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The JBJS Quiz of the Month is a collection of 10 relevant questions from each orthopaedic subspecialty. The questions are drawn from JBJS Clinical Classroom, which houses over 4,500 questions and 3,100 learning resources. Take the Quiz to see how you score against your peers!

NOTE: This quiz does not earn users CME credits. The questions must be answered within Clinical Classroom to earn CME credits.

Which of the following anatomic structures is most at risk while performing a direct medial approach for a Lapidus bunion correction?
    • Posterior tibial tendon
      • The posterior tibial tendon inserts broadly but primarily on the medial navicular. It is well proximal to the site in question

 

    • Dorsalis pedis (DP) artery
      • The DP artery is lateral to the 1st tarsometatarsal joint

 

    • Flexor hallucis longus (FHL)
      • The FHL is relatively plantar as compared to this medial approach

 

    • Anterior tibial tendon
      • The anterior tibial tendon inserts dorsomedially on the medial cuneiform and the 1st metatarsal base (the bones involved in a a Lapidus procedure). It is at risk with a direct medial approach

 

    • Dorsal medial hallucal cutaneous nerve
      • The dorsal hallucal cutaneous nerve is at risk, but the risk is greater to the anterior tibial tendon with a direct medial approach to the 1st tarsometatarsal joint

 

 

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