at the Knot of Henry?
Medial plantar nerve
53
What is the most common cause for wound complications in the surgical treatment of the achilles tendon ruptures?
Smoking
54
Sural nerve injury is higher when which surgical approach is used in the treatment of achilles tendon ruptures?
Percutaneous repair/approach
55
The most common pattern of Peroneal tendon tears is a [...]
longitudinal split tear in the PB
56
What foot deformity/alignment is associated with peroneal tendon injury?
cavovarus hindfoot alignment
57
What accessory muscle is associated with peroneal tendon injury?
accessory peroneus quartus or quintus
58
Peroneus breves lies [...] and [...] to the peroneus longus at the level of the lateral malleolus
anterior; medial
59
What nerve root innervates peroneus brevis?
S1 (SPN)
60
What nerve root innervates peroneus longus?
S1 (SPN)
61
What is the origin and insertion of the superior peroneal retinaculum?
originates from the posterolateral ridge of the fibula and inserts onto the lateral calcaneus (peroneal tubercle)
62
What is the primary restraint of the peroneal tendons within the retromalleolar sulcus?
superior peroneal retinaculum
63
At the level of the peroneal tubercle of the calcaneus, the peroneus brevis lies [...] to the peroneus longus
superior
64
At the level of the peroneal tubercle of the calcaneus, the peroneus longus lies [...] to the peroneus brevis.
inferior
65
What is the blood supply to the peroneal brevis and longus?
branches of anterior and posterior tibial arteries via vincula
66
What is the apprehension test for peroneal tendons?
active dorsiflexion and resisted eversion
67
Proximal migration of the os peroneum is indicative of a [...] rupture
peroneus longus
68
What is the treatment for acute peroneal brevis/longus instability in nonprofessional athletes?
short leg cast with PWB x 6 weeks; activity modification; PT
69
In treatment of peroneal tendon instability, the addition of [...] shows higher rate of return to sport than SPR repair alone
groove deepening
70
Tenosynovectomy and tendon debridement with tubularization is indicated with recalcitrant and symptomatic PB/PL tears less than [...] of the tendon width
50-60%
71
Tenodesis of distal and proximal ends of the brevis tendon to the peroneus longus is indicated when greater than [...] percent of the peroneus brevis tendon is involved
50%
72
In the treatment of peroneal tendon tears, debridement with graft placement is indicated when >50% of the tendons are involved with preserved [...]
muscle excursion
73
In the treatment of peroneal tendon tears, debridement with FDL or FHL transfer is indicated when >50% of the tendons are involved and there is no [...]
muscle excursion
74
What is the most common complication following surgery for peroneal tendons?
Sural nerve neuroma
75
What is the most common cause of adult acquired flat foot deformity?
Posterior tibial tendon insufficiency
76
Posterior tibial tendon insufficiency contributes to attritional failure of [...] stabilizers and collapse of the [...]
static hindfoot; medial longitudinal arch
77
What is the origin of the posterior tibialis muscle?
posterior fibular, tibia, and interosseous membrane
78
What nerve root innervates the posterior tibialis?
L4-5
79
The anterior limb of the posterior tibialis tendon inserts where?
navicular tuberosity and medial cuneiform
80
The middle limb of the posterior tibialis tendon inserts where?
second and third cuneiforms, cuboid, and metatarsals 2-4
81
The posterior limb of the posterior tibialis tendon inserts where?
sustentaculum tali
82
What is the primary dynamic support for the arch of the foot?
Posterior tibialis tendon
83
Posterior tibialis tendon [...] and [...] the forefoot during stance phase of gait
adducts; supinates
84
What is the major antagonist to the posterior tibialis tendon?
Peroneus brevis
85
Activation of posterior tibialis tendon allows locking of the [...] joints creating a rigid lever arm for the toe-off phase of gait.
transverse tarsal
86
Activation of posterior tibialis tendon allows locking of the transverse tarsal joints creating a rigid lever arm for the [...] phase of gait.
toe-off
87
A Meary angle of greater than [...] degrees indicate pes planus
4
88
What is a normal degree of calcaneal pitch on a lateral foot XR?
17-32 degrees
89
What is the primary static stabilizer of the talonavicular joint?
Spring ligament
90
In treating PTTI with an AFO, a [...] orthotic post is utilized to support valgus collapse
medial
91
What is the first line treatment for stage I of PTTI?
