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Foot and ankle anatomy

Andrew R Hsu, Robert B Anderson
Physicians need to be aware of a variety of foot and ankle injuries that commonly occur in American football, including turf toe, Jones fractures, Lisfranc injuries, syndesmotic and deltoid disruption, and Achilles ruptures. These injuries are often complex and require early individual tailoring of treatment and rehabilitation protocols. Successful management and return to play requires early diagnosis, a thorough work-up, and prompt surgical intervention when warranted with meticulous attention to restoration of normal foot and ankle anatomy...
September 2016: American Journal of Orthopedics
M Cody O'Dell, Diego Jaramillo, Laura Bancroft, Laura Varich, Gregory Logsdon, Sabah Servaes
With increasing participation and intensity of training in youth sports in the United States, the incidence of sports-related injuries is increasing, and the types of injuries are shifting. In this article, the authors review sports injuries of the lower extremity, including both acute and overuse injuries, that are common in or specific to the pediatric population. Common traumatic injuries that occur in individuals of all ages (eg, tears of the acetabular labrum and anterior cruciate ligament) are not addressed, although these occur routinely in pediatric sports...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Gary M LiMarzi, Kurt F Scherer, Michael L Richardson, David R Warden, Christopher W Wasyliw, Jack A Porrino, Christopher R Pettis, Gideon Lewis, Christopher C Mason, Laura W Bancroft
A variety of surgical procedures exist for repair of both traumatic and degenerative osseous and soft-tissue pathologic conditions involving the foot and ankle. It is necessary for the radiologist to be familiar with these surgical procedures, so as to assess structural integrity, evaluate for complicating features, and avoid diagnostic pitfalls. Adequate interpretation of postoperative changes often requires access to surgical documentation to evaluate not only the surgery itself but the expected timeline for resolution of normal postoperative changes versus progressive disease...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Grigoris Grigoriadis, Nicolas Newell, Diagarajen Carpanen, Alexandros Christou, Anthony M J Bull, Spyros D Masouros
The complex structural and material behaviour of the human heel fat pad determines the transmission of plantar loading to the lower limb across a wide range of loading scenarios; from locomotion to injurious incidents. The aim of this study was to quantify the hyper-viscoelastic material properties of the human heel fat pad across strains and strain rates. An inverse finite element (FE) optimisation algorithm was developed and used, in conjunction with quasi-static and dynamic tests performed to five cadaveric heel specimens, to derive specimen-specific and mean hyper-viscoelastic material models able to predict accurately the response of the tissue at compressive loading of strain rates up to 150s(-1)...
September 8, 2016: Journal of the Mechanical Behavior of Biomedical Materials
Michael H Theodoulou, Laura Bohman
Posterior ankle pain can occur for many reasons. If it is produced by forced plantarflexion of the foot, it is often a result of impingement from an enlarged posterior talar process or an os trigonum. This condition may present in an acute or chronic state. Management is initially nonoperative, but surgical treatments are available. This condition is often seen in athletes, so procedures that limit surgical trauma and allow early return to activity are ideal. An arthroscopic approach for this disorder produces good outcomes with limited complications...
October 2016: Clinics in Podiatric Medicine and Surgery
Claire L Brockett, Graham J Chapman
This paper provides an introduction to the biomechanics of the ankle, introducing the bony anatomy involved in motion of the foot and ankle. The complexity of the ankle anatomy has a significant influence on the biomechanical performance of the joint, and this paper discusses the motions of the ankle joint complex, and the joints at which it is proposed they occur. It provides insight into the ligaments that are critical to the stability and function of the ankle joint. It describes the movements involved in a normal gait cycle, and also highlights how these may change as a result of surgical intervention such as total joint replacement or fusion...
June 2016: Orthopaedics and Trauma
Yu-Ching Lin, John Y Kwon, Mohammad Ghorbanhoseini, Jim S Wu
Flatfoot deformity is a common disorder of the foot and ankle and is caused by loss of the hindfoot arch. Radiologists and clinicians should be familiar with the anatomy and the imaging criteria used to assess injury to the supporting structures. Radiographs and computed tomography are most useful in characterizing the degree of osseous deformity and ultrasonography and magnetic resonance imaging are most useful in the evaluation of the supporting soft tissue structures. Treatment depends on the clinical symptoms and involves restoring the normal biomechanics of the hindfoot arch through strengthening exercises, foot/ankle orthotics, and surgery...
