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Summary ABFAS EXAM RAPID FIRE
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ABFAS EXAM RAPID FIRE - Must know before the exam - Do these pointers before taking the exam - Pass all first attempt
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ABFAS RAPID FIRE#MUST KNOW
FAS BOARDS:
Neuroma Sx: injure DTML->adjacent contractures
Triple arthrodesis complication: NON-union TN common
Mitchell bunion: distal metaphysis, rectangular wedge, shortening, transfer metatarsalgia
Gastroc recession: sural nerve/>14cm above calc tuberosity safe (posterolateral)
Sequestrum: necrotic bone that is separated by granulation tissue from surrounding living bone
Involucrum: new bone that has formed around dead bone. Involucrum can become perforated
Cloaca: openings/tracts in the involucrum
Acute osteo:
+Tc (phase 3)
+Gallium
Chronic osteo:
+Tc
-Gallium
Ga-67: Diffuse uptake=Soft tissue infection
In-111:
+=Acute OM
-=Chronic OM
Cellulitis:
-Tc
+Gallium
Congenital vertical talus: LATERAL forced PF=*no correction*
Cellulitis: > signal T2/poorly defined
Bone scan shows:
Bladder/Kidneys, facial, sternum, scapula tips, spine, SI J’s, epiphyseal growth centers
1st MTP fusion position:
10-15 DF
10-20 Valgus
Bunion: ABH mm(slides beneath met H)->pulls on proximal phalanx->pronation
,Reverse sural artery flap: Soft tissue defects at heel/ankle, risk critical venous congestion
*include short saphenous V in flap
*maintain peroneal A perforators
Hallux IPJ fusion for: Hallux malleus
Proximal akin: Correct DASA
Distal akin: Correct HAB >15 + HIA >10
Hibbs tenosuspension: Flexible anterior cavus/CLAWtoes
-EDL (insertion->midfoot), distal stumps (to EDB proximal to MTP)
Postaxial polydactyly=most common
Central poldactyly= least common (2nd toes)
Jones tenosuspension: EHL-> medial to lateral 1st met H
*Flexible cavus, PF 1st ray, cock-up hallux, both sesamoids removed, metatarsalgia
**ADD IPJ fusion
Foot drop:
TibP Interosseous membrane dorsal foot
*OUT of phase
Furosemide:
<Na reabsorption
>K secretion=HYPOkalemia
*Hypochloremia
*Metabolic alkalosis
Von Willebrand=>bleeding
Norm PT =11-13
Norm PTT=25-35
LOW risk HPA suppression:
<3 weeks, <5mg/day, <10mg every other day
Cushing: exogenous steroid use
Lateral column lengthening=< F to medial arch
Friebergs: Plantar cartilage healthier
TC coalition: C-sign, talar beaking, dysmorphic sustentaculum
Soft tissue sarcomas lungs common
,Malignant fibrous histiocytoma:
-MOST common ST sarcoma
Engels angle: Mettadductus=>24
Os peroneum: MO view best
Indium-111 scan: wait 24h/ACUTE infections
Hypertrophic nonunion: <mechanical stability/Rigid immobilization best
Bassetts ligament: abnormal accessory AITFL
Screw protruding medially out of calcaneus (posterior facet): FHL risk
Purulence=through cloaca
Posterior ankle scope: visualize FHL
Medial malleolar osteotomy: FOR Medial OCD or Talar BODY Fx
Navicular Fx incision: Dorsal-medial longitudinal
-B/t TibA +EHL
-Straight to periosteum
>Cuboid abduction= EVANS
*Use autograft/allograft (bi/tri cortical)
Flexible calcaneal valgus: Koutsogiannis (medial calc slide)
Metformin: hold for contrast procedures, risk lactic acidosis
Osteogenesis imperfecta: child/multiple fractures/<TYPE1 collagen
Selakovich procedure: opening medial bone graft wedge in the sutentaculum tali
- children with a flexible pes valgus
COX1: protects gastric mucosa; clot formation
COX2: Inflammation/fever
Ricketts: <vitD, <mineralization, weak bone, BOWING
*RA=continue methotrexate perioperatively
, Acral lentiginous melanoma: nail, palms, soles
CRP: most sensitive 48h after implant infection/gone quickly
ESR: lingers with fibrinogen/<sensitive
Calc Fx: sustentaculum tali tightly bound to the talus by the interosseous talocalcaneal
ligaments, spring ligament, and deltoid ligament
-CONTANT fragment
CLUBFOOT:
PosteroMedial Release:
-Plantar : plantar fascia, Abductor Hallucis and FDB, long and short plantar ligaments
-Medial : identify medial structures, release tendon sheaths talonavicular and subtalar release,
lengthening tibialis posterior and also FHL, FDL
-Posterior : ankle and subtalar capsulotomy, esp. releasing posterior talofibular and the
calcaneofibular ligaments
-Lateral : identify lateral structures, release peroneal sheaths, calcaneocuboid, complete of
talonavicular and subtalar release
TRIPLE: POSTERIOR facet calc most important
Dorsal bunion after clubfoot correction from:
-weak achilles
-strong FHL
-strong tibA
Heuters neuroma:1st interspace
Hausers neuroma:2nd interspace
CMT:
-Absent achilles R
-< vibration/proprioception
Endotracheal tube: Too far into R main bronchus; LEFT lung collapse
Proliferative: new collagen, vascular, re-epithelialization
Maturation: collagen remodel, contracts, >tensile strength
Bohlers: 20-40, anterior and posterior superior calc lines; *(<20=calc fx)
Tillaux-chaput: SH3/SER/PER, antero-lateral distal TIBIA: AITFL (12-15yo)
Volkmanns: Posterior lateral malleolus/PITFL syndesmotic
Wagstaff: Avulsion fracture of the medial/distal fibula/ATFL
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