Podiatry Landmarks | UPDATED Questions with Correct Answers | Verified
Solutions
Sheehan in Diabetes Care in 2003
"If patients did not heal 53% of wound by 4 weeks they did not end up healing their wound"
The midpoint between the percentage area reduction from baseline at 4 weeks in patients
healed versus those not healed at 12 weeks was found to be 53%. Subjects with a reduction in
ulcer area greater than the 4-week median had a 12-week healing rate of 58%, whereas those
with reduction in ulcer area less than the 4-week median had a healing rate of only 9%.
Miller in 2017 in FAI
"ORIF of posterior mal restored 97% of syndesmosis stability"
Following ORIF of posterior mal, the syndesmosis stability was restored over 97%.
Supports Gardner et al (2006 Clinic Orthop Rela Res) study that showed that reducing and fixing
posterior mal restores tension to PiTFL
Grayson Et Al in JAMA in 1995
"Probe to bone has a 89% positive predictive value for OM."
56% negative predictive value. 68% sensitivity and 85% specificity
Lavery et al in Diabetes Care 2007
"Probe to bone has a 98% negative predictive value"
,Probe to bone has 57% positive predictive value. 98% negative predictive value. 87% sens and
91% specific
Reilly and Kaleta in JAPMA in 2001
"ESR of 70 had a 100% positive predictive value for OM"
70mm/hr = ESR cut off for OM. 100% predictive value and 83% negative predictive value. 89.5%
sens and 100% spec.
Fleischer in JFAS in 2009
"Ulcer depth of >3mm and CRP > 3.2 you should suspect OM instead of cellulitis"
Most informative clinical and lab test for differentiating OM from cellulits is ulcer depth > 3mm
and CRP > 3.2 mg/dl
Armstrong et al in JBJS in 1999 TAL
"TAL leads to reduction of plantar forefoot pressures by 25 percent"
The mean peak pressure on plantar forefoot went from 86 ± 9.4 newtons per square
centimeter
preoperatively to 63 ± 13.2 newtons per square centimeter at eight weeks s/p Tendoachilles
lengthening
Armstrong Et al in JFAS 1997 Amps
, "60% of hallux amputations lead to a second amputation"
After Hallux amputation, 60% = second amputation,
21% = third amputation
●7% fourth amputation
●15% percent of the patients who had a second amputation had it contralaterally
●17% BKA below-knee amputation and 11% had a Transmetatarsal amputation on the same
extremity
●Mean time from the first to the second amputation was approximately 10 months
Ramsey and Hamilton in JBJS in 1976
"1mm in lateral displacement of talus leads to 42% decrease in tibiotalar contact area."
Yablon et al in JBJS 1977
"Fibular fracture is the dominant fracture in ankle fractures"
Lateral malleolus is the key to anatomical reduction of bimalleolar fratures because the talus
follows the lateral malleolus
●When the medial malleolus is reduced and fixated, residual talar tilt was still evident
McDaniel et Al in Clinic Ortho 1977
"Posterior Mal fracture of 25% of more of articular should be fixed."
Solutions
Sheehan in Diabetes Care in 2003
"If patients did not heal 53% of wound by 4 weeks they did not end up healing their wound"
The midpoint between the percentage area reduction from baseline at 4 weeks in patients
healed versus those not healed at 12 weeks was found to be 53%. Subjects with a reduction in
ulcer area greater than the 4-week median had a 12-week healing rate of 58%, whereas those
with reduction in ulcer area less than the 4-week median had a healing rate of only 9%.
Miller in 2017 in FAI
"ORIF of posterior mal restored 97% of syndesmosis stability"
Following ORIF of posterior mal, the syndesmosis stability was restored over 97%.
Supports Gardner et al (2006 Clinic Orthop Rela Res) study that showed that reducing and fixing
posterior mal restores tension to PiTFL
Grayson Et Al in JAMA in 1995
"Probe to bone has a 89% positive predictive value for OM."
56% negative predictive value. 68% sensitivity and 85% specificity
Lavery et al in Diabetes Care 2007
"Probe to bone has a 98% negative predictive value"
,Probe to bone has 57% positive predictive value. 98% negative predictive value. 87% sens and
91% specific
Reilly and Kaleta in JAPMA in 2001
"ESR of 70 had a 100% positive predictive value for OM"
70mm/hr = ESR cut off for OM. 100% predictive value and 83% negative predictive value. 89.5%
sens and 100% spec.
Fleischer in JFAS in 2009
"Ulcer depth of >3mm and CRP > 3.2 you should suspect OM instead of cellulitis"
Most informative clinical and lab test for differentiating OM from cellulits is ulcer depth > 3mm
and CRP > 3.2 mg/dl
Armstrong et al in JBJS in 1999 TAL
"TAL leads to reduction of plantar forefoot pressures by 25 percent"
The mean peak pressure on plantar forefoot went from 86 ± 9.4 newtons per square
centimeter
preoperatively to 63 ± 13.2 newtons per square centimeter at eight weeks s/p Tendoachilles
lengthening
Armstrong Et al in JFAS 1997 Amps
, "60% of hallux amputations lead to a second amputation"
After Hallux amputation, 60% = second amputation,
21% = third amputation
●7% fourth amputation
●15% percent of the patients who had a second amputation had it contralaterally
●17% BKA below-knee amputation and 11% had a Transmetatarsal amputation on the same
extremity
●Mean time from the first to the second amputation was approximately 10 months
Ramsey and Hamilton in JBJS in 1976
"1mm in lateral displacement of talus leads to 42% decrease in tibiotalar contact area."
Yablon et al in JBJS 1977
"Fibular fracture is the dominant fracture in ankle fractures"
Lateral malleolus is the key to anatomical reduction of bimalleolar fratures because the talus
follows the lateral malleolus
●When the medial malleolus is reduced and fixated, residual talar tilt was still evident
McDaniel et Al in Clinic Ortho 1977
"Posterior Mal fracture of 25% of more of articular should be fixed."
