ABFAS Rearfoot Exam Questions And Answers
Latest Update 2024/2025
A 25 year old ballet dancer presents with an 8 month history of ankle pain following an ankle sprain.
On physical exam there is joint swelling and radio graphs are unremarkable physical therapy and
NSAIDs have not reduced her symptoms. What is the next appropriate step in management of this
patient?
MRI
For a one-year-old patient with calcaneal valgus, what is an acceptable treatment plan?
Manipulation and serial casting
A 25-year-old female sustained an inversion ankle sprain 24 hours ago. The area is severely
edematous and ecchymosis. Diagnostic tests reveal rupture of the lateral collateral ligaments. What
should the treatment consist of at this time?
Compression dressing 24 - 48 hours
Which lateral ankle ligaments are intracapsular/extracapsular?
ATFL - Intracapsular
CFL - Extracapsular
PTFL - Strongest, deepest, usually doesn't rupture
A 30-year-old male complains of a painful right ankle after sustaining a forced plantarflexion injury.
Plantarflexion of the foot and dorsiflexion of the hallux greatly exacerbate the symptoms. What is the
most probable diagnosis?
Fracture of the posterior tubercle of the talus.
Which procedure would be the most appropriate management strategy for treatment of a rigid
flatfoot in an infant diagnosed with a pediatric congenital vertical talus deformity?
1. Manipulation and weekly serial casting for 5 weeks 2. Achilles tendon lengthening and TN joint
pinning.
Following a tendon reconstruction of the ankle for lateral ligamentous instability a 30-year-old female
developed a deformity of the big toe. On exam she has full range of motion of the MP joint and good
ankle stability. What is the most likely diagnosis?
Use of peroneus longus tendon for reconstruction.
What is the first step in the open reduction and internal fixation of an ankle pilon fracture?
Restoration of length and fixation of the fibular fracture.
A patient presents with an inversion ankle sprain. Stress inversion radio graphs reveal a 15 degree
difference between the symptomatic and asymptomatic ankle. A peroneal tenogram reveals contrast
media within the ankle joint and extravasation anterior, lateral, and distal to the lateral malleolus.
These findings are consistent with rupture of the:
ATFL
CFL
For PT tendon transfer where should the tendon go?
, Under the retinaculum. Decreases power but prevents bowstringing
Interosseous membrane incision doesn't need to be small to prevent syndesmotic injury
What makes up the syndesmosis?
AiTFL
PiTFL
Interosseous Ligament
What is the most common complication resulting from a Salter-Harris type III fracture of the distal
tibia in a 9-year-old?
Angulation
A patient sustains a comminuted calcaneal fracture. Two months after injury the patient complains of
clawing of the lesser toes and shoe gear irritation. What is most likely cause of this deformity?
Undiagnosed compartment syndrome
Volkmann Contractures
Which of the following techniques would negatively impact function following ankle syndesmosis
repair?
Stabilization of fibula to tibial incisura parallel to frontal plane.
Posterior to anterior angle, 20-30 degrees to frontal plane
A 45-year-old male sustains a crushing-type injury to the left foot. Radio graphs are negative for
fracture and dislocation. Which of the following tests is the most helpful in determining skin flap
viability?
Fluorescein dye study - SPY Elite system
When performing ORIF of a calcaneal anterior process fracture, the avulsion fracture would be found
to have been caused by which of the following anatomic structures?
Bifurcate ligament
Triplane Salter Harris Fracture
TRUE SH 4
Resembles SH 3 fracture on AP views
Resembles SH 2 fracture on lateral views
Need to ORIF!
Tillaux Fracture correlated to What SH fracture?
SH 3
A split thickness skin graft is applied over the lateral heel following flap necrosis after a calcaneal
fracture ORIF. What would be the most appropriate dressing protocol to promote epithelialization
and prevent shear?
negative pressure wound therapy at 75-100mmHg for 5 days.
Latest Update 2024/2025
A 25 year old ballet dancer presents with an 8 month history of ankle pain following an ankle sprain.
On physical exam there is joint swelling and radio graphs are unremarkable physical therapy and
NSAIDs have not reduced her symptoms. What is the next appropriate step in management of this
patient?
MRI
For a one-year-old patient with calcaneal valgus, what is an acceptable treatment plan?
Manipulation and serial casting
A 25-year-old female sustained an inversion ankle sprain 24 hours ago. The area is severely
edematous and ecchymosis. Diagnostic tests reveal rupture of the lateral collateral ligaments. What
should the treatment consist of at this time?
Compression dressing 24 - 48 hours
Which lateral ankle ligaments are intracapsular/extracapsular?
ATFL - Intracapsular
CFL - Extracapsular
PTFL - Strongest, deepest, usually doesn't rupture
A 30-year-old male complains of a painful right ankle after sustaining a forced plantarflexion injury.
Plantarflexion of the foot and dorsiflexion of the hallux greatly exacerbate the symptoms. What is the
most probable diagnosis?
Fracture of the posterior tubercle of the talus.
Which procedure would be the most appropriate management strategy for treatment of a rigid
flatfoot in an infant diagnosed with a pediatric congenital vertical talus deformity?
1. Manipulation and weekly serial casting for 5 weeks 2. Achilles tendon lengthening and TN joint
pinning.
Following a tendon reconstruction of the ankle for lateral ligamentous instability a 30-year-old female
developed a deformity of the big toe. On exam she has full range of motion of the MP joint and good
ankle stability. What is the most likely diagnosis?
Use of peroneus longus tendon for reconstruction.
What is the first step in the open reduction and internal fixation of an ankle pilon fracture?
Restoration of length and fixation of the fibular fracture.
A patient presents with an inversion ankle sprain. Stress inversion radio graphs reveal a 15 degree
difference between the symptomatic and asymptomatic ankle. A peroneal tenogram reveals contrast
media within the ankle joint and extravasation anterior, lateral, and distal to the lateral malleolus.
These findings are consistent with rupture of the:
ATFL
CFL
For PT tendon transfer where should the tendon go?
, Under the retinaculum. Decreases power but prevents bowstringing
Interosseous membrane incision doesn't need to be small to prevent syndesmotic injury
What makes up the syndesmosis?
AiTFL
PiTFL
Interosseous Ligament
What is the most common complication resulting from a Salter-Harris type III fracture of the distal
tibia in a 9-year-old?
Angulation
A patient sustains a comminuted calcaneal fracture. Two months after injury the patient complains of
clawing of the lesser toes and shoe gear irritation. What is most likely cause of this deformity?
Undiagnosed compartment syndrome
Volkmann Contractures
Which of the following techniques would negatively impact function following ankle syndesmosis
repair?
Stabilization of fibula to tibial incisura parallel to frontal plane.
Posterior to anterior angle, 20-30 degrees to frontal plane
A 45-year-old male sustains a crushing-type injury to the left foot. Radio graphs are negative for
fracture and dislocation. Which of the following tests is the most helpful in determining skin flap
viability?
Fluorescein dye study - SPY Elite system
When performing ORIF of a calcaneal anterior process fracture, the avulsion fracture would be found
to have been caused by which of the following anatomic structures?
Bifurcate ligament
Triplane Salter Harris Fracture
TRUE SH 4
Resembles SH 3 fracture on AP views
Resembles SH 2 fracture on lateral views
Need to ORIF!
Tillaux Fracture correlated to What SH fracture?
SH 3
A split thickness skin graft is applied over the lateral heel following flap necrosis after a calcaneal
fracture ORIF. What would be the most appropriate dressing protocol to promote epithelialization
and prevent shear?
negative pressure wound therapy at 75-100mmHg for 5 days.
