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DEX IOT DAY 4 TEST NEWEST 2024 ACTUAL
EXAM 250 QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS )
|ALREADY GRADED A+
Where is the lisfranc joint? - ANSWER- Spans the entire midfoot articulation with the metatarsals
What is the keystone conformation? - ANSWER- Connection between 2nd met and middle cuneiform that provides stability to lisfranc joint
What does the lisfranc ligament connect? - ANSWER- Medial cuneiform to base of 2nd met
Three aspects of lisfranc ligament: - ANSWER- Dorsal,
interosseous, plantar
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What makes up the lisfranc complex? - ANSWER- 1st and 2nd met & medial and middle cuneiform
What type of injury typically causes instability and gapping between bones of lisfranc complex? - ANSWER- Axial load
Which column of the foot has the most flexibility? - ANSWER- Lateral column
What mechanisms of injury occur with lisfranc pathology? - ANSWER- Direct or indirect, high energy or low energy
What constitutes a direct injury? - ANSWER- axial load with dorsal and plantar forces
What constitutes an indirect injury? - ANSWER- Plantarflexed foot with axial load (heavy object falling on foot- tarsals shift anterior or posterior)
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What is necessary to diagnose lisfranc injury? - ANSWER- Weightbearing x-ray
What is a fleck sign? - ANSWER- Avulsion fracture between 2nd met and medial cuneiform
What type of lisfranc injuries do not require surgery? - ANSWER- Nondisplaced and stable
Lisfranc stability relies on ____ anatomy, while displacement relies on _____ anatomy - ANSWER- Ligamentous, bony
What is a downside of fixing/fusing lisfranc injury with screws? - ANSWER- No micromotion - they can break
What is a benefit of lisfranc ORIF with plates? - ANSWER- Plate fixation maintains stability without violating the articular surface
What is ligamentous lisfranc augmentation (mini tightrope, internal brace) typically indicated for? - 3 / 4
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ANSWER- Low energy injuries, mostly young adults and highly active individuals
What is the gold standard for lisfranc injury fixation? - ANSWER- Plates and screws
What % of all fractures are lisfranc injuries? - ANSWER- 0.2%
Who treats most lisfranc injuries? - ANSWER- Sports surgeons
What is the role of hardware in ORIF? - ANSWER- Maintains reduction, hardware eventually removed
Role of hardware in fusion? - ANSWER- Compresses fusion, hardware left in place
What are lisfranc (diamond) plates indicated for? - ANSWER- Fixation or fusion; high or low energy injuries; orientations left and right; sizes S,M,L; oblong
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