Forefoot Multiple Choice 1, Forefoot Multiple Choice 2,
ABFAS: GTQs Forefoot, ABFAS 22, ABFAS Forefoot, abfas,
ABFAS
What is flexor stabilization?
FHL and FDL gain mechanical advantage over INTEROSSEI in a pronated foot.
Quadratus plantae loses straight pull and adductovarus of 4th and 5th digit are a result
What is the Kalish modification?
Long arm Austin @ 55 degrees
What angle does an Austin correct?
IM
Bicorrectional (dorsal arm wedge) fixes IMA + PASA
Plantar Layers of Foot?
First layer
* Both ABDUCTORs
* FDB
Second layer
* Quadratus plantae (flexor accessorius)
* Lumbricales
* Tendon of FHL and FDL (KNOT OF HENRY)
Third layer
* Adductor hallucis
* Flexor HALLUCIS brevis
* Flexor digiti minimi brevis
Fourth layer
* 4Dorsal interossei
* 3Plantar interossei
* Tendons of PL and PT
Causes of coagulopathy (decreases chances of clotting)
von Willebrand's disease
Vitamin K deficiency
DIC
Hemophilia
Contraindications for elective surgery?
MI within 6 months
CVA/Stoke within 2 months
Lack of NPO
How much distraction for brachymetatarsalgia per day?
Total?
1mm per day - 0.25mm QID
1cm
What is the benefit of an Austin osteotomy perpendicular to weight bearing surface?
,You won't dorsiflex or plantarflex the distal fragment
Clinical features of Gonococcal arthritis?
Migratory Arthritis
Tenosynovitis
Skin lesions
Treatment: Z-Pack or Doxycycline
What is a xenograft? Allograft? Autograft?
Autograft - Graft from same person
Allograft - Graft from same species - OSTEOCONDUCTIVE ONLY
Xenograft - Graft from different species
Kohler's disease statistics?
-Osteochondrosis of navicular - Self-limiting
-Children 6-9
-Mostly boys
Structures that have attachments in the sesamoid apparatus?
Intersesamoid ligament
FHB
Adductor hallucis
Abductor hallucis
NOT FHL
What lights up in a bone scan?
Bladder + Kidneys
Epiphysis - Knee, elbow, ankle,
Facial Area
Sternum
Tips of Scapulae
Si Joints
Mechanism of injury for avulsion fx of 5th metatarsal base?
Inversion on a plantarflexed foot
What doesn't run dorsal to DTML?
Neuroma - It's DEEPER via dorsal approach
Does: dorsal/plantar interossei, adductor hallucis
What is Osteoporosis?
bone disease in which bone becomes weak, brittle and porous and high risk for fracture
What is osteopenia?
A bone disorder, that occurs when the body can't produce new bone as quickly as it resorbs old bone
How long should NSAIDs be held prior to surgery?
,72 hours - 3 days
What is Pletal?
Cilostazol - A phosphodiesterase III inhibitor, is indicated to treat the symptoms of intermittent
claudication and increase walking distance in patients with peripheral arterial disease
What does the medial plantar nerve innervate?
Abductor Hallucis
FDB
FHB
1st Lumbrical
1st 3 toes
Tc-99 & Gallium correlation to pathology?
Acute OM & Septic Arthritis: +TC +Gall
Chronic OM: +TC -Gall
Cellulitis: -TC +Gall
Profile for Ewing's Sarcoma?
Boys younger than 20 y/o
Long bone: Diaphysis or metaphysis
Femur, Tibia, or Humerus (Sometimes pelvis or ribs)
Most common digit for central polydactyly
2nd digit
Poorly controlled RA patient with:
IMA - 17
PASA - 4
DASA - 4
Sesamoid Pos: 5
How to treat bunion?
1st MPJ fusion
What is used to treat vasovagal hypotension, bradycardia, and nausea?
Atropine
HLA-B27 - associated with what diseases?
-Reiter's syndrome - Reactive Arthritis
-Ankylosing spondylitis
-Psoriasis
-Inflammatory bowel disease
Most common side effect of arthroereisis?
Lateral Impingement Syndrome
Common complications of a poorly fixated CBWO?
, Elevatus
Lesser Metatarsalgia
Nonunion
Tc-99 binds to what in the body?
Hydroxyapatite
Characteristics of a ganglion cyst via ultrasound?
well defined
dark (anechoic)
No wall thickness
Oblique modification of CBWO (Juvara) has what benefit?
Better screw fixation
If you have separation of the sesamoids, what has ruptured?
Inter-sesamoid Ligament
Benefits of oblique CBWO (Juvara)?
Oblique wedge = better fixation
Indicated for IM angle > 15
Most efficient fixation with screw
DOES NOT cause greater shortening than CWBO
Major risk of metformin? How long should it be held after MRI with contrast?
Renal excretion
Can cause lactic acidosis
48 hours or after labs show baseline kidney function
Isometric contraction?
Isotonic contraction?
Isometric - Muscle length unchanged
Isotonic - Muscle tonicity unchanged
types of isotonic contractions?
Concentric - Muscle shortens
Eccentric - Muscle lengthens
Which drugs should be continued day of surgery?
Beta blockers
Most common complication of endoscopic plantar fasciotomy?
Lateral column instability - CC joint pain
Nerve innervating the first interspace?
