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Tibial plafond

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https://www.readbyqxmd.com/read/28708778/radiographic-investigation-of-the-distal-extension-of-fractures-into-the-articular-surface-of-the-tibia-the-ridefast-study
#1
Lucas S Marchand, Ajinkya A Rane, Zachary M Working, Lance G Jacobson, Erik N Kubiak, Thomas F Higgins, David L Rothberg
OBJECTIVE: To determine whether radiographic measurements are predictive of involvement of the distal tibia articular surface in tibial shaft fractures. DESIGN: Retrospective review. SETTING: Academic level-I trauma hospital. PATIENTS: Two-hundred seventeen patients with tibial shaft fractures distal to the isthmus (AO/OTA: 42-A1-3;42-B1-3;42-C1-3;43-A1-3). INTERVENTION: Analysis of AP and lateral radiographs...
June 22, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28670918/novel-double-osteotomy-technique-of-distal-tibia-for-correction-of-asymmetric-varus-osteoarthritic-ankle
#2
Beat Hintermann, Roxa Ruiz, Alexej Barg
BACKGROUND: A most challenging condition for balancing a varus arthritic ankle is the presence of a defect in the medial tibial plafond. After our initial results with a medial tibial plafondplasty did not fulfill our expectations of success, we hypothesized that adding a correcting supramalleolar osteotomy of the distal tibia would move the loading force to the tibiotalar joint more medially and move the center of rotation of the talus more laterally. In this study, we analyzed midterm clinical and radiographic outcomes in patients with double tibial osteotomy...
June 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28641973/changes-in-hip-knee-and-ankle-coronal-alignments-after-total-hip-arthroplasty-with-transverse-femoral-shortening-osteotomy-for-unilateral-crowe-type-iv-developmental-dysplasia-of-the-hip
#3
Abdulhamit Misir, Turan B Kizkapan, Kadir I Yildiz, Mehmet A Kaygusuz, Yakup Alpay, Atakan Ezici
BACKGROUND: To investigate changes in lower extremity coronal alignment in patients with unilateral Crowe type IV developmental dysplasia of the hip who underwent total hip arthroplasty with transverse femoral shortening osteotomy. METHODS: We reviewed the preoperative and 1-year postoperative full-length lower extremity radiographs of 25 patients. Femoral offset (FO), mechanical hip-knee-ankle angle, anatomical axis, mechanical axis deviation (MAD), mechanical lateral proximal femoral angle, anatomical medial proximal femoral angle, mechanical lateral distal femoral angle, anatomical lateral distal femoral angle, knee joint line congruency angle, mechanical medial proximal tibial angle, mechanical lateral distal tibial angle, ankle joint line orientation angle, tibial plafond talus angle, extremity length, and pelvic obliquity were measured on both the operative and nonoperative sides...
June 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28633795/valgus-ankle-degenerative-arthritis-with-an-isolated-deltoid-insufficiency-and-tibial-varus-a-case-report
#4
Joo-Yul Bae, Hee-Jae Won, Dong-Kyo Seo
We report a case of valgus ankle degenerative arthritis due to chronic isolated deltoid insufficiency combined with tibial varus that was treated successfully with ankle joint preserving surgery. A 63-year-old male complained of right lateral ankle pain with 10 minutes of maximal pain-free walking time. The assessed American Orthopaedic Foot and Ankle ankle-hindfoot scale score was 33 points. The ankle joint showed 18° of valgus deformity with 6° of tibia varus. Medial displacement calcaneal osteotomy, supramalleolar open wedge osteotomy, and deltoid ligament imbrication were performed...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28623079/restoration-of-articular-geometry-using-current-graft-options-for-large-glenoid-bone-defects-in-anterior-shoulder-instability
#5
Laurent B Willemot, Mohsen Akbari-Shandiz, Joaquin Sanchez-Sotelo, Kristin Zhao, Olivier Verborgt
PURPOSE: The purpose of this cadaveric study was to compare standard and modified coracoid transfer procedures, bicortical and tricortical iliac crest autografts, and tibial plafond and glenoid allografts with respect to glenoid surface curvature restoration. METHODS: Computed tomography scans of 8 cadaveric shoulders were acquired in 9 conditions: (1) intact, (2) 25% width defect, (3) classic Latarjet, (4) modified congruent-arc Latarjet, (5) tricortical iliac crest inner table, (6) outer table, (7) bicortical iliac crest, (8) distal tibia, and (9) glenoid allograft...
