1
ABFAS BOARD EXAM/ ABFAS BOARD EXAM
PREPARATION/ABFAS BOARD EXAM PRACTICE
ACTUAL EXAM 200 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
(VERIFIED ANSWERS) |ALREADY GRADED A
1.
A 58-year-old patient presents with several years of progressively
worsening medial forefoot pain and difficulty wearing conventional
shoes. Examination demonstrates a prominent medial eminence, lateral
deviation of the hallux, increased first intermetatarsal angle, and a
congruent first metatarsophalangeal joint. The patient has failed shoe
modification, padding, and activity modification and is interested in
surgical correction. Weight-bearing radiographs demonstrate an
increased intermetatarsal angle without significant degenerative changes
of the first MTP joint. Which procedure is most appropriate for
correcting this deformity?
A. Isolated Akin osteotomy
B. Distal first metatarsal osteotomy
C. First MTP joint arthrodesis
D. Isolated medial eminence resection
E. Lesser metatarsal Weil osteotomy
Answer: B. Distal first metatarsal osteotomy
2.
A 67-year-old patient with longstanding hallux valgus presents with
severe pain at the first metatarsophalangeal joint. Examination reveals
limited painful first MTP range of motion, crepitus, and significant
dorsal osteophyte formation. Weight-bearing radiographs show
,2
advanced joint-space narrowing, subchondral sclerosis, and osteophytes.
The patient has attempted shoe modifications, orthoses, NSAIDs, and
activity modification without adequate relief. Which surgical procedure
provides the most predictable correction and pain relief?
A. Chevron osteotomy
B. Scarf osteotomy
C. First MTP arthrodesis
D. Akin osteotomy
E. Lapidus arthrodesis
Answer: C. First MTP arthrodesis
3.
A 42-year-old patient presents with painful hallux valgus and
hypermobility of the first ray. Weight-bearing radiographs demonstrate a
markedly increased first intermetatarsal angle and instability at the first
tarsometatarsal joint. The first MTP joint is relatively congruent without
advanced arthritis. Which procedure most directly addresses the
proximal instability contributing to the deformity?
A. Akin osteotomy
B. Distal metatarsal osteotomy
C. First tarsometatarsal arthrodesis
D. Isolated sesamoidectomy
E. Keller arthroplasty
Answer: C. First tarsometatarsal arthrodesis
4.
,3
A 35-year-old patient has symptomatic hallux valgus with a mild
deformity. Radiographs demonstrate a relatively normal distal metatarsal
articular angle and a mildly increased intermetatarsal angle. The patient
has no arthritis and has failed conservative treatment. Which
radiographic parameter is particularly useful in determining whether a
distal first metatarsal osteotomy may adequately correct the deformity?
A. Calcaneal inclination angle
B. Distal metatarsal articular angle
C. Talonavicular uncoverage percentage
D. Meary angle
E. Kite angle
Answer: B. Distal metatarsal articular angle
5.
A patient undergoes hallux valgus correction and subsequently develops
persistent pain beneath the second metatarsal head. Radiographs
demonstrate altered parabola and excessive loading beneath the lesser
metatarsal. Which complication is most consistent with this
presentation?
A. Transfer metatarsalgia
B. Freiberg disease
C. Sesamoiditis
D. Morton's neuroma
E. Plantar plate rupture
Answer: A. Transfer metatarsalgia
6.
, 4
A 29-year-old patient presents with a painful, progressive bunion
deformity. Examination demonstrates lateral deviation of the hallux and
medial deviation of the first metatarsal. During assessment, the first
MTP joint is manually corrected into alignment, but the hallux
immediately returns toward the lesser toes because of a persistent
deforming force within the proximal phalanx. Which additional
procedure is most appropriate for correcting this residual deformity?
A. Akin osteotomy
B. Weil osteotomy
C. Dorsiflexion calcaneal osteotomy
D. Fifth metatarsal osteotomy
E. Gastrocnemius recession
Answer: A. Akin osteotomy
7.
A 61-year-old patient presents with a rigid painful hallux valgus
deformity and severe first MTP arthritis. The patient has a physically
demanding occupation and desires a durable procedure. Which factor
most strongly supports first MTP arthrodesis rather than a joint-
preserving osteotomy?
A. Mild increase in HVA
B. Severe first MTP joint degeneration
C. Flexible lesser toe deformity
D. Mild plantar fasciitis
E. Isolated fifth metatarsalgia
Answer: B. Severe first MTP joint degeneration
8.
