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Ankle trauma

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https://www.readbyqxmd.com/read/27917329/minimally-invasive-treatment-of-tibial-pilon-fractures-through-arthroscopy-and-external-fixator-assisted-reduction
#1
Huasong Luo, Liaobin Chen, Kebin Liu, Songming Peng, Jien Zhang, Yang Yi
OBJECTIVE: The aim of this study was to evaluate the clinical outcome of tibial pilon fractures treated with arthroscopy and assisted reduction with an external fixator. METHODS: Thirteen patients with tibial pilon fractures underwent assisted reduction for limited lower internal fixation with an external fixator under arthroscopic guidance. The weight-bearing time was decided on the basis of repeat radiography of the tibia 3 months after surgery. Postoperative ankle function was evaluated according to the Mazur scoring system...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27902166/is-intramedullary-nailing-applicable-for-distal-tibial-fractures-with-ankle-joint-extension
#2
Ozan Beytemür, Cem Albay, Oktay Adanır, Serdar Yüksel, Mehmet Akif Güleç
OBJECTIVES: This study aims to evaluate the functional and radiographic results and treatment complications of AO/OTA (Arbeitsgemeinschaft fur Osteosynthesefragen/Orthopaedic Trauma Association) type 43C1 and C2 fractures treated with intramedullary nailing. PATIENTS AND METHODS: We retrospectively evaluated 35 AO/OTA type 43C1 and C2 patients (26 males, 9 females; mean age 39.8±16.9 years; range 19 to 82 years) treated with intramedullary nailing. Two interfragmentary screws out of nail were applied in 10 patients (29%), while one interfragmentary screw out of nail was applied in 17 patients (49%)...
December 2016: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
https://www.readbyqxmd.com/read/27900312/posterior-tibial-tendon-displacement-behind-the-tibia-and-its-interposition-in-an-irreducible-isolated-ankle-dislocation-a-case-report-and-literature-review
#3
Alessandro Ortolani, Roberto Bevoni, Alessandro Russo, Maurilio Marcacci, Mauro Girolami
Isolated posteromedial ankle dislocation is a rare condition thanks to the highly congruent anatomical configuration of the ankle mortise, in which the medial and lateral malleoli greatly reduce the rotational movement of the talus, and the strength of the ligaments higher than the malleoli affords protection against fractures. However, other factors, like medial malleolus hypoplasia, laxity of the ligaments, peroneal muscle weakness and previous ankle sprains, could predispose to pure dislocation. In the absence of such factors, only a complex high-energy trauma, with a rotational component, can lead to this event...
July 2016: Joints
https://www.readbyqxmd.com/read/27895200/demographics-mechanisms-of-injury-and-concurrent-injuries-associated-with-calcaneus-fractures-a-study-of-14-516-patients-in-the-american-college-of-surgeons-national-trauma-data-bank
#4
Daniel D Bohl, Nathaniel T Ondeck, Andre M Samuel, Pablo J Diaz-Collado, Stephen J Nelson, Bryce A Basques, Michael P Leslie, Jonathan N Grauer
: Background This study uses the American College of Surgeons National Trauma Data Bank (NTDB) to update the field on the demographics, injury mechanisms, and concurrent injuries among a national sample of patients admitted to the hospital department with calcaneus fractures. Methods Patients with calcaneus fractures in the NTDB during 2011-2012 were identified and assessed. Results A total of 14 516 patients with calcaneus fractures were included. The most common comorbidity was hypertension (18%), and more than 90% of fractures occurred via traffic accident (49%) or fall (43%)...
November 28, 2016: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/27889092/current-quality-measurement-tools-are-insufficient-to-assess-complications-in-orthopedic-surgery
#5
Arjun S Sebastian, Stephanie F Polites, Amy E Glasgow, Elizabeth B Habermann, Robert R Cima, Sanjeev Kakar
PURPOSE: The American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) is a clinically-derived, validated tool to track outcomes in surgery. The Agency for Healthcare Research and Quality Patient Safety Indicators (AHRQ-PSI) are a set of computer algorithms run on administrative data to identify adverse events. The purpose of this study is to compare complications following orthopedic surgery identified by ACS-NSQIP and AHRQ-PSI. METHODS: Patients between 2010 and 2012 who underwent orthopedic procedures (arthroplasty, spine, trauma, foot and ankle, hand, and upper extremity) at our tertiary-care, academic institution were identified (n = 3,374)...
