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A patient with subtalar and tibiotalar arthritis underwent the surgery shown in Figure A. The patient now complains of numbness on the plantar/lateral aspect of his foot including the 4th and 5th toes. Which nerve was most likely injured?
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A 36-year-old construction worker sustained an ankle fracture 4 years ago after falling off a roof. Postoperative radiographs are seen in Figure A. The hardware is removed 2 years later. He now returns with ankle pain and intermittent swelling but has no difficulty with uneven surfaces. Examination reveals 5 degrees of gastrocnemius equinus contracture, pain with passive plantar and dorsiflexion, but no pain with hindfoot inversion and eversion. Recent radiographs are seen in Figure B. CT scan shows no degenerative changes in the hindfoot. What is the best treatment option?
Arthroscopic debridement of the tibiotalar joint and corticosteroid injection
Tibiotalar arthrodesis with screws
Total ankle arthroplasty
Tibiotalocalcaneal arthrodesis with an intramedullary device
Tibiotalocalcaneal arthrodesis with an extramedullary device
When performing an ankle fusion, the foot should be in:
0 degrees dorsiflexion/plantarflexion, 0-5 degree hindfoot valgus, 5-10 degree external rotation
0 degrees dorsiflexion/plantarflexion, 0-5 degrees hindfoot valgus, 0 degrees external rotation
10 degrees dorsiflexion, 0-5 degrees hindfoot valgus, 5-10 degrees external rotation
0 degrees dorsiflexion/plantarflexion, 20 degrees hindfoot valgus, 5-10 degrees external rotation
10 degrees plantarflexion, 0-5 degrees hindfoot valgus, 5-10 degrees external rotation
A 40-year-old male presents with long-standing right heel pain. He reports pain and swelling and points to the region of the sinus tarsi as the maximal area of pain, particularly when walking on uneven surfaces. He also reports a history of recurrent ankle sprains when he was younger. A clinical image of his foot posture is shown in Figure A. Inversion and eversion of the hindfoot reproduce pain. He has no discomfort with passive ankle dorsiflexion and plantarflexion. Coleman block testing reveals a rigid hindfoot. Sensation is fully intact throughout the extremity and he has full strength with ankle dorsiflexion, ankle plantarflexion and he can perform a single-leg heel rise without difficulty. A radiograph is shown in Figure B. What is the most appropriate step in management if conservative measures fail?
Brostrom anatomic reconstruction with Gould modification
Hindfoot arthroscopy with synovial debridement and Os trigonum resection
Chrisman-Snook nonanatomic reconstruction using tendon transfer
COA 2018 Annual Meeting The Great Ankle Arthritis Debate: Arthrodesis - Glenn Pf...
Reconstructing the Arthrodesis Malunion: John Ketz, MD(CSFA #11, 2017)
Reconstructing the Arthrodesis Malunion: John Ketz, MD(CSFA #10, 2017)
HPI - pain& deformity of right ankle since 3 months,varus deformity increses on weight bearing,h/o underwent conservative treatment for 5 weeks by below knee cast,after removal of cast,instability&deformity persists,pt under went orif with reconplate & screw fixation to right ankle, after 6 weeks post operative,pt c/o rt ankle deformity,
what is the choice of treatment?
HPI - Jumped out of second story house. Was found by police screaming and intoxicated.
What would you do for initial treatment
HPI - patient is having pain in his left foot for 7 month aggravated by last 3 month.cant mobilise because on stepping he feels pain.on biopsy we found avn of bones.but ct angio and dopler studies found arterial system intact.
what can be the differential diagnosis and line of treatment