Questions Flashcards
Name characteristics of patients with hallux rigidus
Inverted gait, decreased DF, transfer metatarsalgia, decreased push off strength; NOT associated with FHL rupture
what happens with chronic adult flatfoot deformity to the achilles tendon and why?
hindfoot valgus that causes the AT to become an evertor which then lends to contracture
what is the preferred treatment for painful os navicular that has failed non-operative tx?
split the PT and excise WITHOUT advancement
Optimal positioning of the foot for ankle arthrodesis: ___ rotation, DF/PF, A/P, varus/valgus?
10 deg ER, plantigrade, 5 mm posterior on the plafond, 5 deg valgus
what must be repaired to prevent hallux valgus after medial sesmoidectomy?
FHB
what is the study of choice for total ankle arthroplasty workup far out from surgery with a patient previously doing well and no concerns for infection?
CT with metal artifact reduction; Bone scan could be helpful for aseptic loosening but it would be hard to differentiate with infection
at what % of resection for achilles tendinitis do you need to augment instead of just side to side repairing and closing up?
50% or more
what are the classic findings of an atraumatic TA rupture? what is the mechanism?
- decreased DF, excessive toe hyperextension with DA of the ankle, loss of anterior ankle contour, anteromedial pseudotumor
- eccentric
charcot marie tooth has ___ foot deformity; chromosome ___, the gene is ___, ___ and ___ are weakened but ___ is first
- equinovarus
- 17
- PMP 22
- TA and PB
- TA
Plantar plate deficiency leads to what lesser toe deformity? What causes claw toe? What causes curly toe? What causes mallet toe? What is hammer toe?
- crossover toe
- weak intrinsics cause MTP hyperextension and PIP/DIP hyperflexion
- FDL/FDB contracture with unknown etiology
- Flexion at DIP; either release of EDL distal to the DIP joint or FDL contracture from wearing a toe box that is too short
- PIP flexion with DIP extension; most common lesser toe deformity
excision of both sesamoids causes ___, Tibial causes ___ and fibular causes ___
- cock up deformity
- hallux valgus
- hallux varus
are positive wound cultures indicative of osteomyelitis in diabetic foot ulcers?
no; increase on T2 MRI, exposed bone, periarticular erosions
what is the treatment of a chronic > 7 weeks Anterior tibialis rupture?
those that are traumatic would then be candidates for repair with plantaris augmentation prior to have a PT transfer with gastroc recession
what are the 5 grades of hallux rigidus?
grade 0: stiffness; no pain; no narrowing
grade 1: mild pain at extremes of motion; mild dorsal osteophytes; no narrowing
grade 2: moderate pain at extremes of motion; less than 50% narrowing
grade 3: pain at extremes; no pain with midrange; > 50% joint space narrowing
grade 4: pain with midrange motion; severe dorsal osteophytes; > 50% joint space narrowing
Bunion deformity is characterized by ____ (varus/valgus) and ____ (supination/pronation)
- valgus
- pronation
Arthrodesis vs fixation in lis franc: which has higher hardware removal? outcomes are ___ between the two options
- fixation
- mixed
what is the conjointed tendon of the foot?
when is it encountered?
- FHB + adductor hallucis
- lateral release for a bunion you try to preserve this by releasing tissue lateral to the sesamoid but leaving it attached to the proximal phalanx; remember the adductor hallucis has oblique and transverse heads
Lateral OCD on the talus ____
Medial OCD on the talus ____
- anterior, more shallow, worse prognosis, less common than medial, and usually from traumatic etiology
- posterior, deeper, better prognosis, more common than lateral, and usually without traumatic etiology
what the cutoff for performing a moberg after dorsal cheilectomy for hallux rigidus to achieve more DF?
30 deg
when do you see the floating toe complication/phenomenon in ortho? commonly seen with what procedure?
- it is the result of a shortened metatarsal bone for whatever reason from the decreased tension that causes the affected toe to not reach the floor when standing
- weil osteotomy
what is the type of boot you put a diabetic with charcot into if they have no ulcerations?
CROW: charcot restraint orthotic walker; its basically a double rocket with offset on the plantar midfoot to take pressure away from the area that collapsed
what is the percentage cutoff for isolated resection of talocalcaneal coalition for involvement of ST joint? if other alignment issues are seen in the foot then you must do ___
- 50%
- other procedures
what compresses baxter’s nerve? what would be deinnervated if this happened?
- abductor hallucis
- abductor digiti minimi
what does baxter’s nerve branch off? what does it innervate? what compresses it?
- 1st branch off lateral plantar nerve
- abductor digiti quinti/minimi, FDB, quadratus plantae
- abdcutor hallucis fascia