Walking cast/boot FOR 3-4 months
92
In treating PTTI with a custom orthotic, a [...] heel post with longitudinal arch support is utilized.
medial
93
In treating PTTI with a custom orthotic, a medial forefoot post is indicated if [...] is present
fixed forefoot varus
94
What tendon can be transferred in the treatment of posterior tibialis tendon insufficiency?
FDL
95
A triple arthrodesis includes which joints?
Calcaneocuboid, talonavicular, subtalar
96
What is a Haglund deformity?
an enlargement of the posterosuperior tuberosity of the calcaneus
97
Histology of achilles tendonitis shows what?
disorganized collagen with mucoid degeneration
98
In the treatment of achilles tendonitis, tendon transfer or augmentation with FDL, FHL or PB, is indicated what greater that [...] percent of the achilles tendon must be debrided
50
99
In the treatment of achilles tendonitis which tendon transfer is associated with greater ankle plantar flexion strength post op?
FHL
100
Which three muscles share a common origin on the medial calcaneal tubercle and may be inflamed in plantar fasciits?
abductor hallucis, flexor digitorum brevis, and quadratus plantae
101
Corticosteroid injections for plantar fasciitis can lead to [...] atrophy or [...] rupture
fat pad; plantar fascia
102
Pre-fabricated shoe inserts shown to be [...] effective than custom orthotics in relieving symptoms of plantar fasciitis when used in conjunction with achilles and plantar fascia stretching
more
103
A non-weight bearing, plantar fascia specific stretching program is [...] effective than weight bearing Achilles tendon stretching programs in the treatment of plantar fasciitis.
more
104
Complete release of the plantar fascia should be avoided as it may result in destabilization of the [...], overload of the [...], and [...] foot pain
longitudinal arch, lateral column, dorsolateral
105
Which treatment modality allows for quicker return to play in athletes with a type II jones fracture?
Intramedullary screw fixation
106
Which vein often lies just lateral to the sural nerve?
small saphenous vein
107
FHL transfer for the treatment of insertional achilles tendinopathy results in [...] plantar flexion strength and [...] great toe flexion strength.
increased; no difference
108
What is a Cotton osteotomy?
Plantarflexion opening wedge medial cuneiform osteotomy
109
In the setting of calcaneal malunion, what is the indication for bone block arthrodesis?
The classic indication for bone block arthrodesis is ANTERIOR ankle pain and limited dorsiflexion
110
The spring ligament complex is comprised of what two ligament?
inferior calcaneonavicular and superomedial calcaneonavicular (CNL) ligaments
111
In chronic peroneal tendinopathy, the pathology often occurs near the [...] tunnel.
cuboid
112
What hind foot alignment is seen in peroneal tendinopathy?
Cavovarus
113
In treatment of achilles tendinopathy, Achilles tendon debridement greater than [...] percent indicates FHL/tendon transfer
50
114
Posterior tibialis tendon insufficiency primarily affects which joint?
Transverse tarsal joint; unable to lock transverse tarsal joint during gait
115
Posterior tibialis tendon insufficiency affects which stage of gait?
late stance / toe-off
116
What is the insertion of FHL?
plantar aspect of the great toe distal phalanx
117
What is the insertion of FDL?
plantar aspect of the distal phalanges of the lesser toes
118
In midfoot-driven AAFD, the cuneiform subluxates [...] on the navicular.
Dorsally
119
Are medial or lateral talar dome osteochondral lesions more common?
medial
120
Do medial or lateral talar dome injuries usually have a history of trauma?
Lateral
121
Is the anterior or posterior portion of the talus more broad?
anterior portion broader than posterior
122
What artery provides the majority of the blood supply to the talus?
The deltoid artery
123
[...] hind foot alignment is associated with talar dome injuries.
Cavus
124
MRI findings will show [...] in unstable talar dome injuries
fluid deep to the subchondral bone
125
What is the treatment for an acute, non-displaced fragment of the the talar dome with incomplete fracture?
immobilization & non-weightbearing
126
Arthroscopy with debridement and marrow stimulation can be a treatment option for talar dome lesions less than [...] in size.
1 cm
127
Operative treatment of talar dome fractures with retrograde drilling and/or bone grafting is indicated in lesions greater than [...] in size with an intact cartilage cap.
1 cm
128
Operative treatment of talar dome lesions with osteochondral grafting is indicated in displaced lesions greater than [...] in size.
1 cm
129
[...] percent of the gait cycle is spent in stance phase
60%
130
During [...] phase of gait, the leg accepts body weight and provides single limb support
stance
131
What are the two phases of gait?
