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Anatomy
Classifications
Radiographic Evaluation
Surgical Treatment
Talar fractures/dislocations
100
This is the weakest of the lateral ankle ligaments.
What is the anterior talofibular ligament? It restricts anterior displacement of the foot, internal rotation, and talar inversion.
100
Name the type of Lauge-Hansen classification associated with hallmark fractures of a transverse fibular fracture and vertical tibial fracture.
What is supination-adduction?
100
Open reduction internal fixation of a posterior malleolar fracture is necessary if __% or more of the distal articulating surface is interrupted.
What is 25%.
100
When a one-third tubular plate is applied to the lateral aspect of the fibula for a Danis-Weber B type fracture, what is it referred to?
A neutralization plate.
100
What Hawkins classification involves the TN joint? And what AVN percentage is associated with this classification.
Type 4, 100%
200
This is fractured in a Wagstaffe fracture.
What is the anterior fibula?
200
Name the type of Lauge-Hansen classification associated with the hallmark fracture of a short comminuted butterfly fibular fracture.
What is pronation-abduction?
200
According to Ramsey and Hamilton, this percentage of decrease in tibiotalar contact can result from 1mm of talar shift.
What is 42%?
200
What is another name for a posteriorly placed plate on the fibula?
What is antiglide plate. It acts as a buttress to block displacement and stabilize the fracture.
200
Subchondral atrophy is indicative of vascularity of the talar body? True or False
True, aka Hawkins Sign
300
This is fractured in a Volkman's fracture.
What is the posterior malleolus?
300
Name the type of Lauge-Hansen classification associated with hallmark fractures of a spiral fibular fracture and transverse tibial fracture.
What is supination-external rotation?
300
How many millimeters of widening of the medial joint space indicates a deltoid ligament injury and lateral talar translation?
4mm.
300
Which screw should be inserted first in a neutralization plate?
The screw hole just proximal to the fracture.
300
How are talar dislocations categorized? Describe a medial subtalar dislocation?
By the position of the foot in relation to the talus. Foot lies medial to talus
400
This is fractured in a Tillaux-Chaput fracture.
What is the anterolateral tibia?
400
Name the type of Lauge-Hansen classification associated with hallmark fractures of a Maisonneuve fibular fracture and Volkmann fracture.
What is pronation-external rotation?
400
What should tibiofibular overlap be (how many millimeters)?
It should be greater than or equal to 10mm. Less than 10mm indicates damage to the syndesmosis.
400
What are some advantages of an antiglide plate over a neutralization plate?
- Biomechanically sound - Captures the posterior lateral spike to assure reduction - Advocated for use in osteoporotic bone - Distal holes are aligned perpendicular to the fracture and interfragmentary compression can be achieved by inserting a bone screw through the hole in the plate just below the fracture - Less chance of screw heads being prominent and easily irritated
400
MOA of talar neck fractures?
- Forced DF in which the anterior lip of the tibia hits the sulcus on the dorsal aspect of the talar neck.
500
These four ligaments comprise the syndesmotic ligaments.
What are the anterior and posterior inferior tibiofibular ligaments, interosseous ligament, and the inferior transverse ligament?
500
This percentage of ankle fractures are classified as SER.
What is 80%?
500
What is the Shenton line of the ankle and what does it help evaluate?
An alternative method to assess fibular shortening (another is the talocrural angle). The contour of subchondral bone of the tibial plafond should be aligned with a small spike on the fibula adjacent to the syndesmotic space. A proximal disruption of this line and any divergence >2mm suggests rotation and shortening of the fibula.
500
Where are syndesmotic screws placed in relation to the ankle joint? (If two screws were used).
2cm and 4cm above the ankle joint.
500
Why were fractures of the talar neck first called aviators astragalus?
Coined during WWI, they had a high incidence of this injury. It was observed in pilots who were in combat and trying to control a wayward airplane with rubber pedals. The combination of axial load and gravitational forces was sufficient to cleave the head and neck of the talus away from the body.