Podiatry Classifications Questions With Complete Solutions
1ST MPJ DISLOCATIONS - JAHSS CLASSIFICATION
Correct Answers Type I - Hallux/sesamoid dislocation, no
disruption of sesamoid apparatus, irreducible to closed
reduction.
Type IIa - closed reducible, disrupted intersesamoidal ligament
Type IIb - closed reducible, transverse fx of sesamoids
Type IIc - open reduction, both IIa and IIb.
5th metatarsal base fractures: Stewart Correct Answers Type I-
"Jones fracture" transverse fracture of teh
diaphyseal/metaphyseal jct. Poor healing potential
Type II- Intraarticular avulsion fx
Type III- Extraarticular avulsion fx
Type IV- Intraarticular comminuted fx
Type V- PEDS - Extraarticular fx through epiphysis
ACHILLES RUPTURE - KUWADA CLASSIFICATION
Correct Answers Type I - Partial rupture of tendon
Type II - Complete rupture of tendon, <3cm gap
Type III - Complete rupture, 3-6cm gap
Type IV - Complete rupture, >6cm gap
ANKLE FRACTURES - LAUGE-HANSEN
CLASSIFICATION Correct Answers The first word in this
classification denotes the position of the foot at time of injury;
the second word denotes the position of the leg. The numerical
grades w/in each class occur each in chronological order and
relate to the severity of trauma.
Supination - Adduction
, I - transverse fx of the lateral malleolus
II - vertical fx of the medial malleolus
Pronation - Abduction
I - Rupture of deltoid ligament/medial malleolar fx
II - Rupture of ant inferior tibio-fibular ligament
III - Bending fx of fibula 1cm proximal to plafond
Pronation - Dorsiflexion
I - Fx of medial malleolus
II - Large anterior lip fx of tibia
III - Fracture of superior lateral malleolus
IV - Fracture of third malleolus (posterior tibia)
Supination - External Rotation (SER)
I - Rupture of ant inferior tibio-fibular ligament
II - Spiral oblique fx of lateral malleolus (extending anterior
inferior to posterior superior.)
III - Rupture of post inferior tibio-fibular ligament
IV - Deltoid rupture/fx of medial malleolus
Pronation - External Rotation (PER)
I - Rupture of deltoid ligament/medial malleolar fx
II - Rupture of ant inferior tibio-fibular ligament, Intra-osseous
ligament, intra-osseous membrane
III - Spiral fx above syndesmosis (high fibular fx)
IV - Rupture of post inferior tibio-fibular ligament
This injury typically causes diastasis - separation of the tibio-
fibular syndesmosis. This may also be seen in SER.
ANKLE SPRAINS - DIAS CLASSIFICATION Correct
Answers Grade I - partial rupture of CFL
Grade II - complete rupture of ATFL
Grade III - complete rupture of ATFL, CFL, and/or PTFL
,Grade IV - complete rupture of all 3 lateral ligaments + partial
rupture of deltoid ligament
ANTERIOR TIBIOTALAR SPURS - MCDERMOTT &
SCRANTON Correct Answers Type I - Synovial impingement.
X-rays show inflammatory reaction, up to 3mm spur formation,
confirmed w/ DF stress views. Increased anterior ST swelling.
Type II - Osteochondral reaction exostosis. X-rays show osseous
spur formation >3mm. MRI confirms osteoblastic and chondral
hyperplastic reaction.
Type III - Significant exostosis w/ or w/o fragmentation, 2° spur
formation on the talus w/ fragments, osteophytes.
Type IV - Pan-talocrural arthritic destruction. X-rays suggest
medial, lateral, or posterior degenerative, arthritic changes.
ARTHROSCOPIC STAGING OF TALAR DOME
FRACTURES Correct Answers Stage A - Smooth, intact but
soft; stable
Stage B - Rough surface, intact; stable
Stage C - Fibrillation/fissuing; stable
Stage D - Flap present or bone exposed; unstable
Stage E - Loose, non-displaced fragment; unstable
Stage F - Displaced fragment
AVN OF TH 2ND METATARSAL - KATCHERIAN Correct
Answers Level A - fissures noted in distal metaphysis or
epiphysis
Level B - increased fissuring w/ bone resorbtion
Level C - increased fissuring w/ central collapse of MT head
Level D - collapse & fx w/ fragments on either side of joint
Level E - complete collapse of MT head
, AVN OF THE 2ND METATARSAL - FREIBERG Correct
Answers Type I - no DJD, articular cartilage intact
Type II - periarticular spurs, articular cartilage intact
Type III - severe DJD, loss of articular cartilage
Type IV - epiphyseal dysplasia, multiple head involvement
Benign and malignant tumors - Enneking Correct Answers
Benign Tumors:
Stage 1: lesions are static or tend to heal spontaneously
Stage 2: lesions have a more aggressive radiographic
appearance, are less mature histologically, and show evidence of
continued growth.
Stage 3: Lesions are locally aggressive and histolgically
immature and show progressive growth that is not limited by
natural barriers
Malignant Lesions:
Grade: histology
G1: low grade, uniform cell type without atypia,
few mitosis.
G2: High grade, atypical nuclei, mitoses
pronounced
Site:
T1: intracompartmental (confined within limits of
periosteum)
T2: extracompartmental
Metastasis:
M0: no identifiable skip lesions or distant
metastases
M1: Any skip lesions, regional lymph nodes, or
distant metastases
1ST MPJ DISLOCATIONS - JAHSS CLASSIFICATION
Correct Answers Type I - Hallux/sesamoid dislocation, no
disruption of sesamoid apparatus, irreducible to closed
reduction.