Stance phase and swing phase
132
In the gait cycle, during initial heel strike, the [...] contract to stabilize the hip.
hip extensors
133
Toe flexors and tibialis posterior contract and are the most active during the [...] phase of the gait cycle
terminal stance
134
The gluteus medius and calf muscles undergo eccentric contraction during which phase of the gait cycle?
Mid-stance
135
In Hallux valgus, valgus deviation of phalanx promotes [...] position of metatarsal
varus
136
In hallux valgus, the metatarsal heads translate [...]
medially
137
Sesamoids of the great toe are embodied in what muscle tendon?
flexor hallucis brevis tendon
138
Sesamoids of the great toes are within the respective head of the flexor hallucis brevis tendon and are attached to the base of the proximal phalanx via the [...] ligament
sesamoid-phalangeal
139
What muscle/tendon is the deforming force in hallux valgus?
adductor hallucis
140
Which muscle causes plantarflexion and pronation of the first phalanx in hallux valgus?
Abductor hallucis
141
What foot deformity is associated with progression of hallux valgus?
Pes planus
142
In Juvenile and Adolescent Hallux valgus, which angles are usually increased and can help differentiate from adult hallux valgus?
IMA widened and DMAA usually increased
143
What is the most common complication of adolescent hallux valgus?
recurrence is most common complication (>50%)
144
In hallux valgus, sesamoids displace [...] to metatarsal head
lateral
145
What is the insertion of the adductor hallux muscle?
lateral aspect of the proximal phalanx of the great toe
146
What is the innervation of adductor hallux?
Lateral plantar nerve
147
What is the insertion of the abductor hallux muscle?
medial aspect of proximal phalanx of great toe
148
What is the innervation of the abductor hallux?
medial plantar nerve
149
What is a normal hallux valgus angle?
<15 degrees
150
What is a normal intermetatarsal angle?
< 10 degrees
151
What is a normal distal metatarsal articular angle?
<15 degrees
152
Which radiographic measurement/angle identifies MTP joint incongruity?
DMAA
153
A hallux valgus interphalangeus (HVI) angle great than [...] is a predisposing risk factor for hallux valgus?
10 degrees
154
What is the modified McBride procedure?
adductor release from proximal phalanx/lateral sesamoid, lateral capsulotomy, medial capsular imbrication
155
What is a Chevron osteotomy?
Distal metatarsal osteotomy
156
What is a crescentic osteotomy?
Proximal metatarsal osteotomy
157
What is a Scarf osteotomy?
Proximal metatarsal osteotomy
158
What is an Akin osteotomy?
A medial closing wedge proximal phalanx osteotomy of the great toe
159
Lapidus procedure, in isolation, can fail to correct [...] of the first ray
pronation
160
What is a Lapidus procedure?
1st metatarsal to cuneiform arthrodesis with modified McBride
161
In a hallux MTP arthrodesis, the toe should be positioned in [...] degrees of valgus, neutral rotation, and [...] degrees of dorsiflexion
5-10 degrees; 5-10 degrees
162
Cock up toe deformity is a complication of which Hallux valgus procedure?
Keller resection osteotomy
163
Failure to perform a lateral release of the adductor hallucis tendon in a hallux valgus surgery can lead to what complication?
Recurrence
164
Incomplete reduction of sesamoids during hallux valgus corrective surgery can lead to what complication?
Recurrence; transfer metatarsalgia
165
In the treatment of hallux valgus, a lateral sesamoidectomy increases the risk for what complication?
Hallux varus
166
What is the treatment for transfer metatarsalgia in the setting of hallux valgus post op complications?
Weil osteotomy
167
The medial dorsal cutaneous nerve is a terminal branch of the [...] nerve
superficial peroneal
168
Which nerve is at risk in the surgical treatment of hallux valgus?
medial dorsal cutaneous nerve
169
Hallux rigidis affects which joint?
1st MTP
170
Which nerve overlies the 1st MTP joint?
Medial branch of medial dorsal cutaneous nerve
171
The first MTPJ carries up to [...] percent of an individual's body weight with each step
120%
172
What orthotic is firstline treatment for hallux rigidus?
Morton's extension orthotic
173
Pain with terminal dorsiflexion is an indicator of [...] results with dorsal cheilectomy in treatment of hallux rigidis
good
174
What is the Moberg osteotomy in the foot?
dorsal closing wedge osteotomy of the proximal phalanx
175
Runner's with hallux rigidus and decreased dorsiflexion can benefit from which procedure?
