Abos - Foot And Ankle:trauma & Associated Conditions - Talar Injuries& Management

Front 1

What radiographic study is particularly useful for identifying a talar neck
fracture?

Back 1

Canale view

Front 2

What is the Hawkins classification system?

Back 2

I: nondisplaced ;
II: with associated subtalar
dislocation
lll: with subtalar and ankle ’
dislocation
IV: with subtalar, ankle, and
talonavicular dislocation

Front 3

What are the reported rates of AVN for each Hawkins stage?

Back 3

I: 13%
ll: 30% `
III; 100% E
IV; 100%

Front 4

ls a talar neck fracture still considered a surgical emergency?

Back 4

Controversial
Some have reported higher AVN rates with earlier surgery

Front 5

What screw direction is best biomechanically?

Back 5

Posterior to anterior

Front 6

What is the reported rate of tibiotalar arthritis after talar neck fracture?

Back 6

33%

Front 7

What is the reported rate of subtalar arthritis after talar neck fracture?

Back 7

50%

Front 8

What is the preferred surgical treatment for varus malunion of the talar neck?

Back 8

Triple arthrodesis

Front 9

What is the classic history of a missed talar body fracture?

Back 9

Ankle sprain that does not recover despite prolonged conservative management

Front 10

What is the test of choice to identify talar body fracture?

Back 10

Computed tomography (CT )

Front 11

What is the indication for ORIF?

Back 11

>2 mm displacement

Front 12

What is the preferred surgical approach?

Back 12

Medial malleolar osteotomy

Front 13

With this approach, what structure must be carefully preserved?

Back 13

Deltoid ligament

Front 14

What is the most common complication associated with talar body fracture?

Back 14

Avascular necrosis (AVN)

Front 15

At what joint is posttraumatic arthritis most likely to develop?

Back 15

Ankle

Front 16

What joint is most often arthritic after talar neck fracture?

Back 16

Subtalar joint

Front 17

What structure attaches to the talar posteromedial tubercle? To the to posteromedial tubercle posterolateral tubercle?

Back 17

Posterior talotibial ligament attaches to posteromedial tubercle
Posterior talofibular ligament attaches to posterolateral tubercle

Front 18

A posterior process fracture must be differentiated from what other clinical tenosynovitis condition?

Back 18

Os trigonum and associated FHL tenosynovitis

Front 19

What is the position of the os relative to the FHL tendon?

Back 19

Os is lateral to tendon

Front 20

What patient population is particularly at risk for FHL tenosynovitis/os trigonum syndrome?

Back 20

Dancers

Front 21

What are the two symptoms of FHL tenosynovitis?

Back 21

Posterior ankle pain with plantar
Triggering of the IP joint of the great toe

Front 22

What two studies best differentiate between os trigonum and MRI
fracture?

Back 22

Bone scan
MRI

Front 23

What is the preferred treatment fornondisplaced fracture of the posterior process?

Back 23

Weight bearing as tolerated (WBAT) in cast

Front 24

What is the preferred treatment for displaced fracture with subtalar
involvement?

Back 24

ORIF

Front 25

What is the preferred treatment for vertical fracture of the posterior process?

Back 25

ORIF

Front 26

What is the preferred treatment for os trigonum refractory to conservative management?

Back 26

Excision

Front 27

What is the preferred treatment for associated medial sided pain?

Back 27

Must exclude FHL entrapment within the tunnel under sustentaculum
tali

Front 28

What is the preferred treatment for laceration of the FHL?

Back 28

Repair if lacerated proximal to the MTP and FHB is also disrupted

Front 29

When repairing an FHL laceration,which structure must be identified and
protected?

Back 29

Medial plantar nerve

Front 30

An FHL laceration repair should not be attempted at what location?

Back 30

Within the MTP pulley system

Front 31

What is a snowboarder's fracture?

Back 31

Fracture of the lateral process of the talus

Front 32

What two ligaments attach to the lateral talar process?

Back 32

Lateral talocalcaneal ligament
ATFLI

Front 33

Snowboarder's fracture mechanism of injury involves what four components?

Back 33

Dorsiflexion
Axial load
Inversion
External rotation

Front 34

lf an ORIF is performed for talar crush injury, what is critical in the acute
postoperative phase?

Back 34

Initiate ROM early

Front 35

What is an alternative to ORIF for a talar crush injury?

Back 35

Tibiocalcaneal fusion

Front 36

What is the most common cause for poor outcome after any crush injury of
the foot?

Back 36

Persistent neuritis