Foot and Ankle Surgery Practice Questions

Q: A 32-year-old marathon runner presents with persistent pain over the dorsum of the foot on weight-bearing. The most probable diagnosis is:

March fracture. ***March fracture*** - This is a type of **stress fracture** in the metatarsal bones, common in athletes, particularly runners, due to **repetitive microtrauma** from weight-bearing activities. - The presented symptoms of persistent pain over the **dorsum of the foot** with weight-bearing are classic for a stress fracture in a marathon runner. *Morton's Neuroma* - Characterized by pain and numbness between the third and fourth toes due to **nerve compression**, often described as feeling like a pebble in the shoe. - Pain usually presents in the **forefoot** and is exacerbated by tight shoes, not typically generalized dorsum pain on weight-bearing. *Plantar fasciitis* - Causes heel pain, especially with the **first steps in the morning** or after periods of rest, due to inflammation of the plantar fascia. - The pain is primarily located at the **bottom of the heel**, not the dorsum of the foot. *Anterior talofibular ligament sprain* - Typically results from an **inversion ankle injury**, causing pain and swelling over the **lateral aspect of the ankle**. - This type of injury usually presents with acute pain after a specific event and localized tenderness, different from the diffuse dorsum pain described.

Q: Which of the following conditions is least likely to be associated with rigid flat foot?

Athlete's foot. ***Athlete's foot*** - **Athlete's foot** (tinea pedis) is a **fungal infection** of the skin of the foot, which typically causes itching, scaling, and redness. - It does not directly affect the bony or ligamentous structures of the foot to cause **rigid flat foot** deformation. *Rheumatoid arthritis* - **Rheumatoid arthritis** can cause **inflammatory arthropathy** affecting the joints of the foot, leading to joint destruction and subsequent collapse of the **medial longitudinal arch**, resulting in **rigid flat foot**. - Chronic inflammation and synovitis can alter pedal biomechanics and lead to a painful, **fixed deformity** of the foot. *Peroneal spasm* - **Peroneal spasm** is often associated with conditions like **tarsal coalition** or other painful foot pathologies. - The spasm of the peroneal muscles can pull the foot into **eversion** and **abduction**, contributing to a **rigid flat foot deformity** as the foot becomes fixed in this position. *Congenital tarsal coalition* - **Tarsal coalition** is an **abnormal connection** between two or more bones in the hindfoot or midfoot, which restricts normal motion and leads to a **rigid flat foot**. - It is a common cause of **peroneal spasm** as the body tries to immobilize the painful, rigid hindfoot motion.

Q: Tarsometatarsal amputation is also known as what?

Lisfranc amputation. ***Lisfranc amputation*** - A **Lisfranc amputation** is a surgical procedure that involves the disarticulation of the **tarsometatarsal joint**, effectively removing the forefoot while preserving the midfoot and hindfoot. - This specific anatomical plane defines the **tarsometatarsal amputation**, which is named after Jacques Lisfranc de St. Martin, who first described the surgical technique. *Chopart amputation* - A **Chopart amputation** involves disarticulation through the **midtarsal joint** (talonavicular and calcaneocuboid joints), which is more proximal than the tarsometatarsal joint. - This amputation preserves the talus and calcaneus but removes the entire midfoot and forefoot. *Pirogoff amputation* - A **Pirogoff amputation** is a type of ankle disarticulation that involves a **horizontal osteotomy of the calcaneus**, preserving a portion of the calcaneus and fusing it to the distal tibia. - This procedure is performed more proximally than a tarsometatarsal amputation and is designed to create an end-bearing stump. *Symes amputation* - A **Symes amputation** is an **ankle disarticulation** that removes the entire foot along with the malleoli, preserving the heel pad and attaching it to the distal tibia to create a weight-bearing stump. - This is a more proximal amputation than a tarsometatarsal amputation, involving the ankle joint rather than joints within the foot.

Question 1

A 32-year-old marathon runner presents with persistent pain over the dorsum of the foot on weight-bearing. The most probable diagnosis is:

Accepted Answer

March fracture

Answer

Morton's Neuroma

Answer

Plantar fasciitis

Answer

Anterior talofibular ligament sprain

Question 2

Which of the following conditions is least likely to be associated with rigid flat foot?

Accepted Answer

Athlete's foot

Answer

Rheumatoid arthritis

Answer

Peroneal spasm

Answer

Congenital tarsal coalition.

Question 3

Tarsometatarsal amputation is also known as what?

Accepted Answer

Lisfranc amputation

Answer

Chopart amputation

Answer

Pirogoff amputation

Answer

Symes amputation

Foot and Ankle Surgery — MCQs

Foot and Ankle Surgery — MCQs

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