PC Treatment Planning & Management 4

Question 1

A patient with a subungual hematoma involving more than 50% of the nail plate after acute trauma should receive:

Accepted Answer

Trephination of the nail for decompression

Answer

Total nail avulsion only

Answer

Antifungal nail lacquer

Answer

Observation without intervention

Question 2

Which conservative measure is first-line for a Morton's neuroma causing burning pain between the third and fourth metatarsal heads?

Accepted Answer

Metatarsal pad placed proximal to the metatarsal heads to splay them

Answer

Surgical neurectomy

Answer

Custom rigid orthosis with deep heel cup

Answer

Corticosteroid injection as the very first step

Question 3

A 10-year-old presents with a painful limp and flattened, sclerotic navicular on X-ray. The diagnosis is Köhler disease. Appropriate management is:

Accepted Answer

Short-leg walking cast or supportive footwear until symptoms resolve

Answer

Surgical excision of the navicular

Answer

Corticosteroid injection into the navicular

Answer

Immediate non-weight bearing for 2 years

Question 4

When performing chemical matricectomy with phenol for onychocryptosis, the phenol concentration and contact time most commonly used is:

Accepted Answer

88% phenol for 30 seconds applied three times

Answer

10% phenol for 5 minutes

Answer

50% phenol for 2 minutes once

Answer

100% TCA applied once for 1 minute

Question 5

A patient requires a CAM walker after a Jones fracture. When is return to full weight bearing typically permitted without surgical intervention in a non-displaced Jones fracture?

Accepted Answer

6–8 weeks once radiographic healing is confirmed

Answer

2 weeks post-injury

Answer

Immediately with the boot

Answer

Only after MRI shows complete resolution

Question 6

In planning tendon transfer surgery for a patient with a drop foot deformity due to peroneal nerve palsy, the most commonly transferred tendon to restore dorsiflexion is:

Accepted Answer

Tibialis posterior rerouted through the interosseous membrane to the dorsum

Answer

Peroneus brevis to the dorsum of the foot

Answer

Flexor hallucis longus to the anterior tibialis insertion

Answer

Extensor digitorum longus to the calcaneus

Question 7

A 65-year-old patient with well-controlled diabetes presents with a Grade 1 neuropathic ulcer on the plantar first metatarsal head. After debridement, the most important offloading device is:

Accepted Answer

Total contact cast (TCC)

Answer

Soft-soled athletic shoe

Answer

Accommodative foam insole only

Answer

Crutches with no additional offloading device