Podiatry Boards Part 2

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Author:
dhubbard
ID:
190249
Filename:
Podiatry Boards Part 2
Updated:
2012-12-19 20:45:15
Tags:
Clubfoot
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Description:
Clubfoot Presby
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  1. What is the postural definition of CONGENITAL clubfoot?
    • FF adductus
    • RF Varus
    • Ankle Equinus
  2. Definition of TALIPES EQUINOVARUS clubfoot?
    • FF adductus
    • RF varus
    • Ankle Equinus
    • TN Subluxation
    • Lateral rotation of the Talus in Ankle Mortise
  3. Of the congenital and Talipes which has a better prognosis and can be treated with conservative tx?
    CONGENITAL
  4. Which is more ST?
    Congenital
  5. What are Neuromuscular Disorderes that are acquired causing clubfoot?
    • Polio
    • Meningitis
    • CP
    • Spina Bifida
    • Myelomeningocele
    • Post-CVA
  6. What are some post trauma causes?
    • Spinal cord trauma
    • peripheral nerve trauma
    • tendon laceration
    • mal/nonionin
    • volkman's contracutre
    • burn contracture
  7. Who is Clubfoot MC in?
    • Polynesians
    • Males
    • 50% b/l
  8. What is the talar neck declination angle in clubfoot?
    • 115-135¬†
    • Normal is 150
  9. Where may the navicular go in a clubfoot?
    • Plantar medial, may articulate with the MM
    • Talus head is oriented plantar and medial also
  10. What is the orientation of the talus?
    Lateral rotation with the head and neck medial plantar
  11. What is the general appearance of the LE on examination?
    Foot is adducted, calf atrophy, smaller foot, wrinkles medial, prominent navicular, stretched skin lateral, fibula posterior
  12. What does Kite's angle do on TEV?
    Decreases
  13. What does Lateral TC angle do?
    Decreases
  14. When does the navicular ossify?
    3 years old
  15. What angles do we look at to see if the navicular is subluxed?
    • TC is <15
    • Talo 1st met is >15
  16. When do you begin conservative treatment on clubfoot?
    Immediantly
  17. You manipulate for 10-15 minutes and now what position or corrections are you going to apply in the casting?
    • Abduct FF
    • Evert Heel (Hatch says no)
    • Distract Heel
    • Above the knee cast for 1-2 weeks
  18. After casting for 1-2 months what other therpaies can be done?
    • Night splints
    • Prewalked shoes
    • Orthotics
    • Stretching
  19. What are some complications of serial casting?
    • Rocker bottom foot
    • Flat top talus
    • Wedge shaped navicular
    • Dorsal displacement of navicular
    • AVN: Talus, navicular, distal tibia
  20. What age is ideal for sx?
    3-12 months
  21. What is the squential release of clubfoot?
    • Retract tarsal tunnel
    • PT tendonw lengthening
    • TN Joint Capsulotomy
    • Sping ligament
    • FDL tendon lengthening distal to knot of henry
    • FHL lengthening
    • Superfical deltoid ligament
    • Interosseous ligament
    • Calcaneofibular ligament
    • Achilles tendon lengthening
    • Posterio ankle joint capsulotomy
    • Plantar fascia
  22. When would you do an osseous procedure?
    • Recurrence
    • Severe rigid deformity
    • Performed only in the child and adult never in INFANTS
  23. What is the cincinnati incision?
    • incision starts medially at the medial cuneiform bone, runs around the hindfoot at the same level, and ends at the cuboid bone laterally and a verticle incision to help link it.
    • This is to release the peroneals and any tightness there that may be causing the calcaneus to internally or place fibula posteriorly. This is also to help reposition any osseous deformity noted.
  24. What osseous procedures?
    • Medial column lengthening of the medial cuneiform opening wedge
    • Lateral column shortening: Evans closing wedge, Lichtblau anterior calcaneal osteotomy, Ganley closing abductory cuboid osteotomy
  25. What other osteotomies?
    • Cole: DF wedge
    • Japas: V osteotomy¬†
    • DuVries: DF wedge at the MTJ
    • Dwyer: Lateral closing wedge or opening medial wedge
    • McElvenny-Caldwell procedure: DF Lapidus
    • DFWO: of all mets
    • Jahss: DF of all tarsometatarsals
  26. List all the ST procedures?
    • Plantar fascial release
    • Steindler Stripping
    • Jones tenosuspension
    • Heyman procedure
    • Hibbs
    • Split TA tendon transfer
    • PL tendon transfer
    • PT tendon transfer
    • Peroneal Anastomosis
  27. How do you determine the apex of deformity?
    Meary's Angle in cavus foot >5

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