November 23, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27871101/morphomics-of-the-talus
#6
David Gorman, Ebram Handy, Sikui Wang, Annette L Irwin, Stewart Wang
Previous studies of frontal crash databases reported that ankle fractures are among the most common lower extremity fractures. While not generally life threatening, these injuries can be debilitating. Laboratory research into the mechanisms of ankle fractures has linked dorsiflexion with an increased risk of tibia and fibula malleolus fractures. However, talus fractures were not produced in the laboratory tests and appear to be caused by more complex loading of the joint. In this study, an analysis of the National Automotive Sampling System - Crashworthiness Data System (NASS-CDS) for the years 2004-2013 was conducted to investigate foot-ankle injury rates in front seat occupants involved in frontal impact crashes...
November 2016: Stapp Car Crash Journal
https://www.readbyqxmd.com/read/27870692/wide-variation-of-surgical-cost-in-the-treatment-of-periarticular-lower-extremity-injuries-between-6-fellowship-trained-trauma-surgeons
#7
Robert J Wetzel, Laurence B Kempton, Edwin S Lee, Michael Zlowodzki, Todd O McKinley, Walter W Virkus
OBJECTIVES: We hypothesized that negligible surgical material cost variation exists between traumatolgists for treatment of bimalleolar ankle and bicondylar tibial plateau fractures. DESIGN: Retrospective medical record review. SETTING: Academic level 1 Trauma Center; 2-year period. PATIENTS/PARTICIPANTS: Current Procedure Terminology codes for open treatment of bimalleolar ankle and bicondylar tibial plateau fractures identified patients...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27870672/the-clinical-and-economic-impact-of-generic-locking-plate-utilization-at-a-level-ii-trauma-center
#8
Austin Mcphillamy, Taylor P Gurnea, Alastair E Moody, Christopher G Kurnik, Minggen Lu
OBJECTIVES: In today's climate of cost containment and fiscal responsibility, generic implant alternatives represent an interesting area of untapped resources. As patents have expired on many commonly used trauma implants, generic alternatives have recently become available from a variety of sources. The purpose of this study was to examine the clinical and economic impact of a cost containment program using high quality, generic orthopaedic locking plates. The implants available for study were anatomically precontoured plates for the clavicle, proximal humerus, distal radius, proximal tibia, distal tibia, and distal fibula...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27849465/outcomes-associated-with-the-intrepid-dynamic-exoskeletal-orthosis-ideo-a-systematic-review-of-the-literature
#9
M Jason Highsmith, Leif M Nelson, Neil T Carbone, Tyler D Klenow, Jason T Kahle, Owen T Hill, Jason T Maikos, Mike S Kartel, Billie J Randolph
High-energy lower extremity trauma is a consequence of modern war and it is unclear if limb amputation or limb salvage enables greater recovery. To improve function in the injured extremity, a passive dynamic ankle-foot orthosis, the Intrepid Dynamic Exoskeletal Orthosis (IDEO), was introduced with specialized return to run (RTR) therapy program. Recent research suggests, these interventions may improve function and return to duty rates. This systematic literature review sought to rate available evidence and formulate empirical evidence statements (EESs), regarding outcomes associated with IDEO utilization...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27798553/misuse-of-opioids-in-orthopaedic-post-operative-patients
#10
Gangavalli Anup, Malige Ajith, Terres George, Rehman Saqib, Nwachuku Chinenye
OBJECTIVE: In light of the recent uptrend in the prescription of opioids, this study seeks to identify patterns of opioid misuse among orthopaedic post-operative patients and principal external sources in obtaining these medications. DESIGN: Ten-month survey based study. SETTING: Two Level-I trauma centers (urban and suburban). PATIENTS/PARTICIPANTS: 207 patients between the ages of 18 to 89 years who underwent surgical fixation of fractures involving the pelvis, long bones or peri-articular regions of the knee, ankle, elbow and wrist...
