Uh/ Tamc Millers Foot And Ankle

Front 1

Spring ligament

Back 1

Inferior and superomedial calcaneonavicular ligaments. Help support longitudinal arch

Front 2

Lisfranc ligament

Back 2

2nd metatarsal to medial cuneiform. Plantar strongest part

Front 3

Components of transverse tarsal joints

Back 3

talonavicular and calcaneocuboid- parallel during eversion/ divergent during inversion

Front 4

Stride

Back 4

heel-strike to heel-strike. 62% stance/ 38% swing. Stance phase decreases with increasing speed.

Front 5

Foot changes from heel-strike to toe-off

Back 5

1. plantar fascia tightens as MTPJ extends. 2. Longitudinal arch accentuated. 3. PTT supinates hindfoot. 4. Transverse tarsal joint locks--> rigid lever arm

Front 6

Cutaneous nerves of the foot

Back 6

1. sural- lateral border. 2. Saphenous- medial eminence of great toe. 3. Medial dorsal cut br SPN- dorsomedial foot. 4. Intermediate dorsal cut br SPN- Dorsolateral foot. 5. DPN- 1st dorsal webspace. 6. Posterior tibial- plantar foot

Front 7

Canale view- foot XR

Back 7

15 degrees internal rotation- talar neck fx

Front 8

Harris view- foot XR

Back 8

Axial heel view

Front 9

Broden's view- foot XR

Back 9

Subtalar medial oblique at 10 deg

Front 10

Location of hallux sesamoids

Back 10

in FHB

Front 11

Hallux valgus interphalangeal angle

Back 11

<8deg

Front 12

Hallux valgus angle

Back 12

<15 deg

Front 13

Metatarsus primus varus angle

Back 13

1st MT vs medial cuneiform. <25deg

Front 14

1st IMA

Back 14

<10 deg

Front 15

DMAA

Back 15

<15deg

Front 16

Complications Keller resection arthroplasty

Back 16

transfer metatarsalgia, loss of weight bearing function, cock-up toe deformity. Salvage w/ 1st MTPJ arthrodesis +/- interpositional graft

Front 17

Silver bunionectomy

Back 17

medial eminence resection + distal soft tissue release.; High risk of recurrence

Front 18

Position 1st MTPJ arthrodesis

Back 18

110deg dorsiflexion relative to floor/ 25deg dorsiflexion relative to 1st MT/ 10-15deg valgus

Front 19

Treatment hallux varus

Back 19

AbHL release/ Tx EHL or EHB under IM lig to proximal phalanx. Fusion if fixed

Front 20

Assess flexibility of lesser toe deformities

Back 20

Push up test. Pressure on plantar forefoot reduces deformity- removes overactive intrinsics

Front 21

Mallet toe

Back 21

flexion deformity DIPJ. 2/2 overactive FDL. Tx: FDL tenotomy/ excisional arthroplasty if rigid.

Front 22

Claw toes

Back 22

Usually neurologic origin. Tx: flexor to extensor transfer + EDB tenotomy/EDL lengthening. If fixed-resection arthroplasty or PIP arthrodesis. Weil osteotomy (oblique shortening MT osteotomy) increases correction.

Front 23

Treatment flexible hammer toes

Back 23

FDL flexor to extensor tendon transfer. Add EDL lengthening/tenotomy if active flexion <10-15deg

Front 24

Treatment flexible mallet toe

Back 24

Percutaneous FDL tenotomy

Front 25

Treatment crossover 2nd toe

Back 25

Extensor tenotomy, dorsa/medial MTPJ capsule and MCL release

Front 26

Treatment overlapping 5th toe

Back 26

Capsule release, Z-plasty dorsal skin, EDL lengthening

Front 27

Treatment underlapping 5th toe

Back 27

Kids- FDL/FDB tenotomy. Adults- flexor to extensor transfer, syndactylization

Front 28

Etiology crossover 2nd toe

Back 28

Attritional rupture LCL/lateral capsule + attenuation 1st dorsal IO/plantar plate

Front 29

Proximal osteotomies for bunionette deformity

Back 29

AVOID- tenuous blood supply to proximal metadiaphyseal junction

Front 30

Complications sesamoid excision

Back 30

Medial: hallux valgus; Lateral: hallux varus; Both: cock-up deformity

Front 31

Location interdigital neuroma

Back 31

Between 3rd and 4th metatarsal.

