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Kenneth W DeFontes, Joshua Vaughn, Jeremy Smith, Eric M Bluman
Talar body osteonecrosis can be a devastating, painful condition that is difficult to manage surgically when conservative treatments have failed. With early disease, nonoperative treatments can prolong the need for operative correction in the young patient. Later stage disease with extensive involvement may require a tibiotalocalcaneal (TTC) arthrodesis to retain functionality of the limb. This situation frequently requires a structural bone graft. Using the technique described in this article, the void resulting from collapse of the talar body is filled with talar allograft, which offers a more anatomic and structurally rigid construct than previously described methods using an allograft femoral head...
March 1, 2018: Foot & Ankle International
Joseph Tracey, Danny Arora, Christopher E Gross, Selene G Parekh
BACKGROUND: Third generation total talar prostheses (TTPs) are viable options for talar avascular necrosis (AVN) in the absence of neighboring joint pathology. The use of modern three-dimensional (3D) printing allows the production of custom implants that exactly mimic the patient's anatomy. The aim of this study is to determine the accuracy of 3D printing in reproducing a synthetic talus and, in doing so, restoring more normal anatomical relationships. We hypothesize that this mode of replication will restore and maintain normal radiographic alignment of the ankle, subtalar, and forefoot joints in the setting of talar AVN...
March 1, 2018: Foot & Ankle Specialist
A Burssens, J Peeters, M Peiffer, R Marien, T Lenaerts, G Vandeputte, J Victor
PURPOSE: The exact radiographic assessment of the hindfoot alignment remains challenging. This is reflected in the different measurement methods available. Weightbearing CT (WBCT) has been demonstrated to be more accurate in hindfoot measurements. However, current measurements are still performed in 2D. This study wants to assess the use of computed methods to convert the former uniplanar hindfoot measurements obtained after WBCT towards a 3D setting. METHODS: Forty-eight patients, mean age of 39...
March 9, 2018: International Journal of Computer Assisted Radiology and Surgery
Rajat Mittal, David Drynan, Ian A Harris, Justine M Naylor
BACKGROUND: This systematic review aims to determine the effectiveness of surgical and non-surgical management for the type B ankle fracture with minimal talar shift. METHODS: Two authors independently systematically searched the following databases: MEDLINE, EMBASE and CENTRAL. Only randomized controlled trials were included that evaluated surgical versus non-surgical management of type B ankle fracture with minimal talar shift in adults. Two authors independently performed study selection, risk of bias assessment and data extraction...
March 8, 2018: ANZ Journal of Surgery
Christiane Kruppa, Tyler Snoap, Debra L Sietsema, Thomas A Schildhauer, Marcel Dudda, Clifford B Jones
The outcomes of pediatric talus fractures have been minimally reported in published studies. The purpose of the present retrospective study was to determine the clinical and radiographic outcomes after talus fractures in pediatric and adolescent patients and to define the differences among the different age groups in this population. A total of 52 children and adolescents (54 fractures) with 24 type 1 (44.44%), 13 type 2 (24.07%), 8 type 3 (14.81%), and 9 type 4 (16.67%) Marti-Weber fractures were considered...
March 2, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Yaning Sun, Huijuan Wang, Yuchao Tang, Shiji Qin, Mingming Zhao, Fengqi Zhang
This study aimed to report our institution's experience in the diagnosis and treatment of chronic lateral ankle instability (CLAI) with ligamentum bifurcatum (LB) injury.This retrospective study included 218 consecutive patients with CLAI who underwent surgery from January 2012 to December 2015. The 218 patients received tendon allograft reconstruction of the lateral ligament. CLAI was combined with LB injury in 51.4% (112/218) of patients. The 112 patients with concurrent LB injury had this treated simultaneously; 36 patients underwent excision of the anterior process of the calcaneus, 68 underwent LB repair, and 8 underwent LB reconstruction...
March 2018: Medicine (Baltimore)
Jing Luo, Felix S Chew, Alice S Ha
Ankle cheilectomy as surgical treatment for anterior ankle impingement has high rates of procedural success and low rates of complications when performed before the onset of significant osteoarthritis. We present 3 patients who developed insufficiency fractures of the talar neck following cheilectomy for anterior ankle impingement. Due to the high risk of avascular necrosis associated with displaced talar neck fractures, the recognition of talar insufficiency fractures by the radiologist can aid in the timely diagnosis and initiation of intervention...
February 2018: Radiology Case Reports
Kwasi Y Kwaadu
Fractures of the talus are significant injuries with associated significant complications where the recovery zenith is less frequently good to excellent, and more commonly fair to satisfactory. These outcomes are a consequence of combinations of the inherent intrinsic and surrounding anatomy, technical and logistic difficulties in adequate fracture access, and the high-energy mechanisms typically associated with these injuries that further traumatize the surrounding tissues. This article reviews and provides current management recommendations for these devastating injuries...
