Bunion Deformities and Hallux Valgus

In the context of assessing sagittal plane mobility at the first metatarsophalangeal joint (MTPJ), what clinical finding would most strongly suggest underlying generalized ligamentous laxity, potentially influencing the biomechanical approach to hallux abducto valgus (HAV) correction?

During physical examination of a patient with hallux abducto valgus (HAV), assessment of transverse plane mobility is crucial. Which statement accurately reflects the expected findings and their clinical implications?

When evaluating the quality of motion at the first metatarsophalangeal joint (MTPJ) in a patient with hallux abducto valgus (HAV), what clinical finding is most indicative of structural adaptation of the articular cartilage, which may influence surgical decision-making?

In the evaluation of the axis of motion at the first metatarsophalangeal joint (MTPJ) in hallux abducto valgus (HAV), which observation during physical examination would prompt the consideration of lateral soft tissue release as an initial step?

A patient presents with a pinch callus under the second metatarsal. What specific pathomechanics is most likely influencing the formation of this pinch callus?

What radiographic projection is critical for accurately evaluating the degree of sesamoid subluxation and crista erosion in the context of hallux abducto valgus (HAV) deformity?

When evaluating radiographic parameters for hallux abducto valgus (HAV), what is the clinical implication of an elevated Metatarsus Adductus Angle (MAA) exceeding 35 degrees?

What is the primary advantage of obtaining weightbearing radiographs when assessing hallux abducto valgus (HAV) compared to non-weightbearing radiographs?

In a patient presenting with hallux abducto valgus (HAV) and a hallux interphalangeus angle (HIAA) of 12 degrees, which of the following statements is most appropriate?

Surgical correction of hallux abducto valgus (HAV) aims to restore normal anatomy and biomechanics. Which osteotomy is least likely to correct the PASA?

A surgeon is planning a McBride bunionectomy for a patient with hallux abducto valgus (HAV). Which of the following steps is considered a component of the classical or 'true' McBride procedure but is now largely avoided due to increased risk of complications?

What is the impact of the Silver bunionectomy on deformity correction?

In the context of understanding blood supply to the first metatarsophalangeal joint (MTPJ), which surgical approach minimizes the risk of iatrogenic avascular necrosis (AVN) to the first metatarsal head?

What negative outcome can result from 'staking' the metatarsal head during a silver bunionectomy?

A patient with a complex hallux abducto valgus (HAV) deformity undergoes a Lapidus procedure. Postoperatively, the patient develops persistent pain and radiographic evaluation reveals a non-union at the tarsometatarsal joint and nerve entrapment. What mechanical factor is most likely contributing to the non-union in this scenario?

Which of the following statement accurately reflects a key technical consideration during a Silver bunionectomy?

In the context of proximal phalangeal osteotomies for hallux abducto valgus (HAV) correction, an oblique Akin osteotomy, known for its ability to accommodate screw fixation, is described as a 'cheater' Akin. What does this term imply?

What is the primary factor in determining the type of distal metatarsal osteotomy?

A patient presents with hallux abducto valgus, elevated intermetatarsal angle (IMA), and radiographic evidence of metatarsus primus elevatus. Which surgical procedure addresses all three components of this deformity?

When performing a medial capsulorrhaphy to tighten the medial joint capsule during hallux abducto valgus (HAV) correction, which statement accurately reflects a critical component for optimizing surgical outcome?

A surgeon is considering a distal metatarsal osteotomy (DMO) for hallux abducto valgus (HAV) correction. Which characteristic explicitly prohibits correction of the frontal plane using DMO?

In the context of distal metatarsal osteotomies (DMOs), what is the key distinction between a unicorrectional and a bicorrectional osteotomy?

When performing a SCARF osteotomy for hallux abducto valgus (HAV) correction, what specific complication related to the capital fragment might arise during surgical execution?

During a Lapidus procedure, a surgeon aims to achieve multiplanar correction of hallux abducto valgus (HAV). What statement reflects the most significant advantage when compared to other HAV correction?

Ankle Equinus influence on Bunion?

A patient develops iatrogenic hallux varus following surgical correction of hallux abducto valgus (HAV). If revision surgery is being considered while preserving the joint, what does this indicate?

