Nbr - Common Rearfoot Pathology And Surgery

Front 1

Name 3 systemic causes o fo heel pain
*********
What is the neutral triangle of the calcaneus?

Back 1

gout rheumatoid arthritis and seronegative arthropathy such as reatier's syndrom and ankylsoing spondylits
*****
Theneutral traingle represents a radiolucent area seen on a latear radiograph of hte calcaneus. It is fomred by pressure trabeculae from t he subtalar joint combined with traction trabeculae fomed by the normal pull fo the achilles tendon and plantar fascia.

Front 2

What is Forrester's disease?

Back 2

Diffuse idiopathic skeletal hyperostosis.

Front 3

Name 3 mechanical foot types associated with Haglund's deformity.

Back 3

Compensated rearfoot varus, compensated forefoot valgus, and rigid planrflexed 1st ray.

Front 4

What is the normal value for hte fowler and phillip angle?

Back 4

44-69 degres.

Front 5

What is the toal angle of Ruch?

Back 5

This is the comined value of the calcaneal inclination angle and the Fowler and PHilip angle. A value of over 90 degrees is indicative of a Haglund's deformity.

Front 6

What are the borders of Kager's triangle?

Back 6

The superior calcaneal surface, the Achilles tendon and the long flexor tendons.

Front 7

Where is the retrocalcaneal synovail bursa located?

Back 7

This bursa separates the Achilles tendon from the superior 1/3 of the posterior surface of the calcaneus.

Front 8

Where is the retrocalcaneal synovial bursa located?

Back 8

This bursa separateds the achilles tendon from the superior 1/3 of the posterior surface of the calcaneus.

Front 9

Where is the adventious superficial Achilles bursa located.

Back 9

The bursa is located between the Achilles tendon and the subcutaneouls tissue.

Front 10

Under what circumstances ithe Keck and Kelly procedure appropriate in the treatment of Haglund's deformity?

Back 10

When there is a structural cavus foot wiht a high calcaneal inclination agnle but a normal postero-superior prominence that is symptomatic.

Front 11

What is heel spur syndrome

Back 11

The symptom complex of plantar stress, tendinitis, fasciitis, with or without the presence of an inferior calcaneal spur.

Front 12

Which nerve is often implicated as a cause of inferior calcaneal pain?

Back 12

The nerve to the abductor digit quinti muscle, referred to as Baxter's nerve, is commonly believed to be a source of heel pain.

Front 13

What is the DuVries incisional approach for heel spur surgery?

Back 13

medial horizontal approach

Front 14

What are the advantages of using a plantar approach for heel spur surgery?

Back 14

Direct visualization of exostosis, avoidance of medial calcaneal nerve branches, easy access to the subcalcaneal adventitious bursa.

Front 15

Where does the subcalcaneal adventious bursa form?
************
What are differential diagnoses for heel spur syndrome
What is the pirmay structure that supplies venous draingae othte heel

Back 15

Between the most prominent point of the tuberosity and the plantar fat pad.
8888888
plantar fasciitis, subacacaneal advetnious bursitis, policmena' heel (contusion, stoen buris) tentintis of hte intreinsic muscle, nerve ntrapment , heel neuroma herniaton of plantar fascia, painful peizogenic paules, radiuclaopatha, infecitn and systemic disease
* small saphenous vien

Front 16

Which nerve is often impolicated as a cause of inferior calcaneal pain?

Back 16

The nerve to the abductor quinti muscle, referred to as Baxtger's nerve, is commonly believed to be a source of heel pain.

Front 17

What is the DuVries incisional approach for heel spur surgery?

Back 17

Medial horizontal approach.

Front 18

What are the advantages of using a plantar approach for heel spur surgery?

Back 18

Direct visualization of exostosis, avoidance of medial calcaneal nere branches, easy access to the subacalcanear adventitious bursa.

Front 19

Where does the subcalcanear adventitious bursa form?

Back 19

Between the most prominent pint of hte tuberosity and the plantar fat pad.

