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Tibial plafond

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https://www.readbyqxmd.com/read/28198793/proximity-and-risks-of-the-anterior-neurovascular-and-tendinous-anatomy-of-the-distal-leg-relative-to-anteriorly-applied-distal-locking-screws-for-tibia-nailing-a-plea-for-open-insertion
#1
Phillip M Mitchell, Cory A Collinge, Eric Barcak, Edward Perez, Kostas Triantafillou
PURPOSE: To determine the proximity and potential risks to distal leg anatomy from anterior to posteriorly (A-P) applied distal tibia locking screws for tibial nailing. DESIGN: Retrospective. SETTING: ACS level I trauma center. PATIENTS/PARTICIPANTS: Twenty consecutive adult patients undergoing computed tomograms with intravenous contrast (CTAs) on uninjured legs. MAIN OUTCOME MEASUREMENTS: Simulated 5 mm distal interlocking screws placed in the A-P axis of an ideally placed tibial nail at 10 mm increments from the tibial plafond (10 to 40mm) were studied in relation to the distal leg's anterior anatomy...
February 14, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28167058/posterior-malleolar-fractures-changing-concepts-and-recent-developments
#2
REVIEW
Jan Bartoníček, Stefan Rammelt, Michal Tuček
Injuries to the posterior malleolus are of prognostic relevance in ankle fracture-dislocations. The three-dimensional outline of the fragments as reflected by computed tomography classification, involvement of the fibular notch, and the presence of intercalary fragments seem to be of greater therapeutic relevance than the size of the fragment and amount of the articular surface involved. Operative treatment aims at reconstruction of the posterior tibial plafond, the fibular notch, and the integrity of the posterior inferior tibiofibular syndesmosis...
March 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28159051/an-uncommon-case-of-irreducible-ankle-fracture-dislocation-the-bosworth-like-tibio-fibular-fracture
#3
Michele Cappuccio, Danilo Leonetti, Berardo Di Matteo, Domenico Tigani
An irreducible ankle-fracture dislocation characterized by the dislocation of the proximal fragment of the fibula posteriorly to the tibial tubercle is defined as "Bosworth injury". In the present report it is described, for the first time in literature, a complex case where the Bosworth injury was associated to a tibial plafond fracture: the proximal fibular fragment was entrapped between the tibial pilon and the fractured posterior tibial tubercle, which acted as a clamp, thus avoiding ankle reduction. Due to the presence of the tibial fracture, it was not possible to observe the typical radiological signs of Bosworth injury and therefore two unsuccessful reductions were attempted before performing a CT scan that revealed the complexity of the case, that required an immediate ORIF procedure to prevent the onset of complications...
March 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28054323/classifications-in-brief-r%C3%A3-edi-allg%C3%A3-wer-classification-of-tibial-plafond-fractures
#4
T David Luo, J Matthew Eady, Arun Aneja, Anna N Miller
No abstract text is available yet for this article.
January 4, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27994722/immediate-unrestricted-postoperative-weightbearing-and-mobilization-after-bone-marrow-stimulation-of-large-osteochondral-lesions-of-the-talus
#5
Gregory A Lundeen, Linda J Dunaway
OBJECTIVE: There remains no consensus on a postoperative protocol following arthroscopic treatment of osteochondral lesions of the talus (OLTs) and most studies report a period of immobilization and nonweightbearing. Outcomes are believed to decrease with larger size. The purpose of our study was to evaluate patients who underwent arthroscopic treatment of large (≥150 mm(2)) OLTs with immediate unrestricted weightbearing and mobilization postoperatively. DESIGN: Patients who underwent arthroscopic bone marrow stimulation for osteochondral defects were identified...
January 2017: Cartilage
https://www.readbyqxmd.com/read/27872380/management-of-distal-tibial-metaphyseal-bone-defects-with-an-intramedullary-nitinol-scaffold-a-novel-technique
#6
Samuel E Ford, J Kent Ellington
: Difficult problems that are faced when reconstructing severe pilon fractures include filling metaphyseal defects and supporting an impacted, multifragmented articular surface. Supplements to plate fixation currently available in a surgeon's armamentarium include cancellous bone autograft, structural bone allograft, demineralized bone matrix, and calcium-based cements. Cancellous autograft possesses limited inherent mechanical stability and is associated with graft site morbidity. Structural allografts incorporate inconsistently and are plagued by late resorption...
November 20, 2016: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/27716360/differences-in-joint-morphology-between-the-knee-and-ankle-affect-the-repair-of-osteochondral-defects-in-a-rabbit-model
#7
Manami Makitsubo, Nobuo Adachi, Tomoyuki Nakasa, Tomohiro Kato, Ryo Shimizu, Mitsuo Ochi
BACKGROUND: Although differences in the results of the bone marrow stimulation technique between the knee and ankle have been reported, a detailed mechanism for those differences has not been clarified. The purpose of this study was to examine whether morphological differences between the knee and ankle joint affect the results of drilling as treatment for osteochondral defects in a rabbit model. METHODS: Osteochondral defects were created at the knee and ankle joint in the rabbit...
