8. Foot and Ankle MCQs

The Lisfranc ligament is a critical stabilizing structure of the midfoot. Between which two osseous structures does the primary, strongest band of the Lisfranc ligament course?

A 28-year-old female twists her ankle. Radiographs show a short oblique fracture of the lateral malleolus at the level of the syndesmosis and a transverse fracture of the medial malleolus. According to the Lauge-Hansen classification, what is the mechanism of injury?

A 24-year-old male presents with midfoot pain after a twisting injury. AP radiographs demonstrate a small bony avulsion between the medial and middle cuneiforms, commonly referred to as the 'fleck sign'. The primary ligament avulsed in this injury connects which two osseous structures?

A 58-year-old male with poorly controlled diabetes mellitus presents with a swollen, warm, and erythematous left foot. X-rays show pronounced osteopenia, extensive periarticular bony fragmentation, subluxation of the tarsometatarsal joints, and debris. According to the Eichenholtz classification, what stage of Charcot arthropathy does this represent?

The primary stabilizing ligament of the Lisfranc joint complex (the Lisfranc ligament) anatomically connects which two bones?

A 62-year-old male with poorly controlled type 2 diabetes presents with a swollen, warm, and erythematous foot without ulceration. Radiographs show extensive periarticular fragmentation, debris, and subluxation of the tarsometatarsal joints. According to the Eichenholtz classification of Charcot arthropathy, what stage does this represent, and what is the primary initial treatment?

The Lisfranc ligament is a critical intra-articular stabilizer of the tarsometatarsal joint complex. What are the exact anatomic attachments of this ligament?

During an open repair of an acute Achilles tendon rupture using a posteromedial approach, the surgeon must be cautious to avoid injury to the sural nerve. At approximately what distance proximal to the calcaneal insertion does the sural nerve typically cross the lateral border of the Achilles tendon?

A 30-year-old construction worker sustains a crush injury to his left foot. Radiographs and CT demonstrate lateral subluxation of the second, third, fourth, and fifth metatarsals relative to the cuneiforms and cuboid, while the first metatarsal remains anatomically aligned with the medial cuneiform. According to the Myerson classification of Lisfranc injuries, what type of injury pattern is this?

A 52-year-old male with long-standing, poorly controlled type 2 diabetes presents with a diffusely swollen, erythematous, and warm right foot. There is no history of trauma and no open ulcers. Radiographs reveal prominent periarticular debris, fragmentation of the tarsometatarsal joints, and subluxation. Based on the Eichenholtz classification, what is the current stage of this patient's disease and the most appropriate initial management?

In an intra-articular calcaneus fracture, a decreased Bohler's angle on the lateral radiograph primarily indicates which of the following deformities?

A 55-year-old patient with long-standing diabetes presents with a plantar midfoot ulcer over a bony prominence. Radiographs show a fused midfoot with a large plantar exostosis. There is no clinical or laboratory evidence of infection, and vascular supply is adequate. What is the most appropriate surgical management?

A 12-year-old boy presents with rigid flatfeet and a history of recurrent ankle sprains. Radiographs are obtained. The 'anteater nose' sign is observed on which of the following radiographic views, and what coalition does it represent?

When performing a distal metatarsal osteotomy for hallux valgus, the surgeon must avoid extensive lateral capsular stripping to prevent avascular necrosis. Which artery provides the primary blood supply to the first metatarsal head?

The 'watershed' area of the Achilles tendon is the most common site for spontaneous rupture. Approximately where is this zone of relative hypovascularity located relative to its insertion on the calcaneus?