ABFAS Exam Questions with Correct Answers

ABFAS Exam Questions with Correct Answers Diastasis for Lisfranc = a fracture is present - Answer-2-5 mm of diastis betwen 1st and second mt base Chronic lisfrancs---ct=1 mm diastasis betwen 1st and 2nd mt or an increase of more than 15 degrees in the tarso-metatarsal joint signs of lisfranc on xray - Answer-fleck sign (1 and 2 met bases) first ray elevated arch flattens MCC direction lisfranc displaces - Answer-Dorsal and Lateral When to sx correct lisfranc - Answer-2mm displaced wait 14 days if too much edema Approach to ORIF lisfranc fx - Answer-middle cunii start proximal superior medical to the base of the 2nd mt possibly, 3rd mt. the first lag screw=KEY to REDUCTION. T if needed do a few more lag screws from the the bases metatarsals cuni. If cuni instability **screw across the nition=plates. Rules for bunions in the Juvenile pt - Answer-14-16 yrs. Ideal time frame to do sx for them is near skel. Maturity 11-15 yoa. Don't do anything joint destructive /don't remove the fib sesamoid. take mt adductus into consideration in a peds patient. Transpositional osteotomies ideal e.g. austin, kalish, offset V for rectus foottype and mod. IMA. But if they have Mt Adductus, really high IM or really high PASA Distal metaphyseal peds osteotomies - Answer-Austin, offset v, reverdin, mitchell, wilson and peabody. Mitchell and wilson SE including shortening, transfer lesions, elevatus, metatarsalgia How to fix bunion in a peds pt with IM 15 - Answer-Base procedure aka proximal metaphyseal osteotomy. -closed or open base wedge, cresentic procedure, lapidus =goal to make first and 2nd mt parallel without damaging the open physeal plate. base of proximal phalanx (aka proximal akin) of hallux what does it correct - AnswerDistal Angle DASA Fix pasa with mt head osteotomy like REVERDIN=lat cortex intact proximal cut parallel to 1st mt and distal cut parallel to articular surface Fix DASA W/ proximal akin disadvantage of the fusion vs plasty is the - Answer-fusion has less hallux propulsion and it can shorten which can then lead to contracture of the ehl or fhl You can walk it immediately vs plasty you cant cancellous vs cortical screws - Answer-Cannulated cancellous screws are used for metaphyseal fractures while cannulated and noncannulated cortical screws are used as lag screws for fixation of diaphyseal fractures.