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https://www.readbyqxmd.com/read/28697082/primary-posterior-blade-plate-tibiotalar-arthrodesis-a-salvage-procedure-for-complex-nonreconstructable-pilon-fractures
#1
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/28684112/tibiotalocalcaneal-fusion-with-a-cemented-coated-retrograde-nail-as-a-salvage-procedure-for-infected-orif-of-the-ankle
#2
M Herrera-Pérez, J Boluda-Mengod, M J Gutierrez-Morales, J L Pais-Brito
Tibiotalocalcaneal arthrodesis is an effective salvage procedure in cases of combined ankle and subtalar osteoarthritis as well as severe multiplanar deformities and severe joint destruction of the hindfoot. Special mention should be made of this procedure in cases of bone loss, especially from the talus, secondary to failed previous surgeries or bone infection, often being the only way to achieve a stable and painless foot and ankle. We present a case of ankle fracture in a patient with associated morbidity and multiple complications following osteosynthesis, in which tibiotalocalcaneal arthrodesis with cemented with antibiotic coated retrograde nail has achieved a satisfactory final result...
July 3, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/28645549/staged-treatment-of-infected-tibiotalar-fusion-using-a-combination-antibiotic-spacer-and-antibiotic-coated-intramedullary-nail
#3
Justin Miller, Victor Hoang, Richard S Yoon, Frank A Liporace
Pilon fractures are notoriously difficult injuries to treat. The current published data on salvage procedures after failed pilon fractures includes both total ankle arthroplasty (TAA) and tibiotalar fusion, each with its own specific indications. However, no acceptable treatment algorithm addressing the complications of these limb salvage procedures is available. We present the case of a 23-year-old patient, who sustained a complex pilon fracture after a motor vehicle accident. The patient was referred to our institution after an initial fixation attempt, followed by subsequent failed TAA, which was complicated by an infected fusion attempt...
June 20, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28589334/are-there-differences-in-gait-mechanics-in-patients-with-a-fixed-versus-mobile-bearing-total-ankle-arthroplasty-a-randomized-trial
#4
Robin M Queen, Christopher T Franck, Daniel Schmitt, Samuel B Adams
BACKGROUND: Total ankle arthroplasty (TAA) is an alternative to arthrodesis, but no randomized trial has examined whether a fixed bearing or mobile bearing implant provides improved gait mechanics. QUESTIONS/PURPOSES: We wished to determine if fixed- or mobile-bearing TAA results in a larger improvement in pain scores and gait mechanics from before surgery to 1 year after surgery, and to quantify differences in outcomes using statistical analysis and report the standardized effect sizes for such comparisons...
June 6, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28587485/management-of-nonunited-talar-fractures-with-avascular-necrosis-by-resection-of-necrotic-bone-bone-grafting-and-fusion-with-an-intramedullary-nail
#5
Mohamed Mokhtar Abd-Ella, Ahmed Galhoum, Amr Farouk Abdelrahman, Markus Walther
BACKGROUND: The presence of nonunion of a talar fracture with displacement, together with complete avascular necrosis, is a challenging entity to treat. METHODS: Twelve patients, 8 men (66.7%) and 4 women (33.3%), with nonunited talar fractures and extensive avascular necrosis of the talus were included. The average age was 27.7 years (range, 19-38 years). After exclusion of infection, the patients underwent resection of necrotic bone, bulk autograft, and fusion using an intramedullary nail...
June 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28583192/isolated-talonavicular-arthrodesis-and-talonavicular-cuneiform-arthrodesis-for-the-m%C3%A3-ller-weiss-disease
#6
Hong-Hui Cao, Wei-Zhong Lu, Kang-Lai Tang
BACKGROUND: The study aimed to introduce the isolated talonavicular and talonavicular-cuneiform arthrodesis for the stage III and IV Müller-Weiss disease and analyze their clinical outcomes. METHODS: Thirty patients of stage III and IV Müller-Weiss disease were divided into the talonavicular (TN) arthrodesis group and the talonavicular-cuneiform (TNC) arthrodesis group according to the perinavicular osteoarthritis by MRI scans. For the isolated talonavicular arthrodesis group, 16 patients underwent talonavicular arthrodesis with two 4...
June 5, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28578800/geometric-analysis-of-the-talus-and-development-of-a-generic-talar-prosthetic
#7
Alexandra Trovato, Marwan El-Rich, Samer Adeeb, Suki Dhillon, Nadr Jomha
BACKGROUND: Trauma to the talus can result in fracture, avascular necrosis and structural collapse. Treatment has been limited to surgical fusion and total ankle arthroplasty. Total ankle arthroplasty may not be an appropriate treatment for avascular necrosis while surgical fusion of the joint limits mobility. Custom-made implants have recently been used to address these limitations but have lengthy delays between injury and surgery and higher associated costs. A generic talar prosthesis available in various sizes may serve as a suitable alternative...
