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Ankle fractures

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https://www.readbyqxmd.com/read/28330449/a-cross-sectional-study-of-the-effects-of-load-carriage-on-running-characteristics-and-tibial-mechanical-stress-implications-for-stress-fracture-injuries-in-women
#1
Chun Xu, Amy Silder, Ju Zhang, Jaques Reifman, Ginu Unnikrishnan
BACKGROUND: Load carriage is associated with musculoskeletal injuries, such as stress fractures, during military basic combat training. By investigating the influence of load carriage during exercises on the kinematics and kinetics of the body and on the biomechanical responses of bones, such as the tibia, we can quantify the role of load carriage on bone health. METHODS: We conducted a cross-sectional study using an integrated musculoskeletal-finite-element model to analyze how the amount of load carriage in women affected the kinematics and kinetics of the body, as well as the tibial mechanical stress during running...
March 23, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28328865/novel-management-of-distal-tibial-and-fibular-fractures-with-acumed-fibular-nail-and-minimally-invasive-plating-osteosynthesis-technique-a-case-report
#2
Tie-Jun Wang, Wei-Na Ju, Bao-Chang Qi
RATIONALE: Anatomical characteristics, such as subcutaneous position and minimal muscle cover, contribute to the complexity of fractures of the distal third of the tibia and fibula. Severe damage to soft tissue and instability ensure high risk of delayed bone union and wound complications such as nonunion, infection, and necrosis. PATIENT CONCERNS: This case report discusses management in a 54-year-old woman who sustained fractures of the distal third of the left tibia and fibula, with damage to overlying soft tissue (swelling and blisters)...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28325064/diabetic-foot-complications-despite-successful-pancreas-transplantation
#3
Dong-Kyo Seo, Ho Seong Lee, Jungu Park, Chang Hyun Ryu, Duck Jong Han, Sang Gyo Seo
BACKGROUND: It is known that successful pancreas transplantation enables patients with diabetes to maintain a normal glucose level without insulin and reduces diabetes-related complications. However, we have little information about the foot-specific morbidity in patients who have undergone successful pancreas transplantation. The purpose of this study was to investigate the prevalence and predisposing factors for foot complications after successful pancreas transplantation. METHODS: This retrospective study included 218 patients (91 males, 127 females) who had undergone pancreas transplantation for diabetes...
March 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28323803/patient-response-to-an-integrated-orthotic-and-rehabilitation-initiative-for-traumatic-injuries-the-prioriti-mtf-study
#4
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/28323767/how-to-get-to-the-distal-posterior-tibial-malleolus-a-cadaveric-anatomic-study-defining-the-access-corridors-through-3-different-approaches
#5
Mathieu Assal, Miki Dalmau-Pastor, Adrien Ray, Richard Stern
OBJECTIVE: Our objective is to review the anatomy and exposure of the posterior column and posterior tibial malleolus (the posterior tibial plafond) by defining the access corridors through 3 different approaches-posteromedial, posterolateral, and modified posteromedial. METHODS: Cadaveric dissection with percentage of posterior tibial malleolus exposed, and strain gauge measurements to evaluate traction on the neurovascular bundle. RESULTS: The 3 different approaches are applicable for exposure of different portions of the distal posterior tibial malleolus...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323765/misuse-of-opioids-in-orthopaedic-postoperative-patients
#6
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
#7
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/28316904/management-of-osteoporotic-and-neuropathic-ankle-fractures-in-the-elderly
#8
REVIEW
P Hoogervorst, Cja Van Bergen, Mpj Van den Bekerom
PURPOSE OF REVIEW: Treatment of osteoporotic and neuropathic ankle fractures in the elderly is challenging. The purpose of this paper is to review recent publications on this topic and to identify the optimal treatment for these fractures. RECENT FINDINGS: Treatment consists of a variety of conservative or operative options all with advantages and disadvantages as described in this review. Little research has been published that specifically focuses on elderly patients with ankle fractures...
