Adult Acquired Flatfoot (AAF)

In the context of adult-acquired flatfoot deformity (AAFD), what specific biomechanical alteration is most directly correlated with the initiation of peritalar subluxation, predisposing to subsequent progressive collapse?

Which ligamentous structure is most responsible for resisting plantar, medial, and inferior translation of the talar head in relation to the navicular?

In the pathomechanics of progressive collapsing foot deformity (PCFD), what is the most critical initial event that precipitates subsequent structural failures and compensatory adaptations within the foot?

During a weight-bearing clinical examination of a patient with suspected adult-acquired flatfoot deformity (AAFD), what observation would provide the most compelling evidence of advanced forefoot abduction?

What is the most indicative clinical sign that differentiates Stage II from Stage III AAFD according to the Johnson and Strom classification?

The 'Master Knot of Henry' serves as a crucial anatomical landmark with clinical implications for tendon transfers in foot and ankle surgery. What are the anatomical components?

Which of the following statements is most accurate regarding the contribution of equinus contracture to the pathomechanics of adult-acquired flatfoot deformity (AAFD)?

Which of the following components of the deltoid ligament is the primary restraint against eversion and abduction of the talus within the ankle mortise, and is therefore most critical to address in surgical reconstruction for Stage IV AAFD?

Considering the radiographic assessment of adult-acquired flatfoot deformity (AAFD), which measurement best quantifies the degree of uncoverage of the talar head at the talonavicular joint on a dorsoplantar (DP) radiograph?

In the context of conservative management for Stage 1 AAFD, what functional adaptation is most effectively achieved through the prescription of a custom-molded orthotic with a medial heel skive?

According to the Modified Johnson and Strom classification, what is the defining characteristic that distinguishes Stage IIb AAFD from Stage III AAFD?

In the surgical management of stage II AAFD, how does a flexor digitorum longus (FDL) tendon transfer contribute to the overall biomechanical correction?

What primary biomechanical effect is achieved by performing a medializing calcaneal osteotomy in the surgical correction of Stage II AAFD?

In the surgical correction of AAFD, what specific goal is achieved via a Cotton osteotomy of the medial cuneiform?

What is the most important reason that a surgeon should consider performing a silverskiold test on an adult flatfoot patient?

What is the primary objective of a Young's tenosuspension procedure in the context of surgical management for AAFD?

In the surgical treatment of AAFD, which of the following is a primary indication for performing a lateral column lengthening procedure, such as an Evans osteotomy?

During a comprehensive surgical reconstruction for Stage IV AAFD with valgus ankle tilt, what is the most critical component of the procedure plan to ensure long-term stability and prevent recurrence?

What best describes the arc of motion which must be evaluated when assessing the subtalar joint range of motion?

What statement is the most correct as it relates to non-weight bearing examination in the context of an adult planus foot?

What combination of joints might be fused in a stage Three AAFD?

What is NOT a goal of stage one surgical intervention?

While soft tissue procedures may work for stage 1 and 2 of Adult Acquired Flat Foot Deformity, in stage 3, a surgeon must focus on the joints themselves. What would be a proper surgical intervention?

Which of the following accurately explain the characteristics of a stage two surgical treatment?

What would typically NOT occur when dealing with Stage 1 Conservative management?

Identify a difference between Conservative and Surgical Treatment.

The plantar calcaneonavicular ligament is the primary structure in the foot that is responsible, for what action.

What type of non-weight bearing examination is used for examining a flexible pes planus patient?

What classification would most accurately diagnosis a patient with Stage 4 Modified Johnson and Strom AAFD?

In a stage one surgical procedure, which tendon would typically be used for a tendon transfer?

Which statement would best describe a Cotton osteotomy, in respect to AOOFD

In order to assess equinus, what examination procedure must be completed?

While there are multiple surgical options to address a stage two adult acquired planus foot, what common surgical approach would typically NOT be preformed?

What is the mechanical function, in order to eliminate deforming pronatory forces, that the ground reaction forces places on the foot.

In the context of adult-acquired flatfoot deformity (AAFD) correction, what biomechanical rationale underlies the selection of the flexor digitorum longus (FDL) tendon as the preferred tendon for functional transfer in stage Two?

What is critical to ensure long term stability and to prevent recurrence in a AAFD surgery?

What is NOT a characteristic or goal for a stage 1 surgical treatment?

What is the best description that best explains the importance or utility of a Evans osteotomy.

A cotton osteotomy has the potential to help with correction within multiple plains. What compensation would be the intended purpose when completing said osteotomy.

In the context of AAFD etiology, advanced understanding recognizes a complex interplay of factors. Which of the following statements represents the most nuanced understanding of how congenital factors contribute to the DEVELOPMENT of AAFD?