June 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28578793/medium-to-long-term-results-of-130-ankle-evolutive-system-total-ankle-replacements-inferior-survival-due-to-peri-implant-osteolysis
#8
Helka Koivu, Ia Kohonen, Kimmo Mattila, Eliisa Loyttyniemi, Hannu Tiusanen
BACKGROUND: The study reports the medium to long-term results of 130 Ankle Evolutive System total ankle replacements operated at a single-centre. Previously high amount of peri-implant osteolysis was reported from the same material. METHODS: Between 2002 and 2008 one hundred and thirty consecutive ankles replaced with AES ankle prosthesis were followed both radiologically and clinically. RESULTS: The five-year survival was 87.3% (95% confidence interval (CI) 80...
June 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28576198/current-orthobiologics-for-elective-arthrodesis-and-nonunions-of-the-foot-and-ankle
#9
REVIEW
George F Wallace
A fusion rate of 100% would be ideal. Despite adhering to sound surgical principles, complete compliance, and no adverse comorbidities, that 100% fusion rate goal is elusive. Orthobiologics are a special class of materials developed to enhance the fusion rates in foot and ankle arthrodesis sites. Whether orthobiologics are used for the first fusion or reserved for a nonunion is debatable, especially when considering cost.
July 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/28576189/digital-arthrodesis-of-the-lesser-toes
#10
REVIEW
James P Sullivan, Catherine L Churchill
Foot and ankle surgeons frequently treat digital deformities of the lesser toes surgically. Arthrodesis of the proximal interphalangeal joint is the workhorse procedure for correction of hammer toe contractures. Fusion of the interphalangeal joint can be fixated with a variety of methods, including K-wire fixation, intramedullary implants, absorbable pins, and screws. Each method of fixation has advantages and disadvantages, such as variations in complication rates, cost, and fusion rates. Further research is necessary to determine the best method of fixation for digital interphalangeal joint fusion...
July 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/28566782/early-results-of-an-intraosseous-device-for-arthrodesis-of-the-hallux-metatarsophalangeal-joint
#11
Efstathios Drampalos, Shen Hwa Vun, Levent Bayam, Irfan Fayyaz
BACKGROUND: Arthrodesis of the hallux metatarsophalangeal (MTP) joint is commonly done as a primary procedure either to correct severe hallux valgus deformities or for rheumatoid arthritis, hallux rigidus, in patients with neuromuscular disorders and as a salvage procedure for failed bunion surgery or infection. Prominent metalwork frequently can cause soft tissue impingement and thus require removal. In contrast, osteosynthesis with a completely intraosseous implant has the advantage of less damage to the periosteal circulation...
May 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28562561/comparison-of-mid-term-efficacy-of-spastic-flatfoot-in-ambulant-children-with-cerebral-palsy-by-2-different-methods
#12
COMPARATIVE STUDY
Jie Wen, Hong Liu, Sheng Xiao, Xin Li, Ke Fang, Ming Zeng, Zhongwen Tang, Shu Cao, Fanling Li
To compare the treatment efficacy of spastic flatfoot surgery by 2 different surgical methods: nonfusion subtalar arthroereisis using subtalar joint stabilizer (SJS) and Dennyson-Fulford subtalar arthrodesis (D-FSA).A total of 26 cases of ambulant children with cerebral palsy diagnosed as spastic flatfoot were surgically treated from January 2011 to December 2014. Preoperative and postoperative American Orthopedic Foot and Ankle Society-Ankle and Hindfoot (AOFAS-AH) scores, anteroposterior-talocalcaneal angles (ATAs), and lateral talar-first metatarsal angles (Meary angles) of the affected foot were recorded...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28552836/an-original-fibular-shortening-osteotomy-technique-in-tibiotalar-arthrodesis
#13
N Mehdi, A Bernasconi, J Laborde, F Lintz
Tibiotalar arthrodesis (TTA) is the gold-standard treatment for advanced ankle osteoarthritis. We describe an original fibular shortening osteotomy (FSO) performed during TTA, to allow complete talar ascension and reduce the nonunion rate. Forty-two FSOs were associated to TTA (19 fixed by cross-screwing and 23 by anatomic plates) and assessed clinically and radiographically. At 24.7 months' follow-up, fusion rates were 97.6% for TTA and 100% for FSO, with mean fusion time of 5.2 months. One infection and 1 nonunion (4...
