ABFAS (PODIATRY) EXAM STUDY GUIDE
LATEST UPDATED RATED A
1. Evaluate posterior muscle groups, as if a TAL or gastric would also be
indicated, this will decrease the strain on the medial column
✔✔Adjunct procedure for TNJ
1. medial mal and tibialis anterior tendon, start at the ankle and go to the NC
joint
2. Watch out for the medial marginal vein (great saphenous), which is found
in the deep fascial layer
✔✔incision placement for TNJ
structures to avoid**
1. 56.3% incidence of medial lesions, usually located in the posterior 3rd of
the medial border of the talar dome.
✔✔what is more common medial or lateral ocd?
an inversion force is applied on a dorsiflexed foot,
a wafer-shape
2. Greater incidence of stage IV lesions occurring laterally
,visualized easier with the foot in the dorsiflexed position.
✔✔lateral OCD mechanism
position of the foot
xray position
inversion and plantarflexory ankle forces with concomitant lateral rotation
of the tibia on the talus.
appear deep and cup shaped in appearance.
medial talar dome lesions can be obtained by taking the AP view with the
foot plantar flexed
✔✔medial ocd mechanism
xray position
1. OATS procedure - Harvest initially then after growth is chondrocytes take
patient back to OR 2 to 3 weeks later. Subchondral bleeding will allow
marrow to contaminate the chondrocytes. A periosteal graft has to be taken
,from the ipsilateral knee, which will be secured over the defect with vicryl
with the cambium layer facing toward the bon. Fibrin glue is placed over the
surrounding articular cartilage. Chondrycytes are placed within the defect.
NWB for 6 to 7 weeks.
✔✔1. OATS procedure -
1. Majority of lateral OCD lesions are anterior or middle dome and are easily
accessible through an anterolateral arthrotomy.
2. Most of the medial lesions are in the middle or posterior aspect of the
talus and are obscured by the malleolus
Sometimes a medial malleolar osteotomy is needed
✔✔easier access for repair? medial or lateral OCD
1. Calcaneal Apophysitis - by far the most common cause of heel pain in the
adolescent population
2. Athletic boys 6 to 13, aggravated with activity and relieved with rest
3. Physical Exam
1. no erythema, no edema, no warmth. Pain with direct palpation of the
posterior calc.
Classic sign is tenderness with medial to lateral compression
✔✔1. Sever Disease
1. heel lifts, viscoelastic heel cups, arch supports, taping and orthoses in
conjunction with ice, NSAIDs and stretch are helpful.
, 2. Severe or recalcitrant forms - short leg walking cast applied for 2 to 4
weeks. If does not improve and eventually goes on to surgery than can
perform tendo-achilles lengthening
✔✔tx sever's disesase
1. Osteochondrosis of the Navicular
1. Usually seen in children between 2 and 9 yo.
2. m/c in boys and b/l 20% to 30% of cases
3. Most with this disease have a delay in ossification of the navicular which
increases the risk for vascular insult
4. Symptoms
1. painful limp, pain around the medial longitudinal arch, edema, warmth
and pain with compression.
✔✔1. Kohler Disease
1. X-rays indicate increased density and thinning bone distal to proximal
direction. A case of coalition has been heard of following Kohler's disease
1. similar as Kohler but seen in adults
2. More common in women and 20 to 75
3. b/l conditions is more common that in Kohlers
4. Caused by chronic compression from adjacent joints, leading to
avascular necrosis
5. Similar symptoms as Kohler's but are more prolonged.
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