DEX IOT Day 3 Test - Lateral Ankle Instability & Achilles Pathology (Questions With Proven Solutions) What is the name of the functional stabilizing tendon that runs behind the lateral malleolus and inserts on the base of the 1st met? Right Ans - Peroneus longus What is the name of the functional stabilizing tendon that runs behind the lateral malleolus and inserts on the base of the 5th met? Right Ans - Peroneus brevis Which of the peroneal tendons runs anterior to the lateral malleolus and is absent in 25% of people? Right Ans - Peroneus tertius What neurovascular structure is at risk in lateral ankle procedures (runs behind lateral mal)? Right Ans - Sural nerve What neurovascular structure runs on the anterior aspect of the foot?Right Ans - Superficial peroneal nerve What is the function of the ATFL? Right Ans - Prevents anterior translation of the talus and internal rotation of the foot Where is the fibular attachment site of the ATFL? Right Ans - Attaches 1.4 cm from distal aspect of fibula Where is the talar attachment site of the ATFL? Right Ans - Attaches 1.8 cm anterior and medial from the lateral talar process What is the function of the CFL? Right Ans - Prevents movement of tibiotalar and subtalar joint When is the PTFL typically injured? Right Ans - Due to axial load or traumatic impact (car wreck) What is the mechanism of injury for an ATFL sprain? Right Ans - Subtalar inversion and forced plantarflexion 1 / 2
Difference between functional and mechanical issues in ATFL Right Ans -
Functional: patient complains of pain and difficulty with movement;
mechanical: can physically translate the talus
Classification of ankle sprains: Right Ans - Grade 1: ligament stretched but intact
Grade 2: ligament partially torn
Grade 3: ligament completely torn
CFL instability can be confirmed by: Right Ans - Varus stress, talar tilt test, subtalar inversion How does a Brostrom-Gould differ from traditional Brostrom? Right Ans - Brostrom-Gould incorporates extensor retinaculum into repair What percent of people with lateral ankle sprain don't return to full prior activity level? Right Ans - 42% What percent of people with lateral ankle sprain abandon athletic activity altogether? Right Ans - 26% What is the strength of the native ATFL? Right Ans - 160N What is the strength of a Brostrom repair? Right Ans - 75N What is the strength of an Internal Brace augmentation? Right Ans - 250N How much sooner can you return to activity with IB v. modified Brostrom?Right Ans - 4.2 weeks sooner
DX Fibertak placement for ATFL repair? Right Ans - 1st anchor: 1 cm from
distal tip of fibula
2nd anchor: 1 cm proximal from first anchor
Where do you position talar offset guide? Right Ans - 2 cm medial from lateral talar process; angle guide 40-45 degrees to sagittal plane and parallel with longitudinal line of 5th met; 7:30 for left, 4:30 for right
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