Podiatric surgery - Exam 1 Questions With Complete
Solutions
- a linear measure between the 1st and 2nd met bases
- normal is about 2 mm Correct Answers 1st met base gaping
measurement
- a non osseous tumor or tumor like lesion deep to the epidermis
Correct Answers soft tissue mass
- adjunt procedure
- central stab incision plantar to contracted toe
- both flexor tendons can be involved
- DF tension distal to stab incision during procedure
- Correct Answers flexor tenotomy
- angle
- bisection of the base of the proximal phalanx _ bisection of the
shaft of the distal phalanx Correct Answers DASA
- angle
- bisection of the diaphysis vs bisection of the articular cartilage
of the 1st met Correct Answers PASA
- assess amount and level of dorsal soft tissue contracture at MP
joint
- sustained DF contracture at MP joint = need for soft tissue
release
- intra op - will release dorsal to plantar release of soft tissue
structures
,- office - decision on whether to address MP joint Correct
Answers Keliian push up test
- associated with 4th/5th adducto-varus rotates toes
- usually more severe and rigid contractures
- due to position, not hypertrophic bone
- toe may also have a dorsal lateral PIP joint lesion
- often is mistaken for a 2nd toenail or split nail Correct
Answers hyperkeratosis of the lateral nail border of the 5th toe
- associated with a prominent medial condyle of the proximal
phalangeal head of the 5th toe
- medial condyle rubs on the lateral aspect of the base of the 4th
proximal phalanx Correct Answers hyperkeratosis of the medial
base of the 5ht/4th webspace
- associated with mallet toe and claw toe
- PF DIP joint contracture
- may involved nail bed/distal nail plate Correct Answers
hyperkeratosis of the distal tuft
- bisection fo the head of neck of the 5th metatarsal in
relationship to the medial cortical margin of the base of the fifth
metatarsal Correct Answers lateral deviation angle of the 5th
metatarsal
- bisection of the 4th metatarsal in replationship to the medial
proximal cortical margin of the 5th metatarsal base Correct
Answers IM 4-5 angle
- common in zone 4 and zone 2
,- may extend into zone 5 if they involve digital slip of the
plantar fascia Correct Answers plantar fibroma
- digital procedure
- coverts FHB into plantarflexor of MP joint
- prevents HT recurrence Correct Answers hallux IP arthrodesis
- disables normal windlass mechanosm
- increases hypermobility of 1st ray in the sagital plane
- causes DF of 1st ray, 1st mpj jamming, compensation via
hallus valgus Correct Answers unlocking of 1st mpj
- divergence of associated toes
- due to plantar plate attenuation Correct Answers neuroma
- dorsally, comes from the IP joint of the toe, due to lack of
elaborate sheath, more common Correct Answers digital
mucoid cysts
- dorsiflexory contracture at MP joint
- plantarflexory contracture at PIP joiny
- primary plantarflexion contracture of DIP joint Correct
Answers claw toe
- dorsiflexory contracture at the MP joint
- plantarflexory contracture at the PIP
- secondary dorsiflexion or hyperextension of the DIP joint due
to ground Correct Answers hammertoe
- EDL or EHL muscles fire early and often during swing phase
of gait
, - attempts to provide adequare DF of foot at ankle for clearance
of ground Correct Answers extensor substitution
- EDL tendons distally then overwhelm plantar intrinsic
muscular/tendons that are aimed at stabilizing proximal phalanx
in a PF direction at MP joint
- secondary tensions/tone at distal phalanx by FDL
- no ground effect -> no DF at DIP joint Correct Answers
extensor substitution
- fashion proximal phalangeal head into peg
- fashion middle phalangeal base into hole
- more stable construct, more raw bone to raw bone contact
- better union rate over end to end Correct Answers joint prep,
peg in hole`
- FDL first fires or ahead of the intrinisics
- causes DF MP and PF PIP contractire
- secondary DF DIP joint contracture
- in the sagital plane Correct Answers flexor
stabalization/substitution toes 2/3
- flat saw cuts end to end
- planal resection of both surfaces just behind the articular
cartilage
- not as stable, esp if only using a K wire for fixation
- locked into cuts Correct Answers joint prep, end to end
- focal collection of organism
- difficult abx penetration, because its walled off Correct