What is a transverse plane instability at the first MTPJ?

A 46-year-old female presents with a left bunion. She is having difficulty finding shoes that fit, and has substantial pain. She has tried many conservative treatments, and has no remarkable PMH. PE reveals a severe HAV deformity with a hypermobile first ray, and the ROM of the hallux is track-bound without crepitus. What should be the next step?

A 42-year-old female presents with a right bunion with severe HAV deformity and hypermobile first ray with a history of gastric bypass surgery. Conservative measures have failed. Which step would most likely be involved in the treatment?

A patient presents to your practice complaining of bunion pain with a history of having a gastric bypass. Recognizing the potential impact from the bypass, you order bloodwork. What kind of vitamin deficiency would you be most concerned in terms of its influence on both bone quality and nerve health?

What is a main concern with the Kalish osteotomy

What structural change occur in hallux varus when the hallux assumes the adducted plane?

A 68 year old female needs a bunionecotomy, what should you do?

What should be done during the first step of bunion evaluation?

What view do you view tibial sesamoid?

When would DMO be performed?

A patient undergoes Keller resection, what are their potential complications?

After performing a bunionectomy, what complication can you expect?

What two nerves are you concerned about transection during bunion surgery?

What does reefing a capsule imply, during surgery?

A patient with a severe hallux abducto valgus (HAV) deformity exhibits radiographic evidence of an 'atavistic' medial cuneiform. Which statement best elucidates the clinical implications of this finding?

In the context of hallux abducto valgus (HAV) correction, which of the following statements most accurately correlates the clinical relevance of the metatarsal head shape with the biomechanical function and stability of the first metatarsophalangeal joint (MTPJ)?

When evaluating radiographic parameters in hallux abducto valgus (HAV), an elevated Metatarsus Adductus Angle (MAA) exceeding 35 degrees presents a significant challenge to comprehensive deformity correction. What surgical consideration is most appropriate?

A patient undergoing hallux abducto valgus (HAV) correction exhibits a pre-operative Distal Articular Set Angle (DASA) significantly outside the normal range. Which statement reflects the most critical surgical implication of this finding?

In the context of hallux abducto valgus (HAV) surgery, what is the most critical implication to the surgeon of overtightening the medial capsule?

In scenarios necessitating isolated medial eminence resection, like the Silver procedure, preserving the tibial sesamoid articulation is paramount to prevent a specific complication. What intraoperative error should be avoided?

A surgeon, attempting to re-establish a congruent first metatarsophalangeal joint (MTPJ) following distal metatarsal osteotomy (DMO) for hallux abducto valgus (HAV), overlooks a pre-existing lateral soft tissue contracture. What outcome is most likely?

A 46-year-old female presents with left bunion pain, a severe HAV deformity, a hypermobile first ray and track-bound without crepitus. Shoe-gear and custom orthotics did not help sufficiently . What is the most likely next step?

In performing Keller resection what is the result of complete resection?

In a patient with a progressive hallux abducto valgus deformity where conservative treatments have failed, and radiographic assessment reveals a significantly elevated hallux interphalangeus angle (HIAA) exceeding 20 degrees, What step should be taken?

During a modified McBride bunionectomy, what anatomical structure requires meticulous identification and protection to prevent iatrogenic complications?

During a Lapidus procedure, what is the surgeon's primary goal in correcting frontal plane rotation of the first metatarsal, and how is this achieved?

When performing a distal metatarsal osteotomy (DMO) for hallux abducto valgus correction, which of the following is an absolute contraindication?

In the context of performing a medial capsulorrhaphy as part of hallux abducto valgus (HAV) correction, reefing the capsule implies what surgical maneuver, and what biomechanical principle does it aim to restore?

What are the steps of a true McBride Bunionectomy?

Hallux Varus assumes what kind of position?

What are the primary goals of a Lapidus procedure in the context of hallux abducto valgus (HAV) correction, and how does it achieve multiplanar stability?

In performing distal metatarsal osteotomies (DMOs) for hallux abducto valgus (HAV) correction, surgeons must distinguish between unicorrectional and bicorrectional techniques. At which plane does this distinction occur?

What are the benefits and drawbacks of using the Kalish osteotomy?

