DPM Pediatric Podiatry 2

Question 1

The standard Ponseti protocol for clubfoot typically requires how many weekly casting sessions before tenotomy?

Accepted Answer

5–7 casts

Answer

The Ponseti method typically involves 5–7 weekly plaster casts to gradually correct the cavus, adductus, varus, and equinus components before a percutaneous Achilles tenotomy.

Question 2

Following successful Ponseti casting for clubfoot, what is the recommended bracing protocol?

Accepted Answer

Foot abduction brace (FAB) worn 23 hours/day for 3 months, then nights/naps until age 4–5

Answer

After casting, the foot abduction brace (Mitchell brace) is worn 23 hours/day for the first 3 months, then only during sleep until age 4–5 to prevent relapse, which is the most common complication.

Question 3

Tarsal coalition most commonly occurs between which bones?

Accepted Answer

Calcaneonavicular or talocalcaneal joints

Answer

Calcaneonavicular coalition and talocalcaneal (middle facet) coalition together account for over 90% of all tarsal coalitions.

Question 4

At what age does tarsal coalition typically become symptomatic?

Accepted Answer

8–16 years (adolescence)

Answer

Tarsal coalition becomes symptomatic during adolescence (8–16 years) as the fibrocartilaginous or bony bridge ossifies and limits subtalar motion, causing pain and peroneal spasm.

Question 5

Kohler's disease is osteochondrosis (avascular necrosis) affecting which tarsal bone?

Accepted Answer

Navicular

Answer

Kohler's disease is idiopathic avascular necrosis of the navicular, typically presenting in children ages 4–7 with medial midfoot pain and tenderness over the navicular.

(DPM) Doctor of Podiatric Medicine Practice Test

(DPM) Doctor of Podiatric Medicine Practice Test

DPM Pediatric Podiatry 2