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Ankle fractures

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https://www.readbyqxmd.com/read/28737630/first-in-the-nation-one-unit-s-journey-to-achieving-fragility-fracture-certification
#1
Audry McDonald, Samantha Church, Laura Hixon, Linda Vo, Martha Sleutel
Osteoporosis is related to more than 2 million fractures and $19 billion in healthcare costs each year (). A fragility fracture (FF) is a low-energy fracture of the distal radius, proximal humerus, ankle, or proximal femur (hip) from minimal trauma such as a fall from a standing height. In addition to cost, FFs often result in the loss of independence and productivity (). In 2015, our orthopaedic unit received the first certification ever awarded for FFs. Fragility fracture certification is a new certification demonstrating that a healthcare facility complies with national patient care standards and uses evidence-based practice guidelines to deliver quality outcomes...
July 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28736619/the-role-of-orthobiologics-in-foot-and-ankle-surgery-allogenic-bone-grafts-and-bone-graft-substitutes
#2
REVIEW
James Wee, Gowreeson Thevendran
Orthobiologics are biological substances that are used therapeutically for their positive effects on healing skeletal and soft-tissue injuries. The array of orthobiological products currently available to the foot and ankle surgeon is wide, and includes bone allografts, bone substitutes, growth factors, and chondral scaffolds. Nonetheless, despite the surge in interest and usage of orthobiologics, there remains a relative paucity of research addressing their specific applications in foot and ankle surgery. In this review, we attempt to provide an overview of the literature on commonly available allogenic bone grafts and bone substitutes...
June 2017: EFORT open reviews
https://www.readbyqxmd.com/read/28734495/clinical-experiences-in-the-use-of-a-gentamicin-coated-titanium-nail-in-tibia-fractures-and-revisions
#3
G Schmidmaier, M Kerstan, P Schwabe, N Südkamp, M Raschke
Despite the improvement of surgical techniques surgical site infections (SSIs) still remain a significant clinical burden in high risk patients undergoing osteosynthesis for tibia fractures. The use of an antibiotic coated implant might reduce the adhesion of bacteria on the implant surface and could therefore reduce the rate of implant-related infection or osteomyelitis. In this prospective multicenter study the use of a gentamicin-coated tibia nail for the treatment of open and closed tibia fractures and non-union revision cases was evaluated in 100 patients (99 treated) followed for 18 months...
July 10, 2017: Injury
https://www.readbyqxmd.com/read/28731965/functional-outcomes-post-lisfranc-injury-transarticular-screws-dorsal-bridge-plating-or-combination-treatment
#4
Simon Lau, Catherine Guest, Marcus Hall, Mark Tacey, Samuel Joseph, Andrew Oppy
OBJECTIVE: To identify whether transarticular screws, dorsal bridging plates or a combination of the 2 result in the best functional outcome after Lisfranc injury. DESIGN: Case series. SETTING: Level one trauma center. PATIENTS: Fifty patients who underwent surgical fixation of Lisfranc injuries over a 6-year period were retrospectively reviewed. INTERVENTION: One of 3 treatment arms: transarticular screw fixation alone, dorsal bridge plating alone or a combination of dorsal bridge and transarticular screw fixation...
August 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28727342/-obesity-fat-and-bones-friends-or-foes
#5
Emmanuel Biver
Low fat mass is associated with an increased risk of fracture because of low bone mineral density (BMD) and altered bone micro-architecture. Conversely, overweight and obese patients also have an increased risk of fracture, particularly of the humerus and ankle, despite greater BMD. Visceral abdominal fat, which is the most metabolically active, may be associated with poorer quality of bone tissue properties, as suggested in diabetes. Other factors may contribute to higher fracture risk in overweight patients, notably higher frequency of falls and lower bioavailability of vitamin D stoked in fat...
April 19, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28723779/can-operations-achieve-good-outcomes-in-elderly-patients-with-sanders-ii-iii-calcaneal-fractures
#6
Jun Su, Xuecheng Cao
The aim of this study was to compare the clinical effect of operative treatment and nonoperative treatment for elderly patients with Sanders II-III calcaneal fractures.The study consisted of 60 patients with Sanders II-III calcaneal fractures who were treated in our institution from January 2007 to April 2012. The clinical effect between the operative treatment group of 32 patients and the nonoperative treatment group of 28 patients was studied. Böhler angle, Gissane angle, subtalar joint motion, calcaneal width, and calcaneal height were measured before and after treatment, and these indexes were also measured on the uninjured foot...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28721473/biomechanics-of-the-classic-metaphyseal-lesion-finite-element-analysis
#7
Andy Tsai, Brittany Coats, Paul K Kleinman
BACKGROUND: The classic metaphyseal lesion (CML) is strongly associated with infant abuse, but the biomechanics responsible for this injury have not been rigorously studied. Radiologic and CT-pathological correlates show that the distal tibial CML always involves the cortex near the subperiosteal bone collar, with variable extension of the fracture into the medullary cavity. Therefore, it is reasonable to assume that the primary site of bone failure is cortical, rather than intramedullary...
