Forefoot MCQs

A 52-year-old woman presents with severe bunion pain. Clinical examination demonstrates gross sagittal plane hypermobility of the first tarsometatarsal (TMT) joint. Radiographs show a hallux valgus angle of 42 degrees and an intermetatarsal angle (IMA) of 18 degrees. Which of the following procedures is most appropriate to minimize recurrence?

A trauma surgeon is performing a transolecranon approach for the open reduction and internal fixation of an intercondylar distal humerus fracture (AO type 13-C3). To optimize healing and joint stability, what is the preferred osteotomy shape and orientation?

A 60-year-old male complains of progressive dorsal foot pain and stiffness of his great toe. Radiographs show severe joint space narrowing, dorsal osteophytes, and subchondral sclerosis at the first metatarsophalangeal (MTP) joint. Clinical exam demonstrates less than 10 degrees of dorsiflexion. What is the most reliable surgical treatment for long-term pain relief in this patient?

A 40-year-old female presents with a painful bunion. Clinical examination and weight-bearing radiographs demonstrate a hallux valgus angle (HVA) of 28 degrees and an intermetatarsal angle (IMA) of 11 degrees. The first tarsometatarsal joint shows no hypermobility. Which of the following procedures is most appropriate?

A 35-year-old woman complains of burning pain in the plantar aspect of her forefoot that radiates into her third and fourth toes. Symptoms worsen with tight shoes and improve when barefoot. A Mulder's click is present. Which of the following best describes the underlying histologic pathology of her condition?

A 45-year-old woman presents with a symptomatic hallux valgus deformity. Radiographs show a hallux valgus angle (HVA) of 26 degrees and an intermetatarsal angle (IMA) of 11 degrees. Clinical examination reveals hypermobility of the first tarsometatarsal joint. What is the most appropriate surgical procedure?

A 60-year-old man complains of severe pain and stiffness in his right great toe. Examination reveals less than 10 degrees of dorsiflexion with pain throughout the entire range of motion. Radiographs show joint space obliteration and large dorsal osteophytes of the first MTP joint. What is the most reliable surgical treatment for pain relief?

A 45-year-old female presents with a painful bunion. Radiographs reveal a hallux valgus angle (HVA) of 45 degrees, an intermetatarsal angle (IMA) of 18 degrees, and obvious hypermobility at the first tarsometatarsal (TMT) joint on clinical exam. What is the most appropriate surgical intervention?

A 45-year-old female presents with a painful bunion. Radiographs reveal a hallux valgus angle of 35 degrees, an intermetatarsal angle of 14 degrees, and an abnormally increased distal metatarsal articular angle (DMAA) of 25 degrees. To appropriately correct the deformity while restoring joint congruency, which of the following procedures is required?

A 40-year-old female presents with painful hallux valgus. Weight-bearing radiographs demonstrate a hallux valgus angle (HVA) of 38 degrees and an intermetatarsal angle (IMA) of 16 degrees. There is no hypermobility at the first tarsometatarsal joint. Which of the following surgical procedures is most appropriate to correct her deformity?

A 45-year-old woman complains of painful bunions. Weight-bearing radiographs reveal a hallux valgus angle (HVA) of 38 degrees and an intermetatarsal angle (IMA) of 16 degrees. There is no hypermobility of the first tarsometatarsal joint. What is the most appropriate surgical management?

A 60-year-old woman complains of severe pain and stiffness in her great toe that limits her walking. Examination reveals less than 10 degrees of dorsiflexion at the first metatarsophalangeal (MTP) joint and mid-arc pain. Radiographs demonstrate severe joint space narrowing, a large dorsal osteophyte, and subchondral sclerosis. What is the gold standard operative treatment?

A 45-year-old woman presents with a symptomatic hallux valgus deformity. Radiographs demonstrate a hallux valgus angle (HVA) of 38 degrees, an intermetatarsal angle (IMA) of 18 degrees, and hypermobility at the first tarsometatarsal (TMT) joint. What is the most appropriate surgical treatment?

A 45-year-old male construction worker complains of dorsal big toe pain with push-off. Radiographs show moderate dorsal osteophytes at the first metatarsophalangeal (MTP) joint, but the plantar joint space remains well preserved. He has failed shoe modifications and NSAIDs. What is the most appropriate surgical option?

A 60-year-old man presents with severe pain and stiffness in his first metatarsophalangeal (MTP) joint. Radiographs show joint space obliteration, a large dorsal osteophyte, and subchondral sclerosis. He has pain throughout the entire arc of motion. What is the most reliable surgical treatment for long-term pain relief?

A 50-year-old man presents with pain in his right big toe that is worse during the toe-off phase of gait. Examination shows a palpable dorsal prominence and limited, painful dorsiflexion. Radiographs reveal dorsal osteophytes with preservation of the plantar joint space. What is the most appropriate initial surgical treatment if orthotics fail?

A 40-year-old woman has a symptomatic bunion. Radiographs reveal a hallux valgus angle (HVA) of 45 degrees and an intermetatarsal angle (IMA) of 18 degrees. There is no hypermobility of the first tarsometatarsal joint. What is the most appropriate surgical approach?

A 55-year-old woman complains of painful bunions. Examination reveals a hallux valgus angle (HVA) of 45 degrees, an intermetatarsal angle (IMA) of 18 degrees, and hypermobility of the first tarsometatarsal (TMT) joint. Which of the following procedures is most appropriate?

A 45-year-old woman presents with painful bilateral bunions. Examination reveals significant hypermobility of the first tarsometatarsal (TMT) joint. Weight-bearing radiographs show a hallux valgus angle (HVA) of 38 degrees and an intermetatarsal angle (IMA) of 16 degrees. Which of the following is the most appropriate surgical intervention?

A 45-year-old woman presents with a symptomatic hallux valgus deformity. Clinical examination reveals profound hypermobility of the first tarsometatarsal (TMT) joint. Which of the following surgical procedures is most appropriate to address both the deformity and the underlying pathomechanics?