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Foot and Ankle Injuries - Dr. Montijo

4/24/2014

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Picture
The Ankle
- 3 Bones
- 3 Primary Joints 
    - Medial mal with medial talus
    - Tibial plafond with talar dome
    - Lateral mal with lat talus

Ankle Xrays
- Medial clear space --- if over 4mm, its concerning for syndesmotic injury or possible deltoid ligament incompetence 

- Tib-fib clear space --- greater than 5mm is abnormal 

- Bi-mal and Tri-mal fxs often need surgery

- Pilon fractures ---- high injury mechanism!! - Be sure to get additional films to look at tibia, knee and also LUMBAR SPINE

- Pediatric patients are different
     - Ligaments stronger
     - More likely to fracture bone than sprain ligament

The Foot
- Foot has 28 bones
- Divided into hindfoot, midfoot and forefoot
     - Hindfoot controls inversion and eversion
     - Midfoot controls foot abduction and adduction
     - Forefoot controls plantarflexion and dorsiflexion

- Calcaneal fracture --- 10% associated lumbar fractures!!

- Talar neck fractures - very bad injury, minimal blood flow there; often times need OR for reduction  

- LisFranc fracture dislocation - axial load and foot planted.
     - Can be severe or subtle.
     - If concerned for subtle, then get full weight bearing films.

- Jones fx - 5th metatarsal head fracture - Put in post-op shoe or splint, follow up; Majority non-op

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  • RESIDENCY
    • About CMC
    • Curriculum
    • Benefits
    • Explore Charlotte
    • Official Site
  • FELLOWSHIP
    • EMS
    • Global EM
    • Pediatric EM
    • Toxicology >
      • Tox Faculty
      • Tox Application
    • (All Others)
  • PEOPLE
    • Program Leadership
    • PGY-3
    • PGY-2
    • PGY-1
    • Alumni
  • STUDENTS/APPLICANTS
    • Medical Students at CMC
    • EM Acting Internship
    • Healthcare Disparities Externship
    • Resident Mentorship
  • #FOAMed
    • EM GuideWire
    • CMC Imaging Mastery
    • Pediatric EM Morsels
    • Blogs, etc. >
      • CMC ECG Masters
      • Core Concepts
      • Cardiology Blog
      • Dr. Patel's Coding Blog
      • Global Health Blog
      • Ortho Blog
      • Pediatric Emergency Medicine
      • Tox Blog
  • Chiefs Corner
    • Top 20
    • Current Chiefs
    • Schedules >
      • Conference/Flashpoint
      • Block Schedule
      • ED Shift Schedule
      • AEC Moonlighting
      • Journal Club/OBP/Audits Schedule
      • Simulation
    • Resources >
      • Fox Reference Library
      • FlashPoint
      • Airway Lecture
      • Student Resources
      • PGY - 1
      • PGY - 2
      • PGY - 3
      • Simulation Reading
      • Resident Wellness
      • Resident Research
      • Resume Builder
    • Individualized Interactive Instruction