8. Foot and Ankle MCQs

A 14-year-old boy with Charcot-Marie-Tooth disease presents with bilateral pes cavovarus deformities. A Coleman block test is performed and completely corrects the hindfoot varus to neutral. What does this physical examination finding dictate regarding the surgical management?

A 35-year-old recreational basketball player undergoes a percutaneous repair of an acute Achilles tendon rupture. Post-operatively, he reports numbness along the lateral aspect of his foot. Injury to which nerve most likely occurred, and at what anatomical location is this nerve most vulnerable during percutaneous repair?

In a purely ligamentous Lisfranc injury, what is the classic primary mechanism of injury?

A 28-year-old equestrian presents with severe midfoot pain after her foot was caught in a stirrup during a fall. Weight-bearing radiographs demonstrate a 3 mm diastasis between the bases of the first and second metatarsals. What is the precise anatomic connection of the primary stabilizing ligament (the Lisfranc ligament) that is disrupted in this injury?

The 'watershed' area of the Achilles tendon, which is the most frequent site of spontaneous rupture, is located approximately 2 to 6 cm proximal to its insertion on the calcaneus. The intrinsic vascularity of this highly susceptible region is relatively poor and depends primarily on extrinsically supplied vessels originating from the:

A 55-year-old male with poorly controlled diabetes presents with a red, hot, swollen midfoot. There is no open ulcer. Radiographs show extensive bone fragmentation, periarticular debris, and subluxation at the tarsometatarsal joints. According to the Eichenholtz classification, what stage is this, and what is the standard treatment?

A 24-year-old football player sustains a Lisfranc injury. Intraoperatively, complete disruption of the 'true' Lisfranc ligament is identified. To anatomically restore this ligament using a home-run screw or suture button construct, between which two osseous structures must the implant be placed?

A 28-year-old football player sustains a hyperplantarflexion injury to his midfoot. Non-weight-bearing radiographs appear normal. Weight-bearing radiographs reveal a 3 mm diastasis between the base of the first and second metatarsals. What is the most appropriate definitive management?

A 25-year-old athlete sustains a hyperplantarflexion injury to his midfoot. Weight-bearing radiographs demonstrate widening of the interval between the first and second metatarsal bases without associated fractures (purely ligamentous Lisfranc injury). According to current literature, what surgical treatment is associated with the most predictable, best long-term outcome for a purely ligamentous Lisfranc injury?

A 23-year-old running back sustains a severe axial load to his foot while plantarflexed. Weight-bearing radiographs reveal a 3 mm diastasis between the bases of the first and second metatarsals. He is diagnosed with a Lisfranc injury. The primary stabilizing ligament that has been disrupted connects which two structures?

A 40-year-old male undergoes percutaneous repair of an acute, mid-substance Achilles tendon rupture. Postoperatively, he complains of burning pain and numbness along the lateral aspect of his foot and lateral heel. Which nerve is most likely at risk and potentially injured during a percutaneous or minimally invasive Achilles repair?

A 55-year-old male with poorly controlled diabetes mellitus presents with a massively swollen, erythematous, and warm foot. Radiographs demonstrate marked osteopenia, periarticular fragmentation of the tarsometatarsal joints, and early joint subluxation. According to the Eichenholtz classification, what stage does this represent and what is the primary management?

A 45-year-old male presents with severe right leg pain radiating to the dorsum of the foot. Physical examination reveals intact knee and ankle reflexes, but marked weakness in extensor hallucis longus (EHL) function. Which nerve root is most likely compressed, and which reliable deep tendon reflex corresponds to it?

A 24-year-old football player sustains an axial load injury to a plantarflexed foot. Weight-bearing AP radiographs demonstrate a small bony avulsion fragment in the first intermetatarsal space (the 'fleck sign'). This radiographic finding represents an avulsion of the Lisfranc ligament. What are the correct anatomic attachments of the intact Lisfranc ligament?

A 55-year-old diabetic male presents with a swollen, erythematous, and warm right foot without open ulcers. Radiographs show fragmentation, debris, and subluxation of the tarsometatarsal joints. According to the modified Eichenholtz classification, what is the current stage and the most appropriate initial management?

A 50-year-old overweight woman complains of medial foot pain and an inability to perform a single-leg heel rise. Examination shows a flexible flatfoot with forefoot abduction. Radiographs reveal unroofing of the talonavicular joint without arthritic changes. Which of the following surgical procedures is most commonly indicated for this Stage IIB adult-acquired flatfoot deformity?

A 55-year-old male with long-standing poorly controlled diabetes presents with a swollen, erythematous, and warm left foot. He denies trauma. Radiographs of the foot show osteopenia and soft tissue swelling but no evidence of fracture, subluxation, or debris. MRI demonstrates bone marrow edema in the midfoot. What is the Eichenholtz stage of this patient's Charcot arthropathy?