APMLE APMLE Podiatric Surgery and Wound Care 1 — Questions and Answers
Question 1: Which surgical procedure for hallux valgus involves a distal metatarsal osteotomy to correct an elevated intermetatarsal angle?
- Austin (chevron) osteotomy (Correct answer)
- Lapidus procedure
- Keller arthroplasty
- McBride procedure
Correct answer: Austin (chevron) osteotomy
The Austin (chevron) osteotomy is a distal first metatarsal V-shaped osteotomy used to correct mild-to-moderate hallux valgus with an elevated IMA.
Question 2: Which surgical approach is indicated for severe hallux valgus with hypermobility of the first ray?
- Lapidus arthrodesis (first tarsometatarsal joint fusion) (Correct answer)
- Austin osteotomy
- Keller arthroplasty
- Silver procedure
Correct answer: Lapidus arthrodesis (first tarsometatarsal joint fusion)
The Lapidus procedure fuses the first tarsometatarsal joint to address first ray hypermobility in severe hallux valgus.
Question 3: What is the most common complication of calcaneal osteotomy performed for flatfoot reconstruction?
- Lateral plantar nerve injury (Correct answer)
- Non-union
- Avascular necrosis of the calcaneus
- Infection
Correct answer: Lateral plantar nerve injury
The lateral plantar nerve and its branches are at risk during calcaneal osteotomy due to their proximity to the surgical site.
Question 4: Which classification system is used to stage diabetic foot ulcers based on depth and infection?
- Wagner classification (Correct answer)
- Brodsky classification
- University of Texas classification
- Meggitt classification
Correct answer: Wagner classification
The Wagner classification grades diabetic foot ulcers from Grade 0 (pre-ulcer) to Grade 5 (gangrene of the entire foot) based on depth and infection.
Question 5: What is the primary indication for a digital arthroplasty (proximal interphalangeal joint resection) for hammer toe correction?
- Flexible or rigid hammer toe with painful dorsal corn at the PIPJ (Correct answer)
- Mallet toe deformity
- Claw toe with metatarsophalangeal joint subluxation
- Soft tissue digital contracture only
Correct answer: Flexible or rigid hammer toe with painful dorsal corn at the PIPJ
Digital arthroplasty resects the head of the proximal phalanx to relieve the painful dorsal prominence at the PIPJ in hammer toe correction.
Question 6: Which tourniquet pressure is generally used for ankle/foot surgery in a non-obese adult?
- 250–300 mmHg for ankle tourniquet (Correct answer)
- 150 mmHg
- 400–450 mmHg
- 100 mmHg
Correct answer: 250–300 mmHg for ankle tourniquet
An ankle tourniquet is typically inflated to 250–300 mmHg (or 100 mmHg above systolic) for foot and ankle procedures in non-obese adults.
APMLE APMLE Podiatric Surgery and Wound Care 1
Which surgical procedure for hallux valgus involves a distal metatarsal osteotomy to correct an elevated intermetatarsal angle?