8. Foot and Ankle MCQs

A 10-year-old boy with spastic diplegic cerebral palsy develops a new-onset "crouch gait" one year after undergoing multi-level orthopedic lower extremity surgery. What is the most likely iatrogenic cause of this gait abnormality?

A 14-year-old boy presents with frequent ankle sprains and a rigid, painful flatfoot. Radiographs show a "C-sign" on the lateral ankle view. Which type of tarsal coalition is most likely, and at what age does it typically ossify and become symptomatic?

Which of the following is true regarding the most common tarsal coalitions?

A 13-year-old boy presents with a painful, rigid flatfoot and a history of recurrent ankle sprains. Lateral weight-bearing radiographs reveal an elongated anterior process of the calcaneus forming an "anteater nose" sign.

Which specific tarsal coalition is most consistent with these radiographic findings?

A 13-year-old boy complains of recurrent ankle sprains and a rigid, painful flatfoot. Clinical examination reveals peroneal spasticity. An oblique radiograph of the foot reveals an 'anteater nose' sign. Which condition is most likely present?

A 13-year-old boy presents with a painful, rigid flatfoot and frequent ankle sprains. Radiographs show a "C-sign" on the lateral view. Which of the following is the most appropriate diagnostic imaging to confirm the exact location and extent of the suspected pathology?

During a plantar approach to the midfoot for an excision of a plantar fibroma, the surgeon identifies the 'Master Knot of Henry'. Which of the following anatomic relationships correctly defines this surgical landmark?

In evaluating a high ankle sprain, a surgeon assesses the tibiofibular syndesmosis. Which ligament is the primary restraint to anterior translation of the distal fibula relative to the tibia?

A 24-year-old football player sustains a hyper-plantarflexion injury to his midfoot. Radiographs show widening of the space between the first and second metatarsals. The Lisfranc ligament is injured. Between which two osseous structures does the primary Lisfranc ligament span?

A surgeon is performing a posteromedial exposure of the ankle for a medial malleolus fracture with significant comminution extending posteriorly. From anterior to posterior (starting immediately posterior to the medial malleolus), what is the correct anatomical order of the structures within the tarsal tunnel?

The distal tibiofibular syndesmosis relies on several ligaments for stability. Which of the following ligaments provides the greatest resistance to diastasis (accounts for the greatest percentage of syndesmotic strength)?

During a minimally invasive repair of an Achilles tendon rupture, care must be taken to avoid the sural nerve. At what approximate level does the sural nerve typically cross the lateral border of the Achilles tendon?

A patient with persistent medial midfoot pain is diagnosed with intersection syndrome of the foot (Master Knot of Henry). This anatomical site is critical for understanding tendon transfers in the midfoot. Which best describes the anatomic relationship at the Master Knot of Henry?

A surgeon is repairing a ruptured Achilles tendon using a percutaneous technique. The sural nerve is at risk of being ensnared by the passing sutures. In relation to the lateral border of the Achilles tendon, at what approximate distance proximal to the calcaneal insertion does the sural nerve typically cross from lateral to medial?

A surgeon is exposing the distal fibula for an ankle fracture utilizing a lateral approach. To avoid injuring the superficial peroneal nerve as it transitions from the deep to the superficial compartment, the surgeon should be aware of its typical exit point. Where does the superficial peroneal nerve typically pierce the crural fascia in relation to the lateral malleolus?

During surgical fixation of a talar neck fracture, preservation of the blood supply is paramount to prevent avascular necrosis. Which artery provides the predominant vascular supply to the body of the talus?

A 35-year-old male sustains an acute, complete rupture of the Achilles tendon.

He opts for non-operative management utilizing a functional rehabilitation protocol. Compared to surgical repair, which of the following is true regarding his clinical outcomes according to recent level-1 evidence?

During the surgical evaluation of an acute ankle injury, the 'Cotton test' is performed to assess the integrity of the syndesmosis. Which specific anatomic structure is considered the primary restraint to anterior subluxation of the distal fibula and is typically the first to tear in an external rotation syndesmotic injury?