September 2016: Radiologic Clinics of North America
P Troy Henning
This article reviews commonly performed injections about the foot and ankle region. Although not exhaustive in its description of available techniques, general approaches to these procedures are applicable to any injection about the foot and ankle. As much as possible, the procedures described are based on commonly used or published techniques. An in-depth knowledge of the regional anatomy and understanding of different approaches when performing ultrasonography-guided procedures allows clinicians to adapt to any clinical scenario...
August 2016: Physical Medicine and Rehabilitation Clinics of North America
Jason M Souza, Chad A Purnell, Jennifer E Cheesborough, Armen S Kelikian, Gregory A Dumanian
BACKGROUND: Localized nerve pain in the foot and ankle can be a chronic source of disability after trauma and has been identified as the most common complication following operative interventions in the foot and ankle. The superficial location of the injured nerves and lack of suitable tissue for nerve implantation make this pain refractory to conventional methods of neuroma management. We describe a novel strategy for management using processed nerve allografts to bridge nerve gaps created by resection of both end neuromas and neuromas-in-continuity...
June 23, 2016: Foot & Ankle International
N M Yusof, A S Fadzli, W S Azman, M A Azril
INTRODUCTION: The understanding of the skin's vascular anatomy has improved in the last decade. It has lead to technique modification such as the staged procedure in performing sural flaps and improvement in the flap survival rate. The aim of this study was to evaluate the acute vascular complications (flap necrosis or congestion) of 29 patients who underwent distal base sural flap for coverage of wound around the ankle. METHODS: Twenty-four males and five females with a mean age of 37...
April 2016: Medical Journal of Malaysia
Navin Balasubramanian, Ganesh Babu, Sindhuja Prakasam
INTRODUCTION: Established non-unions pose a real nightmare for even the most accomplished surgeon. The variations in anatomy due to extensive fibrous tissue growth, soft tissue contractures around the fracture site and bony alterations like smoothening and sclerosis of the fracture ends must each be addressed as a whole if good outcome is to be expected. CASE SERIES: Here we present a series of 11 patients who had bimalleolar fracture of the ankle following which they had native splinting...
October 2015: Journal of Orthopaedic Case Reports
Alieh Daryabor, Mokhtar Arazpour, Mohammad Samadian, Masoumeh Veiskarami, Monireh Ahmadi Bani
BACKGROUND: Adolescent idiopathic scoliosis (AIS) is a progressive growth disease that affects spinal anatomy, mobility, and left-right trunk symmetry. As a consequence, AIS can modify human gait. Spinal orthoses are a commonly used conservative method for the treatment of AIS. OBJECTIVE: This review evaluated the AIS spinal orthosis literature that involved gait and energy consumption evaluations. STUDY DESIGN: Literature review. METHOD: According to the population intervention comparison outcome measure methods and based on selected keywords, 10 studies met the inclusion criteria...
June 13, 2016: Disability and Rehabilitation. Assistive Technology
Victor Dubois-Ferrière, Anne Lübbeke, Ashwin Chowdhary, Richard Stern, Dennis Dominguez, Mathieu Assal
BACKGROUND: Injuries to the tarsometatarsal (TMT) joint complex, or Lisfranc injuries, have been reported to result in osteoarthritis (OA) following surgical treatment. Good outcomes with respect to short and medium-term results have been reported. However, long-term results, specifically regarding clinical outcomes and the development of symptomatic OA, are limited. The objectives of this study were to assess clinical outcomes, the occurrence of symptomatic OA, and risk factors for OA at 2 to 24 years after a Lisfranc injury treated surgically with open reduction and internal fixation (ORIF) or with primary arthrodesis...
May 4, 2016: Journal of Bone and Joint Surgery. American Volume
Chao-Ching Chiang, Yun-Hsuan Tzeng, Chun-Cheng Lin, Ching-Kuei Huang, Ming-Chau Chang
BACKGROUND: Open reduction and internal fixation (ORIF), the standard treatment for unstable ankle fractures, has well-known wound complications. Minimally invasive surgery (MIS) has been proposed to decrease these complications. The objectives of this study were to describe an algorithm of MIS for fibular plating and compare the radiographic restoration of fibular anatomy, functional outcomes, and complications between ORIF and MIS for ankle fractures. METHODS: This retrospective study included 71 patients with AO/OTA 44-B ankle fractures treated by a single surgeon...