October 26, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27776094/influence-of-medical-insurance-under-the-affordable-care-act-on-access-to-pain-management-of-the-trauma-patient
#11
Daniel H Wiznia, Theodore Zaki, Julianna Maisano, Chang-Yeon Kim, Thomas M Halaszynski, Michael P Leslie
BACKGROUND AND OBJECTIVES: The Affordable Care Act intended to "extend affordable coverage" and "ensure access" for vulnerable patient populations. This investigation examined whether the type of insurance (Medicaid, Medicare, Blue Cross, cash pay) carried by trauma patients influences access to pain management specialty care. METHODS: Investigators phoned 443 board-certified pain specialists, securing office visits with 235 pain physicians from 8 different states...
October 21, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27764893/post-traumatic-osteoarthritis-of-the-ankle-a-distinct-clinical-entity-requiring-new-research-approaches
#12
Michelle L Delco, John G Kennedy, Lawrence J Bonassar, Lisa A Fortier
The diagnosis of ankle osteoarthritis (OA) is increasing as a result of advancements in non-invasive imaging modalities such as magnetic resonance imaging, improved arthroscopic surgical technology and heightened awareness among clinicians. Unlike OA of the knee, primary or age-related ankle OA is rare, with the majority of ankle OA classified as post-traumatic (PTOA). Ankle trauma, more specifically ankle sprain, is the single most common athletic injury, and no effective therapies are available to prevent or slow progression of PTOA...
October 20, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/27755340/allg%C3%A3-wer-donati-versus-vertical-mattress-suture-technique-impact-on-perfusion-in-ankle-fracture-surgery-a-randomized-clinical-trial-using-intra-operative-angiography
#13
Steven F Shannon, Matthew T Houdek, Cody C Wyles, Brandon J Yuan, William W Cross, Joseph R Cass, Stephen A Sems
OBJECTIVE: The purpose of this study was to evaluate which primary wound closure technique for ankle fractures affords the most robust perfusion as measured by laser-assisted indocyanine green angiography (LA-ICGA): Allgöwer-Donati or vertical mattress. DESIGN: Prospective, randomized. SETTING: Level 1 Academic Trauma Center. PATIENTS/PARTICIPANTS: Thirty patients undergoing open reduction internal fixation (ORIF) for ankle fractures were prospectively randomized to Allgöwer-Donati (n=15) or vertical mattress (n=15) closure...
October 7, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27738897/methoxyflurane-a-review-in-trauma-pain
#14
Hannah A Blair, James E Frampton
Methoxyflurane (Penthrox(®)) is a halogenated ether first used clinically as a volatile inhalational anaesthetic. It has been used as an analgesic in Australia and New Zealand for the past 30 years. In the UK and Europe, methoxyflurane has been approved for the emergency relief of moderate to severe trauma pain in conscious adult patients. Methoxyflurane is self-administered using a hand-held inhaler. This article reviews the pharmacological properties of methoxyflurane and its clinical efficacy and tolerability in these patients...
December 2016: Clinical Drug Investigation
https://www.readbyqxmd.com/read/27735787/the-ankle-injury-management-aim-trial-a-pragmatic-multicentre-equivalence-randomised-controlled-trial-and-economic-evaluation-comparing-close-contact-casting-with-open-surgical-reduction-and-internal-fixation-in-the-treatment-of-unstable-ankle-fractures-in
#15
David J Keene, Dipesh Mistry, Julian Nam, Elizabeth Tutton, Robert Handley, Lesley Morgan, Emma Roberts, Bridget Gray, Andrew Briggs, Ranjit Lall, Tim Js Chesser, Ian Pallister, Sarah E Lamb, Keith Willett
BACKGROUND: Close contact casting (CCC) may offer an alternative to open reduction and internal fixation (ORIF) surgery for unstable ankle fractures in older adults. OBJECTIVES: We aimed to (1) determine if CCC for unstable ankle fractures in adults aged over 60 years resulted in equivalent clinical outcome compared with ORIF, (2) estimate cost-effectiveness to the NHS and society and (3) explore participant experiences. DESIGN: A pragmatic, multicentre, equivalence randomised controlled trial incorporating health economic evaluation and qualitative study...