October 4, 2016: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/27649973/determining-the-cost-savings-threshold-and-alignment-accuracy-of-patient-specific-instrumentation-in-total-ankle-replacements
#8
Kamran S Hamid, Andrew P Matson, Benedict U Nwachukwu, Daniel J Scott, Richard C Mather, James K DeOrio
BACKGROUND: Traditional intraoperative referencing for total ankle replacements (TARs) involves multiple steps and fluoroscopic guidance to determine mechanical alignment. Recent adoption of patient-specific instrumentation (PSI) allows for referencing to be determined preoperatively, resulting in less steps and potentially decreased operative time. We hypothesized that usage of PSI would result in decreased operating room time that would offset the additional cost of PSI compared with standard referencing (SR)...
January 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/27599433/arthroscopic-anatomy-of-the-ankle-joint
#9
REVIEW
Ronald G Ray
There are a number of variations in the intra-articular anatomy of the ankle which should not be considered pathological under all circumstances. The anteromedial corner of the tibial plafond (between the anterior edge of the tibial plafond and the medial malleolus) can have a notch, void of cartilage and bone. This area can appear degenerative arthroscopically; it is actually a normal variant of the articular surface. The anterior inferior tibiofibular ligament (AITF) can possess a lower, accessory band which can impinge on the anterolateral edge of the talar dome...
October 2016: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27574254/preoperative-radiography-versus-computed-tomography-for-surgical-planning-for-ankle-fractures
#10
K H Leung, C Xs Fang, T W Lau, F Kl Leung
PURPOSE: To review preoperative radiography and computed tomography (CT) of the ankle in 69 patients who underwent surgery for ankle fractures to determine the value of CT in diagnosis and surgical planning. METHODS: Preoperative radiography and CT of the ankle of 46 women and 23 men aged 17 to 90 (mean, 48.8) years were reviewed. CT was deemed necessary when radiographs showed the following features: (1) comminuted fracture of the medial malleolus involving the tibial plafond, (2) comminuted fracture of the posterior malleolus, (3) presence of loose bodies, and/or (4) suspected Chaput or Volkman fracture fragment...
August 2016: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/27530984/the-role-of-fluid-dynamics-in-distributing-ankle-stresses-in-anatomic-and-injured-states
#11
Kamran S Hamid, Aaron T Scott, Benedict U Nwachukwu, Kerry A Danelson
BACKGROUND: In 1976, Ramsey and Hamilton published a landmark cadaveric study demonstrating a dramatic 42% decrease in tibiotalar contact area with only 1 mm of lateral talar shift. An increase in maximum principal stress of at least 72% is predicted based on these findings though the delayed development of arthritis in minimally misaligned ankles does not appear to be commensurate with the results found in dry cadaveric models. We hypothesized that synovial fluid could be a previously unrecognized factor that contributes significantly to stress distribution in the tibiotalar joint in anatomic and injured states...
December 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/27528835/expedited-ct-based-methods-for-evaluating-fracture-severity-to-assess-risk-of-post-traumatic-osteoarthritis-after-articular-fractures
#12
Donald D Anderson, Anthony T Kilburg, Thaddeus P Thomas, J Lawrence Marsh
BACKGROUND: Post-traumatic osteoarthritis (PTOA) is common after intra-articular fractures of the tibial plafond. An objective CT-based measure of fracture severity was previously found to reliably predict whether PTOA developed following surgical treatment of such fractures. However, the extended time required obtaining the fracture energy metric and its reliance upon an intact contralateral limb CT limited its clinical applicability. The objective of this study was to establish an expedited fracture severity metric that provided comparable PTOA predictive ability without the prior limitations...
2016: Iowa Orthopaedic Journal
https://www.readbyqxmd.com/read/27502233/syndesmosis-preserving-osteotomy-of-the-fibula-for-access-to-the-lateral-talar-dome
#13
Kalpesh R Vaghela, Hans Clement, Lee Parker
BACKGROUND: Open surgical access to the postero-lateral talar dome for the treatment of osteochondral lesions is challenging, often requiring a segmental osteotomy of the fibula (fibular window) and division of the anterior inferior tibiofibular ligament (AITFL) or a fibular osteotomy with division of the AITFL and the anterior talofibular ligament (ATFL) (fibular door). Alternatively, to preserve the tibiofibular syndesmosis both the fibula and the lateral tibial plafond can be osteotomised to expose the entire lateral talar dome...