Which statement best describes the primary objective of metatarsal osteotomies?

In a patient status post bunionectomy, what are the two main nerves of concern, relative to the transection, during surgery?

In instances when structural adaption of the articular cartilage occurs, what can that lead to?

How is Hallux Interphalangeus diagnosed in radiographic evaluation?

Why must radiorgraphs be weight bearing when dealing with bunion?

In evaluating hallux abducto valgus, how would hypermobility be measured?

When performing a SCARF osteotomy, what surgical error can be made?

With DMO which is Versatility?

What is reefing?

True or False. Silver Bunionectomy has deformity correction.

What was part of the original procedure for Akin when it was described in 1925?

What radiographic parameter should be assessed when taking the first step in bunion evaluation?

What is the next step after seeing a severe HAV deformity with a hypermobile first ray, on a 42 year old female with a history of gastric bypass?

If you have a long and mildly elevated 1st metatarsals, what should you perform?

What should a surgeon do to remove the medial prominence, or a Silver procedure?

Structural deformity within the hallux, are hallux is Hallus Interphalangeus or is it

Metartsal length can be adjuste with which one?

Which vitamin deficiency is commonly seen with bypass surgery, and should be assessed when thinking about bones?

The Modified McBride bunionectomy is more common how?

True or False: is first MTPJ fusion appropriate even with a non-arthritic joint?

Are you able to correct for the lateral plane with Scarf?

In a complex revision case following a failed Lapidus procedure with persistent non-union, what adjuvant surgical intervention, beyond standard bone grafting and internal fixation augmentation, would most directly address compromised intrinsic vascularity at the fusion site?

A patient exhibiting a hallux abducto valgus (HAV) exhibits radiographic evidence of an atavistic medial cuneiform configuration. How would you evaluate this radiographic finding?

During a SCARF osteotomy for hallux abducto valgus (HAV) correction, excessive 'troughing' is observed intraoperatively. This error inadvertently causes which of the following:

A surgeon is planning a Lapidus procedure for a patient with severe hallux abducto valgus (HAV) and noted hypermobility. Considering current evidence-based practice, what adjunctive measure would best mitigate the risk of recurrent deformity and maximize long-term stability?

A patient presents with a painful, recurrent hallux abducto valgus (HAV) deformity several years after undergoing a McBride bunionectomy with fibular sesamoidectomy. Radiographic evaluation reveals significant hallux varus, negative intermetatarsal angle, and degenerative changes at the first metatarsophalangeal joint (MTPJ). What revisional procedure offers the most predictable and biomechanically sound long-term solution?

A 42-year-old female with a history of gastric bypass presents with severe hallux abducto valgus (HAV). Recognizing potential complications related to her prior surgery, what bloodwork would be most beneficial to assess before surgical intervention?

In the context of a Lapidus procedure, meticulous reduction and maintenance of first metatarsal alignment are paramount. Intraoperatively, how can a surgeon best ensure accurate rotational alignment of the first metatarsal in the transverse plane relative to the lesser tarsus?

A 68-year-old female who is an avid caregiver for multiple cats presents for bunion evaluation. Considering her age and lifestyle, what modifications should be done?

In a patient undergoing hallux abducto valgus (HAV) correction with an elevated Metatarsus Adductus Angle (MAA) exceeding 35 degrees, what must be considered about performing a metatarsus adductus correction?

During surgical planning for hallux abducto valgus (HAV) correction, a surgeon notes the patient's first metatarsal head exhibits a significantly rounded shape on radiographs. How best would you interpret this shape?

A surgeon is about to perform a distal metatarsal osteotomy (DMO) for hallux abducto valgus (HAV) correction. Which intraoperative assessment would absolutely contraindicate proceeding with a DMO?

A patient who underwent a hallux abducto valgus (HAV) correction now demonstrates a hallux that assumes an adducted position in the transverse plane. What change in the hallux structures happened?

When performing a medial capsulorrhaphy, reefing of the capsule implies

Which statement is most accurate regarding the classification of distal metatarsal osteotomies (DMOs) as unicorrectional or bicorrectional?

During a true McBride bunionectomy what anatomical structure will be excised or resected?

