3.7 of 66 Ratings
Technique guides are not considered high yield topics for orthopaedic standardized exams including ABOS, EBOT and RC.
A 32-year-old male is diagnosed with a hereditary motor sensory neuropathy resulting from a partial duplication within the gene for peripheral myelin protein 22. In the setting of this disease, each of the following characteristic deformities is accurately represented by the pathologic process responsible EXCEPT:
Claw toes result from both strong extrinsic flexors and extensors overpowering atrophied lumbricals and interossei
First metatarsal plantarflexion is driven by the hypertrophic peroneus longus overpowering a weak tibialis anterior
First metatarsophalangeal joint hyperextension is driven by recruitment of the extensor hallucis longus in place of a weak tibialis anterior
Forefoot supination is driven by the relatively stronger peroneus longus indirectly overpowering a weak peroneus brevis
Hindfoot varus is driven by the preserved tibialis posterior overpowering a relatively weaker peroneus brevis
Select Answer to see Preferred Response
A 39-year-old male presents with chronic bilateral foot pain and the radiographs shown in Figures A and B. All of the following are potential pathologies that may result directly from this condition EXCEPT:
Fifth metatarsal fracture
Peroneal tendon subluxation
For which of the following pathologies would the orthotic shown in Figure A be most appropriate?
Supple adult pes cavus
Mild midfoot arthritis
Rigid pes cavovarus
Figure A is the radiograph of a 36-year-old female that presents with a high-steppage gait and claw toes. On genetic testing, she has duplication of the PMP gene on chromosome 17. Which of the following answers correctly identifies relative muscle strengths in this patient population?
Weak anterior tibialis and weak peroneus longus
Weak peroneus longus and weak brevis
Normal anterior tibialis and weak peroneus longus
Weak peroneus brevis and normal posterior tibialis
Normal peroneus longus and weak posterior tibialis
With a cavovarus foot, plantar flexion of the first ray is driven by a weak muscle "X" being overpowered by a strong muscle "Y". A tendon transfer to correct this involves transferring muscle "Y" to muscle "Z". Which muscles are represented by X, Y, and Z, respectively?
X = Peroneus longus, Y = Tibialis anterior, Z = Peroneus brevis
X = Tibialis anterior, Y = Peroneus longus, Z = Peroneus brevis
X = Tibialis anterior, Y = Peroneus brevis, Z = Peroneus Longus
X = Peroneus brevis, Y = Peroneus longus, Z = Flexor digitorum longus
X = Posterior tibialis, Y = Peroneus brevis, Z = Flexor digitorum longus
A 34-year-old male undergoes cavus foot reconstruction after failed nonoperative treatment. During the procedure, you plan to correct the fixed deformity shown in figure A. Which surgical technique best addresses this deformity?
EHL transfer to the proximal phalanx
EHL transfer to the metatarsal neck
EHL transfer to the metatarsal neck with interphalangeal joint fusion
Metatarsal head resection
What is the preferred orthotic device for a symptomatic adult foot deformity that is shown in Figure A, has no arthritis on radiographs, and responds to Coleman block testing as shown in Figure B?
Short walker boot
Accommodative custom orthotics
Lace up soft ankle brace
Medial hindfoot posting with arch support
Lateral hindfoot posting with recessed first ray
An 18-year-old male presents with recurrent ankle sprains of the left ankle and painful callus underneath the 5th metatarsal. Standing examination is shown in Figures A and B. During Coleman block testing the hindfoot is positioned in 3 degrees of valgus. The peroneus brevis and anterior tibialis have 4/5 strength compared to 5/5 strength in peroneal longus, gastrocsoleus complex, and posterior tibialis. Using a semi-ridged orthotic with a recess for the head of the first ray and lateral hindfoot posting has failed to improve symptoms. Which of the following is most appropriate as one part of the surgical plan??
Peroneus brevis to longus transfer with medial calcaneal slide osteotomy
First ray dorsiflexion osteotomy with plantar fascia release
First tarsometatarsal joint arthrodesis and metatarsophalangeal capsular release