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38 Cards in this Set
- Front
- Back
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What radiographic view is particularly useful for evaluating the subtalar
joint? |
Broden’s view
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Subtalar dislocations in what direction are generally high energy and have
poorer outcomes? |
Lateral
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If a medial subtalar dislocation is irreducible, which structure is likely
responsible? |
EDB
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Quick review: What structure is responsible for an irreducible medial
tibiotalar dislocation? |
Peroneus brevis
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lf a lateral subtalar dislocation is irreducible, what structure is likely
responsible? |
Posterior tibialis tendon
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Subtalar dislocations are often associated with dislocation at what 4
other joint? |
Talonavicular
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What is the preferred location of the anterior arthroscopy portal?
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2 cm anterior, 1 cm distal to fibula
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What is the preferred location of the middle portal?
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Just anterior to the tip of the fibula
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What is the preferred location of the posterior portal?
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Between Achilles tendon and fibula
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What is the orientation of the primary calcaneal fracture line?
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Anterolateral (superolateral) to posteromedial (inferomedial)
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What does Bohler’s angle effectively measure?
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Posterior facet height
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What is the range of normal Bohler’s angle?
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25 to 40 degrees
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On which imaging study is the Sanders classification based?
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Coronal CT
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What is the relationship between the number of visualized fracture lines and Sanders class?
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One fracture line: type II
Two fracture lines: type III Three fracture lines: type IV |
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Do calcaneus fractures tend to fall into varus or valgus?
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Varus
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What percentage of calcaneus fracture patients develop a compartment
syndrome? |
10%
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How do the outcomes of surgical and nonsurgical calcaneus fracture
treatments compare? |
Overall, operative outcomes =nonoperative outcomes
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But patients with what characteristics are especially likely to benefit from ORIF: age?
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Younger
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Gender?
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Female
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Workman’s compensation status?
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Injury unrelated to work
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If treating a calcaneus fracture nonoperatively, should a cast be applied? Why?
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No
Casting is associated with increased rates of reflex sympathetic dystrophy (RSD) and stiffness |
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In general, ORIF is indicated if displacement is greater than?
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2 mm
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How do fracture blisters affect the timing of surgery?
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Blisters must absorb and reepithelialize before surgery
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What is the major arterial supply to the calcaneal skin flap?
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Lateral calcaneal artery
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How is this artery classically injured during surgery?
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Horizontal limb of the flap is made too high
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What structure is at risk if the screws from lateral to medial are too long?
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FHL
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What percentage of type II fractures result in reported good or excellent
outcome after ORIF? |
70%
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What percentage of type III fractures result in reported good or excellent
outcomes? |
70%
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What percentage of type IV fractures result in reported good or excellent
outcomes? |
10%
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Therefore, what alternative to ORIF should be considered with type IV
fracture? |
Primary subtalar fusion
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In what two situations has primary subtalar fusion been shown to be especially helpful?
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Patient is a laborer
Bohler’s angle <0 degrees |
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With bilateral calcaneal fractures, how do operative and nonoperative outcomes compare?
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Operative outcomes are worse than those for unilateral calcaneal fracture
But better than nonoperative bilateral fracture outcomes |
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What is the preferred treatment for a neglected calcaneus fracture with talar impaction and anterior impingement?
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Subtalar arthrodesis with bone blocks for height restoration
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What ligament is often affected with anterior calcaneal process fractures?
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Bifurcate ligament
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This ligament runs between the calcaneus and what two structures?
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Cuboid
Navicular |
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Nonoperative treatment is acceptable if what percentage of the articular
surface is involved? |
<25%
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What does nonoperative treatment generally consist of?
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WBAT in boot or cast
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lf >25% of the articular surface is involved, what are the two treatment options?
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ORIF
Excision |
