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Podiatric Surgery Exam 2024 | Questions with Answers
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Podiatric Surgery Exam 2024 |Questions with Answers
Treatment for a grade I turf toe - ANSWER symptomatic
When can someone return to play with a grade I turf toe? - ANSWER return as
toleratated
- grade of tuft toe
- partial tear of plantar structures
- moderate swelling
- restricted motion due to pain - ANSWER grade II
Treatment for a grade II turf toe - ANSWER - walking boot
- crutches as needed
Return to play with a grade II turf toe - ANSWER - up to 2 weeks
- may beed taping on return to play
- grade of turf toe
- complete disruption of plantar structures
- significant swelling/ecchymosis
- hallux flexion weakness
- frank instability of hallux MTP - ANSWER grade III
Treatment for grade III truf toe - ANSWER - long term immobolization in boot or
case - surgical reconstrictuon
When can somone return to play with a grade 3 turf toe - ANSWER - 10-16 weeks
depending on sport and position
- likely to need taping on return to play
Mechanism of injury with turf toe - ANSWER axial load with a fixed foot
Measurements of the tibial sesamoid in turf toe? - ANSWER > 10.4 mm
Measurements of the fibular sesamoid to the proximal phalanx in tuf toe - ANSWER >
13.3 mm
What grade would you MRI turf toe? - ANSWER 2+
Surgical indications for turf toe - ANSWER - large avulsion with unstable joint
- bipartitie or fracture with diastasis
,- retracted sesamoids
- Vertical Lachmans's (+_
- loose bodies
Surgical incisions used for turf toe? - ANSWER - classic J incision
- medial
- plantar
Technique for turf toe surgery? - ANSWER - sesamoid resection of fracture pieces
- soft tissue repair
- abductor transfer with tibial sesamoidectomy
- IPJ fusion, FHL transfer to the proximal phalanx for chronic TT
In the literature, what percent of theletes will have have persistant pain and stiffness
with no surgical intervention of turf toe? - ANSWER 50%
Independent risk factors for LEA in patients with DM - ANSWER - peripheral neurpathy
- PVD
- prior amputations
Risk factors for leg amputation in the DM patient - ANSWER - prior pedal ulcers
- open pedal ulcers
- deep infection
- complex wound/ulcer
- ischemia
- unstable limb dysfunction
- charcot foot
Normal risk of post op infecton? - ANSWER 1%
Risk of post op infection if an open ulcer is nearby? - ANSWER 10%
Gold standard for screening for elective foot surgery - ANSWER pulse exam
When do elective surgery on someone with DM, and you cant feel palpable pulses,
what do you do? - ANSWER get vascular clearance
Restrictions for Glc control _____ as risk of limb loss without surgery increases? -
ANSWER decrease
A HbA1C of what is required for elective procedures? - ANSWER 8
Prerequisites for prophylactic surgery in diabetics - ANSWER - adequate perfusion
- no active infection of significant coloniczation
- reasonable Glc control
,Guiding principles to prophylactic DM foot surgery - ANSWER - minimize tissue
violation
- minimize reconstructive nature of procedure
- prophylactic abx for 10 days
How to minimize tissue violation in a DM surgical patient - ANSWER - make small
incisions
- minimal flap elevation
- full thickness dissection approach
- non viable wound tissue with little chance of healing on its own - ANSWER fetid foot
- spreading subq infection
ulcer is source of portal - ANSWER cellulitis
- focal collection of organism
- difficult abx penetration, because its walled off - ANSWER abcess
Pathogens that cause subq infection/gas accumulation - ANSWER - strep
- staph
- "soap bubbles" in sq space on XR
Muscle infection/gas acumulation causes - ANSWER - clostridial mynecrosis
What does muscle infection/gas acumulation look like on CR - ANSWER muscle layer
striations
How to manage simple OM - ANSWER - cast with window
- posterior splint/walker
- wheelchair
How to manage complex OM - ANSWER ex fix
- presence of bacteria in the blood - ANSWER bacteremia
- whole body response to infection
- fever, increased HR, AMS, increased breathing rate - ANSWER sepsis
If patient is not a revascularization canidate and has an infection, what is done? -
ANSWER ampuation
Types of exostoses - ANSWER - peri-
articular - subungual
Types of contracture deformities - ANSWER - adducto-varus roational deformities
, - medially deviated 2nd hammertoes
- MP joint subluxation/dislocation
- type of exostosis
- non neoplastic/degenerative process
- caused by an arthritic, degenerative process
- joint space narrowing + subchondral sclerosis
- painfl interdigital or dorsal digital corn - ANSWER periarticular
- types of exostoses
- idiopathic - ANSWER - subungual
- condylar
Non surgial treatment for peri articular exostoses - ANSWER - offload
- toe spacing
- pads/shoes
Why is percutaneous treatment for exostoeses not recommned/ - ANSWER - its blind
- increased risk of NV injury and uncontrolled bony destruction
- surgical principle for exostosis managment
- helps prevent prominence form ectopic reactive bone growth - ANSWER saucerize
- type of exostosis
- involves the bony condyles
- non reactive - ANSWER condylar
Places where condylar exostoses can be found - ANSWER - medial or lateral condyles
- head of the middle or proximal phalanges
- bases of all 3 phalanges
- distal tuft of the distal phalanx
Subungual exostoses are found where speciically - ANSWER central distal aspect of
the distal phalanx
Subungual exostoses can cause what nail deformity? - ANSWER pincer nail
Conservative treatment for subungual exostoses - ANSWER - usually not enough due
to shoe pressure issues
Surgical treatment of subungual exostoses - ANSWER - nail remval
- temp nail removal + exostectomy via distal tuft incision (best)
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