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Ankle trauma

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https://www.readbyqxmd.com/read/28442207/tibio-talo-calcaneal-fusion-after-limb-salvage-procedures-a-retrospective-study
#1
Lukas Zak, Gerald E Wozasek
BACKGROUND: The treatment of limb threatening trauma on the distal tibia or hindfoot often results in posttraumatic osteoarthritis requiring tibiotalocalcaneal (TTC) arthrodesis. The purpose of this study was to present a case series of patients undergoing various techniques of joint fusion after bone reconstruction and deformity correction as a salvage procedure. The study should help trauma surgeons making decisions in limb salvage and deformity correction in complex lower leg and foot injuries by presenting options and treatment strategies...
April 15, 2017: Injury
https://www.readbyqxmd.com/read/28439310/syndesmosis-injuries-in-the-pediatric-and-adolescent-athlete-an-analysis-of-risk-factors-related-to-operative-intervention
#2
D E Kramer, M X Cleary, P E Miller, Y-M Yen, B J Shore
PURPOSE: To review all paediatric ankle syndesmotic injuries occurring at our institution and identify risk factors associated with operative intervention. METHODS: Among 22 873 evaluations for ankle trauma, we found 220 children suffering from syndesmotic injuries (incidence: 0.96%). We recorded demographic data, details of the injury, features on examination and treatment variables. Univariable and multivariable logistic regression modelling was performed to identify risk factors associated with operative intervention...
2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28430746/serial-radiographs-do-not-change-the-clinical-course-of-nonoperative-stable-ota-ao-44-b1-ankle-fractures
#3
Lucas S Marchand, Zachary M Working, Ajinkya A Rane, Lance G Jacobson, Erik N Kubiak, Thomas F Higgins, David L Rothberg
OBJECTIVE: To assess radiographic markers of ankle stability in stable OTA/AO 44-B1 ankle fractures. DESIGN: Retrospective review. SETTING: Academic Level-I trauma hospital. PATIENTS: One hundred thirty-four patients with stable OTA/AO 44-B1 (Danis-Weber B, Supination-External Rotation-II) ankle fractures. INTERVENTION: Analysis of mortise view radiographs at the time of initial evaluation and final follow-up...
May 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28430016/the-use-of-intravenous-lidocaine-for-the-management-of-acute-pain-secondary-to-traumatic-ankle-injury
#4
Billy Sin, Diana Gritsenko, Grace Tam, Kimberly Koop, Eva Mok
Sports-related injuries are a frequent cause of visits to the emergency department (ED) across the United States. A majority of these injuries affect the lower extremities with the ankle as the most frequently reported site. Most sports-related injuries are not severe enough to require inpatient hospitalization; however, they often lead to acute distress and pain which require prompt treatment with analgesics. Approximately 22% of patients who presented to the ED required pharmacotherapy for acute pain management...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28417204/injuries-to-the-chopart-joint-complex-a-current-review
#5
REVIEW
Halah Kutaish, R Stern, L Drittenbass, M Assal
Chopart complex injuries (CCIs) are thought to be uncommon; however, recent literature states the rate of misdiagnosis to be between 20 and 41%. Chopart complex injuries are not ankle injuries, with which they are initially confused due to a similar mechanism of trauma in many cases. Injury to the Chopart complex commonly affects multiple structures. The key to optimal treatment is a high index of clinical suspicion combined with timely accurate imaging studies. Careful diagnostic workup with high-quality radiographs of the foot in neutral position should be obtained...
April 17, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28415868/-epidemiological-data-of-hungarian-skiers-and-snowboarders-medical-problems
#6
Péter Felkai, Ingrid Lengyel, Miklós Szokoly, Gábor Forgó
INTRODUCTION AND AIM: There are no high mountains or any advantageous circumstances for winter sports in Hungary, yet within the 10 million population there are about half a million people (the exact number is 550,000) who tend to go for skiing or snowboarding abroad. Authors compared the injury statistical data with results described in the international literature in order to develop conclusions about the differences in the injury patterns and frequency between the Hungarian ones' and those found in countries with plenty of winter sport possibilities...
April 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28394750/impact-of-body-mass-index-and-bacterial-resistance-in-osteomyelitis-after-antibiotic-prophylaxis-of-open-lower-extremity-fractures
#7
Derek Bremmer, Brandon Bookstaver, Mark Cairns, Kenneth Lindley, Martin Durkin, David Koon, April Miller Quidley
BACKGROUND: We investigated the clinical effectiveness of antimicrobial prophylaxis in lower-extremity open fractures following the Eastern Association for the Surgery of Trauma Guidelines. METHODS: This observational, retrospective, single-center study included adults with lower-extremity open fractures of the ankle, tibia, fibula, or femur. The primary endpoint was the incidence of osteomyelitis within 12 months of the fracture. Secondary endpoint comparisons were the time of antibiotic initiation and drug selection...