October 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/27733557/mri-quantification-of-the-impact-of-ankle-position-on-syndesmosis-anatomy
#16
Marie-Lyne Nault, Melissa Marien, Jonah Hébert-Davies, G Yves Laflamme, Vincent Pelsser, Dominique M Rouleau, Nayla Gosselin-Papadopoulos, Stéphane Leduc
BACKGROUND: Despite the common occurrence of syndesmotic injuries in ankle trauma, the distal tibiofibular relationship remains poorly understood. The aim of this study was to evaluate the anatomical impact of ankle sagittal positioning on the tibiofibular relationship in intact ankles by using a validated magnetic resonance imaging (MRI)-based measurement system. METHODS: In this radiologic study, 34 healthy volunteers underwent a series of ankle MRIs with the ankle stabilized in 3 positions: neutral position (NP), dorsiflexion (DF), and plantarflexion (PF)...
October 12, 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/27727383/close-contact-casting-vs-surgery-for-initial-treatment-of-unstable-ankle-fractures-in-older-adults-a-randomized-clinical-trial
#17
RANDOMIZED CONTROLLED TRIAL
Keith Willett, David J Keene, Dipesh Mistry, Julian Nam, Elizabeth Tutton, Robert Handley, Lesley Morgan, Emma Roberts, Andrew Briggs, Ranjit Lall, Timothy J S Chesser, Ian Pallister, Sarah E Lamb
Importance: Ankle fractures cause substantial morbidity in older persons. Surgical fixation is the contemporary intervention but is associated with infection and other healing complications. Objective: To determine whether initial fracture treatment with close contact casting, a molded below-knee cast with minimal padding, offers outcome equivalent to that with immediate surgery, with fewer complications and less health resource use. Design, Setting, and Participants: This was a pragmatic, equivalence, randomized clinical trial with blinded outcome assessors...
October 11, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27703418/association-between-achilles-tightness-and-lower-extremity-injury-in-children
#18
Raymond W Liu, Katherine K Xie
BACKGROUND: It is unclear whether isolated gastroc/soleus tightness can increase the risk of lower extremity injury in an otherwise healthy child. QUESTIONS/PURPOSES: (1) Is there a difference in gastroc/soleus tightness, as represented by ankle dorsiflexion with the knee extended, in children presenting with upper versus lower extremity complaints? (2) Is there a difference in gastroc/soleus tightness in children presenting with atraumatic versus traumatic lower extremity complaints? METHODS: We performed a cross-sectional study of 206 consecutive walking age children presenting to a county orthopedic clinic with new upper or lower extremity complaints...
October 2016: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/27676924/clinical-prm-care-pathways-patients-after-lower-limb-bone-joint-injury
#19
Patricia Ribinik, Paul Calmels, Patrick Dehail, Alain Yelnik
OBJECTIVE: To describe a clinical care pathway for patients who underwent lower limb bone joint injury, taking into account patients' needs, PRM care objectives, human and material resources to be implemented, chronology as well as expected outcomes. MATERIAL/PATIENTS AND METHODS: This clinical care pathway is designed upon the expertise of the Sofmer-Fedmer signatory group, after analysis of literature, French rules and recommendations. It is ratified by the Sofmer scientific council...
September 2016: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27672576/lateral-subtalar-dislocation-case-report-and-review-of-the-literature
#20
Ewout S Veltman, Ernst Ja Steller, Philippe Wittich, Jort Keizer
A case of complicated lateral subtalar dislocation is presented and the literature concerning this injury is reviewed. Subtalar joint dislocations are rare and often the result of a high-energy trauma. Complications include avascular necrosis of the talus, infection, posttraumatic osteoarthritis requiring arthrodesis and chronic subtalar instability. Negative prognostic factors include lateral and complicated dislocations, total talar extrusions, and associated fractures. A literature search was performed to identify studies describing outcome after lateral subtalar joint dislocation...
September 18, 2016: World Journal of Orthopedics
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