April 2018: Clinics in Podiatric Medicine and Surgery
Yunwei Cui, Pan Hu, Ning Wei, Xiaodong Cheng, Wenli Chang, Wei Chen
BACKGROUND Clinical studies indicate that in total ankle arthroplasty, postoperative implant subsidence and medial tilt become two significant concerns of the ankle replacement system, and which are associated with the contact between the bones and the talar component. Up to now, little attention has focused on the contact between the bones and the talar component. MATERIAL AND METHODS In order to address implant subsidence and medial tilt, one three-dimensional finite element model of contact between the bone and the talar components was built with the material properties of the cancellous bone interpolated from the experimental data, which represents variation of material properties through the cancellous bones...
February 23, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Sang-Lim Kim, Byoung-Hee Lee
Background: This study was to evaluate the effects of weight-bearing-based mobilization with movement (WBBMWM) on balance and gait in stroke patients. Methods: Thirty stroke patients participated in this study. All individuals were randomly assigned to either WBMWM group ( n = 15) or weight-bearing with placebo mobilization with movement group (control, n = 15). Individuals in the WBMWM group were trained for 10 glides of 5 sets a day, 5 times a week during 4 weeks...
January 2018: Journal of Neurosciences in Rural Practice
Ebrahim Izadi, Rahij Anwar, Sarah Phillips, Venu Kavarthapu
Displaced osteochondral fractures of the body of talus quite often require a malleolar osteotomy to gain access to the fracture fragment during internal fixation. We describe a case report in which access to a displaced osteochondral fracture of the lateral talar dome was achieved using an arthroscopy-assisted fibular tunnel approach. This technique resulted in satisfactory fracture healing and a satisfactory clinical outcome.
February 15, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Jiří Jochymek, Jakub Turek
OBJECTIVE: The aim of this study was to assess the role of sonographic evaluation of Talar dysplasia in predicting the outcome of standard Ponseti method in the treatment of clubfoot deformity. METHODS: A total 23 children (15 boys and 8 girls; mean age: 18.2 ± 5.4 days (8-32)) who underwent Ponseti treatment were included in the study. Before the treatment, maximal talus length of affected and non-affected feet were measured by US and relative talar dysplasia ratio (RTDR) was calculated...
February 13, 2018: Acta Orthopaedica et Traumatologica Turcica
Christopher L McCrum, Justin W Arner, Bryson Lesniak, James P Bradley
Anterior ankle impingement is a frequent cause of pain and disability in athletes with impingement of soft-tissue or osseous structures along the anterior margin of the tibiotalar joint during dorsiflexion. In this study, we hypothesized that arthroscopic decompression of anterior ankle impingement would result in significant, reliable, and durable improvement in pain and range of motion (ROM), and would allow National Football League (NFL) players to return to their preoperative level of play. We reviewed 29 arthroscopic ankle débridements performed by a single surgeon...
January 2018: American Journal of Orthopedics
Melissa Corso, Christopher DeGraauw, William Hsu
Introduction: Osteochondral lesions of the tibial plafond account for approximately 2.6% of osteochondral lesions in the ankle. There are few cases describing this lesion in the literature, with little information on mechanism of injury, history/physical findings or recommendations for management. Case Presentation: A 17-year-old male competitive soccer player presented with a 6-7 month history of medial ankle pain after an inversion sprain. He presented with locking and giving way of the ankle with weight-bearing and pushing off the foot to the contralateral side...
December 2017: Journal of the Canadian Chiropractic Association
Alison P Klein, Brian M Wolpin, Harvey A Risch, Rachael Z Stolzenberg-Solomon, Evelina Mocci, Mingfeng Zhang, Federico Canzian, Erica J Childs, Jason W Hoskins, Ashley Jermusyk, Jun Zhong, Fei Chen, Demetrius Albanes, Gabriella Andreotti, Alan A Arslan, Ana Babic, William R Bamlet, Laura Beane-Freeman, Sonja I Berndt, Amanda Blackford, Michael Borges, Ayelet Borgida, Paige M Bracci, Lauren Brais, Paul Brennan, Hermann Brenner, Bas Bueno-de-Mesquita, Julie Buring, Daniele Campa, Gabriele Capurso, Giulia Martina Cavestro, Kari G Chaffee, Charles C Chung, Sean Cleary, Michelle Cotterchio, Frederike Dijk, Eric J Duell, Lenka Foretova, Charles Fuchs, Niccola Funel, Steven Gallinger, J Michael M Gaziano, Maria Gazouli, Graham G Giles, Edward Giovannucci, Michael Goggins, Gary E Goodman, Phyllis J Goodman, Thilo Hackert, Christopher Haiman, Patricia Hartge, Manal Hasan, Peter Hegyi, Kathy J Helzlsouer, Joseph Herman, Ivana Holcatova, Elizabeth A Holly, Robert Hoover, Rayjean J Hung, Eric J Jacobs, Krzysztof Jamroziak, Vladimir Janout, Rudolf Kaaks, Kay-Tee Khaw, Eric A Klein, Manolis Kogevinas, Charles Kooperberg, Matthew H Kulke, Juozas