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QUESTION 1 OF 2

A 46-year-old man presents with pain in the right 1st metatarsal phalangeal joint (MTPJ). He recalls a rugby injury to the joint 20 years ago. On examination he has moderate pain on end range of motion, reduced range of motion (10o dorsiflexion, 50o plantar flexion) and pain on axial loading of the 1st MTPJ. Radiographs demonstrate around 40% joint space narrowing with dorsal osteophyte on the metatarsal and phalanx.  He has failed conservative treatment and still wishes to play rugby. What is the most appropriate treatment?

QUESTION ID: 49

1. A. Dorsal cheilectomy
2. B. Keller’s procedure
3. C. MTPJ arthrodesis
4. D. MTPJ arthroplasty
5. E. Synovectomy

QUESTION 2 OF 2

In an otherwise normally aligned foot when performing a scarf osteotomy, to avoid shortening or lengthening the first metatarsal what landmark or reference point should be used for your distal transverse cut?

QUESTION ID: 50

1. A. Parallel to proximal phalanx base joint surface
2. B. Parallel with the 5th metatarsal phalangeal (MTP) joint
3. C. Perpendicular to 1st metatarsal
4. D. Perpendicular to 2nd metatarsal
5. E. Perpendicular to cut surface after removing medial eminence