Chapter 31 - Rearfoot

  1. Which of the 3 fusions in a triple arthrodesis requires the longest time for revascularization?
    TN fusion
  2. What is the order of resection and fixation for Triple?
    • -resect MTJ (CC then TN) this allows access to STJ
    • -resect STJ
    • -temporarily fixate STJ
    • -temporarily fixate MTJ (TN then CC)
    • -check with C-arm
    • -fixate STJ
    • -fixate MTJ
  3. Name the 5 portals for ankle arthroscopy
    • 1. Anterior medial portal: medial to ATT and lateral to medial mal.
    • 2. Anterior lateral portal: Lateral to Peroneus tertius tendon and medial to lateral mal
    • 3. Anterior central portal: lateral to EHL tendon and medial to EDL tendon
    • 4. Posterior medial portal: medial to Achilles, lateral to tarsal canal. Avoid the PT artery and tibial nerve
    • 5. Posterior lateral portal - lateral to achilles and medial to fibular malleolus
  4. Calcaneal repairs should be done within what window of time after surgery?
    Within 4 hours or wait 7-10 days until swelling has subsided. Perform ORIF within 2 weeks.
  5. What is the classification system for calcaneal fracture? There are 3.
    • Essex Lopresti:
    • Joint depression and Tongue type

    • A, B, C, D.
    • A is superior medial fragment
    • B is anterolateral fragment
    • C Lateral fragment in joint depression type (semilunar fragment, but with tongue type it's termed thalamic or comet fragement.
    • D Tuberosity

    • Rowe:
    • Type 1A: medial tuberosity fx
    • Type 1B: sustentaculum Tali fx
    • Type 1C: Anterior process fx
    • Type IIA: Posterior beak fx (no achilles involvement)
    • Type IIB: Posterior beak fx (achilles involved).
    • Type III: Extraarticular body fx
    • Type IV - Intraarticular body fx without depression
    • Type V - Intraarticular body fx with depression (comminution).

    Sander's Classification:

    • Type I - any nondisplaced intraarticular fracture
    • Type II - 1 fracture through posterior facet (creating 2 fragments)
    • Type III - 2 fracture through posterior facet (creating 3 fragments)
    • Type IV - 3 or more intraarticular fracture lines (comminution).

    ABC are lines on the posterior calcaneus: A is most lateral and C is most medial.
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Chapter 31 - Rearfoot
Pocket podiatrics - Chapter 31 Rearfoot