Rearfoot / Ankle · Reconstructive · Infection & Wound · Advanced
Funny Ankle
Podiatric surgery residency interview case. Work through it the way you would at an interview: take the history, ask for the exam and imaging, then commit to a diagnosis and plan.
Chief complaint
"My ankle has looked funny ever since they took the hardware out, and it hurts all the time."
66-year-old female seen in clinic with chronic left ankle pain.
History of present illness
Chronic left ankle pain after a left ankle fracture that was treated surgically (ORIF) about 2 years ago. The hardware was later removed because of a deep hardware infection.
- Since hardware removal the ankle has looked "funny" (deformed)
- Pain with walking and also at rest, diffusely around the ankle
- Pain has not resolved since the infection was treated
- No current drainage reported
Questions a strong candidate asks at this step
- Onset, duration and progression of the pain; location; character; rest pain or night pain
- Mechanism and details of the original fracture and how it was fixed
- Why the hardware was removed: what organism, what antibiotics, how long, and any further surgery or washouts
- Any drainage, fevers, chills, redness or warmth now (recurrent or residual infection)
- Deformity: when did it change, is it getting worse
- Weight-bearing status, walking tolerance, assistive devices, bracing
Present the rest of the case
Past history, exam, imaging, assessment, plan and discussion questions, with model answers, are in the interactive trainer. The diagnosis is kept there on purpose so you can practice committing to one.