Answers abcess
Solutions
- a linear measure between the 1st and 2nd met bases
- normal is about 2 mm Correct Answers 1st met base gaping
measurement
- a non osseous tumor or tumor like lesion deep to the epidermis
Correct Answers soft tissue mass
- adjunt procedure
- central stab incision plantar to contracted toe
- both flexor tendons can be involved
- DF tension distal to stab incision during procedure
- Correct Answers flexor tenotomy
- angle
- bisection of the base of the proximal phalanx _ bisection of the
shaft of the distal phalanx Correct Answers DASA
- angle
- bisection of the diaphysis vs bisection of the articular cartilage
of the 1st met Correct Answers PASA
- assess amount and level of dorsal soft tissue contracture at MP
joint
- sustained DF contracture at MP joint = need for soft tissue
release
- intra op - will release dorsal to plantar release of soft tissue
structures
,- office - decision on whether to address MP joint Correct
Answers Keliian push up test
- associated with 4th/5th adducto-varus rotates toes
- usually more severe and rigid contractures
- due to position, not hypertrophic bone
- toe may also have a dorsal lateral PIP joint lesion
- often is mistaken for a 2nd toenail or split nail Correct
Answers hyperkeratosis of the lateral nail border of the 5th toe
- associated with a prominent medial condyle of the proximal
phalangeal head of the 5th toe
- medial condyle rubs on the lateral aspect of the base of the 4th
proximal phalanx Correct Answers hyperkeratosis of the medial
base of the 5ht/4th webspace
- associated with mallet toe and claw toe
- PF DIP joint contracture
- may involved nail bed/distal nail plate Correct Answers
hyperkeratosis of the distal tuft
- bisection fo the head of neck of the 5th metatarsal in
relationship to the medial cortical margin of the base of the fifth
metatarsal Correct Answers lateral deviation angle of the 5th
metatarsal
- bisection of the 4th metatarsal in replationship to the medial
proximal cortical margin of the 5th metatarsal base Correct
Answers IM 4-5 angle
- common in zone 4 and zone 2
,- may extend into zone 5 if they involve digital slip of the
plantar fascia Correct Answers plantar fibroma
- digital procedure
- coverts FHB into plantarflexor of MP joint
- prevents HT recurrence Correct Answers hallux IP arthrodesis
- disables normal windlass mechanosm
- increases hypermobility of 1st ray in the sagital plane
- causes DF of 1st ray, 1st mpj jamming, compensation via
hallus valgus Correct Answers unlocking of 1st mpj
- divergence of associated toes
- due to plantar plate attenuation Correct Answers neuroma
- dorsally, comes from the IP joint of the toe, due to lack of
elaborate sheath, more common Correct Answers digital
mucoid cysts
- dorsiflexory contracture at MP joint
- plantarflexory contracture at PIP joiny
- primary plantarflexion contracture of DIP joint Correct
Answers claw toe
- dorsiflexory contracture at the MP joint
- plantarflexory contracture at the PIP
- secondary dorsiflexion or hyperextension of the DIP joint due
to ground Correct Answers hammertoe
- EDL or EHL muscles fire early and often during swing phase
of gait
, - attempts to provide adequare DF of foot at ankle for clearance
of ground Correct Answers extensor substitution
- EDL tendons distally then overwhelm plantar intrinsic
muscular/tendons that are aimed at stabilizing proximal phalanx
in a PF direction at MP joint
- secondary tensions/tone at distal phalanx by FDL
- no ground effect -> no DF at DIP joint Correct Answers
extensor substitution
- fashion proximal phalangeal head into peg
- fashion middle phalangeal base into hole
- more stable construct, more raw bone to raw bone contact
- better union rate over end to end Correct Answers joint prep,
peg in hole`
- FDL first fires or ahead of the intrinisics
- causes DF MP and PF PIP contractire
- secondary DF DIP joint contracture
- in the sagital plane Correct Answers flexor
stabalization/substitution toes 2/3
- flat saw cuts end to end
- planal resection of both surfaces just behind the articular
cartilage
- not as stable, esp if only using a K wire for fixation
- locked into cuts Correct Answers joint prep, end to end
- focal collection of organism
- difficult abx penetration, because its walled off Correct
Answers abcess
