Surgical Interventions & Procedures Flashcards

Which type of metatarsal osteotomy is best suited for an elevatus deformity of the lesser metatarsal causing intractable plantar keratosis?

Answer: Weil osteotomy (distal oblique shortening-plantarflexion osteotomy)

The Weil osteotomy is a distal oblique cut that simultaneously shortens and plantarflexes the lesser metatarsal head, relieving the plantar pressure causing intractable plantar keratosis.

A panmetatarsal head resection is most commonly indicated in which patient population?

Answer: Rheumatoid arthritis patients with severe forefoot deformity and multiple plantar ulcerations

Panmetatarsal head resection is a forefoot salvage procedure commonly performed in rheumatoid arthritis patients who have severe, irreducible lesser toe deformities with multiple plantar metatarsal head ulcerations.

During an ankle arthroscopy, the anterolateral portal is created just lateral to which tendon?

Answer: Peroneus tertius or extensor digitorum longus to the 4th toe

The anterolateral ankle arthroscopy portal is established just lateral to the peroneus tertius or the 4th toe slip of extensor digitorum longus to avoid the intermediate dorsal cutaneous branch of the superficial peroneal nerve.

What is the preferred fixation method for a Jones fracture (proximal fifth metatarsal diaphyseal stress fracture) in a high-demand athlete?

Answer: Intramedullary cannulated screw fixation

Intramedullary cannulated screw fixation of Jones fractures in athletes promotes faster healing and earlier return to activity compared to conservative management, which has high nonunion rates.

Which procedure describes a plantar fascia release combined with a calcaneal spur excision performed endoscopically?

Answer: Endoscopic plantar fasciotomy (EPF)

Endoscopic plantar fasciotomy (EPF) uses a two-portal endoscopic approach to release the medial band of the plantar fascia and remove inferior calcaneal spurs under direct visualization.

Which wound closure technique is recommended for a diabetic foot amputation site with marginal tissue perfusion?

Answer: Staged closure: initial open packing followed by delayed primary closure or STSG

In diabetic amputations with compromised perfusion, staged closure — leaving the wound open initially with moist packing, then performing delayed primary closure or skin grafting once viability is confirmed — reduces dehiscence and infection rates.

Which suture material is most appropriate for Achilles tendon repair due to its strength and low reactivity?

Answer: High-tensile nonabsorbable braided suture (e.g., FiberWire or Ethibond)

High-tensile nonabsorbable braided sutures such as FiberWire or Ethibond provide the strength needed to withstand early rehabilitation loads while minimizing tissue reaction in Achilles tendon repairs.