Basic Science & Miscellaneous

Question 1

36-year-old man who has progressive wasting of his intrinsics in the hand with progressive bilateral cavovarus feet. What genetic disease is this?

Answer 1

Charcot-Marie-Tooth - hereditary motor-sensory neuropathy

Question 2

36-year-old man who has progressive wasting of his intrinsics in the hand with progressive bilateral cavovarus feet. What is the sequence of weakness in his ankle/foot? How does this weakness affect the position of the foot?

Answer 2

1. Anterior tibial tendon - foot drop/plantar flexion
2. Peroneus brevis - foot adduction

Question 3

36-year-old man who has progressive wasting of his intrinsics in the hand with progressive bilateral cavovarus feet. After weakness sets in the ankle/foot, what opposing muscles create deformation? How does this affect the position of the foot?

Answer 3

1. Peroneus. longus - opposition to anterior tendon. Plantar flexes first ray.
2. Posterior tibial tendon - opposition to the peroneus brevis. Adduction of foot.

Question 4

36-year-old man who has progressive wasting of his intrinsics in the hand with progressive bilateral cavovarus feet. After weakness sets in the ankle/foot, what tendon transfers would help reinforce the weak muscles and remove the deforming forces?

Answer 4

1. Posterior tibial tendon to the dorsum of the foot to improve dorsiflexion.
2. Peroneus longus to the peroneus brevis postion to improve foot abduction.

Question 5

What is the treatment for chronic ulcer on distal aspect of toe in patient with diabetic peripheral neuropathy and hammer toe?

Answer 5

Flexor tenotomy