Midfoot & Hindfoot MCQs

In the pathogenesis of posterior tibial tendon dysfunction (PTTD), the spring ligament complex frequently attenuates. Which specific band of the spring ligament is the primary static stabilizer of the talonavicular joint and is most commonly torn?

When performing a tendon transfer for Stage II posterior tibial tendon dysfunction, the Flexor Digitorum Longus (FDL) is typically preferred over the Flexor Hallucis Longus (FHL). What is the primary functional reason for avoiding routine FHL harvest in this setting?

Which of the following structures is the primary static stabilizer of the talonavicular joint and is most commonly attenuated or torn in conjunction with posterior tibial tendon dysfunction?

A 58-year-old man with poorly controlled diabetes presents with a warm, swollen, and erythematous left foot. He denies trauma. Radiographs show periarticular fragmentation and subluxation at the midtarsal joint. There are no open wounds. What is the most appropriate initial management?

A 30-year-old patient presents with a purely ligamentous Lisfranc injury with 4 mm of diastasis on weight-bearing radiographs. According to recent literature, what is the most significant advantage of primary arthrodesis over open reduction and internal fixation (ORIF) for this specific injury pattern?

A 52-year-old patient with poorly controlled diabetes presents with a red, hot, swollen left foot for 2 weeks. There is no history of trauma. Radiographs show fragmentation, periarticular debris, and subluxation at the midfoot. What is the most appropriate initial management?

A 60-year-old woman complains of progressive medial left ankle pain and a collapsing arch. On examination, she is unable to perform a single-leg heel raise on the left. Radiographs show a talonavicular uncoverage of 30% but preserved joint spaces and flexible hindfoot valgus. Which of the following is the most appropriate surgical treatment?

A 55-year-old woman presents with progressive medial foot pain and a "fallen arch." Examination reveals a flexible flatfoot deformity with an inability to perform a single-leg heel rise. Weight-bearing radiographs show 45% uncovering of the talonavicular joint. Which of the following surgical combinations is most appropriate?

During a medial approach to the midfoot, the surgeon encounters the "Master Knot of Henry". This anatomic structure is formed by the crossing of which two tendons?

A 55-year-old woman presents with a painful, flexible flatfoot deformity and an inability to perform a single-leg heel raise.

Clinical examination reveals severe forefoot abduction with 'too many toes' sign. Which of the following procedures is most appropriate to specifically address the forefoot abduction component of her deformity?

A 55-year-old woman presents with a painful, unilateral flatfoot deformity. She is unable to perform a single-leg heel rise, but manual testing reveals that her subtalar joint remains mobile and reducible. What is the most appropriate surgical treatment?

A 15-year-old girl is evaluated for a painful, rigid flatfoot. A lateral weight-bearing radiograph demonstrates a continuous, dense osseous outline extending from the talar dome down to the sustentaculum tali (the "C-sign"). This radiographic finding strongly suggests which underlying condition?