Rearfoot / Ankle · Trauma · Medicine & Peri-op · Advanced
20-Foot Fall
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 left ankle — I can't move it."
50-year-old male brought in by EMS after a fall from 20 feet; seen on the orthopedic trauma service.
History of present illness
Fell approximately 20 feet from a roof and landed on his feet. Immediate severe pain and deformity of the left ankle; unable to bear weight.
- Trauma activation; primary and secondary survey in progress
- Denies LOC; complains of mild low-back pain
- Pain 10/10 left ankle; tingling in the foot
- No open wounds
- Last meal 6 hours ago; tetanus status unknown
Questions a strong candidate asks at this step
- Mechanism, height, landing position (axial load)
- Head strike / LOC; spine, pelvis, chest, abdominal pain (ATLS)
- 6 Ps; open wound
- NPO and tetanus status
- Constitutional symptoms (weight loss, night sweats — history of cancer)
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.