8. Foot and Ankle MCQs

A 30-year-old construction worker falls from a roof, landing directly on his feet. He sustains a high-energy ankle injury characterized by severe coronal plane widening of the syndesmosis, an intact fibula, and impaction of the talus into the tibial plafond. What is the standard eponymous term for this injury pattern?

During closed reduction of a medial subtalar dislocation in a 25-year-old patient, the joint is successfully reduced in the emergency department. Despite an anatomic reduction and appropriate rehabilitation, what is the most common long-term complication associated with this injury?

When assessing the quality of syndesmotic reduction intraoperatively following fixation of a Weber C ankle fracture, which radiographic measurement is historically considered the most reliable parameter on standard AP and mortise fluoroscopic views?

A 30-year-old sustains an ankle fracture requiring syndesmotic fixation. Which of the following intraoperative imaging techniques is most sensitive for evaluating syndesmotic reduction?

A 42-year-old man undergoes percutaneous repair of an acute Achilles tendon rupture. Postoperatively, he complains of numbness and burning pain along the lateral aspect of his foot. Which nerve was most likely injured during the procedure?

A 35-year-old female sustains a purely ligamentous Lisfranc injury involving the first, second, and third tarsometatarsal joints. Which of the following surgical interventions provides superior functional outcomes and lower revision rates for purely ligamentous injuries?

During the surgical approach for a displaced talar neck fracture, an anteromedial approach is utilized. Which critical vascular structure is at greatest risk of iatrogenic injury during this specific approach, potentially worsening the risk of avascular necrosis?

A 14-year-old boy presents with a painful, rigid flatfoot and recurrent ankle sprains. CT imaging confirms a calcaneonavicular coalition. If conservative management fails, which of the following surgical procedures is considered the gold standard?

A 55-year-old female presents with stage IIB adult acquired flatfoot deformity. She has a flexible hindfoot but a fixed forefoot supinatus. Along with flexor digitorum longus (FDL) transfer and a medializing calcaneal osteotomy, which additional procedure is required to address the fixed forefoot deformity?

A 40-year-old male with an uncorrected childhood clubfoot presents with localized medial ankle pain. Weight-bearing radiographs demonstrate varus alignment of the distal tibia and isolated medial tibiotalar joint space narrowing. Hindfoot mobility is preserved. Which of the following is the most appropriate surgical option?

A 28-year-old male is involved in a crush injury to his foot. He develops severe pain out of proportion and tense swelling. The decision is made to perform a fasciotomy of the foot. How many distinct fascial compartments are generally recognized in the foot?

A 32-year-old female has persistent ankle pain following a severe sprain 1 year ago. MRI demonstrates a 1.2 cm x 1.0 cm posteromedial osteochondral lesion of the talus with subchondral cystic changes. The cartilage cap appears intact. What is the most appropriate initial surgical management?

A 25-year-old professional athlete sustains a twisting injury to his midfoot. Non-weight-bearing radiographs are normal. However, weight-bearing radiographs reveal a 3-mm diastasis between the base of the first and second metatarsals without any evidence of osseous avulsion fractures. Which of the following is the most appropriate definitive management to maximize his chances of returning to high-level athletics?

A 40-year-old man undergoes a percutaneous repair of an acute Achilles tendon rupture. Postoperatively, he complains of numbness along the lateral border of his foot. Injury to which of the following nerves is the most likely cause of his symptoms?

A 50-year-old woman presents with medial ankle pain and an acquired flatfoot deformity. Examination reveals a flexible hindfoot valgus. Weight-bearing radiographs show greater than 30% uncoverage of the talar head on the AP view, indicating significant forefoot abduction. She has failed conservative management. Which surgical reconstruction is most appropriate for this Stage IIb posterior tibial tendon dysfunction?

A 60-year-old man presents with advanced ankle osteoarthritis and is inquiring about total ankle arthroplasty (TAA). Which of the following is considered an absolute contraindication for TAA?

A 45-year-old woman presents with a painful bunion. Weight-bearing radiographs reveal an intermetatarsal angle (IMA) of 16 degrees and a hallux valgus angle (HVA) of 38 degrees. Clinical examination demonstrates significant hypermobility of the first tarsometatarsal (TMT) joint. Which of the following surgical procedures is most appropriate?

A 35-year-old construction worker falls from a ladder and sustains a displaced intra-articular calcaneus fracture. The surgeon plans an extensile lateral approach. Which vascular structure is most critical to the blood supply of the apex of the subperiosteal corner flap?

A 55-year-old man requires surgery for chronic insertional Achilles tendinopathy with a large retrocalcaneal exostosis after failing conservative therapy. Intraoperatively, the diseased Achilles tendon is debrided. At what threshold of tendon detachment or debridement is a flexor hallucis longus (FHL) tendon transfer primarily indicated to augment the repair?

A 45-year-old man presents with chronic heel pain that worsens at the end of the day. He has focal tenderness over the medial calcaneal tuberosity, and compression reproduces radiating pain. EMG reveals denervation of the abductor digiti minimi muscle. Which nerve is most likely entrapped?