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. Which component of the deltoid ligament blends with the spring ligament? - Answer- Tibiocalcaneal Which component of the deltoid ligament is deep to the others? - Answer-Anterior tibiotalar What two tendons pass over the Deltoid ligament? - Answer-FDL and Tibialis posterior What is the strongest of the lateral collateral ligaments of the ankle? - Answer-Posterior talofibular ligament Which of the lateral collateral ligaments of the ankle are extrasynovial but intracapsular? - Answer-Posterior talofibular ligament Which of the extracapsular lateral collateral ligaments of the ankle are just deep to the peroneal tendons? - Answer-CFL Which is the shortest lateral collateral ligament of the ankle? - Answer-ATFL A surgeon is inverting the foot with the ankle in a dorsiflexed position. The surgeon is preparing to do a modified brostrum. Which ligament are they specifically assessing? - Answer-CFL The proximal tibiofibular joint is best described as what type of joint? - Answer-plain synovial joint A patient presents to the office complaining that they "rolled their ankle". X-rays reveal soft tissue inflammation. If the patient were to have, hypothetically, inverted their foot while the foot was in neutral position (neither dorsiflexed nor plantarflexed) on the sidewalk, which ligament would be at stake? - Answer-CFL What degree of talar tilt with reference to the contralateral side requires surgical correction? - Answer-10 degrees All of the following lateral ankle stabilizing procedures address one ligament except. . . A. Lee and Evans B. Watson Jones C. Nilson D. Christman Snook - Answer-Christman Snook and Elmslie address correction of the CFL and the ATFL. All the other procedures listed address only the ATFL Avulsion fracture of the tibia from anterior inferior tibial fibular ligament - Answer- Chaput-Tilleaux Fracture Avulsion fracture of fibula from anterior inferior tibial fibular ligament - Answer-wagstaff Occurs because of a closure of the medial tibial physis before the lateral physis. - Answer-Tillaux Kleiger Fracture of the posterior tibia (posterior malleolus) from the posterior inferior tibiofibular ligament. - Answer-Volkmann's Lauge Hansen Classification: Rupture of lateral collateral ligaments or classic transverse avulsion fracture of lateral malleolus. The fracture is transverse (horizontal) at or below the ankle joint level. - Answer-Supination-Adduction Stage I Lauge Hansen Classification: With further force of talus, there is an abutment of talus against the medial malleolus causing a short oblique fracture (classic vertical fracture of the medial malleolus). - Answer-Supination-Adduction Stage II