In the pathomechanics cascade of AAFD, consider the intricate relationship between equinus and subsequent joint involvement. Which of the following statements best encapsulates the immediate effect of equinus on the lesser tarsal joints and arches of the foot?

During weightbearing examination, the appreciation of pathognomonic indicators is crucial. Which clinical evaluation maneuver would yield the most SPECIFIC information regarding the integrity and functional capacity of the posterior tibial tendon in a patient with suspected Stage II AAFD?

The Modified Johnson and Strom classification provides a structured framework for AAFD. In discerning between Stage IIb and Stage III AAFD, which physical examination finding represents the MOST critical differentiating factor that dictates treatment strategy?

In the context of Stage II AAFD surgical planning, consider the goals of addressing both the flexible forefoot abduction and the compromised posterior tibial tendon function concurrently. Which of the following surgical interventions BEST addresses the pathomechanics during a Flexor Digitorum Longus procedure?

When surgically addressing Stage II AAFD, a medializing calcaneal osteotomy is often performed in conjunction with other procedures. Which of the following biomechanical effects is the MOST significant rationale in directly restoring functional alignment?

A Cotton osteotomy is a dorsiflexion opening wedge osteotomy of the medial cuneiform. What is the primary goal when utilizing a Cotton osteotomy in AAFD to address multiplanar correction?

In surgical management of AAFD, the Silverskiold test has a crucial diagnostic role. What is the MOST accurate indication and purpose for a surgeon to consider when performing the Silverskiold test?

Young's tenosuspension is considered when surgically addressing AAFD. What is the primary objective?

Lateral column lengthening procedures, such as the Evans osteotomy, are surgical interventions used to address AAFD. What specific scenario/planus foot would the Evans osteotomy be MOST appropriate?

When considering comprehensive surgical reconstruction for Stage IV AAFD, what is most critical to ensure the long term stability of the foot and ankle complex?

When assessing subtalar joint range of motion, what best describes the arc of motion which must be evaluated?

What best describes a non-weight bearing examination in the context of an adult planus foot?

What combination of joints might be fused when surgically addressing a stage Three AAFD?

Which of the following is NOT a considered goal of a stage one surgical intervention for AAFD?

Which of the following accurately explains the characteristics of a stage two surgical treatment for AAFD?

Following Stage 1 Conservative management, what would typically NOT occur?

What is a key difference between Conservative and Surgical Treatment for correction of AAFD?

Which of the following would be the most accurate Modified Johnson and Strom diagnosis for an AAFD patient?

While there are multiple surgical options to address a stage two adult acquired planus foot, what surgical approach would typically NOT be preformed?

When performing a surgical reconstruction, what is critical to ensure long term stability and to prevent recurrence in a AAFD surgery?

What is NOT a characteristic or goal for a stage 1 surgical treatment for AAFD?

What is the description that is the best explanation of the utility or purpose of an Evans osteotomy?

The posterior tibial tendon is responsible for what action within the foot?

What anatomical components form the 'Master Knot of Henry'?

Which of the following is the primary function of the deltoid ligament?

What is the clinical relevance of the spring ligament in the context of adult-acquired flatfoot deformity (AAFD)?

Which of the following is considered a potential etiological factor in the development of adult-acquired flatfoot deformity (AAFD)?

According to the presented pathomechanics of AAFD, what is the immediate effect of equinus on the foot?

What observation found during a clinical examination might indicate AAFD?

What is the significance of 'Too-Many-Toes Sign' during a weightbearing exam?

During the double heel-rise test which components should be implemented?

Why is the single heel-rise test useful?

What examination process should be utilized when examining a posterior tibial tendon, in a non-weightbearing examination?

The Silverskiold test helps to identify a limitation in ankle joint dorsiflexion. What is the silverskiold test assessing?

When preforming a subtalar joint range of motion examination, what position would the patient be in?

During a non-weightbearing exam, regarding the rearfoot alignment, what normal or abnormal condition would be noted?

What radiographic finding is consistent with an abnormal lateral talocalcaneal angle (Kite's angle)?

When evaluating a lateral radiograph of the foot, what is considered a normal calcaneal pitch?

What is the proper terminology to be used when the navicular is in an abnormal position in respect to the talus?

The modified Johnson and Strom classification system is utilized for what diagnosis?

What type of foot deformity is noted in a patient with Stage 1 of the Modified Johnson and Strom classification?

In the Modified Johnson and Strom classification for AAFD, what characteristic is unique to Stage IIb?

In stage 2 AAFD, what deformity is noted upon examination?

During the single heel raise test, a surgeon notes marked weakness. What stage of AAFD could this be?

