PRACTICE QUESTIONS WITH SURGICAL FOOT
AND ANKLE CASES
◉ What is a likely cause of fever 12 hours after a Lisfranc ORIF?
Answer: Pulmonary atelectasis
◉ What additional imaging is important for a patient with a
suspected injury after an 8-foot fall?
Answer: Spin radiograph
◉ What structure should be carefully dissected to avoid damage
during a lapidus procedure?
Answer: Tibialis anterior tendon
◉ What can cause pseudarthrosis after a fracture?
Answer: Post-injury inflammation
◉ What is the most commonly reported complication following a
Weil osteotomy?
Answer: Floating toe
,◉ What structure is likely damaged if the 2nd digit abducts towards
the 3rd digit after a lateral release?
Answer: 1st dorsal interossei
◉ What occurs in neurotmesis?
Answer: Complete disruption of the axon, Schwann cell, and
endoneurial tubes
◉ What is neuropraxia?
Answer: A lesser injury with the endoneurial structure intact, often
having a better prognosis for axonal regrowth.
◉ What is the most common fungal pathogen found in infected
hardware and implants?
Answer: Candida
◉ What is the most common cause of flexor stabilization in foot
conditions?
Answer: Pronated or flat feet (pes planus) leading to adductovarus
in the 4th and 5th digits.
◉ What is extensor substitution in foot mechanics?
Answer: A condition seen in high arch feet (cavus foot) during the
swing phase of gait, where lumbricals overpower.
,◉ What is flexor substitution?
Answer: The least common compensation, occurring in cavus foot
type with weak triceps surae.
◉ What is the most appropriate fixation after breaking through the
lateral cortex of an oblique akin osteotomy?
Answer: Crossing K wires
◉ What is a common cause of hallux varus?
Answer: Excessive plantarflexion of the osteotomy is NOT a cause.
◉ Which artery is most vulnerable to injury during a medial
approach of a plantar fasciotomy?
Answer: Medial plantar artery
◉ What are the next steps in managing a patient with heavy
purulent drainage post-1st MTPJ arthrodesis?
Answer: Admit to the hospital, leave hardware in, perform
debridement, culture, and administer IV antibiotics.
◉ What complication is likely if a patient aggressively turns an
external fixator device more than 1 mm a day?
, Answer: Extreme pain due to excessive distraction.
◉ What is the most common reason for non-union of the Lapidus
bunionectomy?
Answer: Inadequate joint preparation and poor fixation.
◉ What is the maximum allowable shortening during preparation of
the 1st metatarsal cuneiform joint?
Answer: 0.5 cm before compensatory procedures must be added.
◉ What is the most appropriate treatment for a painful hallux valgus
deformity after a failed silver bunionectomy?
Answer: Lapidus procedure.
◉ What is the most common complication following skin grafts?
Answer: Seroma or hematoma.
◉ What is the primary reason for failed 1st MTP joint arthrodesis?
Answer: Improper fixation.
◉ What is the most likely cause of fever 28 hours post-charcot foot
reconstruction?
Answer: Pulmonary atelectasis.