Midfoot & Hindfoot MCQs

A 61-year-old male with poorly controlled type 2 diabetes presents with a globally swollen, erythematous, and warm right foot. He denies trauma. Pulses are palpable, and sensation to a 5.07 Semmes-Weinstein monofilament is absent. Radiographs show periarticular debris and early fragmentation at the tarsometatarsal joints. His ESR and CRP are normal. What is the most appropriate initial management?

A 55-year-old female presents with progressive medial ankle pain and an acquired flatfoot deformity. Examination reveals a flexible hindfoot valgus, inability to perform a single-leg heel rise, and significant forefoot abduction (Stage IIb posterior tibial tendon dysfunction). Which combination of procedures is most appropriate?

A 45-year-old runner with chronic heel pain undergoes surgical release. The surgeon targets the first branch of the lateral plantar nerve. This nerve courses between which two muscles?

A 50-year-old runner presents with chronic heel pain refractory to conservative management. Entrapment of the first branch of the lateral plantar nerve (Baxter's nerve) is suspected. Which muscle is predominantly innervated by this specific nerve branch?

Surgical dissection in the plantar midfoot requires navigating the Master Knot of Henry. Which of the following describes the correct anatomic relationship at this intersection?

Figure 28 shows the radiograph of a 6-year-old girl who has a right thoracic scoliosis that measures 60 degrees. Examination shows multiple cafe-au-lait spots, and family history reveals that the child's mother has the same disorder. The gene responsible for this disorder codes for

A 55-year-old poorly controlled diabetic presents with a swollen, erythematous, warm, and painless right foot. Pulses are palpable and bounding. Radiographs are unremarkable. MRI demonstrates diffuse marrow edema in the midfoot without focal fluid collections. What is the most appropriate initial management?

A 50-year-old diabetic male undergoes total contact casting for Eichenholtz Stage I Charcot arthropathy of the midfoot. Which of the following radiographic findings marks the transition to Eichenholtz Stage II (Coalescence)?

A 58-year-old patient with poorly controlled type 2 diabetes presents with an ulcerated, swollen midfoot. The clinician is concerned about osteomyelitis versus acute Charcot arthropathy. Which of the following MRI findings is most specific for diagnosing osteomyelitis over Charcot arthropathy?

A 58-year-old male with long-standing diabetes presents with a red, hot, swollen unilateral foot without open wounds. Radiographs show periarticular fragmentation and subluxation at the tarsometatarsal joints. What is the most appropriate initial management?

A 45-year-old female sustains a purely ligamentous Lisfranc injury with 3 mm of displacement between the medial and middle cuneiforms. She has no significant past medical history. Which surgical treatment has been shown in prospective studies to yield superior functional outcomes and a lower rate of revision compared to traditional open reduction and internal fixation (ORIF)?

A 55-year-old patient with long-standing, poorly controlled type 2 diabetes presents with a unilaterally red, hot, and swollen right midfoot. There are no open ulcerations. Radiographs reveal acute bone fragmentation, periarticular debris, and joint subluxation at the midfoot. What is the most appropriate initial management?

A 62-year-old woman presents with progressive flattening of her left medial longitudinal arch and medial hindfoot pain. On examination, she is unable to perform a single-leg heel raise, and her hindfoot valgus is passively correctable to neutral. Weight-bearing radiographs show no subtalar or talonavicular osteoarthritis. If conservative measures fail, what is the most appropriate surgical intervention?

A 32-year-old man sustains a Hawkins Type III talar neck fracture after a high-energy motorcycle crash. The fracture exhibits displacement of the talar body with dislocation from both the subtalar and tibiotalar joints. What is the approximate rate of avascular necrosis (AVN) of the talar body associated with this specific injury pattern?

A 55-year-old woman presents with a progressive flatfoot deformity. Examination shows a "too many toes" sign, and she is unable to perform a single-leg heel rise on the affected side. The hindfoot remains flexible and passively correctable to neutral. If conservative management fails, which surgical procedure is most appropriate?

A 55-year-old patient with poorly controlled diabetes mellitus presents with a red, hot, swollen, and painless left foot.

Radiographs demonstrate acute periarticular fragmentation and debris around the midfoot, with no clinical signs of an open ulcer or osteomyelitis. Which of the following is the most appropriate initial management?

A 55-year-old woman presents with a painful, progressive flatfoot deformity. Clinical examination reveals a "too-many-toes" sign, flexible hindfoot valgus, and more than 30% uncovering of the talonavicular joint with forefoot abduction. She is unable to perform a single-limb heel rise. What is the most appropriate surgical management if conservative treatment fails?

A 45-year-old woman presents with medial ankle pain and a progressive flatfoot deformity. Examination reveals a "too many toes" sign and an inability to perform a single-leg heel rise. The deformity is passively correctable. What is the most appropriate surgical treatment after failed conservative measures?

A 34-year-old man falls from a ladder and sustains a displaced fracture of the talar neck. Radiographs demonstrate displacement of the talar neck with subluxation of the subtalar joint, while the tibiotalar and talonavicular joints remain congruent. According to the Hawkins classification, what is the historically reported risk of avascular necrosis (AVN) of the talar body for this specific injury pattern?

A 58-year-old male with long-standing, poorly controlled diabetes presents with a red, hot, swollen foot. He has bounding pedal pulses and intact skin. Radiographs show early fragmentation and subluxation of the midfoot. What is the most appropriate initial management?