Moberg osteotomy (dorsal closing wedge of proximal phalanx) with dorsal cheilectomy
176
Arthroplasties for hallux rigidus requiring secondary fusions have [...] outcomes than primary fusion.
worse
177
Morton's extension orthotic provides pain relief and allows for minimal [...]-flexion
dorsi
178
When performing a dorsal cheilectomy for hallux rigidus, resection greater than [...] percent may lead to joint subluxation
30
179
In performing a Keller resection arthroplasty, transfer metatarsalgia can be decreased with [...] interposition
capsular
180
In performing arthrodesis for hallux rigidus, [...] degrees of valgus and [...] degrees of dorsiflexion is preferred
5; 15
181
In treatment of diabetic Charcot neuropathy, a [...] orthotic can be used after total contact casting
CROW (Charcot restraint orthotic walker) boot
182
A Hb A1C greater than [...] is associated with decreased healing potential of a diabetic ulcer.
8
183
An albumin greater than [...] and an absolute lymphocyte count greater than [...] is associated with increased healing potential of a diabetic ulcer.
3; 1500
184
What is the primary risk factor for diabetic ulcer development?
sensory dysfunction
185
What is the most common pathogen associated with infection of diabetic foot ulcers?
aerobic gram positive cocci (s. aureus)
186
TCO2 greater than [...] is a sign of good healing potential.
30-40 mmHg
187
ABI greater than [...] is needed to heal am amputation.
0.45
188
In the treatment of diabetic foot ulcers, of the available shoe only modifications, [...] shoes best reduce the plantar pressure on the forefoot
rocker sole
189
For diabetic foot ulcers, medicare will cover modifications and custom shoes/insoles [...]
yearly
190
What is the absolute contraindication to treating diabetic ulcers with total contact casting?
infection
191
If ulcers recur after TCC for diabetic ulcers, it usually occurs [...] weeks after cast removal
3-4
192
Tendoachilles lengthening is associated with a [...] risk of recurrent ulceration in plantar forefoot ulcerations
lower
193
In the treatment of diabetic foot ulcers, total contact casting is often necessary for up to [...] months
4
194
[...] is considered the most likely predictor of eventual lower extremity amputation in patients with diabetes mellitus
Diabetic foot ulceration
195
What is the most common etiology for ankle arthritis?
Post-traumatic; ankle fractures > ligamentous
196
In patient undergoing supramalleolar osteotomy for ankle arthritis, patients with [...] degree of preoperative talar tilt have five-year survival rates of 85% while those with greater than [...] degrees of talar tilt have five-year survival rates of 65%
4-10; 10
197
Patients with ankle arthritis who have undergone total ankle arthroplasty have [...] gait speed and [...] stride length compared with arthrodesis
increased; increased
198
The optimal position for ankle arthrodesis is [...] dorsiflexion, [...] external rotation, [...] hind foot valgus, [...] posterior talar translation
neutral; 5-10 degrees; 5 degrees, 5 mm
199
In ankle arthrodesis, concomitant fusion of the talonavicular joint decreases hindfoot ROM greater than [...] percent
90
200
The risk of nonunion following ankle arthrodesis is [...] times higher risk in tobacco users.
2.7
201
[...] is greatest risk factor for persistent nonunion with revision of nonunion of ankle arthrodesis
neuropathy
202
Total ankle arthroplasty has [...] performance on uneven surfaces compared to ankle arthrodesis
superior
203
Total ankle arthroplasty is done via an anterior approach to the ankle in the interval between [...]
tibialis anterior and EHL
204
What is the most common complication following total ankle arthroplasty?
Delayed wound healing
205
Following an infection of a total ankle arthroplasty, studies have shown a [...] success rate of component reimplantation
low
206
Is a medial or lateral malleolus intra-operative fracture more common in total ankle arthroplasty?
medial
207
In a total ankle arthroplasty, does the talar or tibial component fail more commonly?
Talar
208
What is the most common foot deformity following a stroke?
Equinovarus
209
What tendon transfer can be utilized in a chronic foot drop?
Posterior tibialis transfer to lateral cuneiform
210
Loss of ankle eversion is an injury to which nerve?
SPN
211
A positive Silverskiold test is indicative of what?
Isolated gastroc tightness (NOT gastrocsoleus/achilles tightness)
212
What is a useful salvage procedure for plantar IP diabetic ulceration with a rigid forefoot in a low demand patient?
Keller resection arthroplasty (resection of base of proximal phalanx)
213
What are the requirements to perform a Syme amputation in non healing ulcer/diabetic patient?