Front 20

What are the differential diagnoses for heel spur syndrome?

Back 20

Plantar fasciitis, subacalcaneal adventitous bursitis, policeman's heel (contusion, stone bruise) tendinitis of intrinsic muscles, nerve entrapment, heel neuroma, herniation of plantar fascia, painful piezogenic papules, radiculopathy, infection, and systemic disease.

Front 21

What is the primary structure that supplies venous drainage to the heel?

Back 21

Small saphenous vein.

Front 22

What are the differential diagnoses of posterior heel pain?

Back 22

Haglund' deformity, retrocalcaneal bursitis, achilles tendinitis, calcifications within the achilles tendon, systemic arthrides, DISH.

Front 23

What are the incisional approaches for Haglund's deformity?

Back 23

Fowler and Philip direct posterior, lateral linear, lateral lasy L, 2 incisional

Front 24

what are the incision approaches of hagulund's deformity
***************
What does "chasing the bump" refer to in Haglund' deformity surgery

Back 24

Fowler and phllip direct posterior, lateral linear, lateral lazy l, 2 incisional
*******
This refers to the xcessive resection of hte posteriro superi prominece ad compromise of the insertion of the Achilles tendon by sucessively resecting the bony prominence created by the previos use of the osteotome for bony remova.

Front 25

What is the miller and Vogel procedure?

Back 25

A surgical procedure used for Haglund's deformity, which combines the Keck and Kelly procedure with resection of the poster-superior prominece and using internal fixation.

Front 26

Where does the calcaneus receive its blood supply?

Back 26

Via calcaneal branches of hte posterior tibial deformity and lateral plantar artery medially, by communicating branches of hte peroneal and lateral malleolar arteries laterally and communicating branches posteriorly.

Front 27

What cystic lesion of bone is commonly seen in the calcaneus?

Back 27

unciameral bone cyst

Front 28

What are the three type sof tarsal coalitions?

Back 28

Syndesmosis (fibrous), synchondrosis (cartilaginous), and synostosis (bony).

Front 29

Which tarsal coalition has the highest prevalence?

Back 29

Middle facet STJ coaliton

Front 30

Which radiographic view is best used to visualize a calcaneo-navicular coaltion?

Back 30

High angle medial oblique

Front 31

What are the three branches of the posterior tibial nerve?

Back 31

medial plantar, lateral plantar, and medial calcaneal nerves

Front 32

What are the advantages of endoscopic plantar fasciotimy in the surgical treatment of heel spur surgery?

Back 32

Decreased levles of soft tissue damage and postoperoative pain.

Front 33

What is the postoperative care for endoscopic plantar fasciotomy?

Back 33

Immediate full weightbearing, but avoid excess ambulation. Patient returns to regualr shoes with orthotic devices as as soon as toelrated.

Front 34

What is the "Windlass action" of the plantar fascia?

Back 34

This is the action that raises the longitudinal arch as the metatarsophalangeal joints are dorsiflexed and the plantar fascia tightens.

Front 35

How does a calcaneal stress fracture appear radiographically?

Back 35

lateral radiograph: vertical sclerotic band with the normal trabecualr pattern running perpendicular to the line of hte stress fracture.

Front 36

With a stress fracture of the calcaneus, when do routine radiographs become positive?

Back 36

Within 3-4 seeks following the onset of symptoms.

Front 37

Name 4 conservative mehtods of treating heel pain syndrome?

Back 37

Rest, NSAIDS, steroid injections, and iontophoresis.

Front 38

What is the postoperative course for a plantar fasciotomy via a plantar inscision?

Back 38

nonweightbearing 3 seeks, then patient is change to a postoperative shoe for several more weeks.

Front 39

How is superficial achilles bursitis treated?

Back 39

Shoe modification, heel lift, softening of the heel counter of the shoe.

Front 40

What is a Kidner procedure?

Back 40

Excision of an accessory navicualr with adavnacement of the posterior tibial tendon plantarly.

