MTSS
Lateral Ankle Sprain
Tib-Fib Fracture
Compartment Syndrome
Achilles Tendon
100
Patients describe MTSS pain at which point with activity at the onset of symptoms?
Beginning of exercise, returns after
100
What landmark(s) of the ankle is pain localized in with a lateral ankle sprain?
sinus tarsi, ATFL, CFL
100
What special tests can be used for a tib-fib fracture?
Bump test, squeeze test
100
What is compartment syndrome?
The increased pressure withing the compartment that obstructs the neurovascular network
100
Achilles tendon rupture is confirmed through which clinical special test?
Thompson's Test
200
What is MTSS?
periostitis at the posterior medial border of tibia
200
How likely are basketball players with a history of ankle sprains more likely to resprain their ankle than a basketball player with no history of ankle sprains?
5 times
200
What are the possible MOI's for a tib-fib fracture?
direct blow, inversion or eversion stress
200
What is the MOI for traumatic compartment syndrome?
Direct trauma to the anterolateral or lateral leg, Inversion mechanism that avulses peroneals
200
If tendinitis is an inflammatory condition, what is tendinosis?
a progressive degeneration of the tendon
300
Why is it most beneficial to take an x-ray three weeks after initial symptoms?
x-ray will look for bone remodeling which only occurs after the tibia has begun to heal
300
Which position is the ankle least stable?
open-packed position of plantarflexion and inversion (supination)
300
Name two differential diagnosis
Lateral ankle sprain, talocrural joint dislocation, subtalar dislocation, deltoid ligament sprain, compartment syndrome
300
What surgical intervention is required when the intracompartmental pressure is greater than 30 mm Hg?
Fasciotomy
300
The lack of adequate blood supply to the tendon brings to question if inflammation is possible within the tendon proper. However, what highly vascular structure associated with the tendon proper could be the cause of inflammation and pain? Hint: progression; peritendinitis--> tendinosis--> tendon rupture
Paratenon; the condition is peritendinitis
400
Name two differential diagnosis
Stress fracture, deep posterior exertional compartment syndrome, deep vein thrombosis, popliteal artery entrapment syndrome
400
What percentage of moderate to severe ankle sprains reoccur?
70%
400
What other factors do you want to look for with a tib-fib fracture?
Shock
400
Name one differential diagnosis for traumatic compartment syndrome and one for exertional compartment syndrome.
Traumatic compartment syndrome: tibial fracture, fibular fracture Exertional compartment syndrome: tibial or fibular stress fracture, medical tibial stress syndrome
400
The most common site of Achilles tendon pathology, including inflammation and ruptures is called the ________________ and is located ____________cm proximal to its insertion on the calcaneus.
distal avascular zone; 2-6cm
500
Which muscles may replicate symptoms when tested?
Flexor hallucis longus, flexor digitorum longus, tibialis posterior, soleus
500
What are two predisposing factors?
history of ankle sprains (decreased proprioceptive ability), decrease strength, lack of muscular coordination; Achille's tendon/triceps surae tightness, tarsal coalition, pes cavus/supinated foot type, overweight (BMI)
500
Why are fractures of the tibia commonly associated with fibula fractures?
The force is transmitted along the interosseus membrane the the fibula
500
What are the “five P’s” used to describe the sign and symptoms of compartment syndrome?
Pain, Pallor, Pulselessness, Paresthesia, and Paralysis
500
Name 5 factors (can be anatomical or functional in nature) that lead to the onset of Achilles tendon pathology.
anatomical: tibial varum, calcaneal valgus,hyperpronation, tightness of triceps surae and/or hamstrings functional: running mechanics, increase in duration/intensity of workout, type of shoe, running surface, weak plantarflexion strength, increased dorsiflexion(>9degrees)
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