Forefoot / Midfoot · Reconstructive · Advanced
Third Surgery?
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 big toe still hurts after two surgeries."
47-year-old female seen in the podiatry clinic for a second opinion.
History of present illness
Underwent an attempted 1st MPJ fusion elsewhere for hallux rigidus that did not heal; it was revised to a hemi-implant. Continued pain at the great toe joint since.
- Aching pain 7/10 at the 1st MPJ, worse with push-off and in shoes
- Toe feels short and "floppy"; transfer pain under the 2nd met head
- No redness, drainage, fever
- Last surgery about 2 years ago
Questions a strong candidate asks at this step
- Original diagnosis and each prior procedure (get operative reports)
- Timeline; post-op course; was the fusion a nonunion or malunion?
- Current pain, location, transfer metatarsalgia
- Signs of infection (drainage, wound problems, fever)
- Patient expectations
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.