Midfoot & Hindfoot MCQs

The patient's smoking history is a significant comorbidity. According to the landmark Buckley trial (JBJS 2002) referenced in the case, how does smoking status impact outcomes following operative intervention for displaced intra-articular calcaneal fractures?

A 7-year-old child undergoes limb salvage surgery for Ewing's Sarcoma of the distal femur, which included resection of the growth plate. What is a primary long-term concern related to growth in this patient?

A 58-year-old male with long-standing diabetes mellitus presents with a swollen, warm, and erythematous right foot. He denies trauma and is afebrile. Radiographs show fragmentation of the navicular and cuneiforms, with subluxation of the tarsometatarsal joints, but no open ulcers are present. Which of the following is the most appropriate initial management?

A 60-year-old overweight female complains of medial foot pain and a collapsed arch. On examination, she has a flexible pes planus deformity and cannot perform a single-leg heel rise. Which of the following is the standard surgical treatment for this Stage II posterior tibial tendon dysfunction (PTTD)?

A 55-year-old poorly controlled diabetic male presents with a painless, erythematous, and significantly swollen left foot. He is afebrile with bounding pedal pulses. Radiographs show soft tissue swelling, periarticular debris, and early subluxation of the tarsometatarsal joints. What is the most appropriate initial management?

A 55-year-old diabetic patient presents with a red, hot, swollen unilateral foot. Peripheral pulses are bounding. Radiographs show soft tissue swelling but no fractures or dislocations. What is the most appropriate initial management for this suspected Eichenholtz "stage 0" Charcot arthropathy?

A 55-year-old male with poorly controlled diabetes presents with a swollen, erythematous, and warm right foot without open ulceration. Radiographs show acute fragmentation, periarticular debris, and subluxation at the tarsometatarsal joints. Inflammatory markers are mildly elevated. What is the most appropriate initial management?

A 50-year-old patient presents with Charcot neuroarthropathy primarily affecting the subtalar, talonavicular, and calcaneocuboid joints. According to the Brodsky classification system, what type of Charcot involvement does this patient exhibit?

A 55-year-old male with a long-standing history of diabetes mellitus presents with a red, hot, swollen right foot. He denies trauma, fever, or chills. He has palpable pedal pulses and a severe peripheral neuropathy. Radiographs show soft tissue swelling, periarticular debris, and early fragmentation at the tarsometatarsal joints. According to the Eichenholtz classification, what is the most appropriate initial management?

In the pathogenesis of Charcot neuroarthropathy, the neurovascular theory proposes that autonomic neuropathy directly leads to which of the following physiological changes?

According to the Brodsky classification of Charcot joints, which anatomical location represents a Type 1 deformity, being the most common site of involvement?

A 55-year-old diabetic male presents with an acutely swollen, red, and warm right foot. He denies trauma. Radiographs reveal periarticular debris, subluxation of the tarsometatarsal joints, and fracture fragmentation. What is the most appropriate initial management?

A 48-year-old construction worker undergoes ORIF for a severe Lisfranc fracture-dislocation. Despite meticulous surgical technique and anatomical reduction, he develops persistent midfoot pain, swelling, and stiffness 18 months post-operatively. Radiographs show degenerative changes across the first, second, and third tarsometatarsal joints. Which of the following is the most common long-term complication of Lisfranc injuries, and what is the most likely salvage procedure for this patient?

A 60-year-old patient with a history of diabetes and pre-existing midfoot osteoarthritis presents with a severely comminuted Lisfranc fracture-dislocation that is irreducible with closed manipulation. Given the patient's comorbidities and the nature of the injury, the surgeon considers primary arthrodesis. Which of the following statements regarding primary arthrodesis for Lisfranc injuries is most accurate?

A 38-year-old male presents with a Lisfranc injury following a motor vehicle accident. Pre-operative imaging confirms a Type B2 injury according to the Myerson classification, with partial incongruity involving the second and third rays. During the surgical approach, the surgeon identifies the dorsalis pedis artery and deep peroneal nerve. Which of the following statements accurately describes the typical anatomical relationship of these structures relative to the surgical incisions for a Lisfranc repair?

A 38-year-old female sustains a purely ligamentous Lisfranc injury. Studies have shown that primary arthrodesis yields superior functional outcomes for this specific injury pattern compared to open reduction internal fixation (ORIF). Which joints are typically included in this primary arthrodesis?

A 45-year-old male presents with severe midfoot pain after a misstep off a curb. MRI confirms a complete, purely ligamentous rupture of the Lisfranc complex with associated diastasis on weight-bearing films, but no fractures. Based on recent literature, which of the following treatments provides the lowest rate of hardware failure and subsequent revision surgeries for this specific injury pattern?

A 15-year-old male has a symptomatic talocalcaneal coalition that has failed 6 months of conservative management. Preoperative CT scans reveal a bony coalition involving 60% of the posterior facet of the subtalar joint, with early degenerative changes noted in the remaining posterior facet. Based on the provided table of indications and contraindications, what is the MOST appropriate surgical recommendation for this patient?