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Flashcards in Foot and Cankles Deck (29)
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1

describe the GAIT cycle

2

Describe anatomical changes with Halgus Valgus:

3

Describe the normal angular measurments for Halgus Valgus:

4

what are the three main presenting types of bunion deformity?

5

How do you treat a degenerative bunion?

6

What are some options to treat Halux Varus complication after bunion surgery?

7

Is avascular necrosis a complication of bunion surgery?

8

What are the three radiology grades of Halgus Rigidus?

Grade 1: Stiff ROM, maintained joint space, minimal osteophytes

Grade II: large osteophytes, narrowed joint space

Grade III: severe osteophytes, loss of joint space

 

9

What are the treatment options for Halgus Ridigus?

CONSERVATIVE: extra depth shoe to accomodate osteophyte, carbon fiber footplate with Morton's extension.

OPERATIVE GRADE 1,2: Chielectomy (up to 30% metatarsal head), +/- moberg dorsiflexion osteotomy

OPERATIVE GRADE 3: Joint Fusion: neutral, 5 deg valgus, 10-15 dorsiflexion, keller resection arthoplasty only medical ill, frail. 

10

Define the three lesser toe deformities

11

What is the anatomic definition of lesser toe deformities?

12

Describe the surgical treatment for hammer and mallet toe:

13

Describe the surgical treatment for claw toe deformity:

14

What is a Frieberg infarction of the toe?

Treatment options are:

Orthotics limited benefit

Joint Debridement

No evidence for core decompression

Dorsal closing wedge osteotomy

excision of metatarsal head not supported

15

Bunionnette Deformities:

Types

type 1: elarged metatarsal head

Type II- Bowing of the diaphysis of the 5th metatarsal

Type III: greater than 8 degrees IMA

TREATMENT:

Type 1-distal chevron osteomtomy 1mm for 1 degree

Type II, III- obligue diaphyseal metatarsal osteotomy

avoid proximal metatarsal osteotomy

16

Name some key facts about the seasamoids:

17

Describe Turf Toe

Forced Dorsiflexion injury

Avulsion of plantar plate

Proximal migration of seasamoids

seasamoids do not move with fluroscopic ROM

GRADE 1: (Capsule Strain) Stiff insole, toe taping

GRADE II-(partial tear) stiff insole, no sports 2wks/ rtp painless dorsiflexion greater than 60 degrees

Grade III-(Complete tear)-surgical repair, RTP 6 weeks

Mandatory with 3mm or more proximal retraction

18

Pearls on Seasamoid pathology

all recalcitrant seasamoid pathology best treated by removal of the seasamoid. 

seasamoid removal complications are:

halgus valgus, halgus varus, cock-up deformity

nerve injury

19

Morton's Neuroma Diagnosis Pearls

20

Non-operative treatments for Morton's Neuroma

21

Operative treatment for Morton's Neuroma

22

What to do with a recurrent Morton Neuroma?

23

How to diagnosis and treat 5th metatarsal fractures

Zone 1: Peroneus Brevus avulsion fracture vs inversion injury-- Boot

 

Zone 2: metaphyseal/diaphyseal watershed area (Jones)

operative in an elite athlete/ NWB Boot x 6 weeks

Zone 3: Diaphyseal

33% refracture risk with non-op, consider ORIF with bone grafting

24

What is the best operative treatment for purely ligamentous lisfranc injuries?

25

What are some common ways to diagnose a Lisfranc Injury?

26

Describe the anatomy considerations of a Lisfranc injury:

27

Key Points to an Accessory Navicular

Type 1: small accessory bone with no attachment

type 2: tuberosity separated by 2mm fibrous cartilage

Type 3: accessory bone united by bony bridge

KEY RADIOGRAPH:EXTERNAL OBLIQUE FOOT

 

operative treatment: modified Kidner--(os excision with advancement of posterior tibial tendon

28

Navicular Stress Fractures

tx- nwb in boot 6-8 weeks, ct scan prior to activity:

need to operate on any fracture displacement (>2mm)

single or multiple screws

add bone graft if any sclerotic edges

CT scan required prior to return to play

29