Orthopedics Hyperguide Review | Dr Hutaif General Ortho -...

The most common complication of arthrodesis of the proximal interphalangeal (PIP) joint is:

Figure 1
A 59-year-old woman presents for treatment of a painful hallux valgus deformity. She has a prominent bunion, normal motion of the hallux metatarsophalangeal (MP) joint, and painful callosity under the second MP joint. Radiographs of the foot are
presented. The recommended treatment is:

In surgical correction of the adult acquired flatfoot deformity, a medial translational calcaneal osteotomy is often performed in conjunction with additional soft tissue correction medially. One of the proposed biomechanical effects of the osteotomy associated with improvement in the arch of the foot is:

One year ago, a patient underwent a triple arthrodesis for management of a severe foot deformity. Although the deformity of her foot is notably improved since the surgery, she has not walked comfortably and the pain is worse than it had been prior to surgery. Upon clinical examination, she is noted to have a fixed supination deformity of the forefoot and callosity under the base of the fifth metatarsal. The recommended management of this problem is:

A 28-year-old woman presents for treatment of pain and swelling in the foot. She had twisted her ankle 2 months ago and her initial treatment consisted of limited activity, crutches, and immobilization. Because she has not been able to wean off the crutches, she has pain in the foot radiating to the ankle and distal lateral leg. She has constant pain in the foot and the swelling appears worse than at the time of her injury. C linically, there are multiple areas of tenderness in the foot and ankle that appear swollen and sensitive to examination. The study that would be most helpful to clarify this diagnosis is:

A 52-year-old man presents for evaluation and treatment of a painful flatfoot deformity. While playing tennis 2 years ago, he felt a tearing sensation in his foot and ankle. Since that time, he notes that the arch of his foot has become progressively flatter. Upon examination, he has a flatfoot inability to perform a single heel rise and weak inversion strength. He desires to have this deformity corrected. At surgery, the posterior tibial tendon is grossly normal in appearance. The most likely source of his deformity is:

A 27-year-old man sustained an injury to his foot 2 ½ years ago when a forklift crushed his foot. He sustained a fracture dislocation of the midfoot and was treated with open reduction and internal fixation. His current complaints are burning in the
foot associated with numbness over the dorsal foot surface. On examination, he has severe focal sensitivity over the dorsal foot, particularly in the first web space radiating proximally to the ankle. Radiographs demonstrate mild arthritis and anatomic reduction of the tarsometatarsal and midfoot joints. The prognosis for relief of his foot pain at this stage is:

A 34-year-old woman presents for treatment of pain in the hallux. She notes pain upon weight bearing and wearing high-heel shoes. Upon examination, the range of motion of the hallux metatarsophalangeal (MP) joint is 10° dorsiflexion and 30° plantarflexion, with pain upon passive dorsiflexion. Radiographs demonstrate osteophytes over the dorsal surface of the metatarsal head, maintenance of the joint space, and a metatarsal declination angle of 10°. The first metatarsal is elevated above the second metatarsal at the level of the metatarsal neck by 4 mm. The ideal procedure to correct this problem and alleviate pain is:

A patient experienced a nondisplaced fracture of the medial and middle cuneiforms. His nonoperative treatment consisted of cast immobilization for 2 weeks with no weight bearing permitted, followed by ambulation as tolerated. He presents for treatment 1 week later with severe swelling in the foot, stiffness of the toes, and limited motion of the hindfoot. The fracture of the
cuneiforms appears healed. The ideal management of the stiffness and swelling of the foot is:

A 31-year-old woman presents for treatment of pain in the hallux. She has been experiencing the pain for 2 years. She notes limited motion of the hallux with pain in the joint, particularly when wearing high-heel shoes. She is unable to toe off with running activities. Upon examination, the motion in the hallux metatarsophalangeal (MP) joint is limited in dorsiflexion and radiographs demonstrate mild arthritis of the joint. She requests surgery to correct this disorder. The recommended treatment is:

