ABFAS Clinical Procedures and Protocols 5

Question 1

Which surgical approach is used to access the posterior ankle for os trigonum excision or flexor hallucis longus decompression?

Accepted Answer

Posterolateral approach

Answer

The posterolateral approach between the Achilles tendon and peroneal tendons provides direct access to the posterior ankle compartment while protecting the neurovascular bundle.

Question 2

A patient undergoing foot surgery under spinal anesthesia develops hypotension intraoperatively. What is the first-line intervention?

Accepted Answer

IV fluid bolus and IV ephedrine or phenylephrine

Answer

Spinal-induced hypotension is managed first with IV fluid bolus and vasopressors such as ephedrine or phenylephrine to restore sympathetic tone.

Question 3

When performing a primary repair of a lacerated flexor tendon in zone 2 of the foot, which core suture technique is most commonly used?

Accepted Answer

Modified Kessler suture

Answer

The modified Kessler technique provides strong core suture purchase with minimal disruption of tendon vascularity, making it the standard in zone 2 tendon repairs.

Question 4

Which bone graft substitute contains both an osteoconductive scaffold and demineralized bone matrix (DBM) to provide osteoinductive properties?

Accepted Answer

Combination DBM with calcium sulfate carrier

Answer

DBM combined with a calcium sulfate carrier provides both osteoconductive scaffold properties and osteoinductive growth factors from the demineralized matrix.

Question 5

In which clinical scenario is a transmetatarsal amputation (TMA) the preferred level of amputation for a diabetic foot patient?

Accepted Answer

Full-thickness forefoot infection with viable midfoot and adequate perfusion

Answer

TMA is indicated when infection or necrosis involves the forefoot but viable tissue with adequate perfusion is present at the midfoot level.

(ABFAS) American Board of Foot and Ankle Surgery Practice Test

(ABFAS) American Board of Foot and Ankle Surgery Practice Test

ABFAS Clinical Procedures and Protocols 5