Forefoot / Midfoot · Trauma · Advanced
Car Crash
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 right foot is killing me after the car accident."
33-year-old male seen in the ER after a motor vehicle accident.
History of present illness
Restrained driver in a frontal-impact MVA about 3 hours ago; his right foot was jammed against the brake pedal. Severe midfoot pain and swelling, worsening despite pain medication; unable to bear weight.
- No head strike/LOC; cleared by trauma
- Pain increasing, out of proportion
- Tingling in the toes
Questions a strong candidate asks at this step
- Mechanism (axial load on a plantarflexed foot)
- Polytrauma — ATLS clearance
- Pain trajectory — escalating pain is a red flag
- Paresthesias
- NPO, tetanus
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.