June 2016: Foot & Ankle International
Ravi Kumar Chittoria, Harsha Pratap, Suma Hottigoudar Yekappa
Abductor hallucis (AH) is an intrinsic muscle of sole of the foot. It is commonly used in the coverage of ankle and heel defects and chronic nonhealing ulcers of the foot; its use is reported to have a favorable long-term outcome. The muscle's apt bulk and size, its simple surgical isolation, absence of donor-site defect, unvaried anatomy, and long neurovascular pedicle are some of the advantages that make it a promising muscle flap. During routine cadaver dissection in the Department of Anatomy of Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India, we identified an anatomical variation in AH in both feet of a 45-year-old embalmed male Indian cadaver...
December 1, 2015: Advances in Wound Care
Adam D Singer, Abhijit Datir, Jonathan Tresley, Travis Langley, Paul D Clifford, Jean Jose, Ty K Subhawong
Pain and focal masses in the foot and ankle are frequently encountered and often initiate a workup including imaging. It is important to differentiate benign lesions from aggressive benign or malignant lesions. In this review, multiple examples of osseous and soft tissue tumors of the foot and ankle will be presented. Additionally, the compartmental anatomy of the foot and ankle will be discussed in terms of its relevance for percutaneous biopsy planning and eventual surgery. Finally, a general overview of the surgical management of benign, benign aggressive and malignant tumors of the foot and ankle will be discussed...
March 2016: Skeletal Radiology
Rahul Kotwal, Narendra Rath, Vishal Paringe, Sandeep Hemmadi, Rhys Thomas, Kath Lyons
OBJECTIVES: To devise a new protocol for targeted CTscanning of the distal tibiofibular syndesmosis with minimal radiation exposure to patients. We also aimed to correlate the reduction of the syndesmosis as seen on CT scans with the functional outcome of patients. MATERIALS AND METHODS: Prospective study. Forty adults undergoing surgical stabilisation of an acute distal tibiofibular syndesmosis injury were recruited. A targeted five-cut computerised tomography scan protocol was developed...
March 2016: Skeletal Radiology
Xingchao Yan, Jianfeng Liu, Bin Liu, Zhigang Liu, Yuehai Pan, Xiaoyan Jia, Yanan Zhang, Jiangbo Shao
OBJECTIVE: To explore the effectiveness of the procedure of reconstructing the transverse arch of the forefoot by anastomosing adductor hallucis and abductor hallucis tendons in correcting hallux valgus. METHODS: A retrospective analysis was made on the clinical data from 28 patients (40 feet) with hallux valgus treated with the procedure of reconstructing the transverse arch of the forefoot by anastomosing adductor hallucis and abductor hallucis tendons between January 2010 and January 2014...
April 2015: Chinese Journal of Reparative and Reconstructive Surgery
Thomas O Clanton, Brady T Williams, Evan W James, Kevin J Campbell, Matthew T Rasmussen, C Thomas Haytmanek, Coen A Wijdicks, Robert F LaPrade
BACKGROUND: An injury to the deltoid ligament complex of the ankle can require surgical intervention in cases of chronic instability. There is an absence of data describing medial ankle ligament anatomy on standard radiographic views. PURPOSE: To quantitatively describe the anatomic origins and insertions of the individual ligamentous bands of the superficial and deep deltoid on standard lateral and mortise radiographic views with reference to osseous landmarks and anatomic axes...
November 2015: American Journal of Sports Medicine
Michel De Maeseneer, Hardi Madani, Leon Lenchik, Monica Kalume Brigido, Maryam Shahabpour, Stefaan Marcelis, Johan de Mey, Aldo Scafoglieri
The anatomy of the nerves of the foot and ankle is complex, and familiarity with the normal anatomy and course of these nerves as well as common anatomic variants is essential for correct identification at imaging. Ultrasonography (US) and magnetic resonance (MR) imaging allow visualization of these nerves and may facilitate diagnosis of various compression syndromes, such as "jogger's heel," Baxter neuropathy, and Morton neuroma. It may be difficult to distinguish the nerves from adjacent vasculature at MR imaging, and US can help in differentiation...
September 2015: Radiographics: a Review Publication of the Radiological Society of North America, Inc
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