Foot/Ankle Flashcards by Tyler Paras

Foot bone at risk of AVN and why?

Talus, retrograde blood supply

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Which tendon passes through groove on cuboid bone?

Peroneus longus

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Which muscle inserts on the tuberosity of naviular

Posterior tibialis

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Which muscle inserts on base of 5th MT?

Peroneus brevis

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Contents of tarsal tunnel?

Within medial malleolus:

Tibialis posterior

FDL

Posterior tibial A, V, N

FHL

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2nd MT aligns with which bone?

medial cuneiform

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Weber/AO classification

Ankle fx (fibula) based on relation to plafond

A: distal to plafond (tibial plane)

B: at plafond

C: proximal to plafond (torn syndesmosis common)

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Classification for ankle fractures?

Lange-Hansen classification

Ankle fx based on foot position and mechanism

SA: supination/adduction I-II

SER: supination/ER I-IV

PER: pronation/ER I-IV

PA: pronation/abduction I-III

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Essex-Lopresti fx

Fx of calcaneus Either tongue-type or joint depression

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Sanders fx

Calcaneus based on coronal CT findings

I-IV: how many fragments/fracture lines

A-C: lateral to medial

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Rule out with ankle fx?

Spine injury

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Bohler’s angle

Lines drawn tangential to anterior and posterior aspects of the calcaneus. May indicate fx if too low

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What is the classification of talus neck fractures? AVN percentages?

Hawkins classification

Predicts AVN risk

I: 10%

II: 40%

III: 70%

IV: 100%

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Hawkin’s sign

Resorption of subchondral bone in talus (lucency on XR) indicates fracture healing

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Fleck sign

Avulsion of lisfranc ligament from 2nd MT base

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Lisfranc (TMT joint) classification

Isolated, homolateral, divergent

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5th MT base fx classification

Zone 1: avulsion fx

Zone 2: metadiaphyseal jxn (Jones fx)

Zone 3: proximal diaphysis (stress fx)

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Jones fx?

Zone 2 fx of 5th MT base (metadiaphysial)

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1 and # 2 injured ligaments in ankle sprains

ATFL #1, CFL #2

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Action of ATFL?

Resists anterior motion

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Action of CFL?

Resists inversion

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Action of deltoid ligament?

Resists eversion

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Ankle relocation blocked by which tendons?

Study These Flashcards

EDB (medial) or PT (lateral)

Morning foot pain?

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Plantar faciitis

Thompson test

Squeeze calf, absent foot plantarflexion = achillies tendon rupture

Ankle anterior drawer

Stabilize tibia, PF foot, anterior force. Tests lateral ligament (esp. ATFL)

Talar tilt

Stabilize tibia, DF foot, invert foot. Tests lateral ligaments (esp. CFL)

Ext. rotation stress test: how to do + ligaments tested

Stabilize tibia, ER foot. Tests deep deltoid and syndesmotic ligaments

Eversion stress test: how to +ligament tested

Stabilize tibia evert foot. tests superficial deltoid ligament

Squeeze test

Compress distal tibia/fibula. Pain may indicate syndesmosis injury

Heel rise test: how to + whats tested

Standing, rise onto toes. Heel should go into varus. No varus in posterior tibiasis tendon dysfuction.

Coleman block test: how to + what tested

Lateral foot and heel on block; 1st ray hands free. Flexible hind foot varus: ankle will go into valgus or neutral on block. Fixed hind foot varus: ankle will stay in varus on the block.

Tinel's sign (ankle): how to + tests what

Tap nerve posterior to MM. Tingling may indicate tibial nerve entrapment in tarsal tunnel.

Compression test ankle: how to + tests what?

Squeeze foot at MT heads. Pain or numbness/tingling may indicated interdigital (Morton's) neuroma

Phases of gait (8) and important muscles

1: heel strike (TA) 2: Foot flat (gastroc) 3: Midstance 4: Heel off (PT+gastroc) 5: Toe off 6: preswing 7: midswing 8: terminal swing

1st layer of foot and innervation

Abductor hallucis (medial plantar) Flexor digitorum brevis (medial plantar) Adbuctor digiti minimi (lateral plantar 1st branch) Nerves come from tibial

2nd layer of foot and innervation

Quadratus plantae (LP) Lumbricals (1 - MP, 2-4 - LP) FHL, FDL tendons

3rd layer of foot and innervation

Flexor hallucis brevis (MP) Adductor hallucis (LP) Flexor digiti minimi brevis (LP)

4th layer of foot an innervation

Plantar interossei (3) (LP) Dorsal interossei (4) (LP) PL and TP tendons

Possible entrapment of lateral plantar n?

Abductor Digiti Minimi fascia

What artery supplies talar head and neck?

dorsalis pedis --\> direct talar branches

Does surgery decrease achilles tendon rerupture?

Yes

#1 musculoskeletal injury?

Ankle sprain

Gout: findings physical exam and labs

1st MTPJ, negatively birefringent crystals (yellow when parallel)

Hallux rigidus findings on XR?

Dorsal osteophyte or OA

Hallux Valgus angle?

\>15°

Morton neuroma locations?

2nd and 3rd interdigital space

Acquired hindfoot cause and stages?

Posterior tibialis tendon failure Stage 1: tenosynovitis, no deformity Stage 2: Pes planus, flexible hindfoot, no single heel raise Stage 3: rigid hindfoot,