2017: Current Geriatrics Reports
https://www.readbyqxmd.com/read/28306181/total-ankle-replacement-in-patients-with-haemophilic-arthropathy-primary-arthroplasty-and-conversion-of-painful-ankle-arthrodesis-to-arthroplasty
#9
M Preis, T Bailey, M Jacxsens, A Barg
INTRODUCTION: There are two general surgical approaches for operative treatment of end-stage haemophilic ankle arthropathy: ankle arthrodesis and total ankle replacement (TAR). AIM: The aim of this study was to determine intraoperative and postoperative complications and evaluate the mid-term clinical and radiographic outcomes of TAR in patients with haemophilic arthropathy. METHODS: Fourteen patients with a mean age of 51.4 ± 10.2 years (range = 32...
March 17, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28296225/treatment-of-medial-malleolus-or-pure-deltoid-ligament-injury-in-patients-with-supination-external-rotation-type-iv-ankle-fractures
#10
Xu Wang, Chao Zhang, Jian-Wen Yin, Chen Wang, Jia-Zhang Huang, Xin Ma, Cheng-Wei Wang, Xue Wang
OBJECTIVE: To investigate the effect of internal fixation on postoperative ankle function in patients with supination-external rotation type IV ankle fractures, including medial malleolus fractures and deltoid ligament injury. METHODS: Between January 2012 and June 2014, patients with medial structure injuries were enrolled in this study and assigned to the medial malleolus fracture group or the deltoid ligament group. The surgical procedures for the two groups were documented...
March 10, 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28295127/the-crush-index-orthopedic-trauma-as-an-economic-indicator
#11
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/28293302/3-d-computer-modelling-of-malunited-posterior-malleolar-fractures-effect-of-fragment-size-and-offset-on-ankle-stability-contact-pressure-and-pattern
#12
Teresa Alonso-Rasgado, David Jimenez-Cruz, Michael Karski
BACKGROUND: The positioning of the fracture fragment of a posterior malleolus fracture is critical to healing and a successful outcome as malunion of a posterior malleolar fracture, a condition seen in clinical practice, can affect the dynamics of the ankle joint, cause posterolateral rotational subluxation of the talus and ultimately lead to destruction of the joint. Current consensus is to employ anatomic reduction with internal fixation when the fragment size is larger than 25 to 33% of the tibial plafond...
2017: Journal of Foot and Ankle Research
https://www.readbyqxmd.com/read/28293156/indications-of-implant-removal-a-study-of-83-cases
#13
Muhammad Haseeb, Muhammad Farooq Butt, Tariq Altaf, Khalid Muzaffar, Anil Gupta, Aleena Jallu
INTRODUCTION: Fracture fixation has become advanced with the advent of new and custom metal implants for each type of bone/fracture. After union though, the implant ceases to be important and may be removed. Routine removal is advocated by some and opposed by others. Nevertheless, some patients require removal of the hardware because of various implant-related problems. Our study was aimed at identifying the most common causes for implant removal. OBJECTIVE: To investigate the common indications of orthopedic implant removal surgeries...
January 2017: International Journal of Health Sciences
https://www.readbyqxmd.com/read/28292290/comparison-of-the-direct-and-indirect-reduction-techniques-during-the-surgical-management-of-posterior-malleolar-fractures
#14
Hong-Fei Shi, Jin Xiong, Yi-Xin Chen, Jun-Fei Wang, Xu-Sheng Qiu, Jie Huang, Xue-Yang Gui, Si-Yuan Wen, Yin-He Wang
BACKGROUND: The optimal method for the reduction and fixation of posterior malleolar fracture (PMF) remains inconclusive. Currently, both of the indirect and direct reduction techniques are widely used. We aimed to compare the reduction quality and clinical outcome of posterior malleolar fracture managed with the direct reduction technique through posterolateral approach or the indirect reduction technique using ligamentotaxis. METHODS: Patients with a PMF involving over 25% of the articular surface were recruited and assigned to the direct reduction (DR) group or the indirect reduction (IR) group...
