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A 16-year-old presents with lateral based ankle pain of the sinus tarsi. Examination reveals a rigid flatfoot with diminished subtalar motion. The ankle is stable to anterior drawer testing. The patient states that he has had recurrent ankle sprains while playing sports. A lateral radiograph of the foot is shown in Figure A. This reveals an abnormal connection between which two bones, and what is the next step in treatment?
Calcaneus and talus; short period of immobilization
Navicular and calcaneus; coalition resection
Cuboid and navicular; coalition resection
Calcaneus and navicular; short period of immobilization
Calcaneus and talus; shoe-wear modification
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A 13-year-old female complains of a year long history of anterior and lateral foot and ankle pain. Physical exam demonstrates limited subtalar motion compared to her contralateral foot. A lateral radiograph is shown in Figure A. A selected CT image of the hindfoot is shown in Figure B. What foot deformity is commonly associated with this condition?
Rigid pes planus
Rocker bottom foot
A 13-year-old girl presents to the office for the first time with a history of occasional ankle sprains while playing soccer. A history reveals activity-related pain localized to the sinus tarsi. Clinical exam demonstrates pes planus without instability. A radiograph is shown in figure A. What is the most appropriate next step in treatment?
Plantar fascia repair
Figure 33 shows the oblique radiograph of an 11-year-old boy who has a mild left flatfoot deformity. Examination reveals that subtalar motion is limited and painful. Despite casting for 6 weeks, the patient reports foot pain that limits participation in sport activities. A CT scan shows no subtalar joint abnormalities. Management should now include
manipulation of the foot under general anesthesia.
coalition resection with interposition of fat or muscle.
distal calcaneal lengthening osteotomy.
A 10-year-old girl complains of foot pain for the past 4 weeks while playing basketball for her school team. A radiograph is shown in Figure A. What is the most appropriate treatment?
coalition excision with fat interposition
coalition excision with extensor digitorum brevis interposition
4 weeks of immobilization in a short leg cast
excision of accessory navicular
A 14-year-old girl complains of left midfoot pain with activity. She has recently sustained multiple inversion sprains of this ankle. Radiographs of the left foot are shown in figures A and B. Shoe modification and bracing and therapy have failed to provide relief. Surgical management should consist of:
Resection of periarticular osteophytes at the talonavicular joint
Excision of the os trigonum
Mobilization of the flexor hallucis longus and excision of Steida's tubercle
Resection of the calcaneonavicular coalition and interposition of the extensor digitorum brevis
Resection of the talonavicular coalition and interposition of the flexor hallucis longus
A 10-year-old girl has had recurrent left ankle sprains for the past 9-months. She has tried immobilization in a cast for 5-weeks which has failed to provide relief. She is tender to palpation at the tarsal sinus. Radiographs and CT scan of the left foot show an isolated calcaneonavicular coalition and physical exam revealed a neutral hind foot. What is the next best step in management?
Resection of coalition at the middle facet if <20° hindfoot valgus is present
Coalition resection and interposition of extensor digitorum brevis
Complete excision of sustentaculum tali
Resection of coalition with concomitant calcaneal neck lengthening or medial slide
A 14 year-old girl has chronic foot pain which has failed to respond to previous surgical coalition resection and soft tissue interposition. A radiograph of her foot is shown in Figure A. A CT scan demonstrates a talocalcaneal coalition with almost complete involvement of the subtalar joint. What is the treatment of choice?
revision coalition resection and extensor digitorum brevis interposition
revision coalition resection and fat interposition
A 14-year-old female presents with 6 months of bilateral foot pain at the tarsal sinus. Clinical images of standing examination and heel rise are shown in Figures A and B, respectively. Radiographs of the left foot are shown in Figure C and D. Which of the following findings most likely is associated with this patient's condition?
Dynamic supination during swing phase of gait
Limited push-off power, limited forefoot contact, and excessive heel contact during stance phase of gait
Recurrent ankle sprains
Posterior tibial tendon insufficiency
Weak tibialis anterior relative to the peroneus longus resulting in first ray plantar flexion