Kupcinskas, Robert J Kurtz, Daniel Laheru, Stefano Landi, Rita T Lawlor, I-Min Lee, Loic LeMarchand, Lingeng Lu, Núria Malats, Andrea Mambrini, Satu Mannisto, Roger L Milne, Beatrice Mohelníková-Duchoňová, Rachel E Neale, John P Neoptolemos, Ann L Oberg, Sara H Olson, Irene Orlow, Claudio Pasquali, Alpa V Patel, Ulrike Peters, Raffaele Pezzilli, Miquel Porta, Francisco X Real, Nathaniel Rothman, Ghislaine Scelo, Howard D Sesso, Gianluca Severi, Xiao-Ou Shu, Debra Silverman, Jill P Smith, Pavel Soucek, Malin Sund, Renata Talar-Wojnarowska, Francesca Tavano, Mark D Thornquist, Geoffrey S Tobias, Stephen K Van Den Eeden, Yogesh Vashist, Kala Visvanathan, Pavel Vodicka, Jean Wactawski-Wende, Zhaoming Wang, Nicolas Wentzensen, Emily White, Herbert Yu, Kai Yu, Anne Zeleniuch-Jacquotte, Wei Zheng, Peter Kraft, Donghui Li, Stephen Chanock, Ofure Obazee, Gloria M Petersen, Laufey T Amundadottir
In 2020, 146,063 deaths due to pancreatic cancer are estimated to occur in Europe and the United States combined. To identify common susceptibility alleles, we performed the largest pancreatic cancer GWAS to date, including 9040 patients and 12,496 controls of European ancestry from the Pancreatic Cancer Cohort Consortium (PanScan) and the Pancreatic Cancer Case-Control Consortium (PanC4). Here, we find significant evidence of a novel association at rs78417682 (7p12/TNS3, P = 4.35 × 10-8). Replication of 10 promising signals in up to 2737 patients and 4752 controls from the PANcreatic Disease ReseArch (PANDoRA) consortium yields new genome-wide significant loci: rs13303010 at 1p36...
February 8, 2018: Nature Communications
Xian-Xun Wang, Chang-Tao Wan, Li Yu
OBJECTIVE: To investigate the clinical effects of compression hollow screws combined with external fixator in treating talar neck fracture of Hawkins III, IV type. METHODS: From March 2010 to August 2014, 15 patients with talar neck fractures of Hawkins III, IV type were treated by open reduction and compression hollow screws fixation complicated with external fixator fixation. Including 9 males and 6 females, aged from 17 to 65 years old with an average of 37.5 years old...
May 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Alessio Bernasconi, Nazim Mehdi, François Lintz
Ankle arthrodesis is still considered the gold standard in the treatment of advanced painful ankle osteoarthritis. More than 3 decades ago, it was performed under arthroscopy; thereafter, many authors have reported excellent results and a low complication rate. Despite the significant improvements in surgical techniques, nonunion remains a problematic and relatively frequent event. This is one of the reasons the research is constantly active in this field. Ten years ago, a fibular resection during ankle arthrodesis was, for the first time, described in the literature as a means to correct malalignment in varus cases...
October 2017: Arthroscopy Techniques
Luigi Manzi, Jorge Hugo Villafañe, Cristian Indino, Jacopo Tamini, Pedro Berjano, Federico Giuseppe Usuelli
BACKGROUND: The purpose of this study was to investigate the test-retest reliability of the Phi angle in patients undergoing total ankle replacement (TAR) for end stage ankle osteoarthritis (OA) to assess the rotational alignment of the talar component. METHODS: Retrospective observational cross-sectional study of prospectively collected data. Post-operative anteroposterior radiographs of the foot of 170 patients who underwent TAR for the ankle OA were evaluated...
November 8, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Atif Ahmed Khan, Alparslan Bayram Çarlı, Uzma Akhlaque, Murat Kara, Akhtar Waheed, Levent Özçakar
BACKGROUND: Unilateral lower limb amputation can alter the tissue morphology leading to increase future risk of degenerative secondary disorders. METHODS: Thirty-four consecutive male patients with unilateral lower limb amputations of different levels and 34 well matched male controls were included. To explore whether the ankles of traumatic lower limb amputees were undergoing morphological changes, three different tissue types i.e. talar cartilage, plantar fascia and Achilles tendon thicknesses in the intact limb of the lower limb amputee and healthy controls were measured by using ultrasound...
June 12, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Riccardo D'Ambrosi, Camilla Maccario, Chiara Ursino, Nicola Serra, Federico Giuseppe Usuelli
BACKGROUND: To assess the functional and radiological outcomes after arthroscopic talus autologous matrix-induced chondrogenesis (AT-AMIC®) in 2 groups: patients with and without bone marrow edema (BME). METHODS: Thirty-seven patients of which 24 without edema (GNE) and 13 with edema (GE) were evaluated. All patients were treated with AT-AMIC® repair for symptomatic osteochondral talar lesion. Clinical and radiological parameters were evaluated with VAS score for pain, AOFAS and SF-12 at T0 (preoperatively), T1 (6 months), T2 (12 months), T3 (24 months) and MRI and CT-scan at T0, T1, T2 and T3...
March 6, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
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