Heel pain (Surgery)

Question 1

Haglund’s deformity

True hauglands more 1?

Answer 1

1. lateral

Lazy S incision

The edge of the calcaneus

Question 2

What are different tx options for heel pain?

Conservative:

1? 2? 3? 4? 5? 6?

Surgical:

7? 8? 9?

Answer 2

Conservative:

1. ice
2. ultrasound
3. heeled shoe/sneaker
4. Calf/plantar fascia
5. stretching
6. steroid

Surgical:

7. instep fasciotomy
8. excision of spur with
9. fascectomy neurolysis

Question 3

How many months (at least) you should try consrvative treatment before actual surgery?

Answer 3

3-6 months

Question 4

INSTEP Fasciotomy

1? only

L.A. with/out I.V. seda,on

2? n.w.b., b.k.cast  night splint (1/12)

w.b. in sneaker with orthoses

return to work 3?

Answer 4

1. 2/3 width of medial band
2. 7/7
3. 2 to 3 weeks

Question 5

What does Neurolysis with spur excision & fascectomy involve:1? 2? 3?

The only people that should have a tarsal tunnel release are the people with 4?

Answer 5

1. Tarsal tunnel ‐ 6weeks n.w.b.
2. Lateral plantar nerve ‐ 3weeks n.w.b.
3. 1st branch lateral plantar nerve ‐ 3 weeks n.w.b.
4. space occupying tumor in that location

Question 6

What does the nerve entarpment clinical examination involve?Percussion over P.T. nerve 1?

Hyperaesthesia 2?• Paralysis of abductor digi, minimi ‐ inability to 3?

Always compare to 4?

Answer 6

1. following medial and lateral branches. Paraesthesia?
2. plantar medial/lateral, heel or arch
3. abduct the 5th toe
4. other side

Question 7

What could x-ray show regarding Achilles tendinopathy?

1?

2?

3?

4?

Answer 7

1. Calcification
2. Haglund􀁠s
3. Retrocalcaneal Spurs
4. Trauma

Question 8

What does MRI imaging show regarding Achilles tendinopathy?

1?

2?

3?

Answer 8

1. Hypertrophy
2. Degeneration
3. Tear

Question 9

What are the conservative modalities for Achilles tendinopathy?

1?

2?

3?

4?

5?

Answer 9

1. NSAIDs/Steroids

2. Rest, Ice

3. Night Splint

4. CAM Walker

5. Physical Therapy

6. Heel Lifts

Question 10

Achilles tendinosis

Pain 1?

2? Condition

 Abundant 3?

Associated with 4?

5? is compromised

 Reacts Poorly to 6?

Answer 10

1. to Midportion of Achilles
2.  Non‐inflammatory
3. Disorganized Collagen
4. Overuse
5.  Nutrition to Tendon
6. Conservetaive Treatments

Question 11

Topac device:

Used for 1?

Radiofrequency Based 2?

RF creates a 3?

Disolves 4?

Causes 5?

Revasc. 6?

Answer 11

1. Arthrocare, Sunnyvale and CA
2. Microtenotomy
3. Plasma
4. Tissues Bonds Without Heat
5. inflammatory reaction
6. Weeks 3 to 9

Question 12

Conclusion‐Postoperative Care

Insertional Tendinosis

Case by case assessment depending on 1?

Postop course 2?

No 3?

Midsubstance Tendinosis

Originally 4?

Currently 5?

months.

No 6?

Answer 12

1. Calcaneal involvement
2. Typically 3‐4 wks NWB, CAM Walker and PT x 4 wks
3. NSAIDs
4. NWB x 3 wks
5. CAM Walker x 3 wks. Start PT at 1 week. Full activity at 2‐3 months.
6. NSAIDs

Question 13

What does the top and botton arrow show?

Answer 13

Top arrow: Medial calcaneal branch

Bottom arrow: 1st branch of lateral plantar nerve