What exam finding signifies a flatfoot deformity is flexible
Double heel rise, looking for inversion of the heels
What two structures are aligned to confirm adequate reduction
2nd digit with ipsilateral patella
Name the typical incision to access the lateral STJ
Ollier incision
Subchondral bone is left intact on which bone
talus due to soft bone compared to navicular, increases the strength of fusion construct
neuroma on MRI
low T1, low T2
Most common displacement of Evan's wedge
Dorsal
Note the incision orientation for Talonavicular access
Medial gutter of the ankle to the navicular tuberosity
STJ axis
42 sagittal
16 transverse
The most common complication of TN AD and the common reason
1. non-union/malunion
2. poor prep of plantar/lateral joint secondary to poor visualization
Typical displacement of TMTJ and why
Dorsal subluxation/dislocation
Weaker dorsal ligaments results in earlier failure
Incision placement for MDCO is important as the sural nerve travels approx ____ from the distal fibula?
14mm
CC joint positioning
pushing the Cuboid superiorly to maintain lateral column length adn prevent abduction of forefoot
STJ arthroesis implant position of axis in foot
abduction and dorsiflexion
An isolated talonavicular joint arthrodesis will limit rearfoot ROM by approximately how much?
90%
The dynamic stabilizer of the 1st ray acts to?
Position the first ray/medial column in eversion and elevate the talus
The calcaneal slide osteotomy should be oriented in what position
45 degrees to WB surface
Name the order of recommended joint preparation followed by the order of arthrodesis
Prep: CC, STJ, TN
Desis: STJ, TN, CC
STJ arthrodesis in neglected calcaneal fractures requires
re establishing height and frontal plane alignment of heel
Disruption of which ligament would increase chances of non union in talus
Deltoid ligament due to disruption of deltoid arcuate artery located within the deltoid ligament
What tendon is at risk with Mau osteotomy?
Peroneus longus insertion
What orientation should the screws in an MDCO be and why?
DIVERGENT; allows for rotational stability
Sliding the calcaneus anteriorly will result in
Dorsiflexion of forefoot on rearfoot and decreases arch height
Your 7.0mm x 65mm partially threaded Fixios screw is not demonstrating compression across the STJ during arthrodesis. What technique will you initiate and how will you do perform this in the OR?
1. Lag by technique
2. Overdrill with 7.0mm drill to the joint line
MRI can be used to evaluate two things:
1. soft tissue involvement (PTT/spring ligament)
2. AVN/Stress Fx
biopsy revealed: chronic inflammatory cells, hemosiderin- laden macrophages and scattered giant cells, fluid filled levels on MRI
ABC