Pes planus

Question 1

Kite’s angle

Answer 1

15-35
Transverse plane
Bisect talus and calcaneus AP view

Question 2

Cuboid abduction

Answer 2

0-5
Transverse plane
Lateral border of cuboid and calcaneus AP view

Question 3

Talar head uncoverage

Answer 3

0-30%
Transverse plane
Amount of talar cartilage uncovered by navicular bone

Question 4

Meary’s angle

Answer 4

0-10
Sagittal plane
Bisect talar head and 1st met Lateral view

Question 5

Calcaneal inclination

Answer 5

18-20ish
Sagittal plane
Inferior border of calcaneus and the ground lateral view

Question 6

Talar declination

Answer 6

18-20ish
Sagittal plane
Bisection of head of the talus and the ground lateral view

Question 7

Cyma line

Answer 7

Curved line that connects the TN and the CC joints on the lateral view. This line should be continuous

Question 8

STJ angles

Answer 8

42 from transverse

16 from sagittal

Question 9

STJ ROM

Answer 9

Mostly equal amounts inversion/eversion and abduction/adduction

Question 10

MTJ oblique

Answer 10

52 from transverse

57 from sagittal

Question 11

MTJ Longitudinal

Answer 11

15 from transverse

9 from sagittal

Question 12

MTJ ROM

Answer 12

Oblique axis is mostly pronation/supination

Longitudinal axis is mostly inversion/eversion

Question 13

Heel rise test

Answer 13

Patient stands on tip toes and the valgus heel should invert

Question 14

Hubscher maneuver

Answer 14

Dorsiflexion of the hallux should cause the arch to rise

Question 15

RCSP and NCSP

Answer 15

Measures bisection of the heel as compared to the ground when standing relaxed and neutral STJ, respectively

Question 16

Tibial influence

Answer 16

Measures bisection of the tibia as compared to the floor with patient standing

Question 17

Stage I PTTD

Answer 17

Medial ankle pain along PTT
Patient able to perform single and double heel rise
No radiographic changes

Question 18

Stage IIa PTTD

Answer 18

Medial ankle pain along PTT
Flexible heel valgus
Heel inverts with double heel rise

Question 19

Stage IIb PTTD

Answer 19

Medial ankle pain along PTT
Increased heel valgus as compared to stage II
Flexible
Heel inverts with heel rise

Question 20

Stage III

Answer 20

Rigid deformity

Pain located medial and lateral

Question 21

Stage IV

Answer 21

Rigid deformity

Ankle joint degeneration

Question 22

FDL transfer

Answer 22

Can be used in all stages

Question 23

Cobb procedure

Answer 23

Split TA transfer, transfer through a drilled hole in the navicular or medial cuneiform

Question 24

Young tenosuspension

Answer 24

Rerouting half the TA through the navicular bone

Question 25

Kidner procedure

Answer 25

Resection of accessory navicular and reinsertion of the PTT into the navicular

Question 26

Evans procedure

Answer 26

Lateral column lengthening via the lateral surface of the calcaneus. Transverse plane.

Question 27

Cotton osteotomy

Answer 27

Medial cuneiform opening wedge. Plantarflexion of the first ray. Sagittal plane correction

Question 28

MDCO procedure

Answer 28

Slide the posterior aspect of the calcaneus medially to create more a varus force from the ground. Frontal plane correction

Question 29

Miller arthrodesis

Answer 29

Fusion of the naviculocuneiform joints, also fusion of 1st metatarsal cuneiform (Lapidus)

Question 30

Hoke arthrodesis

Answer 30

Fusion of the navicular and first 2 cuneiform joints

Question 31

Triple arthrodesis

Answer 31

Fusion of the STJ, TN, and CC joints

Question 32

Pantalar arthrodesis

Answer 32

Fusion of the ankle, STJ, and midtarsal joints

Question 33

Stage 1 conservative treatment

Answer 33

Short leg cast or walking boot 4-6 weeks PT Anti-inflammatory Orthotics

Question 34

Stage 2 A conservative treatment

Answer 34

Typically orthotics with a deep heel cup

Question 35

Stage 2 B conservative treatment

Answer 35

Typically orthotics with a deep heel cup, UCBL, extended medial counter or medial heel wedge

Question 36

Stage 3 conservative treatment

Answer 36

Custom AFO, supramalleolar brace, allow AJ ROM

Question 37

Stage 4 conservative treatment

Answer 37

Non-articulated AFO

Question 38

Stage 1 surgery

Answer 38

Synovectomy

Question 39

Stage 2 A surgery

Answer 39

``` Synovectomy Debridement Direct tendon repair Tendon Transfer Osteotomy Posterior muscle lengthening ```

Question 40

Stage 2 B surgery

Answer 40

Synovectomy Tendon transfer Osteotomy and/or Arthrodesis Arthroeresis

Question 41

Stage 3 surgery

Answer 41

Typically arthrodesis and lengthening of the posterior muscle group

Question 42

Stage 4 surgery

Answer 42

This typically involves the AJ, so it will require arthrodesis and deltoid ligament repair. MDCO is sometimes required when valgus ankle deformity without DJD Total ankle replacement or supramalleolar osteotomy