Type IIa - closed reducible, disrupted intersesamoidal ligament
Type IIb - closed reducible, transverse fx of sesamoids
Type IIc - open reduction, both IIa and IIb.
5th metatarsal base fractures: Stewart Correct Answers Type I-
"Jones fracture" transverse fracture of teh
diaphyseal/metaphyseal jct. Poor healing potential
Type II- Intraarticular avulsion fx
Type III- Extraarticular avulsion fx
Type IV- Intraarticular comminuted fx
Type V- PEDS - Extraarticular fx through epiphysis
ACHILLES RUPTURE - KUWADA CLASSIFICATION
Correct Answers Type I - Partial rupture of tendon
Type II - Complete rupture of tendon, <3cm gap
Type III - Complete rupture, 3-6cm gap
Type IV - Complete rupture, >6cm gap
ANKLE FRACTURES - LAUGE-HANSEN
CLASSIFICATION Correct Answers The first word in this
classification denotes the position of the foot at time of injury;
the second word denotes the position of the leg. The numerical
grades w/in each class occur each in chronological order and
relate to the severity of trauma.
Supination - Adduction
, I - transverse fx of the lateral malleolus
II - vertical fx of the medial malleolus
Pronation - Abduction
I - Rupture of deltoid ligament/medial malleolar fx
II - Rupture of ant inferior tibio-fibular ligament
III - Bending fx of fibula 1cm proximal to plafond
Pronation - Dorsiflexion
I - Fx of medial malleolus
II - Large anterior lip fx of tibia
III - Fracture of superior lateral malleolus
IV - Fracture of third malleolus (posterior tibia)
Supination - External Rotation (SER)
I - Rupture of ant inferior tibio-fibular ligament
II - Spiral oblique fx of lateral malleolus (extending anterior
inferior to posterior superior.)
III - Rupture of post inferior tibio-fibular ligament
IV - Deltoid rupture/fx of medial malleolus
Pronation - External Rotation (PER)
I - Rupture of deltoid ligament/medial malleolar fx
II - Rupture of ant inferior tibio-fibular ligament, Intra-osseous
ligament, intra-osseous membrane
III - Spiral fx above syndesmosis (high fibular fx)
IV - Rupture of post inferior tibio-fibular ligament
This injury typically causes diastasis - separation of the tibio-
fibular syndesmosis. This may also be seen in SER.
ANKLE SPRAINS - DIAS CLASSIFICATION Correct
Answers Grade I - partial rupture of CFL
Grade II - complete rupture of ATFL
Grade III - complete rupture of ATFL, CFL, and/or PTFL
,Grade IV - complete rupture of all 3 lateral ligaments + partial
rupture of deltoid ligament
ANTERIOR TIBIOTALAR SPURS - MCDERMOTT &
SCRANTON Correct Answers Type I - Synovial impingement.
X-rays show inflammatory reaction, up to 3mm spur formation,
confirmed w/ DF stress views. Increased anterior ST swelling.
Type II - Osteochondral reaction exostosis. X-rays show osseous
spur formation >3mm. MRI confirms osteoblastic and chondral
hyperplastic reaction.
Type III - Significant exostosis w/ or w/o fragmentation, 2° spur
formation on the talus w/ fragments, osteophytes.
Type IV - Pan-talocrural arthritic destruction. X-rays suggest
medial, lateral, or posterior degenerative, arthritic changes.
ARTHROSCOPIC STAGING OF TALAR DOME
FRACTURES Correct Answers Stage A - Smooth, intact but
soft; stable
Stage B - Rough surface, intact; stable
Stage C - Fibrillation/fissuing; stable
Stage D - Flap present or bone exposed; unstable
Stage E - Loose, non-displaced fragment; unstable
Stage F - Displaced fragment
AVN OF TH 2ND METATARSAL - KATCHERIAN Correct
Answers Level A - fissures noted in distal metaphysis or
epiphysis
Level B - increased fissuring w/ bone resorbtion
Level C - increased fissuring w/ central collapse of MT head
Level D - collapse & fx w/ fragments on either side of joint
Level E - complete collapse of MT head
, AVN OF THE 2ND METATARSAL - FREIBERG Correct
Answers Type I - no DJD, articular cartilage intact
Type II - periarticular spurs, articular cartilage intact
Type III - severe DJD, loss of articular cartilage
Type IV - epiphyseal dysplasia, multiple head involvement
Benign and malignant tumors - Enneking Correct Answers
Benign Tumors:
Stage 1: lesions are static or tend to heal spontaneously
Stage 2: lesions have a more aggressive radiographic
appearance, are less mature histologically, and show evidence of
continued growth.
Stage 3: Lesions are locally aggressive and histolgically
immature and show progressive growth that is not limited by
natural barriers
Malignant Lesions:
Grade: histology
G1: low grade, uniform cell type without atypia,
few mitosis.
G2: High grade, atypical nuclei, mitoses
pronounced
Site:
T1: intracompartmental (confined within limits of
periosteum)
T2: extracompartmental
Metastasis:
M0: no identifiable skip lesions or distant
metastases
M1: Any skip lesions, regional lymph nodes, or
distant metastases