April 2017: Surgical Infections
https://www.readbyqxmd.com/read/28392074/associations-of-timing-of-surgery-with-postoperative-length-of-stay-complications-and-functional-outcomes-3-6-years-after-operative-fixation-of-closed-ankle-fractures
#8
M G Naumann, U Sigurdsen, S E Utvåg, K Stavem
AIMS: To evaluate the associations of timing of surgery with postoperative length of stay (LOS), complications, and functional outcomes 3-6 years after open reduction and internal fixation (ORIF) in closed ankle fractures. PATIENTS AND METHODS: Historical cohort study by chart review of 1011 patients for postoperative LOS and complications; 959 individuals were invited to participate in a postal survey with functional outcomes questionnaires. Complications were classified as perioperative, early, or late...
March 31, 2017: Injury
https://www.readbyqxmd.com/read/28365167/outcomes-of-the-ilizarov-frame-use-in-elderly-patients
#9
Efthymios Iliopoulos, Natasha Morrissey, Seok Cho, Arshad Khaleel
AIM: The use of circular frame is widely accepted. This is an outcome review on use of circular Ilizarov frame in elderly patients. MATERIALS & METHODS: Data from all patients treated with an Ilizarov circular frame between January 2002 and December 2014, who were 65 years of age or over at surgery was collected. Seventy Ilizarov circular frames were applied during this period in our unit at a mean age of 71.2 years. Clinical, radiological and quality of life questionnaire (SF-12) data were gathered...
March 30, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28361015/development-of-an-internally-braced-prosthesis-for-total-talus-replacement
#10
Markus Regauer, Mirjam Lange, Kevin Soldan, Steffen Peyerl, Sebastian Baumbach, Wolfgang Böcker, Hans Polzer
Total loss of talus due to trauma or avascular necrosis, for example, still remains to be a major challenge in foot and ankle surgery with severely limited treatment options. Implantation of a custom made total talar prosthesis has shown promising results so far. Most important factors for long time success are degree of congruence of articular surfaces and ligamentous stability of the ankle. Therefore, our aim was to develop an optimized custom made prosthesis for total talus replacement providing a high level of primary stability...
March 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28341786/effectiveness-of-foot-fasciotomies-in-foot-and-ankle-trauma
#11
Katherine M Bedigrew, D J Stinner, J F Kragh, B K Potter, S B Shawen, J R Hsu
BACKGROUND: Foot compartment syndrome (FCS) has been reported to cause neuropathic pain, claw or hammer toes, and motor and sensory disturbances. The optimal treatment of FCS is controversial. The purpose of this study was to determine if foot fasciotomies improve patient outcomes in high-energy, combat-related lower extremity trauma. METHODS: Medical records of patients with documented FCS from May 2007 to January 2009 were retrospectively reviewed. Consecutive, matched control patients were identified based on similar hindfoot, mid-foot and/or forefoot injuries who did not undergo foot fasciotomy during the same period...
March 23, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28336099/direct-fixation-of-fractures-of-the-posterior-pilon-via-a-posteromedial-approach
#12
Harm Hoekstra, Wouter Rosseels, Stefan Rammelt, Stefaan Nijs
The treatment of fractures of the posterior pilon is a timely issue. Restoration of the integrity of the incisura fibularis and subsequent anatomic reduction of the fibula are essential for reconstruction of the ankle mortise after trauma, and syndesmotic stability. Inappropriate treatment ultimately will lead to a poor functional outcome and quality of life. Open reduction and direct internal fixation through a posterolateral or posteromedial approach are increasingly preferred over indirect reduction and anteroposterior screw fixation...
March 19, 2017: Injury
https://www.readbyqxmd.com/read/28323803/patient-response-to-an-integrated-orthotic-and-rehabilitation-initiative-for-traumatic-injuries-the-prioriti-mtf-study
#13
Joseph R Hsu, Johnny G Owens, Jennifer DeSanto, John R Fergason, Kevin M Kuhn, Benjamin K Potter, Daniel J Stinner, Robert G Sheu, Sandra L Waggoner, Jason M Wilken, Yanjie Huang, Daniel O Scharfstein, Ellen J MacKenzie
Although limb salvage is now possible for many high-energy open fractures and crush injuries to the distal tibia, ankle, hindfoot, and midfoot, orthotic options are limited. The Intrepid Dynamic Exoskeletal Orthosis (IDEO) is a custom, energy-storing carbon fiber orthosis developed for trauma patients undergoing limb salvage. The IDEO differs from other orthoses in that it allows patients with ankle weakness to have more normal ankle biomechanics and increased ankle power. This article describes the design of a study to evaluate the effectiveness of the IDEO when delivered together with a high-intensity, sports medicine-based approach to rehabilitation...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323802/outcomes-after-severe-distal-tibia-ankle-and-or-foot-trauma-comparison-of-limb-salvage-versus-transtibial-amputation-outlet
#14
Michael J Bosse, David Teague, Lisa Reider, Joshua L Gary, Saam Morshed, Rachel B Seymour, James Toledano, Lisa K Cannada, Barbara Steverson, Daniel O Scharfstein, Jason Luly, Ellen J MacKenzie
