How do you fixate a danis weber B ?

Danis weber B with a medial mall fracture classifies which SER? SER 4

AP/ Mortise decreased overlap = syndesmotic rupture

How to fix syndesmosis? 3 screws, tight rope, 4 screws

How do position the tight rope for syndesmosis?

Pic of erythrysma? medication? erythrymcin

Topical ointment for MRSA ? pic of infection – Bactroban

Oral medication for mrsa? Bactrim

What is the dose for Lamisil? 250mg

Should you plate a high fibular fracture? No, be aware of common peroneal

Posterior spike synonymous with? SER2

Secondary ORIF using a delta frame for comminuted pilon fracture. Why? wound dehiscnence wait for swelling, and ligamentotaxis

Name some nsaids other than Ibuprofen

What should you always order for pilon fxs? CT

How do you evaluate the posterior facet from a lateral view for intra-operative Calc fxs? Broden’s view

What is AO principles?

Pic of well defined lesions in caclaneus. Name 3 differentials – UBC, ABC, Lipoma, GCT

Pic of well defined lesions in fingers. Name 3 differentials – GCT, enchondromas

Flat foot reconstruction pics – name the procedures, name the plane of dominance

What are P’s of compartment syndrome?

Which side of the talus is this?

What should be used for CRPS?

What is Sudeck’s atrophy?

Name the stages of charcot and how each stage is treated?

Name 3 lateral ankle stablization procedures?

Pic of christmas snook xray with a hole in the fibula. What procedures and where does it attach? Christman snook

Clicking sound heard upon ROM ankle, pain along lateral side of ankle, constant sprains. what Musculoskeletal questions? eversion prodceues pain, palpate the peroneal tendon, have patient do a talar tilt.  know all eckert and davis classifications and who added the last classification?  Oden

What foot type causes Haglunds? compensated forefoot valgus, compensated forefoot varus, rearfoot varus

 

 

 

Can be cateogrized by “physical examination – and subcategorized – patient does the test? eg jack’s test….or physician squeezes something and causes tinel’s sign”

 

Silver

Keller

Mitchell

Chevron

Austin

Joplin

Youngswick

Hohmann

Riverdin

Riverdin – Green

Mc Bride

Logroscino

Hibb’s angle/tenosus

Young’s

Fowler

Cotton 

Lapidus

Evan’s

Hoke’s fusion

Hoke’s recession

Hoke’s tonsil

Charcot foot

Morton’s neuroma

Jone’s fracture

Stieda’s process

Cedell’s fracture

Sheperd’s fracutre

Heberden’s nodes

Bouchard’s nodes

Hubscheur maneuveur

Jack’s test

Tinel’s sign

Valeux’s sign

Kirby’s sign

Engle’s angle

Simon’s angle

Kite’s angle

Lachman’s test

McMurray’s test

Coonrad-Bugg-Trap

Renandier’ s disease – tibial sesamoid

Trevor’ s disease – fibular sesamoid

Freiberg’ s disease – second metatarsal head

Reiter’s syndrome

 

 

 

 

Which are the most common treatments used?

• Cam Walker
• NSAIDS
• RICE
• Custom orthotics
• Compression stockings

 

Plantar Fasciitis

CC: Pain is worse upon ambulation at mornings. Pain is on the medial posterior heel. Patient had pain for a couple years.

Objective: MSK- POP to medial calcaneal tubercle. Equinus.

Assessment: Plantar fasciitis

Plan: Duexis (NSAID), Stretching, RICE,

Hammertoes/Bunion

Gas gangrene

Plantar wart

Tinea pedis/ungium

Gout

Hallux limitus/arthiritis

DFU (Neuropathic)

VLU

Ischemic leg ulcer

Ruptured achilles tendon

Capsulitis

Midfoot arthritis

Toe fracture/Metatarsal fx

Ankle fracture/Calcaneal fracture

Peroneal tendinitis

PTTD

Talar dome lesion

Plantar Neuroma

Tarsal tunnel syndrome

Cellulitis

 

An introduction to identifying STIR images.

by Rossi Bad

Original Date: 2016-04

 

MRI image appearance

The best way to identify STIR images is to look for areas that should be filled with either fat or fluid. For example bone marrow should be filled with fat, and joint spaces should be filled with fluid. Next, you want to see that the fat is very dark, while the fluid is lighting up, and bright. Remember that STIR is a “fat suppression” technique that allows for detection of water and fluid content. 

Therefore, muscle will appear darker than fat. Bone marrow, blood, fat (eg. subcutaneous), air will also appear dark. Fluids will appear very bright. Since pathological processes usually involve edema, which is an increase in the water content, this type of MRI is great for for pathological processes.

With regards to the podiatry, a minimal amount of fluid is found within tendon sheaths. This is usually clinically insignificant. However, fluid within the flexor hallucis longus tendon is a common finding, and should not be treated as pathological. This is due to the communication between the sheath of the FHL and ankle joint.

 Therefore STIR is great for joint pathology, and tendon pathology.

 

The following website is a great resource for identifying and learning about imaging techinques!

References:

https://mrimaster.com/index-2.html

 

ALL IMAGE CREDITS GO TO THE ORIGINAL CONTENT and AUTHORS LINKED IN THE IMAGE. I DID NOT REMOVE THE HYPERLINK.

Hydrocolloid

It is a type of peri-wound dressing helpful in exudative wounds. It’s gel polymer

There are three main theories that help determine the cause of the foot pathology from a biomechanical standpoint:

1. Sagittal plane facilitation (SPF)
2. Subtalar joint neutral (SJN) or Foot Morphology theory
3. Tissue stress theory (TS)

 

STJN was initially described by Merton L. Root, and therefore is  also known as “Rootian” biomechanics. STJN occurs at heel strike, and at the end of midstance. Foot morphology is currently used term to describe abnormal or normal foot function as it relates to STJN. For example, a foot that has FM that deviates from “normal” such as forefoot varus, would need to an orthotic device to return the foot to normal. If the foot remains with a forefoot varus,  pronatory compensatory motion would occur at the STJ thereby causing an abnormal STJN.

How is the orthosis made to return the abnormal FM to normal?

Negative Casting

1. Casting the foot in NWB neutral position
2. Lock the midfoot i.e. end point so that arch isn’t “wobbly”
3. Ensure the forefoot to rearfoot alignment is correctly captured
4. Ensure the cast has a proper arch, and the lateral edge of the foot is captured

Positive Cast

1. After pouring

Runner’s toe – subungal hematoma of the SECOND TOE

Tennis toe – subungal hematoma of HALLUX

Turf toe – sprain of HALLUX MPJ due to hyperextension

Sand toe – sprain of HALLUX MPJ due to hyperflexion

Runner’s knee – Patellofemoral dyfunction

Basketball foot – STJ dislocation

Lachman’s test – ACL test

McMurray’s test – Meniscal test

dreaded black line – transverse stress fracture across the anterior tibial cortex

Theater sign – patellofemoral dysfunction

 

 

 

Terms to know:

1. Jahss classification

 

Conservative treatment for 1st met fractures: NWB in SLC for 4-6 weeks

When should you do ORIF for met fractures?

1. Extra-articular: >2-3 mm displacement and >10 degrees angulation
2. Intra-articular: fracture involves >20% articular surface if

 

When should you do open surgery for Jahss?

1. Jahss classification 1
2. Order is ADI – adductor, DTML, intersesamoidal ligament