A 46-year-old female presents with a painful left bunion. Physical examination reveals a severe hallux abducto valgus (HAV) deformity with a hypermobile first ray, and the hallux is track-bound without crepitus. Shoe-gear modifications and custom orthotics have provided insufficient relief. What should you consider?

Which statement best articulates the overarching objective of metatarsal osteotomies performed for hallux abducto valgus (HAV) correction?

In the context of hallux abducto valgus (HAV) surgery, what is the most critical implication of overtightening the medial capsule?

Hallux varus assumes what position?

While performing a Silver bunionectomy, you must preserve the medial groove (tibial sesamoid articulation) because do not

A normal sagittal plane position demonstrates 20 mm total, with 10 mm dorsiflexion & 10 mm plantarflexion.

Hypermobility in the sagittal plane is associated with what total excursion?

What is the first step to correcting ROM when tracking is largely dependent on lateral soft tissue contracture?

Increased HIAA is hallux ______________.

Which of the following radiographic views must always be taken weightbearing?

What is the normal reference value for the Hallux Abductus Angle (HAA)?

A normal Distal Articular Set Angle (DASA) is 15-20 degrees.

Which tibial sesamoid position is considered normal on radiographic evaluation?

Which of the following joint positions is characterized by lines that intersect inside the joint space on radiographic evaluation?

Which metatarsal head shape is considered the most unstable on radiographic evaluation?

Medial cuneiform obliquity is considered stable.

What term describes a modification of a biological structure whereby an ancestral genetic trait reappears after having been lost through evolutionary change?

Match the following anatomical structures with their corresponding labels:

The adductor hallucis tendon inserts along the fibular sesamoid and the __________ phalanx.

Which of the following is a surgical indication for bunion correction?

A Silver bunionectomy is a soft tissue procedure that includes deformity correction and reduction of the IMA.

What factor makes proper orientation important during saw use while resecting the medial eminence of the Silver Bunionectomy procedure?

What is a potential risk associated with fibular sesamoidectomy?

During medial first MTPJ capsulorrhaphy, what nautical term describes folding a sail to reduce surface area?

Which proximal phalangeal osteotomy is described as needing further correction following the initial procedure?

In the context of hallux abducto valgus (HAV) surgery, what does DMO stand for?

Distal metatarsal osteotomies can correct frontal plane deformity.

Which of the following is a type of distal metatarsal osteotomy?

Which of the following osteotomies can correct PASA?

The Reverdin-Laird osteotomy spares the sesamoid articulations.

Which osteotomy is useful for long and mildly elevated 1st metatarsals?

Which of the following is a metatarsal shaft osteotomy?

A Kalish osteotomy can correct PASA.

What term describes a specific complication of the traditional scarf osteotomy that causes elevation of the capital fragment?

Which of the following is a component of triplanar correction achieved with a Lapidus procedure?

After a Lapidus procedure, patients are traditionally non-weightbearing for 1-2 weeks.

In which scenario may a 1st MTPJ fusion be more appropriate?

Hallux assumes an adducted position in the transverse plane in hallux _________.

What general principle is critical to avoid iatrogenic hallux varus?

What is a treatment aption for iatrogenic hallux varus?

Hypermobility of the first ray is always present in cases of severe HAV deformity.

A radiographic finding of a DASA greater than 12 may be indicative of which structural deformity within the hallux?

Post-op course after a Silver bunionectomy is based on _______________ of the incision.

A 42-year-old female who presents with a right bunion and a history of gastric bypass surgery poses a challenge for ideal bunion correction. Which of these factors is most likely to be the challenge?

An elderly patient presents for painful bunion deformity. She has no remarkable findings. What can you expect from exam findings?

Increased HAV mobility is generally associated with decreased transverse plane mobility

What is being evaluated when assessing the quality of 1st MTPJ motion through full ROM in both the deviated and corrected positions during a physical exam?

What does crepitus indicate during physical examination of the 1st MTPJ?

Poor quality of motion during physical examination of the 1st MTPJ is typically indicative of structural _____________ of cartilage.

A normal sagittal plane position allows for a total excursion of 20 mm (10 mm dorsiflexion & 10 mm plantarflexion).

Hypermobility in the sagittal plane is often associated with which condition?

