8. Foot and Ankle MCQs

A 45-year-old woman presents with progressive, painful adult-acquired flatfoot deformity. Intraoperatively, the plantar calcaneonavicular ligament is found to be significantly attenuated and stretched. This ligament provides critical static support to prevent plantarflexion of which of the following structures?

A 45-year-old woman is undergoing excision of a symptomatic accessory navicular with concurrent tendon advancement. During the medial approach to the midfoot, the posterior tibial tendon (PTT) is mobilized. Which of the following statements accurately describes the anatomy of the PTT?

A 30-year-old man requires open reduction and internal fixation of a displaced medial malleolus fracture. The surgeon plans a longitudinal incision centered directly over the medial malleolus. If the dissection strays too far anteriorly over the medial malleolus, which structures are at greatest risk of iatrogenic injury?

A 28-year-old male sustains an isolated, displaced fracture of the sustentaculum tali. During open reduction and internal fixation through a medial approach to the calcaneus, a specific tendon running directly inferior to the sustentaculum tali must be identified and protected to visualize the inferior margin of the fracture. Which tendon is this?

A 28-year-old male is involved in a motor vehicle collision and sustains a Hawkins Type III talar neck fracture. He is counseled on the high risk of avascular necrosis of the talar body. Which of the following arteries provides the primary, dominant blood supply to the body of the talus?

During an anterolateral approach to the distal tibia and ankle for pilon fracture fixation, the surgeon must be careful to protect a nerve that typically courses from medial to lateral across the surgical field. Injury to this nerve leads to what primary deficit?

During a direct lateral approach to the distal fibula for an open reduction and internal fixation of an ankle fracture, the surgeon identifies a nerve piercing the crural fascia approximately 10 to 12 cm proximal to the tip of the lateral malleolus. If this nerve is inadvertently transected at this level, which of the following clinical deficits will the patient most likely experience postoperatively?

When establishing the anterolateral portal for ankle arthroscopy, the surgeon must be careful to avoid injuring a nerve that supplies sensation to the dorsum of the foot. Which nerve is this?

Which two tendons cross at the anatomical landmark known as the Master Knot of Henry in the plantar aspect of the foot?

A surgeon is performing an extensile lateral approach to the calcaneus. The sural nerve is at risk during this exposure. The sural nerve is typically formed by the junction of the medial sural cutaneous nerve and the communicating branch of which nerve?

A patient undergoes percutaneous repair of an acute Achilles tendon rupture. To avoid trapping the sural nerve with a lateral suture pass, the surgeon must be aware of its anatomic course. Where does the sural nerve typically cross the lateral border of the Achilles tendon?

In a patient with tarsal tunnel syndrome, a release of the flexor retinaculum is planned. From anterior to posterior, what is the correct order of structures passing behind the medial malleolus?

During operative fixation of an ankle fracture, a surgeon evaluates the distal tibiofibular syndesmosis. The anterior inferior tibiofibular ligament (AITFL) originates from the Chaput tubercle. On which bone is the Chaput tubercle located, and where does the AITFL insert?

What is the correct anatomic order of structures passing behind the medial malleolus within the tarsal tunnel, strictly from anterior to posterior?

During a posterolateral approach to the ankle for fixation of a posterior malleolus fracture, the sural nerve is at risk. It typically courses distally in close proximity to which vascular structure?

Entrapment of the deep peroneal nerve beneath the inferior extensor retinaculum (anterior tarsal tunnel syndrome) typically causes isolated sensory loss in which anatomic area?

A 32-year-old male sustains a displaced talar neck fracture. Which of the following blood vessels provides the predominant blood supply to the talar body and is most at risk of disruption in this injury?

An extensile lateral approach is planned for an intra-articular calcaneus fracture. The sural nerve is at risk during the posterior limb of the incision. What venous structure accompanies the sural nerve posterior to the lateral malleolus?

When performing an extensile lateral approach to the calcaneus for open reduction and internal fixation of a fracture, a "no-touch" technique is strictly employed for the flap. Which of the following structures is most at risk of iatrogenic injury at the proximal and inferior margin of the incision?

An anterolateral approach to the distal tibia is utilized for open reduction and internal fixation of a pilon fracture. During superficial dissection, which nerve is at greatest risk of transection as it crosses the ankle joint?