May 25, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28552043/tibiotalocalcaneal-arthrodesis-using-a-soft-tissue-preserved-fibular-graft-for-treatment-of-large-bone-defects-in-the-ankle
#14
Kota Watanabe, Atsushi Teramoto, Takuma Kobayashi, Izaya Ogon, Yuzuru Sakakibara, Tomoaki Kamiya, Tomoyuki Suzuki, Toshihiko Yamashita
BACKGROUND: Pathogenesis of ankle disorders with a large bone defect is varied and treatment for those problems is challenging for orthopaedic surgeons. The aims of this study were to present an operative technique of arthrodesis for the reconstruction of the ankle and hindfoot with a large bone defect using a soft tissue-preserved fibular strut graft and to report outcomes of consecutively treated patients. METHODS: Twelve feet from 11 patients, including feet with aseptic necrosis of the talus and total ankle implant loosening, were treated...
June 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28551465/spinal-fusion-limits-upper-body-range-of-motion-during-gait-without-inducing-compensatory-mechanisms-in-adolescent-idiopathic-scoliosis-patients
#15
R M Holewijn, I Kingma, M de Kleuver, J J P Schimmel, N L W Keijsers
INTRODUCTION: Previous studies show a limited alteration of gait at normal walking speed after spinal fusion surgery for adolescent idiopathic scoliosis (AIS), despite the presumed essential role of spinal mobility during gait. This study analyses how spinal fusion affects gait at more challenging walking speeds. More specifically, we investigated whether thoracic-pelvic rotations are reduced to a larger extent at higher gait speeds and whether compensatory mechanisms above and below the stiffened spine are present...
May 17, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28543369/directing-clinical-care-using-lower-extremity-biomechanics-in-patients-with-ankle-osteoarthritis-and-ankle-arthroplasty
#16
REVIEW
Robin Queen
Ankle osteoarthritis is a debilitating disease with approximately 50,000 new cases per year leading to skeletal deformity, severe and recurrent pain, cartilage breakdown, and gait dysfunction limiting patient mobility and well-being. Although many treatments (total ankle arthroplasty [TAA], ankle fusion [arthrodesis], and ankle distraction arthroplasty) relieve pain, it is not clear that these procedures significantly improve patient mobility. The goal of the research presented here is to summarize what is presently known about lower extremity gait mechanics and outcomes and to quantify the impact of ankle osteoarthritis and TAA have on these measures using an explicitly holistic and mechanistic approach...
May 19, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28535724/long-term-results-of-scandinavian-total-ankle-replacement
#17
Helka Koivu, Ia Kohonen, Kimmo Mattila, Eliisa Loyttyniemi, Hannu Tiusanen
BACKGROUND: The purpose of this study was to evaluate the long-term results of the Scandinavian Total Ankle Replacement (STAR) implant in a single center. METHODS: Between 1997 and 2002, 34 consecutive ankles were replaced with the STAR ankle prosthesis and reviewed in 2016. Patients were followed both radiologically and clinically; clinical outcomes were measured with the Kofoed ankle score and subjective measurements. The median follow-up period was 159 months (13...
May 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28524751/pseudogout-of-the-cervical-and-thoracic-spine-mimicking-infection-after-lumbar-fusion-case-report
#18
Kelly J Bridges, Carli L Bullis, Ajay Wanchu, Khoi D Than
Pseudogout is a form of acute calcium pyrophosphate deposition (CPPD) disease that typically afflicts the elderly. CPPD commonly involves larger joints, such as the knees, wrists, shoulders, and hips, and has been known to involve the spine. The authors report the case of a 66-year-old woman with a recent history of lumbar laminectomy and fusion who presented 5 weeks postprocedure with a clinical and radiographic picture consistent with multilevel skip lesions involving the cervical and thoracic spine, thoracic discitis, and epidural abscess...
May 19, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28523427/-total-ankle-arthroplasty-with-simultaneous-subtalar-fusion
#19
J Mainzer, P Rippstein
OBJECTIVE: Pain free weight bearing ability with orthograde hindfoot position and preserved tibiotalar motion. INDICATIONS: Symptomatic arthritis of the ankle and subtalar joint, additional subtalar hindfoot malalignment. CONTRAINDICATIONS: Absolute: acute infection, noncorrectable ligamentous instability or bony defects, restricted perfusion, diabetic foot syndrome. Relative: inability to comply with postoperative partial weight bearing, only moderate symptoms of subtalar arthritis, smoking, intricate soft tissue situation...
June 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28502347/ankle-arthrodesis-versus-total-ankle-arthroplasty
#20
REVIEW
Joel Morash, David M Walton, Mark Glazebrook
Reoperation rates are higher in total ankle arthroplasties (TAAs) compared with ankle arthrodesis. Infection rates for primary TAAs are 1.4% to 2.4%. The survival rate of TAA is approximately 75% to 90% at 10 years. Arc of motion is maintained with TAAs compared with ankle arthrodesis. Ankle arthrodesis increases arc of motion through the talonavicular joint. Several factors are strong reasons to favor ankle fusion rather than TAA. TAA and ankle arthrodesis are effective treatments of end-stage ankle arthritis but the choice must be tailored to individual patients...
June 2017: Foot and Ankle Clinics
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