July 18, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28719778/medial-malleoli-fractures-clinical-comparison-between-newly-designed-sled-device-and-conventional-screws
#8
Hemil Maniar, Harish Kempegowda, Akhil A Tawari, Michael R Rutter, Amrut Borade, Gerard Cush, Daniel S Horwitz
BACKGROUND: The Trimed Medial Malleolar Sled is a newer device designed to treat medial malleolus fracture. The purpose of this study was to compare the outcome of medial malleolar fractures treated with the sled and conventional malleolar screws. METHODS: After obtaining an institutional review board approval, we conducted a retrospective study to identify all skeletally mature patients who sustained an ankle fracture with medial malleolar involvement treated with the sled and we identified a matched cohort treated with conventional malleolar screws...
August 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28716100/quality-of-life-and-clinical-radiological-long-term-results-after-implant-associated-infections-in-patients-with-ankle-fracture-a-retrospective-matched-pair-study
#9
Patrick Ziegler, Donat Schlemer, Ingo Flesch, Sonja Bahrs, Ulrich Stoeckle, Sebastian Werner, Christian Bahrs
BACKGROUND: Ankle fractures are frequently occurring injuries. Despite the relatively simple operative technique, patients often suffer from postoperative complications. Little is known about postoperative treatment of implant-associated infections of the ankle. Therefore, this study shows and evaluates a treatment algorithm in long- and short-term outcomes compared to infection-free patients. METHODS: Data from patients of over 20 years of a level 1 trauma center and university hospital was retrospectively analyzed including age, gender, comorbidities, smoking status, fracture classification, number of revisions, length of in-patient stay due to fracture and infection, and results of microbiological specimen with the length of antibiotic treatment...
July 17, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28713455/a-pilot-study-of-the-effect-of-outsole-hardness-on-lower-limb-kinematics-and-kinetics-during-soccer-related-movements
#10
Dong Sun, Qichang Mei, Julien S Baker, Xuewen Jia, Yaodong Gu
The purpose of this study was to investigate the effect of different outsole hardness of turf cleats shoes on the lower limb kinematics and kinetics of soccer players playing on artificial turf. The participants were required to complete tasks of straight running and 45° left sidestep cutting movements, respectively, at the speed of 4.5 ± 0.2 m/s on artificial turf. They were asked to randomly select turf cleats shoes with a soft outsole (SO), medium hardness outsole (MO) and hard outsole (HO). During the stance phase of straight running, peak pressure and force-time integral in medial forefoot (MFF) of players wearing cleats shoes with MO were significantly higher than those wearing cleats shoes with SO...
June 2017: Journal of Human Kinetics
https://www.readbyqxmd.com/read/28710794/ultrasound-assessment-of-the-sural-nerve-in-patients-with-neuropathic-pain-after-ankle-surgery
#11
Nadia Rbia, Tim H J Nijhuis, Gert R Roukema, Ruud W Selles, Cornelis H van der Vlies, Steven E R Hovius
BACKGROUND: The sural nerve may be damaged following ankle injury. The aim of our study was to determine the diagnostic utility of high-resolution sonography in patients with ankle fractures treated by open reduction and internal fixation in whom there was a clinical suspicion of sural neuropathy. METHODS: We examined the ultrasound (US) characteristics of patients with and without post-surgical sural neuropathic pain and healthy volunteers. Cross-sectional area (CSA), echogenicity and vascularization of the sural nerves were recorded...
July 15, 2017: Muscle & Nerve
https://www.readbyqxmd.com/read/28708780/syndesmotic-ankle-fractures-a-systematic-review
#12
James D Michelson, Michael Wright, Michael Blankstein
OBJECTIVES: The diagnosis and treatment of syndesmotic ankle fractures is controversial. This systematic review was performed to clarify the current understanding addressing several clinical questions that arise in the treatment of such injuries DATA SOURCES:: The English language literature was searched using PubMed, EMBASE, and Web of Science. The search terms were "syndesmosis" or "syndesmotic" in combination with the terms "ankle fracture" or "fracture". The included dates were between 1967 and July 2015...
June 22, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28707536/radiation-dose-reduction-in-multi-detector-ct-in-fracture-evaluation
#13
Jung Woo Yi, Hee Jin Park, So Yeon Lee, Myung Ho Rho, Hyun Pyo Hong, Yoon Jung Choi, Mi Sung Kim
OBJECTIVE: To evaluate whether multi-detector CT with low-dose radiation (low-dose CT) of joints can be useful when evaluating fractures. METHODS AND MATERIALS: Our study included CT scans of 398 patients, 103 shoulder cases, 109 wrist cases, 98 pelvis cases and 88 ankle cases. There were 191 women and 207 men. The low-dose CTs were performed using identical voltage and parameters with the exception of decreased (half of standard dose) tube current. Lowdose and standard-dose images were compared with regards to objective image quality, subjective evaluation of image quality and diagnostic performance for the fractures...
