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Flashcards in foot and ankle Deck (60)
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1

True foot and ankle emergencies (5)

Open fractures (OR right away)
Check for pulses first!!!
Compartment syndrome/crush injury
Ischemic foot
Infection (blisters = bad)

2

red flags of foot injury

edema-compare
ecchymosis -mondor
Point Tenderness
Obvious deformity
Gait abnormality

3

mondor

– sign of calcaneal fx (look at the sole of the foot)

4

approach to erythema as a rf

Whiteness with erythema around – no vascular supply present, huge crater underneath present
Looking for streaking/lymphangitis – infection going up lymph chain (signals a much worse infxn)
Draw a line around the cellulitis – if the redness crosses the blue line, then come back right away for IV abx

5

High tib-fib squeeze
checks for

Syndesmotic injury – looking for maisoneuve fx

6

Ankle external rotation test allows for evaluation of

Syndesmotic injury
Move their foot to the side

7

Anterior drawers, talar tilt
helps evaluate what

ATFL or CFL injury

Stabilize lower leg with hand on top; grab the calcaneus and move the foot forward and back

8

stress foot abduction tests looks for

Lisfranc fracture dislocation
Move the toes and the forefoot to see if there is movement of the mid foot

9

other than MSK what other systems would you want to evaluate

NEURO-gross and distal
VASC DERM -DP and PT pulses; if you cant feel them- Doppler them!

DERM- Open wounds or other red flags

10

ankle rules xray

need to be non tender over the malleolus

weight bearing for at least three steps

11

foot rules xray

any tenderness in the mid foot

base of metatarsal or navicular bone

12

three views of the foot

AP, Lateral, and oblique views

13

three views of the ankle

AP, Lateral, and Mortise views

14

if problem with proximal leg get this xray

Calcaneal axial, high tibia/fibula (if problem with proximal leg)


suspect Calcaneal fracture

15

weber classification

describes destruction of syndysmosis in ankle fractures

16

weber A

most distal
below syndesmosis

17

weber B

level of syndesmosis

18

weber V

above level of syndesmosis

19

special view of joint that helps evaluate syndesmosis

stress view

20

preferred treatment for non-displaced stable fracture of the ankle (isolated malleolar)

Non-displaced, stable
Posterior splint, Jones, NWB
F/u 5 – 7 days

21

three types of ankle fractures

isolated
bimalleolar
trimalleolar

22

jones compression dressing

splint for ankle fracture

the idea is that you want to reduce the swelling

23

jones fractures concerns

not a lot of blood flow so they need to be splinted and NWB VS Dancers with is an avulsion

24

trimal MOA

severe force from underneath or twisting

bony ligamentous ring is completely disrupted and a cradle needs to be formed to keep the NVS intact

25

post traumatic ankle pain causes

Watch for Chronic Post-Traumatic Ankle Pain
Osteochondral fracture of talus
CRPS (Complex regional pain syndrome)
Occult fracture

26

MOI for calcaneal fracture

what is the imaging study of choice

fall from a height


Imaging- NWB plain films B/L feet;

*Then if fx- CT with 3D recon is preferable

27

if pt has a calcaneal fx what else do you worry about?

what do you ask any traumatic pt

Also worry about lumbar spine and the other foot

NECK PAIN
BACK PAIN
CP
ABD PAIN?

28

management of calcaneal fx

NWB
Jones compression splint
If fracture blisters occur, use oil emulsion dressing to cover
Usually delay in ORIF of 1-2 weeks while edema and skin issues resolve

29

talar fx MOI

High energy
MVA or fall

30

talus tx

NWB
DO NOT attempt to reduce
Call for consultant
Treated as emergency due to high rate of AVN
ORIF vs casting and immobilization
Can be prolonged course for healing >12 weeks