Foot and Ankle Surgery
What you must understand
Know the anatomy and biomechanics of the ankle, hindfoot, midfoot, and forefoot. Understand common conditions: ankle fractures (Danis–Weber, Lauge–Hansen), Achilles tendon rupture, plantar fasciitis, hallux valgus, and adult-acquired flatfoot. Be fluent in the diabetic foot - Charcot arthropathy, ulceration, and infection. Understand the role of the deltoid ligament and syndesmosis in ankle stability.
Traps in questions
- Weber classification: A (below syndesmosis), B (at syndesmosis), C (above syndesmosis) - C has highest syndesmotic injury risk.
- Achilles rupture: positive Thompson test; gap in tendon; treatment operative or functional bracing.
- Charcot arthropathy: warm, swollen, erythematous foot in a diabetic - distinguish from infection; offloading is key.
- Hallux valgus: first metatarsal varus and great-toe valgus; assess the intermetatarsal angle for surgical planning.
- Plantar fasciitis: medial heel pain, worse with first steps; conservative management first.
Worked rule of thumb
For ankle fractures, restore the mortise - assess the deltoid ligament and syndesmosis. A widened medial clear space on stress views indicates instability requiring fixation.
Exam strategy
Questions often test classification and its treatment implication - know Weber and Lauge–Hansen patterns.