Sm Caq - Ankle

Front 1

peculearity about shape of talus at ankle?

Back 1

talus is broad in front

Front 2

lateral ligaments of ankle and where to test?

Back 2

ATFL - test in plantarflexion
CFL - test in neutral or dorsiflexion

Front 3

major blood supply to talus?

Back 3

artery of the tarsal canal branch of the deltoid

Front 4

Where does Achilles insert relative to midline?

Back 4

Achilles insertion is lateral to midline.

Front 5

How test equinus contracture?

Back 5

test ankle dorsiflexion in both knee extension and knee flexion (diff will be due to gastrocs)

Front 6

The primary constraint to inversion when the ankle is in plantarflexion is...?

Back 6

antreior talofibular

Front 7

see pic p 501: what is it identifying?

Back 7

accessory soleus!!

Front 8

Weber A fibula fx?

Back 8

below syndesmosis

Front 9

Weber B fibula fx?

Back 9

at syndesmosis

Front 10

Weber C fibula fx?

Back 10

above syndesmosis

Front 11

most common complication talus fx?

Back 11

subtalar arthritis

Front 12

talar neck fx I:

Back 12

nondisplaced

Front 13

talar neck fx II:

Back 13

subtalar dis/subluxation

Front 14

talar neck fx III:

Back 14

ankle and subtalar dis/subluxation

Front 15

talar neck fx IV:

Back 15

talonavicular

Front 16

Hawkins sign?

Back 16

subchondral osteopenia indicating that blood can get to the subchondral bone to remove calcium (Good Thing!)

Front 17

Gr I lateral ankle sprain?

Back 17

stretching of the ATFL, no instability

Front 18

Gr II lateral ankle sprain?

Back 18

complete ATFL tear, typically partial CFL tear moderate laxity (+ant drawer, -talar tilt)

Front 19

Gr III lateral ankle sprain?

Back 19

complete rupture of ATFL and CFL (++ant drawer and talar tilt)

Front 20

College athlete has lower extremity injury evaluated in training room. What allows deferred radiographic imaging?

Back 20

*Distal and anterior fibular tenderness - Ottawa ankle reles include posterior edge or either malleali. Foot films for navicular and 5th MT. p517

Front 21

basis for decision to ORIF bimalleolar fx's?

Back 21

biomechanical studies!!

Front 22

Most common complication of talar neck fx's is...?

Back 22

Arthritis if the subtalar joint.

Front 23

depiction of poss Charcot foot. Recommended test to ID underlying condition?

Back 23

fasting glucose

Front 24

DDx of rigid cavus foot?

Back 24

tarsal coalitions
post-traumatic arthritis
Charcot-Marie-Tooth
Neuromuscular disorders

Front 25

Coleman block test?

Back 25

see description p 504
drop first ray off edge, if heel moves to valgus position the cavus is FLEXIBLE,
- if cavus unchanged, cavus is RIGID.

Front 26

primary Rx for ankle instability?

Back 26

Gould modification of Brostrum procedure (anatomic ATFL repair with reinforcement w inferior extensor retinaculum)
>90% success

Front 27

position for ankle arthrodesis?

Back 27

-neutral plantarflexion
-slight (5 deg) valgus
-neutral to 10 deg ER

Front 28

18yo w progressive recurrent ankle instab. +fatigueability
Bilat cavovarus feet. Intrinsic muscle weakness in hands. Eval should include...?

Back 28

EMG (evaluate for CMT)

Front 29

Achilles rupture ass'd with what med?

Back 29

fluorpuinolones, av age 35

Front 30

name of test to squeeze calf-->dorsiflexion?

Back 30

Thompson test

Front 31

Diff closed Rx Achilles rupture?

Back 31

-cast in equinus
-inc risk DVT
-slower to initiate WB
higher rerupture rate (marginal)

Front 32

Which approach favored for Achilles rupture?

Back 32

medial approach
repair tendon and tendon sheath

Front 33

Treatment for Achilles tendinosis?

Back 33

Eccentric loading physiotherapy (this is when there is a palpable nodule in tendon)

Front 34

Haglund's deformity?

Back 34

posterolateral "pump bump"
retrocalcaneal bursitis
inject into BURSA, not tendon

Front 35

When do surgery in chronic Achilles rupture?

Back 35

When tendon lengthened >5cm

Front 36

Which peroneal tendon most commonly involved?

Back 36

P brevis, and at fibula is most common site

Front 37

Structure torn in peroneal subluxation?

Back 37

superior peroneal retinaculum

Front 38

type of stretching to hlep 18yo basketball player w Achilles tenonitis?

Back 38

Eccentric strengthening. The Achilles primarily functions in that phase.

Front 39

30yo w Achilles insertion pain Rx for sinusitis w Cipro, mgmt?

Back 39

discontinuation of fluoroquinalone antibiotics because of potential direct affect on tendon rupture.

Front 40

op vs nonop Achilles rupture treatment?

Back 40

higher complication rate and lower re-rupture rate.

Front 41

most common complication to arthroscopy for impingement ant ankle?

Back 41

cutaneous nerve injury to the superficial peroneal nerve

Front 42

Osteochondral talar defect preferred surgical treatment?

Back 42

debridement and drilling/picking is primary option

Front 43

location of posteromedial portal for ankle arthroscopy?

Back 43

Achilles tendon and peroneus longus tendon

Front 44

most common complication ass'd w ankle arthroscopy?

Back 44

neurologic injury

Front 45

Stress fx distal tibia/talus, mgmt?

Back 45

check DEXA, if <2.0 then treat

Front 46

Os Trigonum: where located?

Back 46

lateral of FHL posteriorly
Rx injection.

Front 47

relative to the FHL the os trigonum is....?

Back 47

LATERAL

Front 48

23 yo ballet dancer w hindfoot pain "en pointe". Most likely cause?

Back 48

Os trigonum impingement.