September 2016: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/27502221/does-external-fixation-result-in-superior-ankle-function-than-open-reduction-internal-fixation-in-the-management-of-adult-distal-tibial-plafond-fractures
#14
REVIEW
Christopher E Hill
BACKGROUND: Traditionally distal tibial plafond fractures were managed with open reduction internal fixation however, high complication rates have prompted the use of external fixation as an alternative. No definitive review has been conducted and the issue of superior treatment method remains contentious. This review assesses the comparative effectiveness of both with regards ankle function. METHOD: A search strategy was formulated with keywords ensuring full use of Medical Subject Headings terms for maximum sensitivity with Boolean combinations...
September 2016: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/27441938/anterolateral-approach-to-the-pilon
#15
Lindsay E Hickerson, Diederik O Verbeek, Craig E Klinger, David L Helfet
This video reviews the indications, surgical approach, and case examples of the anterolateral approach to a distal tibial plafond fracture. If this approach is used in a staged fashion, when the soft envelope is ready, it affords excellent visualization for fracture fixation through thick skin flaps. An associated article reviews a cohort of 44 mainly type C3 pilon injuries treated by 2 orthopaedic traumatologist using the anterolateral approach after staged external fixation. An anatomic or good fracture reduction was obtained in 41 fractures with 13...
August 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27301724/longterm-outcome-of-886-posterior-malleolar-fractures-a-systematic-review-of-the-literature
#16
REVIEW
Ewout S Veltman, Jelle J Halma, Arthur de Gast
INTRODUCTION: The objective of the present study was to review the current data on the long-term outcomes of posterior malleolar fractures, with special emphasis on the role of the type of treatment, surgical approach, and reduction and internal fixation. METHODS: The search was limited to skeletally mature patients. Major databases were searched from 1978 to 2014 to identify studies relating to functional outcome, subjective outcome, and radiographic evaluation at least 2 years after either surgical or conservative treatment of posterior malleolar fractures...
June 2016: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/27218695/suprapatellar-intramedullary-nail-technique-lowers-rate-of-malalignment-of-distal-tibia-fractures
#17
Frank R Avilucea, Kostas Triantafillou, Paul S Whiting, Edward A Perez, Hassan R Mir
OBJECTIVES: To report on the immediate postoperative alignment of distal tibia fractures (within 5 cm of the tibial plafond) treated with suprapatellar intramedullary nail (IMN) insertion compared with the infrapatellar technique. Primary outcomes include alignment on both the anteroposterior and lateral radiographic views. DESIGN: Retrospective cohort study. SETTING: Two urban level I trauma centers. PATIENTS: A total of 266 skeletally mature patients with a distal tibia fracture were treated with an IMN...
October 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27206975/additional-mesenchymal-stem-cell-injection-improves-the-outcomes-of-marrow-stimulation-combined-with-supramalleolar-osteotomy-in-varus-ankle-osteoarthritis-short-term-clinical-results-with-second-look-arthroscopic-evaluation
#18
Yong Sang Kim, Moses Lee, Yong Gon Koh
BACKGROUND: Supramalleolar osteotomy (SMO) is reported to be an effective treatment for varus ankle osteoarthritis by redistributing the load line within the ankle joint. Mesenchymal stem cells (MSCs) have been proposed as a new treatment option for osteoarthritis on the basis of their cartilage regeneration ability. The purpose of this study was to compare the clinical, radiological, and second-look arthroscopic outcomes between MSC injection with marrow stimulation and marrow stimulation alone in patients with varus ankle osteoarthritis who have undergone SMO...
December 2016: Journal of Experimental Orthopaedics
https://www.readbyqxmd.com/read/27188693/impact-of-intraoperative-cone-beam-computed-tomography-on-reduction-quality-and-implant-position-in-treatment-of-tibial-plafond-fractures
#19
Sven Yves Vetter, Finn Euler, Jan von Recum, Klaus Wendl, Paul Alfred Grützner, Jochen Franke
BACKGROUND: The intraoperative assessment of the articular surface in displaced intra-articular distal tibia fractures can be challenging using conventional fluoroscopy. The aim of the study was to determine the frequency and the method of intraoperative corrections of fracture reductions or implant placements during open reduction, internal fixation by using cone beam computed tomography (CT) after conventional fluoroscopy. METHODS: Displaced intra-articular distal tibia fractures were retrospectively analyzed from August 2001 until December 2011...
September 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/27053800/comparison-of-outcome-of-tibial-plafond-fractures-managed-by-hybrid-external-fixation-versus-two-stage-management-with-final-plate-fixation
#20
Luis Natera Cisneros, Mireia Gómez, Carlos Alvarez, Angélica Millán, Julio De Caso, Laura Soria
BACKGROUND: Tibial platfond fractures are usually associated with massive swelling of the foot and ankle, as well as with open wounds. This swelling may cause significant decrease of the blood flow, so the state of the soft tissue is determinant for the surgical indication and the type of implant. This retrospective study compares the union times in cases of tibial plafond fractures managed with a hybrid external fixation as a definitive procedure versus those managed with a two stage strategy with final plate fixation...
March 2016: Indian Journal of Orthopaedics
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