What does crepitus during the physical examination of the 1st MTPJ suggest?

Inability to adduct the hallux indicates a track-bound condition.

Tracking is largely dependent on the lateral soft tissue ______.

What is often the first step to correct ROM when tracking is present?

What does a pinch callus typically indicate?

What does a Sub 2nd met lesion most likely indicate?

Radiographs for HAV should be taken without weightbearing to accurately assess 'angles and dangles.'

What is a normal range for the Hallux Abductus Angle (HAA)?

An increased Hallux Interphalangeal Abductus Angle (HIAA) indicates which condition?

What is the normal range (in degrees) for the Proximal Articular Set Angle (PASA)?

The normal range for the Distal Articular Set Angle (DASA) is 0-5 degrees.

What is considered a normal Metatarsal Protrusion Distance?

In radiographic evaluation, a tibial sesamoid position of '1' indicates what?

Match the joint positions with their radiographic characteristics:

Which metatarsal head shape is considered the most unstable?

An 'atavistic' cuneiform refers to an unusually stable medial cuneiform alignment.

What anatomical structure is represented by 'C' in the provided diagram?

The adductor hallucis tendon inserts along the fibular sesamoid and the [blank] phalanx.

Which surgical approach is typically used in the described bunion correction?

According to the material provided, deformity is NOT a recognized surgical indication for bunion correction.

Match the following surgical procedure categories with their descriptions:

Which of the following is TRUE regarding deformity correction in a Silver bunionectomy?

A Silver bunionectomy is appropriate if the goal is to remove the medial ______ only.

What must be preserved when resecting the medial eminence during a Silver bunionectomy?

A key step in a McBride bunionectomy procedure involves bone grafting at the MTPJ.

Steps of a Modified McBride procedure includes:

Medial capsulorrhaphy involves reefing, which is similar to what?

After an Akin procedure is performed at the proximal phalanx, what deformity does it correct?

What does DASA stand for?

Oblique Akin is popular because it's easy to correct the PASA.

Which of the following DMO procedures can correct intermetatarsal angle?

The Reverdin osteotomy corrects the ______ but violates the sesamoid articulation.

Reverdin-Laird spares sesamoid articulation

Which osteotomy is useful for a long and mildly elevated first metatarsal?

Which of the following is a triplanar correction?

Positioning during MTPJ fusion is not critical and can be adjusted during the procedure.

What is a common complication of HAV correction, resulting in an adducted position of the hallux?

Excessive medial ______ can lead to iatrogenic hallux varus.

Overcorrection of a bunion always results in a successful outcome; true of false?

What is the normal total sagittal plane position excursion during a physical examination for HAV?

Hypermobility in the sagittal plane during physical examination is defined as greater than 15 mm total excursion and is often associated with generalized ligamentous laxity.

In the context of hallux abducto valgus (HAV), what does 'tracking' refer to during a physical examination?

During the physical examination of a patient with a suspected bunion, the entirety of the 1st ______ should be palpated for symptoms.

A pinch callus on the foot indicates what?

Radiographs for evaluating hallux abducto valgus (HAV) deformities should always be non-weightbearing to accurately assess the angles and alignment.

What range defines a normal Metatarsus Adductus Angle (MAA)?

Match the Intermetatarsal Angle (IMA) ranges with the correct classification.

What is the reference value for a normal hallux abductus angle (HAA)?

What is the normal range for the Proximal Articular Set Angle (PASA)?

A Distal Articular Set Angle (DASA) of 15 degrees is considered within normal limits.

In radiographic evaluation, a tibial sesamoid position value of ______ is considered normal.

What type of joint position is defined by lines that intersect inside the joint space on radiographic evaluation?

According to the information provided, what type of blood supply can be found within the safe zone for osteotomy.

The Silver bunionectomy is an isolated procedure that corrects deformity and reduces IMA.

What is the primary goal when performing a Silver bunionectomy?

What complication is associated with fibular sesamoidectomy?

Reefing during a medial first MTPJ capsulorrhaphy is a ______ term referring to folding a sail to reduce surface area.

Which of the following Distal Metatarsal Osteotomies (DMO) spares the sesamoid articulations, corrects PASA, and keeps the lateral cortex intact?