8. Foot and Ankle MCQs

During clinical evaluation of an acute ankle injury, the external rotation stress test produces severe pain anterior to the lateral malleolus. Which ligament is the primary restraint to anterior translation of the distal fibula and is typically the first to tear in a syndesmotic injury?

A 48-year-old woman complains of chronic plantar foot pain, burning, and numbness that worsens with prolonged standing. Examination reveals a positive Tinel's sign posterior to the medial malleolus. Entrapment of which nerve is the primary cause of her symptoms?

A 24-year-old professional ballet dancer presents with chronic posteromedial ankle pain, especially when en pointe. Examination reveals pseudo-hallux rigidus and triggering of the great toe during active motion. In this specific tendinopathy, where is the most common site of stenosing tenosynovitis?

A 45-year-old female with chronic, severe plantar fasciitis has failed 6 months of conservative care, including dedicated Achilles and plantar fascia stretching, custom orthotics, and NSAIDs. She wishes to avoid surgery if possible. What is the most appropriate next step in her management?

A 45-year-old female presents with a painful bunion. Radiographs reveal a hallux valgus angle of 35 degrees, an intermetatarsal angle of 14 degrees, and an abnormally increased distal metatarsal articular angle (DMAA) of 25 degrees. To appropriately correct the deformity while restoring joint congruency, which of the following procedures is required?

During surgical fixation of a displaced intra-articular calcaneus fracture via an extensile lateral approach, meticulous soft tissue handling is necessary. Which nerve is at greatest risk of iatrogenic injury during the dissection and retraction of the inferior limb of this incision?

A 55-year-old woman is diagnosed with acquired adult flatfoot deformity secondary to posterior tibial tendon dysfunction. Examination and weight-bearing radiographs reveal flexible hindfoot valgus and greater than 40% uncoverage of the talonavicular joint. What is the most appropriate surgical reconstruction?

A 22-year-old competitive rugby player sustains a purely ligamentous Lisfranc injury with dynamic instability demonstrated on weight-bearing radiographs. To minimize the risk of articular cartilage damage and hardware breakage while allowing early return to sport, what is the current recommended surgical treatment?

A 24-year-old patient with Charcot-Marie-Tooth disease presents with a bilateral cavovarus foot deformity. During physical examination, a Coleman block test is performed and the hindfoot varus corrects to neutral. What does this specific finding indicate?

A 28-year-old skier presents with chronic posterolateral ankle pain and a popping sensation when circumducting the ankle against resistance. Examination reveals the peroneal tendons translating anterior to the lateral malleolus. Incompetence of which anatomical structure is primarily responsible for this pathology?

A 70-year-old low-demand community ambulator reports feeling a "snap" over his anterior ankle while walking down stairs. He presents with a painless foot drop, a palpable step-off anterior to the ankle joint, and inability to actively dorsiflex the ankle. What is the most appropriate initial management?

A 14-year-old boy presents with a history of recurrent ankle sprains and a rigid, painful flatfoot. Clinical exam reveals peroneal muscle spasm. A lateral radiograph demonstrates a tubular elongation of the anterior process of the calcaneus known as the "anteater nose" sign. Which anatomic joints are involved in this coalition?

A 25-year-old professional athlete lands awkwardly on a plantarflexed foot. He complains of severe midfoot pain. Initial non-weight-bearing radiographs are normal, but subsequent weight-bearing radiographs reveal a 3 mm widening between the base of the 1st and 2nd metatarsals. What is the most appropriate management for this injury?

A 45-year-old male sustains an acute Achilles tendon rupture while playing tennis. He opts for non-operative management. According to recent literature, which of the following is the most critical factor for optimizing his functional outcome and minimizing the risk of rerupture?

A 55-year-old female presents with medial ankle pain and a progressive flatfoot deformity. Examination reveals she is unable to perform a single-leg heel raise, but the hindfoot remains flexible and corrects to neutral. Which of the following is the most commonly accepted surgical intervention for this condition?

A 40-year-old female presents with painful hallux valgus. Weight-bearing radiographs demonstrate a hallux valgus angle (HVA) of 38 degrees and an intermetatarsal angle (IMA) of 16 degrees. There is no hypermobility at the first tarsometatarsal joint. Which of the following surgical procedures is most appropriate to correct her deformity?

A 35-year-old patient undergoes open reduction and internal fixation of a Weber C fibula fracture. Following anatomic fixation of the fibula, an intraoperative intra-articular hook test is performed, demonstrating 4 mm of lateral shift of the fibula. What is the most appropriate next step in management?

A 28-year-old downhill skier experiences acute posterolateral ankle pain after catching an edge, causing sudden forced dorsiflexion and inversion. Examination reveals swelling posterior to the lateral malleolus and a palpable snapping sensation with ankle circumduction. This clinical presentation is primarily associated with injury to which structure?