June 13, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28617051/radiographic-detection-of-marginal-impaction-in-supination-adduction-ankle-fractures
#6
Ram K Alluri, J Ryan Hill, Steven Donohoe, Mark Fleming, Eric Tan, Geoffrey Marecek
BACKGROUND: The purpose of this study was to describe the incidence of plafond impaction in supination-adduction type II (SAD-II) ankle fractures and assess the accuracy of plain radiographs in detecting plafond impaction and predicting planned operative management compared to computed tomography (CT). METHODS: Patients with SAD-II ankle fractures were retrospectively identified. All SAD-II plain radiographs were reviewed (120 fractures) and compared to CT images (55 fractures)...
June 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28503349/medial-malleolar-fractures-an-anatomic-survey-determining-the-ideal-screw-length
#7
P J Labronici, R E Pires, M V Franco, R Freitas, G C Araújo, R S Pires E Albuquerque, V S Gameiro, K Jeray
BACKGROUND: Medial malleolar fractures are frequent, and their treatment is familiar to the orthopedic surgeon. Lag screw fixation using partially threaded screws remains the standard treatment method for medial malleolar fractures. However, the literature lacks a defined method for selecting lag screw length, relying more so on the empiric choice of the surgeon. AIM: The aim of this study is to help define the ideal lag screw length for medial melleolar fracture fixation...
September 2016: Annals of Medical and Health Sciences Research
https://www.readbyqxmd.com/read/28476395/all-arthroscopic-treatment-of-dependent-osteochondral-lesions-of-the-ankle-surgical-technique
#8
Nick R Johnson, Spencer Skinner, Amgad M Haleem
A large number of articular cartilage defect treatments have been described. However, few have discussed the use of biologic agents implanted into the so-called dependent defect arthroscopically. Furthermore, even fewer of these reports have contained a description for treating dependent osteochondral lesions of the tibial plafond. Generally, these lesions have been treated with either microfracture or debridement, and the long-term outcomes have been less than satisfactory. With new interest in biologic treatments for osteochondral defects, we believe that bone marrow aspirate concentrate combined with a biologic scaffold provides the necessary components to provide healing of these so-called dependent lesions...
May 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28410782/posterior-arthroscopic-tibiotalar-arthrodesis-anatomic-feasibility-study
#9
Louis Malekpour, Said Rahali, Damien Potage, Fabrice Duparc, Franck Dujardin, Xavier Roussignol
Anterior arthroscopic tibiotalar arthrodesis has been well codified. A posterior approach with the patient in prone position is indicated when the anterior approach is precluded by soft tissue issues or for a 1-step procedure associated with posterior subtalar fusion. In an anatomic study, we assessed the feasibility of posterior arthroscopic tibiotalar fusion and sought to determine the arthroscopy entry points, mortise cartilage freshening quality, and risk of osseous, tendinous, vascular, and neural complications...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28370304/inflammatory-cytokine-response-is-greater-in-acute-tibial-plafond-fractures-than-acute-tibial-plateau-fractures
#10
Justin M Haller, Lucas Marchand, David L Rothberg, Erik N Kubiak, Thomas F Higgins
The purpose of the study was to compare the inflammatory cytokine and matrix metalloproteinase (MMP) concentrations in synovial fluid after acute plafond fracture with acute tibial plateau fracture. Between December 2011 and August 2014, we prospectively enrolled patients with acute tibial plateau and plafond fractures. Synovial fluid aspirations were obtained from injured and uninjured joints. The concentrations of IL-1β, IL-1RA, IL-6, IL-8, IL-10, MCP-1, TNF-α, MMP-1, -3, -9, -10, -12, and -13 were quantified using multiplex assays...
