ABFAS Trauma Section Exam Questions and Answers All Correct

ABFAS Trauma Section Exam Questions and Answers All Correct Achilles tendon rupture is likely to occur in this position - Answer-Sprinters Gastroc-soleal complex is enervated by: - Answer-Tibial nerve (S1 - S2) Runs between the gastrocnemius and soleus. Assists in plantarfexion of the foot and flexion of the knee - Answer-Plantaris Nerve enervation of the plantaris - Answer-L4, L5, S1 The narrowest part of the achilles tendon - Answer-4cm proximal to its insertion An Achilles tendon rupture is likely to occur at what anatomical location? - Answer-2- 6cm proximal to attachment (watershed area) of the left lower extremity (due to handedness: Right handed individuals more commonly push off with the left foot). Name the Test: squeezing of the calf muscle does not result in plantar flexion of the foot - Answer-Thompson Test Name the Test: A 25 gauge needle is inserted at a right angle to the leg through the skin of the calf muscle just medial to midline. This should be performed 10 cm proximal to the calcaneal insertion of the Achilles tendon. Motion of the hub of the needle in a direction opposite that of the tendon during passive dorsiflexion and plantarflexion of the foot confirms an intact tendon distal to the level of needle insertion. - Answer-O'Brien Test The parameters of Kager's triangle are. . . - Answer-Anterior border: FHL, Posterior border: Achilles Tendon, Inferior Border: Superior cortex of the calcaneus What classification is used for achilles tendon ruptures? - Answer-Kuwada (1: partial tear 2: complete tear up to 3, 3: 3-6cm tear, 4: greater than 6cm tear Case: 34 year old male presents with left 2cm Achilles tendon rupture confirmed on MRI. No other comorbidities. What is the best treatment of choice? - Answer-End-to-end anastomosis Case: 36 year old female presents with 7cm Achilles tendon rupture occurring just yesterday while skiing. She states that she had been on levofloxacin for 2 weeks for abscess in her left thigh. She has no other significant past medical history. What is the best treatment of choice? - Answer-1. Gastroc recession, 2. Turn down with tendon graft and or synthetic graft. Case: a 42 year old male presents with an Achilles tendon rupture to the left lower extremity occurring while running a marathon the previous day. He denies taking any medications and has no significant / contributory past medical history. MRI reveals a 4cm complete rupture of the left Achilles tendon. Which of the following is the most appropriate treatment of choice. - Answer-Following surgical debridement of the tendon ends to healthy tissue. Recommended treatment: Tendon graft flap, +/- a synthetic graft augment. Additionally a V-Y advancement, a Bosworth turndown, tendon transfer, or a combination of these may also be used for type 3 injuries.