ABFAS BOARD EXAM/ ABFAS BOARD EXAM
PREPARATION/ABFAS BOARD EXAM PRACTICE
ACTUAL EXAM 200 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
(VERIFIED ANSWERS) |ALREADY GRADED A
1.
A 58-year-old patient presents with several years of progressively
worsening medial forefoot pain and difficulty wearing conventional
shoes. Examination demonstrates a prominent medial eminence, lateral
deviation of the hallux, increased first intermetatarsal angle, and a
congruent first metatarsophalangeal joint. The patient has failed shoe
modification, padding, and activity modification and is interested in
surgical correction. Weight-bearing radiographs demonstrate an
increased intermetatarsal angle without significant degenerative changes
of the first MTP joint. Which procedure is most appropriate for
correcting this deformity?
A. Isolated Akin osteotomy
B. Distal first metatarsal osteotomy
C. First MTP joint arthrodesis
D. Isolated medial eminence resection
E. Lesser metatarsal Weil osteotomy
Answer: B. Distal first metatarsal osteotomy
2.
A 67-year-old patient with longstanding hallux valgus presents with
severe pain at the first metatarsophalangeal joint. Examination reveals
limited painful first MTP range of motion, crepitus, and significant
dorsal osteophyte formation. Weight-bearing radiographs show
,2
advanced joint-space narrowing, subchondral sclerosis, and osteophytes.
The patient has attempted shoe modifications, orthoses, NSAIDs, and
activity modification without adequate relief. Which surgical procedure
provides the most predictable correction and pain relief?
A. Chevron osteotomy
B. Scarf osteotomy
C. First MTP arthrodesis
D. Akin osteotomy
E. Lapidus arthrodesis
Answer: C. First MTP arthrodesis
3.
A 42-year-old patient presents with painful hallux valgus and
hypermobility of the first ray. Weight-bearing radiographs demonstrate a
markedly increased first intermetatarsal angle and instability at the first
tarsometatarsal joint. The first MTP joint is relatively congruent without
advanced arthritis. Which procedure most directly addresses the
proximal instability contributing to the deformity?
A. Akin osteotomy
B. Distal metatarsal osteotomy
C. First tarsometatarsal arthrodesis
D. Isolated sesamoidectomy
E. Keller arthroplasty
Answer: C. First tarsometatarsal arthrodesis
4.
,3
A 35-year-old patient has symptomatic hallux valgus with a mild
deformity. Radiographs demonstrate a relatively normal distal metatarsal
articular angle and a mildly increased intermetatarsal angle. The patient
has no arthritis and has failed conservative treatment. Which
radiographic parameter is particularly useful in determining whether a
distal first metatarsal osteotomy may adequately correct the deformity?
A. Calcaneal inclination angle
B. Distal metatarsal articular angle
C. Talonavicular uncoverage percentage
D. Meary angle
E. Kite angle
Answer: B. Distal metatarsal articular angle
5.
A patient undergoes hallux valgus correction and subsequently develops
persistent pain beneath the second metatarsal head. Radiographs
demonstrate altered parabola and excessive loading beneath the lesser
metatarsal. Which complication is most consistent with this
presentation?
A. Transfer metatarsalgia
B. Freiberg disease
C. Sesamoiditis
D. Morton's neuroma
E. Plantar plate rupture
Answer: A. Transfer metatarsalgia
6.
, 4
A 29-year-old patient presents with a painful, progressive bunion
deformity. Examination demonstrates lateral deviation of the hallux and
medial deviation of the first metatarsal. During assessment, the first
MTP joint is manually corrected into alignment, but the hallux
immediately returns toward the lesser toes because of a persistent
deforming force within the proximal phalanx. Which additional
procedure is most appropriate for correcting this residual deformity?
A. Akin osteotomy
B. Weil osteotomy
C. Dorsiflexion calcaneal osteotomy
D. Fifth metatarsal osteotomy
E. Gastrocnemius recession
Answer: A. Akin osteotomy
7.
A 61-year-old patient presents with a rigid painful hallux valgus
deformity and severe first MTP arthritis. The patient has a physically
demanding occupation and desires a durable procedure. Which factor
most strongly supports first MTP arthrodesis rather than a joint-
preserving osteotomy?
A. Mild increase in HVA
B. Severe first MTP joint degeneration
C. Flexible lesser toe deformity
D. Mild plantar fasciitis
E. Isolated fifth metatarsalgia
Answer: B. Severe first MTP joint degeneration
8.