March 14, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28291191/which-lateral-malleolar-fractures-do-not-need-an-operation-commentary-on-an-article-by-simo-nortunen-md-et-al-dynamic-stress-testing-is-unnecessary-for-unimalleolar-supination-external-rotation-ankle-fractures-with-minimal-fracture-displacement-on-lateral-radiographs
#15
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
#16
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/28288613/outcome-of-patients-after-lower-limb-fracture-with-partial-weight-bearing-postoperatively-treated-with-or-without-anti-gravity-treadmill-alter-g%C3%A2-during-six-weeks-of-rehabilitation-a-protocol-of-a-prospective-randomized-trial
#17
Ralf Henkelmann, Sebastian Schneider, Daniel Müller, Ralf Gahr, Christoph Josten, Jörg Böhme
BACKGROUND: Partial or complete immobilization leads to different adjustment processes like higher risk of muscle atrophy or a decrease of general performance. The present study is designed to prove efficacy of the anti-gravity treadmill (alter G®) compared to a standard rehabilitation protocol in patients with tibial plateau (group 1)or ankle fractures (group 2) with six weeks of partial weight bearing of 20 kg. METHODS AND DESIGN: This prospective randomized study will include a total of 60 patients for each group according to predefined inclusion and exclusion criteria...
March 14, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28283180/does-intra-articular-load-distribution-change-after-lateral-malleolar-fractures-an-in-vivo-study-comparing-operative-and-non-operative-treatment
#18
Christian Deml, Martin Eichinger, Wouter F van Leeuwen, Stefanie Erhart, Simon A Euler, Alexander Brunner
PURPOSE: The impact of isolated malleolar fractures on the intra-articular load distribution within the ankle joint has been studied in several biomechanical cadaver studies during the last decades. Recently, computed tomography osteoabsorptiometry (CT-OAM) has been proposed as a valuable tool to assess intra-articular joint load distribution in vivo. The purpose of this retrospective matched pair analysis was to apply CT-OAM to evaluate in vivo changes of talar load distribution after lateral malleolar fractures in patients treated with open anatomic reduction and internal fixation (ORIF) compared to patients treated non-operatively...
March 6, 2017: Injury
https://www.readbyqxmd.com/read/28280846/obesity-type-2-diabetes-and-bone-in-adults
#19
REVIEW
Jennifer S Walsh, Tatiane Vilaca
In an increasingly obese and ageing population, type 2 diabetes (T2DM) and osteoporotic fracture are major public health concerns. Understanding how obesity and type 2 diabetes modulate fracture risk is important to identify and treat people at risk of fracture. Additionally, the study of the mechanisms of action of obesity and T2DM on bone has already offered insights that may be applicable to osteoporosis in the general population. Most available evidence indicates lower risk of proximal femur and vertebral fracture in obese adults...
March 9, 2017: Calcified Tissue International
https://www.readbyqxmd.com/read/28279428/nadroparin-or-fondaparinux-versus-no-thromboprophylaxis-in-patients-immobilised-in-a-below-knee-plaster-cast-protect-a-randomised-controlled-trial
#20
Marlieke M Bruntink, Yannick M E Groutars, Inger B Schipper, Roelf S Breederveld, Wim E Tuinebreijer, Robert J Derksen
BACKGROUND: The immobilisation of the lower leg is associated with deep vein thrombosis (DVT). However, thromboprophylaxis in patients with a below-knee plaster cast remains controversial. We examined the efficacy and safety of nadroparin and fondaparinux to ascertain the need for thromboprophylaxis in these patients. METHODS: PROTECT was a randomised, controlled, single-blind, multicentre study that enrolled adults with an ankle or foot fracture who required immobilisation for a minimum of four weeks...
February 22, 2017: Injury
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