Severe foot and ankle injuries are complex and challenging to treat, often requiring multiple operations to salvage the limb contributing to a prolonged healing period. There is some evidence to suggest that early amputation for some patients may result in better long-term outcomes than limb salvage. The challenge is to identify the regional injury burden for an individual that would suggest a better outcome with an amputation. The OUTLET study is a prospective, multicenter observational study comparing 18-month outcomes after limb salvage versus early amputation among patients aged 18-60 years with severe distal tibia, ankle, and foot injuries...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323765/misuse-of-opioids-in-orthopaedic-postoperative-patients
#15
Anup Gangavalli, Ajith Malige, George Terres, Saqib Rehman, Chinenye Nwachuku
OBJECTIVE: In light of the recent uptrend in the prescription of opioids, this study seeks to identify patterns of opioid misuse among orthopaedic postoperative 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: Two hundred seven patients between the ages of 18 and 89 years who underwent surgical fixation of fractures involving the pelvis, long bones, or periarticular regions of the knee, ankle, elbow, and wrist...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28320508/staged-minimally-invasive-plate-osteosynthesis-of-proximal-tibial-fractures-with-acute-compartment-syndrome
#16
Joon-Woo Kim, Chang-Wug Oh, Jong-Keon Oh, Hee-Soo Kyung, Kyeong-Hyeon Park, Hee-June Kim, Jae-Wook Jung, Young-Soo Jung
PURPOSE: High-energy proximal tibial fractures often accompany compartment syndrome and are usually treated by fasciotomy with external fixation followed by secondary plating. However, the initial soft tissue injury may affect bony union, the fasciotomy incision or external fixator pin sites may lead to postoperative wound infections, and the staged procedure itself may adversely affect lower limb function. We assess the results of staged minimally invasive plate osteosynthesis (MIPO) for proximal tibial fractures with acute compartment syndrome...
March 11, 2017: Injury
https://www.readbyqxmd.com/read/28314214/gait-biomechanics-following-lower-extremity-trauma-amputation-vs-reconstruction
#17
Elizabeth Russell Esposito, Daniel J Stinner, John R Fergason, Jason M Wilken
BACKGROUND: Surgical advances have substantially improved outcomes for individuals sustaining traumatic lower extremity injury. Injuries once requiring lower limb amputation are now routinely managed with limb reconstruction surgery. However, comparisons of functional outcomes between the procedures are inconclusive. PURPOSE: To compare gait biomechanics after lower limb reconstruction and transtibial amputation. METHODS: Twenty-four individuals with unilateral lower limb reconstruction wearing a custom ankle-foot orthosis (Intrepid Dynamic Exoskeletal Orthosis), 24 with unilateral, transtibial amputation, and 24 able-bodied control subjects underwent gait analysis at a standardized Froude speed based on leg length...
February 21, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28295127/the-crush-index-orthopedic-trauma-as-an-economic-indicator
#18
Armin Arshi, Justin H Barad, Riki K Patel, J Ben Allis, Nelson F Soohoo, Eric E Johnson
The purpose of this study was to evaluate the relationship between economic activity and the incidence of high-energy orthopedic trauma. California's Office of Statewide Health Planning and Development patient discharge database was queried to identify monthly orthopedic trauma incidence from 1995 to 2010. Patient inclusion required 1 diagnosis code and 1 associated procedural code for fractures of the femur, tibia, ankle, pelvis, or acetabulum. Data on composite market indices, energy and transportation use, and unemployment were obtained from government sources...
March 14, 2017: Orthopedics
https://www.readbyqxmd.com/read/28291180/dynamic-stress-testing-is-unnecessary-for-unimalleolar-supination-external-rotation-ankle-fractures-with-minimal-fracture-displacement-on-lateral-radiographs
#19
Simo Nortunen, Hannu-Ville Leskelä, Heidi Haapasalo, Tapio Flinkkilä, Pasi Ohtonen, Harri Pakarinen
BACKGROUND: This study aimed to identify factors from standard radiographs that contributed to the stability of the ankle mortise in patients with isolated supination-external rotation fractures of the lateral malleolus (OTA/AO 44-B). METHODS: Non-stress radiographs of the mortise and lateral views, without medial clear space widening or incongruity, were prospectively collected for 286 consecutive patients (mean age, 45 years [range, 16 to 85 years]), including 144 female patients (mean age, 50 years [range, 17 to 85 years]) and 142 male patients (mean age, 40 years [range, 16 to 84 years]) from 2 trauma centers...
March 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28271091/osteochondritis-dissecans-of-the-humeral-head-a-case-report-and-review-of-the-literature
#20
Davod Jafari, Hooman Shariatzadeh, Farid Najd Mazhar, Mohammad Ali Okhovatpour, Mehran Razavipour
Osteochondritis dissecans (OCD) is a common joint disorder in knee, ankle and elbow, however it can be rarely found in glenohumeral joint. In this study, we report an asymptomatic case of humeral head OCD, which was detected incidentally following a trauma. X-rays showed an area of lucency around an oval bony fragment measuring about 1 cm on the superior aspect of the humeral head. However, the patient was pain-free and the shoulder range of motion was normal.
January 2017: Archives of Bone and Joint Surgery
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