Midfoot & Hindfoot MCQs

A 55-year-old female presents with medial ankle pain and a progressively flattening arch. She is unable to perform a single-limb heel rise, but her hindfoot is passively correctable. Which of the following is the most standard surgical intervention for this stage of disease?

A 55-year-old female presents with medial ankle pain, a flexible pes planovalgus deformity, and an inability to perform a single-leg heel raise. The deformity completely corrects when she stands on her toes. If 6 months of conservative management with a custom orthosis fails, which of the following is the most appropriate initial surgical intervention?

A 55-year-old woman presents with a painful, flexible flatfoot deformity. Standing radiographs reveal greater than 40% talonavicular uncoverage on the AP view. She is diagnosed with Stage IIb posterior tibial tendon dysfunction. What is the most appropriate surgical management?

A 60-year-old patient with long-standing, poorly controlled diabetes presents with a unilaterally warm, swollen, and erythematous foot without ulceration. Radiographs show periarticular debris, fragmentation, and joint subluxation at the midfoot. What is the most appropriate initial management?

A 14-year-old boy presents with frequent ankle sprains and a rigid, painful flatfoot. Lateral radiographs demonstrate a prominent 'C-sign.'

This finding is most indicative of which pathology?

In adult acquired flatfoot deformity (posterior tibial tendon dysfunction), the spring ligament complex is often attenuated. Which specific band of the spring ligament is the primary static stabilizer of the talonavicular joint and is most commonly torn?

A 50-year-old woman presents with progressive medial foot pain and loss of her arch. On examination, she has a flexible valgus hindfoot and pronounced forefoot abduction. Weight-bearing radiographs demonstrate greater than 40% talonavicular uncoverage. What is the most appropriate surgical management?

A 50-year-old woman presents with medial ankle pain and a progressively flattening arch. She has pain and inability to perform a single-leg heel raise. The hindfoot valgus is flexible and corrects to neutral when she stands on her toes. Radiographs show uncovering of the talonavicular joint but no arthritis. What is the most appropriate surgical intervention?

During surgical reconstruction for flexible adult acquired flatfoot deformity (Stage II PTTD), the surgeon explores the medial soft tissues. Which ligamentous structure is most commonly attenuated and requires imbrication or repair along with the FDL transfer?

In a patient with Stage IIb posterior tibial tendon dysfunction, a flexor digitorum longus transfer and lateral column lengthening are performed. Intraoperatively, the foot is noted to have persistent forefoot supinatus with the hindfoot held in neutral. Which of the following procedures should be added?

A 62-year-old woman presents with a flexible, acquired flatfoot deformity (Stage II PTTD). She has a positive single-leg heel rise test. Radiographs show uncovering of the talonavicular joint and a talonavicular sag. Conservative measures have failed. Which surgical combination is most appropriate?

A 55-year-old woman presents with a progressive flatfoot deformity. She is unable to perform a single-leg heel rise. Examination shows a flexible hindfoot valgus. Weight-bearing radiographs show uncovering of the talonavicular joint of 40%. Which of the following surgical procedures is most appropriate?