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Tibial plafond

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https://www.readbyqxmd.com/read/28410782/posterior-arthroscopic-tibiotalar-arthrodesis-anatomic-feasibility-study
#1
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...
April 11, 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
#2
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
#3
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...
March 22, 2017: Injury
https://www.readbyqxmd.com/read/28347196/distribution-of-subchondral-bone-puncture-strength-in-the-talus-and-tibial-plafond
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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