Front 32

Recurrent metatarsal neuroma

Back 32

Secondary to traction neuritis due to neural stump adherence. Tx: excision- plantar or dorsal incision. 65-75% success rate

Front 33

Tarsal tunnel syndrome

Back 33

Compression posterior tibial nerve. Increased risk w/ pes planus/ hindfoot valgus.

Front 34

Anterior tarsal tunnel syndrome

Back 34

Compression DPNunder inferior extensor retinaculum. Cause: tight shoes/ anterior osteophytes/pes cavus/tendinitis. Sx worse w/ ankle plantarflexion and toe extension. Tx: night splints/ shoewear modifications/retinacular release w/ bone spur excision- relief may take months

Front 35

Treatment adolescent CMT w/ supple deformity

Back 35

1. plantar fascia release. 2. closing wedge dorsiflexion osteotomy 1st MT. 3. calcaneal slide and closing wedge osteotomy. 4. transfer PL to PB at distal fibula. 5. TAL

Front 36

Treatment clawed hallux

Back 36

arthrodesis of IPJ and transfer EHL to 1st MT

Front 37

Position ankle arthrodesis

Back 37

5deg DF/ 5-10deg ER/ neutral varus and valgus

Front 38

Position subtalar arthrodesis

Back 38

10deg valgus/ 0deg rotation

Front 39

Position talonavicular arthrodesis

Back 39

0 deg varus/valgus hindfoot; 0 deg Meary's angle

Front 40

Stage I PTT dysfunction

Back 40

pain- nml alignment. Bracing/ synovectomy

Front 41

Stage II PTT dysfunction

Back 41

Flexible pes planovalgus. UCBL orthosis/ AFO/TAL; FDL transfer; medial calc slide

Front 42

Stage III PTT dysfunction

Back 42

Rigid deformity. Hindfoot arthritis. Triple arthrodesis + TAL/gastroc slide

Front 43

Stage IV PTT dysfunction

Back 43

Ankle involvement. Triple arthrodesis + TAL+ deltoid reconstruction

Front 44

Unilateral cavus foot

Back 44

R/o intraspinal etiology

Front 45

Initially affected muscles CMT

Back 45

TA/ EDL/ PB

Front 46

Most common location stenosing tenosynovitis of FHL

Back 46

bet posterolateral and posteromedial tubercles of talus

Front 47

Achilles debridement over 50%

Back 47

Need augmentation w/ tenodon transfer (FHL)

Front 48

ABI

Back 48

1.0= nml/ 0.45 needed for wound healing

Front 49

Toe pressures

Back 49

100mmHg=nml/ 40mmHg needed for healing

Front 50

TcPO2

Back 50

>40mmHg predictive of healing

Front 51

Cuboid syndrome

Back 51

Subluxation. More common in ballet dancers. Pain/ click when foot dorsiflexed/everted

Front 52

Joint where most hindfoot motion occurs

Back 52

talonavicular

Front 53

Cause navicular avulsion fx

Back 53

forcible contraction tibialis posterior

Front 54

Treatment navicular body fracture

Back 54

ORIF even if non-displaced

Front 55

Blood supply to talus

Back 55

posterior tibial/ dorsalis pedis/ perforating peroneal. Artery of tarsal canal is main supply esp to body. Artery of tarsal sinus/ DP important for head/neck

Front 56

Malunion talar neck fractures

Back 56

Varus deformity most common- more if medial comminution. Causes cavus/supination of foot--> tx w/ medial column lengthening/lateral column shortening/talar neck osteotomy

Front 57

Reduction talar neck fractures

Back 57

Plantarflexion and manipulation of heel. Immediate reduction necessary.

Front 58

Anterior process of calcaneus fracture

Back 58

Avulsion of bifurcate ligament. Fix or excise if displaced over 1cm

Front 59

Most common location intra-articular calcaneus fractures

Back 59

posterior facet

Front 60

Normal Bohler's angle

Back 60

25-40deg

Front 61

Compartments of the foot

Back 61

medial: AbH/FHB. Central: FHB,lumbricals,QP, AdH. Lateral: flexors, abductors, opponens of 5th toe. Interosseous compartment.

Front 62

Risk of compartment syndrome w/ calcaneus fracture

Back 62

10%