In stage three AAFD, the deformity will present as _________.

What foot deformity classification would a patient receive if their ankle alignment examination found valgus alignment?

According to the Modified Johnson and Strom classification, what surgical intervention is typically recommended for Stage IIb AAFD, in addition to a FDL tendon transfer and medial slide osteotomy?

What surgical procedure is sometimes preformed when addressing stage two AAFD, in order to elevate the first ray?

According to the surgical treatment for Stage II AAFD, which procedure is considered?

What is a typical surgical procedure performed for Stage 2 surgical treatment?

What would NOT be a treatment option for conservative treatment for stage two AAFD?

According to an Evans osteotomy mechanics, what structure moves move as a unit?

If performing a medializing calcaneal osteotomy, that is intended to help a patient with <30% uncoverage, what other clinical presentation must also be present?

What structure is stabilized when a Naviculo-Cuneiform Arthrodesis is completed?

What is the main goal when completing a medial cuneiform Cotton Osteotomy?

A flexor digitorum longus (FDL) tendon transfer is sometimes utilized in AAFD repair. The transferred portion of the FDL provides what percentage of posterior tibial tendon strength?

In stage 3 AAFD surgical treatment, which of the following is a potential surgical correction?

A patient is diagnosed with stage four AAFD, what is typically included with this surgical treatment plan?

What would be utilized to passively correct forefoot abduction?

A patient is found to need 'Essential Joint Sparing'. What stage surgical treatment option do they need?

What is the most predictable component to address with AAFD stage 4: surgical intervention?

A patient is diagnosed with Moderate tendon, moderate tenderness and the surgeon diagnoses the patient with Stage 2 AAFD, regarding the FDL, what pathological feature can be expected?

When is gastrocnemius recession indicated?

What procedure does NOT improve STJ motion?

What action does the posterior tibial tendon assist, regarding the subtalar joint?

In addition to inverting the subtalar joint (STJ), what additional foot action does the posterior tibial tendon provide?

What is the primary anatomical landmark which is utilized in a Flexor Digitorum Longus tendon transfer?

The deltoid ligament complex resists which of the following?

Damage to the spring ligament is an important component of what type of foot deformity?

Which of the following is considered a possible etiological factor in the development of adult acquired flatfoot deformity?

In the pathomechanics of adult acquired flatfoot deformity, what is the effect of equinus on the calcaneus?

On a lateral radiograph, where is the position of the calcaneus in relation to the talus and leg, when considering ground reactive forces?

Which of the following clinical presentations might indicate adult acquired flatfoot deformity?

Which of the following should be avoided during a weight bearing exam?

Lateral skin wrinkles are pathognomonic for what clinical presentation?

What is the significance of the 'Too-Many-Toes' sign during a weightbearing exam?

During the double heel-rise test, what key components should be implemented?

The Silverskiold test helps to identify a limitation in ankle joint dorsiflexion. What is the Silverskiold test assessing, specifically?

According to Evan's osteotomy mechanics, what structure moves as a unit?

What structure is anatomically stabilized when a Naviculo-Cuneiform Arthrodesis is completed?

What would be a surgical contraindication when considering Gastrocnemius Recession?

What is the primary function of the Posterior Tibial Tendon?

Forefoot abduction is caused by the Posterior Tibial Tendon.

The Flexor Digitorum Longus transfers at the ______.

Which ligament is a critical component of the medial ankle and is assessed in the context of adult-acquired flatfoot?

The spring ligament's integrity is not a significant factor in adult flatfoot deformity.

What term describes the position of the navicular relative to the talus in dorsolateral peritalar subluxation?

Match the following etiologies with their descriptions related to adult-acquired flatfoot deformity:

Which of the following best describes the initial direction of pain associated with posterior tibial tendon dysfunction?

The 'too many toes' sign indicates forefoot adduction

During the double heel rise test, the patient must start with their ______ on the ground.

According to the American College of Foot and Ankle Surgeons, is the single heel raise test considered pathognomonic for diagnosing symptomatic adult-acquired flatfoot resulting from posterior tibial tendon insufficiency?

The strength of the posterior tibial tendon is assessed during a weightbearing exam.

What type of equinus is assessed using the Silversköldt test?

Match the following terms with whether they describe a normal or abnormal foot:

What does dorsolateral peritalar subluxation specifically refer to?

The Modified Johnson and Strom Classification is only used for congenital flatfoot deformities.

According to the Modified Johnson and Strom Classification, a foot with a fixed deformity involving the triple-joint complex is classified as Stage ______.

What is a primary goal of Stage 1 conservative treatment for adult-acquired flatfoot deformity?

An Arizona brace is more commonly used in stage 1 conservative treatment, compared to stage 2.

