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DEX IOT DAY 4 TEST ACTUAL EXAM COMPLETE QUESTIONS AND CORRECT VERIFIED ANSWERS(DETAILED ANSWERS)|ALREADY GRADED A+|100% GUARANTEED PASS!$17.99
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DEX IOT DAY 4 TEST ACTUAL EXAM COMPLETE QUESTIONS AND CORRECT VERIFIED ANSWERS(DETAILED ANSWERS)|ALREADY GRADED A+|100% GUARANTEED PASS! 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 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) 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? - 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 compression hole across lisfranc joint placed on 2nd met, other holes take 3.5 Lisfranc Internal Brace: - ANSWER -Purely ligamentous injuries, ideal for athletes; cons: difficult to tension properly, can be difficult for soft bone; benefits: low -profile fixation, strong biomechanical data (multi -plane fixation) Knotless Mini Tightrope: - ANSWER -Purely ligamentous injuries, ideal for athletes; alternative for those that struggle with IB; cons: medial button prominence; benefits: knotless and tensionable, no change in surgical technique (6 strand #2 coreless machin e suture) Supplemental internal brace fixation in intercuneiform joint creates a ______ stronger construct across Lisfranc complex - ANSWER -2x For ligamentous injuries, fixation into medial cuneiform is comparable to - ANSWER -Using a cannulated screw What two structures should you look out for in lisfranc fixation? - ANSWER -
Tibialis anterior tendon, dorsalis pedis artery What trajectory do you aim k wire for lisfranc mini tightrope? What direction do you pass suture button? - ANSWER -Lateral to medial, slightly plantar and inferior to tib ant tendon; medial to lateral What trajectory do you aim k wire for lisfranc internal brace? What direction do you pass suture button? - ANSWER -Lateral to medial, slightly plantar and inferior to tib ant tendon; lateral to medial What are the available sizes and lengths of snap off comp ft pins in the tray? - ANSWER -1.9 mm and 2.4 mm, 10 -50 mm in 2 mm increments What are the available lengths in sterile boxed snap off comp ft pins? - ANSWER -1.9 and 2.4; 30 and 50 mm lengths What makes these pins compressive? - ANSWER -Variable thread pitch What are the hard bone drill sizes for snap off comp ft pins? - ANSWER -1.5 mm (1.9) and 1.7 mm (2.4) Mallet toe pathology - ANSWER -Normal MTP , normal PIP , flexed DIP
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