Hershey Manual Ch 27 Tendons

Front 1

Why is it imp to scrape off the epitenon when anastomizing two tendons

Back 1

encourages fibrous union

Front 2

Strayer technique

Back 2

complete severance of the gastroc at the tendo-muscle junction, suture the proximal retracted aponeurosis to the underlying soleus

Front 3

Silverskiold procedure

Back 3

-proximal recession, release of the muscular heads gastroc from femoral condyles and reinsertion to the tibia (makes a 3 joint muscle a 2 joint muscle)

Front 4

Fulp and McGlamery procedure

Back 4

-distal, Gastroc tongue in groove recession in the aponeurosis (modified baker), tongue points distally

Front 5

Baker procedure

Back 5

Gastroc tongue in groove, where the tongue points proximally (like a Bakers hat)

Front 6

Hokes tenotomy

Back 6

triple tenotomy of the Achilles, starting 2.5 cm from the insertion and continuing at 2.5 cm intervals, only cutting half of the tendon each time

Front 7

How much does a Strayer gastroc recession decrease strength

Back 7

1 muscle grade

Front 8

What type of tendon transfer can be used for dropfoot deformity when anterior muscles are weak or paralyzed or flexible cavus

Back 8

PL transfer to the 3rd cuneiform
- reduces PL cavus influence
-easy phase conversion

Front 9

Which tendon transfer can be used for spastic RF varus, fixed equinovarus

Back 9

STATT (TA to lateral portion of the tertius to increase DF of foot by balancing its power laterally)

Front 10

If both sesamoids are removed what tendon transfer can be done to prevent cock up hallux

Back 10

Jones; EHL through 1st met head. Jones can also be done for PF 1st ray.

Front 11

What is the function of a Kidner procedure (advancement of the TP tendon to inferior navicular or medial cuneiform)

Back 11

increase the adductory influence of the TP tendon on the forefoot

Front 12

What is a Heyman procedure and when is it used

Back 12

for equinus, it’s a panmetatarsal suspension by suturing the EDL to its respective met head

Front 13

Post op course for tendon transfer

Back 13

4 weeks casting, passive ROM at 3 weeks
-arom at 4 weeks

Front 14

What is one reason to anastomize the peroneals

Back 14

decrease the PF force of the PL on the 1st ray in pes cavus

Front 15

Plantaris rupture may mimic an Achilles rupture, how can you differentiate

Back 15

Thompson test will be normal and pain is felt along the course of the plantaris (lateral femur to medial calcaneus)

Front 16

When can a complete Achilles rupture be conservatively treated

Back 16

24 hours to 5 days

Front 17

tendon transfer that suspends Talar neck, eliminates flexible vertical talus

Back 17

- PB into talus
-Type 1 vertical talus or severe pes planus

Front 18

eliminates spastic posterior ankle equinus, CP induced dropfoot with post contracture equinus

Back 18

Murphy's advancement

Front 19

Normal diameter of PTT compared to the adjacent FDL tendon on MRI

Back 19

PTT is twice the flexor; disease PTT is 5-10 times larger

Front 20

Back 20

Front 21

Back 21

Partial tear of distal ant tib tendon

Front 22

A

Back 22

Ant tib tendon rupture at insertion on medial cuneiform (and first met base)

Front 23

What must be evaluated in a PTTD pt who failed conservative tx

Back 23

Equinus: valgus hindfoot causes Achilles insertion to be lateral to the STJ axis. Leads to more arch collapse from inefficient biomechanics

Front 24

Tx PTTD 1

Back 24

Immobilization 3 months, then UCBL with medial post

Front 25

Tx PTTD 1

Back 25

Immobilization 3 months, then UCBL with medial post

Front 26

Tx PTTD 2

Back 26

UCBL with medial post
Or
FDL transfer, PT cleaning, Evans, louts, TAL, spring log repair (combo of these)

Front 27

Tx PTTD 1

Back 27

Immobilization 3 months, then UCBL with medial post

Front 28

Tx PTTD 2

Back 28

UCBL with medial post
Or
FDL transfer, PT cleaning, Evans, louts, TAL, spring log repair (combo of these)

Front 29

Tx PTTD 3

Back 29

3 is rigid with STJ involved
AFO
Or
Triple with TAL

Front 30

Tx PTTD 1

Back 30

Immobilization 3 months, then UCBL with medial post

Front 31

Tx PTTD 2

Back 31

UCBL with medial post
Or
FDL transfer, PT cleaning, Evans, louts, TAL, spring log repair (combo of these)

Front 32

Tx PTTD 3

Back 32

3 is rigid with STJ involved
AFO
Or
Triple with TAL

Front 33

Tx PTTD 4

Back 33

AFO
Or
TTC AD or Triple with TAL and deltoid repair

-stage 4 has ankle involvement with talar tilt and deltoid involvement

Front 34

Flexible flat foot, can't heel rise: stage and treat

Back 34

Stage 2: Evans, kouts, TAL

Front 35

triad : Pseudo tumor at ant ankle, loss of contour of ant ankle Tendon, weak DF of ankle with hyper ext of toes

Back 35

Ant tib rupture

Front 36

At what gap would u need to augment Achilles teat

Back 36

> 4 cm use Fhl transfer with V-y advancement of gastroc

Less than 4 cm can use V-y alone(gastroc turn down flap)

Front 37

Tx Peroneal tears less than 50%, greater than 50%

Back 37

Less than 50%: primary repair
Greater than 50%; tenodesis pl and PB

Front 38

Fhl relation to fdl

Back 38

Crosses dorsal to fhl at knot of Henry, stays dorsal to fhl and nv bundle

Front 39

When is ATFL taut

Back 39

PF and inv- this is the MOI
Perform ant drawer with ankle in 20 degrees PF

Front 40

When is ATFL taut

Back 40

PF and inv- this is the MOI
Perform ant drawer with ankle in 20 degrees PF

Front 41

When is CFL taut

Back 41

In DF and inv- this is MOI
Perform ant drawer in DF to show laxity if CFL

Front 42

When is ATFL taut

Back 42

PF and inv- this is the MOI
Perform ant drawer with ankle in 20 degrees PF

Front 43

When is CFL taut

Back 43

In DF and inv- this is MOI
Perform ant drawer in DF to show laxity if CFL

Front 44

How to test for hi ankle sprain

Back 44

ER xray
Asymmetric mortise
Medial clear space > 4 mm
Tib fib clear space > 6 mm

Front 45

When is ATFL taut

Back 45

PF and inv- this is the MOI
Perform ant drawer with ankle in 20 degrees PF, pf of the foot causes ATFL to be parallel with the axis of foot and bc taut