Front 41

When excising an accessory navicular or hypertrophic navicular tuberosity how much bone should be resected?

Back 41

The hypertopohic tuberosity should be resected flush with the medial cuneiform.

Front 42

what are the indicatiosn fo r akdner procedure?

Back 42

THE Kidner procdure is not a corective procedrue fo rflatfoot deformity; is sohould be used for sympotmatic promenence about an enlarge navicular tuberosisty

Front 43

what anatomical structures msut be concountere when excinga nd acessor y navicualr bone

Back 43

communicateing branche sof hte greater sapheons veirn (medial marginal verin) saphenos nerve, and osterior tibial tneodn

Front 44

what is the posteroateive course status post kidner procdure?

Back 44

nwb bk cast with foot inequinovarus x 4 skes, then kb partially wb cst with well moslded arch x 4 wks, thenfull wb with firmorhtosis

Front 45

name 3 acessor y ossicles of the refoot and theri crrespoiidng antamcilocatiosn

Back 45

os trigonum- posterior talus
ostibiale extenmum- navular tubreosity
os peroneum - cuboid

Front 46

What venosu structurs msut be concoutnered when perfoim gsoft tissue dissectiojn along the navicualr tuberosity

Back 46

medial marginal veins ystem

Front 47

what radiographic view is helpful when evaluatedg for tarsal coalition (stj)

Back 47

harris beath view

Front 48

when rescign as ymptomatic ostrigonu, which tenidinous tructur msu tbe retracted carfully and not transected

Back 48

flexor hallucs longsu

Front 49

which ldgament bmust be transected when performign a tarsal tunnel relase

Back 49

lacinaite lgimaent (flexor retincaculum)`

Front 50

whic is th last refoot bone to appear radicgraphicllyh after birht?

Back 50

navicular

Front 51

where does the medial aspect of hte heel recieve its crculation?

Back 51

calcaneal branches of psterio tibial nad latera plantar arteris

Front 52

what is themsot comon complciation seen after total palntar fasciotomy?:

Back 52

lateral column pain (cuboid syndrome)

Front 53

what is the only refoot bone with no tendinous attachments

Back 53

talus

Front 54

what foot types ar commonly seen in patient presenting wht hagulund's deformtiy?

Back 54

compensated reafoot varus, compensated forefoot valugs, rigid plantarflexed 1st ray

Front 55

at what age does the calcaneal apohysis dtypically close

Back 55

14-16 years fo age

Front 56

how woud la calcane stress fractue appear on gbone scan

Back 56

incrased uptake in al 2 phases

Front 57

what is the mchanism typically involved ina anterio prsoces sfractures of hte calcanus

Back 57

;plantarflexion of na supinated foot

Front 58

What is the clincila presentation fo apaeient with "ost trgonum syndrome?"

Back 58

gernealized reafoot pain or aching, pain may be more pseterior latera, icnreases with activity,decreases with rest, pain my abe exacerbated withmotion ohallux, pain may be exacerbtge with the ankle pantarfelxion, palpaiton deep behnid lateral malleolus eleicit pain, may see psoterior lateral edem

Front 59

What is a saddle bone deformity?

Back 59

a metatarsa cueniform exostosis

Front 60

Neuritsof what nerve is sometime associated with asaddle bone defoarmity?

Back 60

deep peroneal nerve

Front 61

wha t is an in-stpe platnar faxciotomy

Back 61

this is a fascotomy performed ont he palntar aspect of hte foot anterir ot the heel ve the medial bnad of the plantar fasia. it si pefomed through a smal tarnsvers o linear incison. the supreficial fatty tissu is spearated allowign visualizaitonj of the fasia whti gently ncised whei the foefoot is gently dorsiflext

Front 62

What is ESWT

Back 62

extracoproeal shock waver therapy is a procedure use to treat chrnic heel ian ie. plantar fsciitis. this is anon-invasive surgical prcdureinwhic strong sound wave are directed ath eharea fo theheel which si painful and induce ahealing rsopnse by the body.