Surgical Interventions & Procedures Flashcards

Which surgical approach is used for open reduction of a Lisfranc fracture-dislocation affecting the medial and middle columns?

Answer: Two parallel dorsal incisions between 1st-2nd and 3rd-4th rays

Two parallel dorsal incisions — one between the 1st and 2nd rays and one between the 3rd and 4th rays — provide optimal exposure for ORIF of Lisfranc injuries while protecting neurovascular structures.

When performing a digital flexor tenotomy for diabetic hammertoe with ulceration, which tendon is released?

Answer: Flexor digitorum longus at the distal phalanx

Percutaneous tenotomy of the flexor digitorum longus at the distal phalanx eliminates the flexion deformity causing tip-of-toe pressure and ulceration in diabetic patients.

What is the definition of an Austin (chevron) osteotomy in hallux valgus surgery?

Answer: Distal metatarsal V-shaped osteotomy with lateral capital fragment displacement

The Austin osteotomy is a distal first metatarsal V-shaped (chevron) cut that allows the capital fragment to be shifted laterally to reduce the intermetatarsal angle.

Which complication is most specific to the tibialis anterior tendon repair compared to other ankle tendon repairs?

Answer: Extensor retinaculum bowstringing if not repaired

When repairing the tibialis anterior tendon, the superior extensor retinaculum must be repaired or the tendon will bowstring across the ankle rather than tracking smoothly.

In a first metatarsophalangeal joint (MPJ) cheilectomy for hallux rigidus, approximately what percentage of the dorsal metatarsal head is resected?

Answer: 25–30%

Cheilectomy removes approximately 25–30% of the dorsal metatarsal head, eliminating osteophytes and impingement while preserving enough articular surface for joint function.

What structure must be repaired to prevent peroneal tendon subluxation after a superior peroneal retinaculum repair?

Answer: Superior peroneal retinaculum (SPR) at the fibular groove

The superior peroneal retinaculum (SPR) must be reattached firmly to the posterior fibular groove to prevent re-subluxation of the peroneal tendons after repair.

Which is the most appropriate surgical treatment for an irreducible acute Lisfranc dislocation?

Answer: Open reduction and internal fixation (ORIF) with screws or plates

Irreducible Lisfranc dislocations require open reduction and internal fixation with screws or bridging plates to restore anatomic alignment and stability.