A 17-year-old woman presents for evaluation of a painful hallux valgus deformity. She is unable to wear shoes comfortably, has pain with athletic and daily activities, and notices that the deformity is gradually worsening. Upon clinical examination, she has generalized ligamentous laxity, with motion of the hallux metatarsophalangeal (MP) joint 75° dorsiflexion and 25° plantarflexion. Motion of the first metatarsal is approximately 8° to 10° of combined dorsiflexion and plantarflexion. There is no pain to range of motion of these joints. The hallux valgus angle is 28° and the 1-2 intermetatarsal angle is 12°. The recommended treatment is:

An 82-year-old woman presents for treatment of a painful second toe deformity. The toe is subluxated at the metatarsophalangeal (MP) joint, and a fixed claw toe deformity is present. Despite severe hallux valgus, and the hallux under riding the second toe, the hallux and bunion are not symptomatic. The procedure that will ideally correct this deformity is:

Figure 1
A 19-year-old woman had previously been treated for hallux valgus deformity with resection of the medial eminence only. She now presents with severe recurrent deformity of the hallux, with pain. There is neither pain nor crepitus upon range of motion of the hallux metatarsophalangeal (MP) joint. The procedure that will successfully correct the deformity of the hallux and the first metatarsal and maintain motion at the MP joint is:

Figure 1
A 63-year-old woman who underwent attempted correction of a hallux valgus deformity 3 years previously presents to the office. She has pain in the hallux from dorsal abutment of the hallux on the shoe. There is no pain in the lesser toes or metatarsals. The recommended procedure to alleviate the irritation of the hallux is:

Figure 1 Figure 2
A 66-year-old woman has experienced the gradual onset of a flatfoot deformity over the past 10 years. She notes that the condition is bilateral, although worse on one side. Presented are clinical and radiographic images of her condition. This is associated with pain upon ambulation and difficulty with shoe wear. The most likely cause of this flatfoot deformity is:

Slide 1 Slide 2
A 66-year-old woman has experienced the gradual onset of a flatfoot deformity over the past 10 years. She notes that the condition is bilateral, although worse on one side. Presented are clinical and radiographic images of her condition. This is associated with pain upon ambulation and difficulty with shoe wear. The most likely cause of this flatfoot deformity is tarsometatarsal arthritis. The initial recommended treatment is:

Many materials are used in the production of orthotic arch supports. Plastizote is a material commonly used either alone or in combination. The problem with this material is:

Figure 1
A 35-year-old man has experienced ankle pain for 7 years. It is associated with giving way and progressive deformity of the foot. He notices that the foot is rolling inward and is becoming flatter. The cause of his condition is:

Figure 1
A 14-year-old boy presents for treatment of a painful foot, which has been present for 2 years. He has limited his athletic activities. He has similar symptoms in the opposite foot, although not as severe. On clinical examination, the alignment and appearance of the foot are normal; motion of the foot and ankle is good; and some discomfort is present in the sinus tarsi. Standard radiographs, of which the lateral view is presented, include anteroposterior, lateral, and oblique views. Because the diagnosis is unclear, more imaging studies are required. The next study to obtain is:

Figure 1
The radiograph of a 22-year-old woman with ankle pain and instability is presented. She has noted this problem for 10 years, and it appears to be worsening. The opposite ankle is not symptomatic. She has not had any previous treatment for foot or ankle problems. The cause of this ankle deformity is most likely to be associated with which of the following conditions:

The sustentaculum tali is the anatomic roof of which tendon:

The nerve most likely to be at risk during surgical exposure when performing a triple arthrodesis is the:

Slide 1
A 55-year-old man presents for treatment of pain in the Achilles tendon. This has been present for 2 years, but has suddenly become much worse. The pain is approximately 6 cm proximal to the insertion. He is unable to push off during walking and has pain when ascending stairs. C linical examination reveals thickening of the tendon, weakness of the gastrocnemius-soleus, and pain upon squeezing the Achilles tendon. The magnetic resonance image is shown. The diagnosis is:

Slide 1
A patient presents for surgical correction of a ruptured Achilles tendon. He recalls injuring his ankle 1 year previously, but did not seek any medical treatment at that time. You plan to repair the tendon, and at surgery, a gap between the tendon ends is noted (Slide). The following procedure is not consistent with an acceptable outcome:

You are commencing a repair of an acute rupture of the Achilles tendon that occurred 8 days previously in a 32-year-old recreational tennis player. Fibrillation of the tendon ends is noted. The following is most important to maximize the ultimate outcome of the repair:

Slide 1
A 17-year-old patient presents for evaluation and treatment of pain in the back of her ankle. She is a ballet dancer and has noticed that for the past year, she is unable to assume the pointe position without pain. Upon clinical examination she has full range of motion, excellent strength, normal toe function, and pain with pressure in the posterior ankle. The cause of her pain is:

Figure 1
The structure that lies immediately medial to the bone prominence in the posterior ankle shown is the:

Slide 1
A 43-year-old construction worker sustained a work-related injury to his foot 7 months ago. He was initially treated with cast immobilization and limited weight bearing. He has lateral foot pain and inability to walk comfortably. He has limited walking endurance. Upon examination, pain is present laterally along the course of the peroneal tendons, and no motion of the subtalar joint is present. The recommendation is:

Slide 1
The structure on the side of the metatarsophalangeal joint of the second toe which is marked by the pointer is the:

Figure 1
A 21-year-old man presents for evaluation of high arches, which have been present his entire life. C urrently, he is experiencing some discomfort with running activities. His brother and mother have high arches. He does not recall any trauma as a child, or any other pertinent childhood musculoskeletal problems. C linical examination reveals a rigid deformity bilaterally. The most common cause for his high arches is:

Figure 1
A 21-year-old man presents for evaluation of high arches, which have been present his entire life. C urrently, he is experiencing some discomfort with running activities. His brother and mother have high arches. He does not recall any trauma as a child, or any other pertinent childhood musculoskeletal problems. C linical examination reveals a rigid deformity bilaterally. What structure is responsible for plantarflexion of the first metatarsal:

A 22-year-old patient presents for treatment of a painful foot deformity. On examination, a flexible cavovarus deformity is present. The patient has good dorsiflexion foot strength, and eversion strength is weak. A possible tendon transfer that can be used to correct this deformity is:

Figure 1 Figure 2
A 56-year-old man presents for treatment of chronic ankle pain. He has noted long-standing pain associated with activities since early adulthood. He does not have any other pertinent musculoskeletal history. C linical and radiographic examinations reveal ankle arthritis. A probable cause for this arthritis and deformity is:

When performing fasciotomy of the foot for acute compartment syndrome, the muscle specifically decompressed through medial fasciotomy is:

This muscle group demonstrates electrical activity at the time of heel strike:

A 7-year-old boy presents with bilateral high arches. His parents report that they are having difficulty finding shoes that comfortably fit him. The patient denies any foot pain. The father had similar problems with his feet and was diagnosed with a âmildâ neurologic condition. On exam, the child has bilateral pes cavus with a supple hindfoot. Treatment of the feet at this time should consist of:

A 50-year-old woman presents with pain in the second toe. She describes this as burning and notes swelling of the toe for the past month. Upon examination, there appears to be instability of the toe with a positive dorsal subluxation stress test. The anatomic structure which is responsible for this patientâs symptoms is:

Figure 1
A 15-year-old boy presents with a 2-year history of pain in the foot associated with a sense stiffness and of giving way of the ankle. Upon examination, pain in the sinus tarsi, slightly decreased subtalar motion, and normal ankle motion with no apparent instability are noted. A lateral foot radiograph is presented. The next radiograph to obtain is:

Which ancillary test is not helpful in the diagnosis of C harcot-Marie-Tooth disease (C MT):