Deep peroneal nerve
ABFAS: GTQs Forefoot, ABFAS 22, ABFAS Forefoot, abfas,
ABFAS
What is flexor stabilization?
FHL and FDL gain mechanical advantage over INTEROSSEI in a pronated foot.
Quadratus plantae loses straight pull and adductovarus of 4th and 5th digit are a result
What is the Kalish modification?
Long arm Austin @ 55 degrees
What angle does an Austin correct?
IM
Bicorrectional (dorsal arm wedge) fixes IMA + PASA
Plantar Layers of Foot?
First layer
* Both ABDUCTORs
* FDB
Second layer
* Quadratus plantae (flexor accessorius)
* Lumbricales
* Tendon of FHL and FDL (KNOT OF HENRY)
Third layer
* Adductor hallucis
* Flexor HALLUCIS brevis
* Flexor digiti minimi brevis
Fourth layer
* 4Dorsal interossei
* 3Plantar interossei
* Tendons of PL and PT
Causes of coagulopathy (decreases chances of clotting)
von Willebrand's disease
Vitamin K deficiency
DIC
Hemophilia
Contraindications for elective surgery?
MI within 6 months
CVA/Stoke within 2 months
Lack of NPO
How much distraction for brachymetatarsalgia per day?
Total?
1mm per day - 0.25mm QID
1cm
What is the benefit of an Austin osteotomy perpendicular to weight bearing surface?
,You won't dorsiflex or plantarflex the distal fragment
Clinical features of Gonococcal arthritis?
Migratory Arthritis
Tenosynovitis
Skin lesions
Treatment: Z-Pack or Doxycycline
What is a xenograft? Allograft? Autograft?
Autograft - Graft from same person
Allograft - Graft from same species - OSTEOCONDUCTIVE ONLY
Xenograft - Graft from different species
Kohler's disease statistics?
-Osteochondrosis of navicular - Self-limiting
-Children 6-9
-Mostly boys
Structures that have attachments in the sesamoid apparatus?
Intersesamoid ligament
FHB
Adductor hallucis
Abductor hallucis
NOT FHL
What lights up in a bone scan?
Bladder + Kidneys
Epiphysis - Knee, elbow, ankle,
Facial Area
Sternum
Tips of Scapulae
Si Joints
Mechanism of injury for avulsion fx of 5th metatarsal base?
Inversion on a plantarflexed foot
What doesn't run dorsal to DTML?
Neuroma - It's DEEPER via dorsal approach
Does: dorsal/plantar interossei, adductor hallucis
What is Osteoporosis?
bone disease in which bone becomes weak, brittle and porous and high risk for fracture
What is osteopenia?
A bone disorder, that occurs when the body can't produce new bone as quickly as it resorbs old bone
How long should NSAIDs be held prior to surgery?
,72 hours - 3 days
What is Pletal?
Cilostazol - A phosphodiesterase III inhibitor, is indicated to treat the symptoms of intermittent
claudication and increase walking distance in patients with peripheral arterial disease
What does the medial plantar nerve innervate?
Abductor Hallucis
FDB
FHB
1st Lumbrical
1st 3 toes
Tc-99 & Gallium correlation to pathology?
Acute OM & Septic Arthritis: +TC +Gall
Chronic OM: +TC -Gall
Cellulitis: -TC +Gall
Profile for Ewing's Sarcoma?
Boys younger than 20 y/o
Long bone: Diaphysis or metaphysis
Femur, Tibia, or Humerus (Sometimes pelvis or ribs)
Most common digit for central polydactyly
2nd digit
Poorly controlled RA patient with:
IMA - 17
PASA - 4
DASA - 4
Sesamoid Pos: 5
How to treat bunion?
1st MPJ fusion
What is used to treat vasovagal hypotension, bradycardia, and nausea?
Atropine
HLA-B27 - associated with what diseases?
-Reiter's syndrome - Reactive Arthritis
-Ankylosing spondylitis
-Psoriasis
-Inflammatory bowel disease
Most common side effect of arthroereisis?
Lateral Impingement Syndrome
Common complications of a poorly fixated CBWO?
, Elevatus
Lesser Metatarsalgia
Nonunion
Tc-99 binds to what in the body?
Hydroxyapatite
Characteristics of a ganglion cyst via ultrasound?
well defined
dark (anechoic)
No wall thickness
Oblique modification of CBWO (Juvara) has what benefit?
Better screw fixation
If you have separation of the sesamoids, what has ruptured?
Inter-sesamoid Ligament
Benefits of oblique CBWO (Juvara)?
Oblique wedge = better fixation
Indicated for IM angle > 15
Most efficient fixation with screw
DOES NOT cause greater shortening than CWBO
Major risk of metformin? How long should it be held after MRI with contrast?
Renal excretion
Can cause lactic acidosis
48 hours or after labs show baseline kidney function
Isometric contraction?
Isotonic contraction?
Isometric - Muscle length unchanged
Isotonic - Muscle tonicity unchanged
types of isotonic contractions?
Concentric - Muscle shortens
Eccentric - Muscle lengthens
Which drugs should be continued day of surgery?
Beta blockers
Most common complication of endoscopic plantar fasciotomy?
Lateral column instability - CC joint pain
Nerve innervating the first interspace?
Deep peroneal nerve