What surgical procedure is initially considered for Stage 1 surgical treatment to address equinus?

Match the following surgical procedures to their corresponding stage of AAFD based on the Modified Johnson and Strom classification:

In the context of flatfoot surgery, what is the primary purpose of an Evans calcaneal osteotomy?

A Medializing Calcaneal Osteotomy is recommended for patients with greater than 30% talonavicular uncoverage.

A dorsally-based wedge opening osteotomy of the medial cuneiform is also known as a ______ Osteotomy.

When performing an FDL transfer, what percentage of the posterior tibial tendon strength is typically expected from the transferred FDL?

Spring ligament augmentation is used for Stage 4 surgical treatment.

What type of brace is typically used for Stage 3 conservative treatment?

Match the following Modified Johnson and Strom stages with the appropriate surgical goals:

What does the term 'equinus' refer to?

Double Arthrodesis can be considered a Stage 1 surgical correction.

In a normal lateral talocalcaneal angle, also known as ______ angle, is about 35 degrees.

A patient presents with an abnormal lateral talocalcaneal angle of 47 degrees. What does this suggest?

The Cyma Line is normal in flatfoot deformity.

What is the relationship between PTT dysfunction and overpull of PB (Peroneus Brevis)?

Indicate at which Modified Johnson and Strom Stage these findings area observed:

What is the goal of the Flexor Digitorum Longus (FDL) transfer when addressing adult-acquired flatfoot deformity?

The use of an ankle arthrodesis is a surgical option for late stage AAFD.

A heel that cannot be passively dorsiflexed past neutral is termed ______.

During a weightbearing examination, which of the following observations would suggest an adult-acquired flatfoot deformity?

The subtalar joint in AAFD is flexible.

Which of the following is NOT a characteristic of adult-acquired flatfoot deformity?

The posterior tibial tendon everts the subtalar joint.

What anatomical structure does the Flexor Digitorum Longus (FDL) transfer often utilize as a transfer site in flatfoot reconstruction?

The deep posterior tibiotalar ligament attaches from the tibia to the ______.

Match the following ligaments with their corresponding location:

According to the American College of Foot and Ankle Surgeons (ACFAS) Clinical Consensus Statement, spring ligament damage is considered what in the management of adult acquired flatfoot deformity?

Trauma is not considered a potential cause of adult-acquired flatfoot.

What term describes the position of the calcaneus relative to the talus and leg in ground reactive forces that contribute to flatfoot deformity?

In pathomechanics, increased stress on the posterior tibial tendon and __________ contributes to the development of flatfoot.

Match the following terms with their roles in flatfoot pathomechanics:

What is the typical initial symptom reported by patients with progressive collapsing foot deformity?

When examining a patient for flatfoot, external rotation of the leg should be encouraged to get a better view of the arch.

What specific visual finding on weightbearing examination suggests impingement in the sinus tarsi area in advanced flatfoot?

On physical exam, forefoot abduction is assessed by the 'Too-Many-Toes' sign, which indicates the number of ______ visible from a posterior view.

Match the key components of the Double Heel Rise Test:

According to the American College of Foot and Ankle Surgeons Clinical Consensus Statement, a single heel raise is defined as?

In a non-weightbearing exam, only the strength of the posterior tibial tendon should be assessed.

What specialized exam assesses gastrocnemius tightness separate from soleus tightness?

In spring ligament assessment, the foot is manipulated prone or ______.

Match the following terms to their descriptions:

In a non-weightbearing exam, what structural foot characteristic may be noted?

A normal lateral talocalcaneal angle, also known as Kite's angle, typically measures around 55 degrees.

In dorsolateral peritalar subluxation, the position of what bone is being referred to in relation to the talus?

According to the Modified Johnson and Strom Classification, the presence of an ankle deformity, notably lateral talar tilt, categorizes the flatfoot as Stage ______.

Match each Modified Johnson and Strom Classification stage with its corresponding description:

PTT Swelling/Tenderness is defined as what in Stage 1?

In stage 2 Conservative Treatment, goals include slow deformity.

During Stage 1 Surgical Treatment, what is addressed?

During Stage 2 Surgical Treatment, a ___________ procedure can be implemented.

Match Goals and Options for Stage 1 Conservative Treatment:

According to the Modified Johnson and Strom Classification, which of the following surgical treatments is most appropriate for a Stage IIb flatfoot deformity?

Evans osteotomy lengthens the lateral column.

Medializing Calcaneal Osteotomy medializes the insertion of what tendon?

In reference to FDL transfer, FDL tranfer is about _____ % strength of PPT.

Pantalar arhtrodesis refers to arthrodesis of the ankle plus [Blank] joints.