Core Knowledge in Orthopaedics: Foot and Ankle

Pediatric Foot and Ankle Disorders

KEY FACTS Clubfeet can be idiopathic or syndromic. Initial treatment in almost all cases should be Ponseti casting, even if the patient presents outside of infancy, as casting can be quite effective. Surgery is reserved for those cases in whom…

Amputations

KEY FACTS General Amputation and disarticulation should be viewed as reconstructive procedures and not a failure of treatment. In this manner, one realizes that it is the initial step in getting patients back to their previous functional status. Indications for…

Tumors of Foot and Ankle

KEY FACTS Foot and ankle tumors are relatively rare entities but must be kept in the differential diagnosis of musculoskeletal complaints in that area. The overwhelming majority of bone and soft tissue tumors in the foot and ankle are benign,…

Metatarsal Fractures

KEY FACTS Toe and metatarsal fractures are the most common fractures of the foot with an incidence of 140 per 100,000 per year. The 5th metatarsal is the most frequently fractured metatarsal (23%). The metatarsals are affected by stress fractures…

Lisfranc and Midfoot Injuries

KEY FACTS The midfoot includes 5 tarsal bones: Navicular, cuboid, and 3 cuneiforms (medial, 1st; middle, 2nd; and lateral, 3rd). Mobile or "essential" midfoot joints include: Talonavicular Calcaneocuboid Cuboid: 4th and 5th metatarsals Nonmobile or "nonessential" midfoot joints include: Naviculocuneiform…

Navicular and Cuboid Fractures

KEY FACTS Navicular Fractures Three types of navicular fractures generally occur: Avulsion fractures, high-energy fractures with other associated injuries, and stress fractures. Avulsion fractures can generally be treated nonoperatively, except in those cases in which the fragment is large enough…

Talus Fractures

KEY FACTS The talus is the 2nd most commonly fractured tarsal bone (after the calcaneus). The blood supply of the talus can be tenuous, as there are limited spaces at which vessels can enter the bone, given its morphology and…

Calcaneus Fractures

KEY FACTS Calcaneus fractures account for ~ 2% of all fractures. The calcaneus is the most frequently fractured tarsal (hindfoot) bone. It represents 60% of all tarsal fractures. Minor avulsion fractures off anterior process are common and usually benign. Most…

Tibial Pilon Fractures

KEY FACTS The tibial pilon fracture is a rare, yet devastating injury. Despite the best treatment, patients sustaining high-energy pilon fractures generally do not return to their previous state of general health or function. After recovery from pilon fractures, many…

Ankle Fractures

KEY FACTS The treatment of ankle fractures is chiefly concerned with mitigating and minimizing the risk of posttraumatic arthritis. The relative stability of an ankle fracture will ultimately determine whether surgical intervention is warranted. Supination-external rotation ankle fractures are the…