April 1, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28365069/quality-of-life-and-prognostic-factors-after-intra-articular-tibial-pilon-fracture
#11
Jorge De-Las-Heras-Romero, Ana M Lledo-Alvarez, Alejandro Lizaur-Utrilla, Fernando A Lopez-Prats
BACKGROUND: Intra-articular tibial plafond fractures are a challenge for the surgeon with generally poor functional outcomes. The purpose was to assess the impact of this injury on patient quality of life (QOL), as well as analyzed the predictor factors. METHODS: Retrospective study of 47 patients with mean age of 44.4 (range 18-79) years. Patients were also invited for new clinical and radiological assessments. QOL was evaluated by the Short Form-36 questionnaire and compared to the standard in the age-matched general population...
June 2017: Injury
https://www.readbyqxmd.com/read/28347196/distribution-of-subchondral-bone-puncture-strength-in-the-talus-and-tibial-plafond
#12
Slif D Ulrich, Brent G Parks, Michael A Tsai, Stuart D Miller
We investigated talus and tibial plafond subchondral bone puncture strength based on surface location. Puncture tests of the subchondral bone were performed in 9 equal zones on the articular surface of 12 cadaver specimens aged 49.1 years (range, 36-56 years). Compressive load was applied through a microfracture awl at 2 mm/min. Puncture strength was defined as the first load drop in load-deflection curves. In the talus, zone 1 (215 ± 91 N) and zone 2, the anterior medial and anterior middle zones, had significantly greater puncture strength than zones 7, 8, and 9, the posterior medial, middle, and lateral zones (104 ± 43 N, 115 ± 43 N, and 102 ± 35 N, respectively; P < ...
March 1, 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28323798/supplemental-perioperative-oxygen-to-reduce-surgical-site-infection-after-high-energy-fracture-surgery-oxygen-study
#13
Robert V OʼToole, Manjari Joshi, Anthony R Carlini, Robert A Sikorski, Armagan Dagal, Clinton K Murray, Michael J Weaver, Ebrahim Paryavi, Alec C Stall, Daniel O Scharfstein, Julie Agel, Mary Zadnik, Michael J Bosse, Renan C Castillo
Supplemental perioperative oxygen (SPO) therapy has been proposed as one approach for reducing the risk of surgical site infection (SSI). Current data are mixed regarding efficacy in decreasing SSI rates and hospital inpatient stays in general and few data exist for orthopaedic trauma patients. This study is a phase III, double-blind, prospective randomized clinical trial with a primary goal of assessing the efficacy of 2 different concentrations of perioperative oxygen in the prevention of SSIs in adults with tibial plateau, pilon (tibial plafond), or calcaneus fractures at higher risk of infection and definitively treated with plate and screw fixation...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323797/local-antibiotic-therapy-to-reduce-infection-after-operative-treatment-of-fractures-at-high-risk-of-infection-a-multicenter-randomized-controlled-trial-vanco-study
#14
Robert V OʼToole, Manjari Joshi, Anthony R Carlini, Clinton K Murray, Lauren E Allen, Daniel O Scharfstein, Joshua L Gary, Michael J Bosse, Renan C Castillo
A number of clinical studies in the spine literature suggest that the use of local vancomycin powder may substantially reduce surgical site infections (SSIs). These studies are primarily retrospective and observational and few focus on orthopaedic trauma patients. This study is a phase III, prospective, randomized, clinical trial to assess the efficacy of locally administered vancomycin powder in the prevention of SSI after fracture surgery. The primary goal of the VANCO Study is to compare the proportion of deep SSI 6 months after fracture fixation surgery...
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
#15
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/28298142/effect-of-complete-syndesmotic-disruption-and-deltoid-injuries-and-different-reduction-methods-on-ankle-joint-contact-mechanics
#16
Jeremy LaMothe, Josh R Baxter, Susannah Gilbert, Conor I Murphy, Sydney C Karnovsky, Mark C Drakos
BACKGROUND: Syndesmotic injuries can be associated with poor patient outcomes and posttraumatic ankle arthritis, particularly in the case of malreduction. However, ankle joint contact mechanics following a syndesmotic injury and reduction remains poorly understood. The purpose of this study was to characterize the effects of a syndesmotic injury and reduction techniques on ankle joint contact mechanics in a biomechanical model. METHODS: Ten cadaveric whole lower leg specimens with undisturbed proximal tibiofibular joints were prepared and tested in this study...
March 1, 2017: Foot & Ankle International
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
#17
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/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
#18
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
#19
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
#20
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
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