Stable heel pad and palpable PT pulse
214
What foot deformity is associated with increased risk of ankle sprain?
subtle cavovarus
215
The deep deltoid limits talus [...] and the superficial deltoid limits talus [...]
external rotation; abduction
216
Which ligament is most commonly involved in low ankle sprains?
ATFL
217
Injury to ATFL physical exam shows drawer laxity in [...] flexion
plantar
218
Injury to CFL physical exam shows drawer laxity in [...]-flexion
dorsiflexion
219
In patients with Charcot arthropathy, the most sensitive test to diagnose soft tissue (and bone) infection is [...].
MRI
220
The abductor digiti minimi is supplied by what nerve?
Baxter's nerve (first branch of the lateral plantar nerve)
221
Tinels and pain just proximal to the origin of abductor hallicus that radiates to the 5th metatarsal is indicative of entrapment of which nerve?
first branch of lateral plantar nerve (Baxter's nerve)
222
The first branch of the lateral plantar nerve travels [...] to the fascia of abductor hallucis and [...] to the quadratus plantae
dorsal; plantar
223
Where does the AITFL originate?
anterolateral tubercle of tibia (Chaput's)
224
Where does the AITFL insert?
anterior tubercle of fibula (Wagstaffe's)
225
Where does the PITFL originate?
posterior tubercle of tibia (Volkmann's)
226
Where does the PITFL insert?
posterior part of lateral malleolus
227
What is the strongest component of the ankle syndesmosis?
PITFL
228
In the ankle syndesmosis, what is the main restraint to proximal migration of the talus
Interosseous ligament
229
During dorsiflexion, the distal fibula [...] rotates and translates [...] and [...]
externally; proximally; posterolaterally
230
During normal gait, the syndesmosis widens [...]
1 mm
231
What is the Hopkin's test?
squeeze test; compression of tibia and fibula at midcalf level causes pain at syndesmosis
232
What is a normal tib/fib overlap on an AP ankle?
>6 mm
233
What is a normal tib/fib overlap on an ankle mortise?
>1 mm
234
Bilateral cavovarus foot is due to what disease?
Charcot Marie Tooth
235
In unilateral cavovarus foot, what neurologic condition(s) need to be ruled out?
Tethered cord and spinal cord tumor
236
Which muscles are weak in a cavovarus foot?
Tibialis anterior and peroneus brevis
237
Which muscles are strong in cavovarus?
Posterior tibialis and peroneus longus
238
What are the foot deformities in cavovarus foot?
- plantar flexed 1st ray
- forefoot pronation
- hindfoot varus
239
Talonavicular angle greater than [...] degrees indicates forefoot adduction
7
240
Are medial or lateral malleolar stress fractures more common in a cavovarus foot?
Medial
241
What are the anatomic borders of the posterior tarsal tunnel?
calcaneus & talus (medially), abductor hallucis muscle (inferiorly), flexor retinaculum (laciniate ligament)
242
What are the three branches of the tibial nerve?
medial plantar, lateral plantar, medial calcaneal
243
In surgical release of the tarsal tunnel, which layers must be release?
Flexor retinaculum, deep investing fascia of leg, superficial and deep fascia of abductor hallucis
244
During surgical treatment of metatarsus primus varus (hallux valgus) and hypermobility with metatarsocuneiform arthrodesis anatomic [...]-flexion of the first metatarsal is crucial to prevent loading of the lesser metatarsals following surgery.
plantar
245
Chevron osteotomy can be used for a congruent or incongruent deformity that have hallux valgus angles less than [...] degrees and intermetatarsal angles less than [...] degrees.
25-30; 13
246
Biplanar Chevron metatarsal osteotomy can correct which angle?
DMAA
247
In MTP arthrodesis for hallux rigidus, the toe should be fused in [...] degrees of valgus in relation to the metatarsal shaft and [...] degrees of dorsiflexion in relation to the floor.
10-15; 15
248
What is the most common cause of hallux varus following hallux valgus surgery?
Resection of the fibular sesamoid
249
Resection of the fibular sesamoind in hallux valgus surgery can lead to what complication?
Hallux varus
250
The most common associated MRI finding in the setting of acute lateral ankle ligament injury is [...]
talar bone bruising
251
Following Ponseti casting for clubfoot, a dorsal bunion can develop due to a normal tibialis anterior muscle overpowering a weak [...].
dorsal bunion develops due to a normal tibialis anterior muscle overpowering a weak peroneus longus.
