Class Capture 1St Ray 2

Front 1

osteoarthritis

Back 1

› Most common form of arthritis termed as a
disease of

Front 2

OA - common site, physical exam

Back 2

› Common site of OA in the lower extremity
is the 1st MPJ
› On physical exam may exhibit crepitus and
limited movement during ROM of the joint.
› OA is likely to form in an area of previous
injury.
› OA can present in the digits of the hands.
› Spur formation at the PIPJ is termed
Bouchard

Front 3

OA - radiographic features

Back 3

› Spur or osteophyte formation
› Subchondral sclerosis
› Loose osseous bodies or

Front 4

Gout arthritis

Back 4

› Occurs as a result of crystal deposition
disease, due to under excretion or
overproduction of uric acid.
› Uric acid crystals form and cause joint
damage- (tophi formation)
› Gout is much more common in men then
women

Front 5

Gouty arthritis - clinical features

Back 5

› The 1st MPJ is most commonly affected
› Presents clinically as a

Front 6

gouty arthritis - radiographic features

Back 6

› Usually affects 1 joint or mono-articular
› C shaped or

Front 7

joint aspiration of GA

Back 7

› Microscopic analysis of joint fluid reveals
needle shaped crystal
› These crystals have a negative
birefringence, which is a reaction to
polarized light

Front 8

Treatment of gout

Back 8

› In treatment in acute cases colchicine and
indomethacin are used
› In treatment of chronic case probenecid and
allopurinol are used

Front 9

Reverding Green

Back 9

Distal - L
corrects abonrmal PASA
protects sesamoid appartus

Front 10

Reverding Laidr

Back 10

corrects abnormal PASA and IM angle u to 12 degrees

Front 11

fixation of revredin

Back 11

28 guage monofilament wire
0.062 k -wire
non-absorbable suture
2.0 cortical screw

Front 12

shortening for austin, for mitchell

Back 12

austin 3.0 mm
mitchell 4.5 mm

Front 13

How do you compensate for shortening

Back 13

use axis guide, plantarflex, head

Front 14

What is hohmann

Back 14

trapezoidal cut,

Front 15

Wilson

Back 15

45 degree cut, shift head over, lots of shortenitng

Front 16

Austin

Back 16

60 degree wedge, point in center of haead

Front 17

What is angle of wedge for Kalish

Back 17

55 degrees

Front 18

What screws for Kalish

Back 18

two 2.7 cortical screws,
or two 3.0 cannulated scres

Front 19

complications of metatphyseal osteotomies

Back 19

fracture of dorsal or plantar wing, delayed union, non-union
avascualr necrosi
hallux liitus
shortening
elevation of capital fragment
transfer metatarsalgia

Front 20

scarf=complication

Back 20

shortening
delayed union
hallux limitus
transfer metatarsalgia
TROUGHING

Front 21

Ludloff

Back 21

Proximal dorsal to distal plantar at 45 degree angle

Front 22

Mau

Back 22

proxmal plantar to distal dorsal

Front 23

What IM angles for Base osteotomies

Back 23

15 to18, higher than that, probably lapidus

Front 24

Another name for opening base wedge

Back 24

trethowan

Front 25

fixate CBWO

Back 25

k-wire or steinman pin

Front 26

juvarra

Back 26

CBWO at oblique angle, fixate with 2 screws

Front 27

Crescentic base osteotomy - advantage

Back 27

less shortening

Front 28

what nerve could be damaged by BK cast

Back 28

common peroneal

Front 29

indication for trethowan

Back 29

short 1st met

Front 30

Complicaton for trethowan

Back 30

jamming, arthrits, long healing time

Front 31

post op ofr base procedure

Back 31

NWB 6 weeks bk cast
WB 2 weeks bk cas
surgical shoe

Front 32

complications of base wedge

Back 32

elevation fo captial fragmen
non unin/dleayed uni
transfer metatrsalgie
shorenting of 1st ray

Front 33

indication for arthrdesis (mckeever)

Back 33

HAV
hallux rigidus/limitus
hallux varus
neuromuscular diease
failed previous surgery
DJD

Front 34

position of mckeever

Back 34

15-20 degrees abducted
5-10 degrees dorsiflexed
no valgus, no varus especially varus
depends on shoe

Front 35

ancillary procedure fro 1st mpj fusion

Back 35

EHL lengthening
IPJ fusion

Front 36

complicatonf of mckeever

Back 36

poor psoition causes difficult walking wearn shoes
DJD of IPJ
ingrown nails
stress fracute
delayed non uion
hallux malleus

Front 37

Lapidius is

Back 37

Fuse met cuneiform joint, fuse 1st met and medial cuneiform, and 1st met and 2nd met

Front 38

Proximal akin - corrects

Back 38

correct DASA
straingens hallus

Front 39

distal akin corrects

Back 39

abnormal hallux abductus angle

Front 40

central akin

Back 40

corrects long proximal phalanx

Front 41

fixation for hallux ostoeotomis

Back 41

k wire
staples
monofialment wire
screw on oblique akin

Front 42

indicaiton ofr hallux IPJ fusion

Back 42

cavus foot
NM disease
hammertoes
traumatic arthritis

Front 43

complication of Akin

Back 43

delyaed union
agular deviation
inadequate/over correction

Front 44

hallux limitus

Back 44

decreased range of motin of 1st MPJ (normal is 50-65 degrees of dorsiflexion

Front 45

hallux rigidus

Back 45

= absent motion o fhte 1st MPJ

Front 46

will orthotics help structural hallux limitus?

Back 46

no

Front 47

distal akin corrects

Back 47

abnormal hallux abductus angle

Front 48

central akin

Back 48

corrects long proximal phalanx

Front 49

fixation for hallux ostoeotomis

Back 49

k wire
staples
monofialment wire
screw on oblique akin

Front 50

indicaiton ofr hallux IPJ fusion

Back 50

cavus foot
NM disease
hammertoes
traumatic arthritis

Front 51

complication of Akin

Back 51

delyaed union
agular deviation
inadequate/over correction

Front 52

hallux limitus

Back 52

decreased range of motin of 1st MPJ (normal is 50-65 degrees of dorsiflexion

Front 53

hallux rigidus

Back 53

= absent motion o fhte 1st MPJ

Front 54

will orthotics help structural hallux limitus?

Back 54

no