DEX IOT FINAL EXAM SCRIPT
COMPREHENSIVE STUDY GUIDE
●● talus anchor in atfl
Answer: 2cm from lateral talar process angled 40-45 degrees to the
sagittal plane and parallel with the longitudinal line of fibula, 4:30 for R,
7:30 for L
●● fibula anchor in atfl
Answer: 15mm from distal tip of fibula
●● tensioning atfl ib
Answer: neutral with 10-15 degrees plantar flexion
●● medial mal anchor for deltoid ib
Answer: medial mal in intercollicular grove w/ 4.75 anchor
●● talus anchor in deltoid ib
Answer: deep deltoid, 12.2mm/1cm in talus
●● sustentaculum tali anchor for deltoid ib
Answer: superficial deltoid, 8mm anterior
,●● deltoid recon
Answer: superficial tibiocalcaneal & deep posterior tibiotalar
●● superficial deltoid
Answer: 4, resists eversion of hindfoot
●● deep deltoid
Answer: 2, medial ankle sprain, lateral ankle sprain, ankle fracture,
flatfoot
●● mechanical instability
Answer: clinical and radiographic evidence that demonstrates excess
movement of the talus within ankle mortise
●● functional instability
Answer: subjective complaint of patient
●● sorain classifications
Answer: Grade 1: ATFL sprain
Grade 2: ATFL & CFL partial tear
Grade 3: ATFL, CFL, and possibly PTFL
,●● sural & superficial peroneal
Answer: nerves to watch out for with ATFL IB
●● syndesmosis mechanism of injury
Answer: forced external rotation of the foot (specifically talus)
●● syndesmosis function
Answer: resists movement of:
coronal translation (side to side/left to right)
rotational
sagital translation (forward or backwards)
ideally syndesmosis resists diastesis but allows normal physiological
micro-motion
●● Aitfl mechanism of injyry
Answer: external rotation -> force of the talus pushing on fibula causes
tear/stress
●● when to use aitfl internal brace
Answer: Re-assess syndesmotic motion. mild rotational instability
●● Weber Classifications
, Answer: based on level of fibula fracture compared to
ankle/syndesmosis joint & better for surgical decision making
●● Weber A
Answer: below ankle joint (infrasyndesmotic)
Avulsion type injury of distal fibula Foot supinated (inversion) with an
adduction deforming force
Stress on atfl & cfl causes bone to break off (similar to medial mal)
Usually doesn't involve syndesmotic injury
medial mal is also often fractured
●● Weber B
Answer: at the ankle joint (transyndesmotic)
could include syndesmosis injury
most common
medial mal may be fractured or deltoid ligament may be torn
variable stability
foot inverted with external rotation
●● Weber C
Answer: above the ankle joint (suprasyndesmotic)
most likely a syndesmosis injury
distal tibiofibular articulation widened
COMPREHENSIVE STUDY GUIDE
●● talus anchor in atfl
Answer: 2cm from lateral talar process angled 40-45 degrees to the
sagittal plane and parallel with the longitudinal line of fibula, 4:30 for R,
7:30 for L
●● fibula anchor in atfl
Answer: 15mm from distal tip of fibula
●● tensioning atfl ib
Answer: neutral with 10-15 degrees plantar flexion
●● medial mal anchor for deltoid ib
Answer: medial mal in intercollicular grove w/ 4.75 anchor
●● talus anchor in deltoid ib
Answer: deep deltoid, 12.2mm/1cm in talus
●● sustentaculum tali anchor for deltoid ib
Answer: superficial deltoid, 8mm anterior
,●● deltoid recon
Answer: superficial tibiocalcaneal & deep posterior tibiotalar
●● superficial deltoid
Answer: 4, resists eversion of hindfoot
●● deep deltoid
Answer: 2, medial ankle sprain, lateral ankle sprain, ankle fracture,
flatfoot
●● mechanical instability
Answer: clinical and radiographic evidence that demonstrates excess
movement of the talus within ankle mortise
●● functional instability
Answer: subjective complaint of patient
●● sorain classifications
Answer: Grade 1: ATFL sprain
Grade 2: ATFL & CFL partial tear
Grade 3: ATFL, CFL, and possibly PTFL
,●● sural & superficial peroneal
Answer: nerves to watch out for with ATFL IB
●● syndesmosis mechanism of injury
Answer: forced external rotation of the foot (specifically talus)
●● syndesmosis function
Answer: resists movement of:
coronal translation (side to side/left to right)
rotational
sagital translation (forward or backwards)
ideally syndesmosis resists diastesis but allows normal physiological
micro-motion
●● Aitfl mechanism of injyry
Answer: external rotation -> force of the talus pushing on fibula causes
tear/stress
●● when to use aitfl internal brace
Answer: Re-assess syndesmotic motion. mild rotational instability
●● Weber Classifications
, Answer: based on level of fibula fracture compared to
ankle/syndesmosis joint & better for surgical decision making
●● Weber A
Answer: below ankle joint (infrasyndesmotic)
Avulsion type injury of distal fibula Foot supinated (inversion) with an
adduction deforming force
Stress on atfl & cfl causes bone to break off (similar to medial mal)
Usually doesn't involve syndesmotic injury
medial mal is also often fractured
●● Weber B
Answer: at the ankle joint (transyndesmotic)
could include syndesmosis injury
most common
medial mal may be fractured or deltoid ligament may be torn
variable stability
foot inverted with external rotation
●● Weber C
Answer: above the ankle joint (suprasyndesmotic)
most likely a syndesmosis injury
distal tibiofibular articulation widened
