8. Foot and Ankle MCQs

During the normal gait cycle, maximum dorsiflexion of the ankle occurs just prior to heel off. Which muscle group is primarily responsible for eccentrically controlling the forward progression of the tibia over the talus during the midstance phase?

A 45-year-old runner presents with medial heel pain and paresthesias radiating to the plantar foot. Symptoms are reproduced with percussion posterior to the medial malleolus. During surgical decompression of the affected structure, what is the anatomical order of the structures encountered deep to the flexor retinaculum, from anterior to posterior?

Which component of the medial collateral (deltoid) ligament of the ankle is the primary restraint to valgus tilting of the talus within the ankle mortise?

When performing a direct posterior approach for Achilles tendon repair, the sural nerve is at risk of iatrogenic injury. At approximately what distance proximal to the calcaneal insertion does the sural nerve typically cross the lateral border of the Achilles tendon?

A patient sustains a hyperplantarflexion injury to the midfoot resulting in a Lisfranc fracture-dislocation. The primary ligamentous stabilizer of the Lisfranc joint complex connects which two bones?

When performing a lateral extensile approach for a calcaneus fracture, the sural nerve must be protected. Which of the following accurately describes the typical course of the sural nerve at the level of the lateral malleolus?

Which of the following structures is located immediately posterior/lateral to the posterior tibial artery within the tarsal tunnel?

An extensile lateral approach is planned for the open reduction and internal fixation of a displaced intra-articular calcaneus fracture. The vertical limb of the incision is placed midway between the posterior aspect of the fibula and the Achilles tendon. What nerve is at greatest risk during the creation of the full-thickness subperiosteal flap?

A surgeon is performing an extensile lateral approach to the calcaneus for a displaced intra-articular fracture. To minimize the risk of iatrogenic injury to the sural nerve, the surgeon must recognize its typical anatomic location relative to the lateral malleolus. Where is the sural nerve located at this level?

A patient undergoes open reduction and internal fixation of a distal fibula fracture via a standard lateral approach. Postoperatively, she complains of numbness over the dorsum of her foot, sparing the first web space. The injured structure typically crosses the fibula from posterior to anterior at what average distance proximal to the distal tip of the fibula?

During a plantar approach to the foot for an extensive midfoot fusion, the surgeon encounters the "Master knot of Henry." This structure is anatomically defined as the location where:

During an anterior retroperitoneal approach to the L4-L5 disc space, the surgeon is at risk of injuring a neural structure situated on the anterolateral aspect of the L4 vertebral body. Injury to this structure most commonly results in which of the following?

During an extensile lateral approach to the calcaneus for open reduction and internal fixation of a displaced intra-articular fracture, a specific nerve is contained within the inferior (plantar) full-thickness flap. Which nerve is most at risk if this flap is poorly handled?

During an extensile lateral approach to the calcaneus for open reduction and internal fixation, the vertical limb of the incision is placed between the posterior aspect of the fibula and the Achilles tendon. If the incision is placed too anteriorly, which of the following structures is at greatest risk of iatrogenic injury?

During an external rotation injury to the ankle resulting in a syndesmotic disruption, the anterior inferior tibiofibular ligament (AITFL) is avulsed from its fibular attachment. This specific anatomical bony prominence is known as the:

The Lisfranc ligament is crucial for midfoot stability. Anatomically, this ligament provides a direct, stout connection between which of the following two osseous structures?

While performing a tarsal tunnel release for compressive neuropathy, the surgeon identifies a sensory nerve branch originating from the tibial nerve proximal to its bifurcation into the medial and lateral plantar nerves. This branch courses distally to supply the medial heel pad. Which structure is this?

During a plantar approach for the excision of a severe, recurrent deep plantar fibromatosis, the surgeon carefully dissects near the midfoot and identifies the 'Master Knot of Henry.' At this anatomic crossover point, what is the spatial relationship of the crossing tendons?