July 14, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28705216/surgical-management-of-hawkins-type-iii-talar-neck-fracture-through-the-approach-of-medial-malleolar-osteotomy-and-mini-plate-for-fixation
#14
Hui Liu, Zhida Chen, Wenrong Zeng, Yuanfei Xiong, Yongzhi Lin, Huacheng Zhong, Jin Wu
BACKGROUND: Fractures of the talar neck are relatively uncommon yet current interventions suffer from a high incidence of complications and poor functional outcomes. In the present study, we report a surgical treatment of Hawkins type III talar neck fracture through the approach of medial malleolar osteotomy and mini-plate for fixation and discuss the therapeutic effects after long-term follow-up. METHODS: From January 2010 to January 2015, 21 patients with 22 fractures were treated using this approach within days of sustaining the injury...
July 14, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28704747/two-cases-of-late-medial-instability-of-the-knee-due-to-hip-disease-after-total-knee-arthroplasty
#15
Masanori Tsubosaka, Tomoyuki Matsumoto, Koji Takayama, Naoki Nakano, Ryosuke Kuroda
INTRODUCTION: There are few specific reports of late medial instability after total knee arthroplasty (TKA). We described two cases of late medial instability of the knee due to hip disease with osteoarthritis or rheumatoid arthritis after TKA, which required revision TKA. PRESENTATION OF CASES: An 82-year-old woman experienced right femoral neck fracture due to a fall that required conservative treatment at age 77 years and underwent left TKA at age 80 years. A 68-year-old woman underwent left TKA at age 54 years, right TKA at age 64 years, and left THA at age 67 years...
June 29, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28697881/incarceration-of-the-posterior-tibial-tendon-in-an-isolated-comminuted-medial-malleolus-fracture
#16
David Jaffe, Matthew W Christian, Annie Weber, R Frank Henn
Isolated medial malleolar fractures are a less common presentation of an ankle fracture. Treatment is not universally accepted, although many have agreed that any displacement warrants anatomic reduction and fixation. We present a case of an isolated, comminuted medial malleolar fracture that was displaced secondary to entrapment of the posterior tibial tendon between the fracture fragments requiring surgical intervention. The patient was treated with prompt open reduction and internal fixation and had an excellent functional outcome at 1 year...
July 8, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28697082/primary-posterior-blade-plate-tibiotalar-arthrodesis-a-salvage-procedure-for-complex-nonreconstructable-pilon-fractures
#17
Ermias Abebe, Dana J Farrell, Boris Zelle, Gary Gruen
A subset of C2/C3 pilon fractures, open pilon injuries, metaphyseal bone comminution, and those involving substantial soft tissue or vascular injury may be nonreconstructable. Such injuries are at risk of progress to nonunion and failing open reduction internal fixation (ORIF). The risk of infection, malunion, and nonunion is relatively high with such injury patterns. In such cases, tibiotalar arthrodesis is performed after ORIF fails as a salvage procedure. Overall, the literature agrees that all pilon fractures will develop posttraumatic osteoarthritis, and these patients are ultimately treated with an arthrodesis or in narrow population with total ankle arthroplasty...
August 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28697075/posterolateral-bone-grafting-for-distal-tibia-nonunion
#18
Sanjit Konda, Hesham Saleh, Nina Fisher, Kenneth A Egol
INTRODUCTION: This video demonstrates the technique of posterolateral bone grafting with iliac crest bone graft for a distal tibial nonunion. METHODS: The patient is a 42-year-old man who is 6 months status post an open distal tibia-fibula fracture treated surgically, and presents complaints of persistent right ankle pain. The fracture site was tender to palpation, and 3 consecutive plain radiographs spaced 6 weeks apart demonstrated no evidence of callus formation...
August 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28697074/repair-of-bimalleolar-ankle-fracture
#19
Nina Fisher, Abiola Atanda, Stephanie Swensen, Kenneth A Egol
PURPOSE: The incidence of ankle fractures is rapidly increasing in geriatric populations. Of the 4 fracture patterns described by the Lauge-Hansen classification system, supination-external rotation (SER) accounts for most ankle fractures. This video demonstrates surgical repair of a SER type 4 ankle fracture in a geriatric patient. METHODS: SER type 4 ankle fractures are considered unstable and are generally treated with surgical fixation. After placement of plate and screws, intraoperative stress tests can be used to assess for syndesmotic widening...
August 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28696780/evaluation-of-the-effectiveness-of-toe-board-energy-absorbing-material-for-foot-ankle-and-lower-leg-injury-reduction
#20
John P Patalak, Joel D Stitzel
OBJECTIVE: Since 2000 numerous improvements have been made to the National Association for Stock Car Auto Racing, Incorporated (NASCAR®) driver restraint system, resulting in improved crash protection for motorsports drivers. Advancements have included seats, head and neck restraints (HNR), seat belt restraint systems, driver helmets and others. These enhancements have increased protection for drivers from severe crash loading. Extending protection to the driver's extremities remains challenging...
July 11, 2017: Traffic Injury Prevention
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