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https://www.readbyqxmd.com/read/28042750/pseudo-aneurysm-a-rare-complication-of-ankle-arthroscopy
#1
Mathew Davis, David Brooks, William Bryceson
A 53-year-old woman underwent arthroscopic ankle debridement for posttraumatic arthrofibrosis 2 years following a bimalleolar ankle fracture. Twelve months postarthroscopy, the patient returned to physical therapy with a 2-week history of pain and prominent swelling to her anterior ankle. Urgent follow-up was arranged with an orthopaedic surgeon, who ordered a radiograph and magnetic resonance imaging, which demonstrated a large heterogeneous mass. Doppler ultrasound was also ordered and confirmed the mass to be a pseudo-aneurysm of the anterior tibial artery...
January 2017: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/28041950/association-of-body-mass-index-with-the-pattern-of-surgically-treated-ankle-fractures-using-two-different-classification-systems
#2
Knut Stavem, Markus G Naumann, Ulf Sigurdsen, Stein Erik Utvåg
The present retrospective cohort study assessed the association of body mass index (BMI) with the pattern of ankle fractures using 2 classifications systems. Of the 1011 consecutive patients who underwent surgery for ankle fractures in 2 hospitals from January 2009 to December 2011, 837 had a classifiable fracture according to 1 of 2 classification systems and complete information available for covariates. The association of BMI, adjusted for age, sex, corticosteroid use, diabetes, and smoking status with having a more proximal fibula fracture (Weber class A to C) and an increasing number of malleoli involved (uni-, bi-, or trimalleolar) was assessed using multivariable ordered logistic regression analysis...
December 29, 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28041949/comparison-of-early-adverse-events-after-operative-treatment-of-bimalleolar-and-trimalleolar-fractures-versus-pilon-fractures
#3
Karim Z Masrouha, Hani Tamim, Assad Taha, Abdel Majid Sheikh Taha, Racha Abi-Melhem, Muhyeddine Al-Taki
Ankle fractures requiring open reduction and internal fixation vary in severity from unimalleolar fractures to bimalleolar/trimalleolar (BT) fractures to pilon fractures. Consequently, the postoperative outcomes with these surgeries can vary. Most previous studies of these injuries had small sample sizes, studied a single risk factor or adverse event, or did not compare different injuries by severity. The purpose of the present study was to describe and compare the patient characteristics and postoperative outcomes of 2 high-energy ankle fractures: BT and pilon fractures...
December 29, 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28027660/cross-sectional-study-to-assess-the-functional-outcome-of-neglected-bimalleolar-fracture
#4
Rajeev Shukla, Ravi Kant Jain, Shravan Patidar, Nikhil Jain, Pranav Mahajan
INTRODUCTION: Ankle fracture is the most common intra-articular fracture of a weight-bearing joint and accounts for 9% of all fractures. Ankle fractures are classified into 3 subgroups: unimalleolar, bimalleolar, and trimalleolar fractures. Accurate reduction and stable internal fixation is necessary in bimalleolar fractures; otherwise, it may lead to posttraumatic painful restriction of movements or osteoarthritis. The purpose of this study is to assess the functional outcome and results of treatment of neglected bimalleolar fracture...
December 1, 2016: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28005114/an-update-on-management-of-syndesmosis-injury-a-national-us-database-study
#5
James C Carr, Brian C Werner, Seth R Yarboro
We conducted a study to determine the incidence of syndesmotic injury and stabilization within various ankle fracture patterns along with the rate of syndesmotic implant removal. All data were obtained from a publicly available for-fee healthcare database, the PearlDiver Patient Records Database. Current Procedural Terminology (CPT) codes were used to search the database for cases of fixation of lateral malleolus, bimalleolar, and trimalleolar fractures in addition to syndesmotic fixation and implant removal...
November 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/27872379/predictors-of-time-to-union-after-operative-fixation-of-closed-ankle-fractures
#6
Andrew P Matson, Kamran S Hamid, Samuel B Adams
: Background Ankle fractures are common and represent a significant burden to society. We aim to report the rate of union as determined by clinical and radiographic data, and to identify factors that predict time to union. Methods A cohort of 112 consecutive patients with isolated, closed, operative malleolar ankle fractures treated with open reduction and internal fixation was retrospectively reviewed for time to clinical union. Clinical union was defined based on radiographic and clinical parameters, and delayed union was defined by time to union >12 weeks...
November 20, 2016: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/27870692/wide-variation-of-surgical-cost-in-the-treatment-of-periarticular-lower-extremity-injuries-between-6-fellowship-trained-trauma-surgeons
#7
Robert J Wetzel, Laurence B Kempton, Edwin S Lee, Michael Zlowodzki, Todd O McKinley, Walter W Virkus
OBJECTIVES: We hypothesized that negligible surgical material cost variation exists between traumatolgists for treatment of bimalleolar ankle and bicondylar tibial plateau fractures. DESIGN: Retrospective medical record review. SETTING: Academic level 1 Trauma Center; 2-year period. PATIENTS/PARTICIPANTS: Current Procedure Terminology codes for open treatment of bimalleolar ankle and bicondylar tibial plateau fractures identified patients...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27865154/a-narrow-bimalleolar-width-is-a-risk-factor-for-ankle-inversion-injury-in-male-military-recruits-a-prospective-study
#8
Hannah Rice, Michael Nunns, Carol House, Joanne Fallowfield, Adrian Allsopp, Sharon Dixon
BACKGROUND: Ankle inversion injuries are one of the most common and burdensome injuries in athletic populations. Research that prospectively identifies characteristics associated with this injury is lacking. This prospective study compared baseline anthropometric and biomechanical gait characteristics of military recruits who sustained an ankle inversion injury during training, with those who remained injury-free. METHODS: Bilateral plantar pressure and three-dimensional lower limb kinematics were recorded in 1065 male, injury-free military recruits, during barefoot running...
January 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/27821660/limb-salvage-after-failed-initial-operative-management-of-bimalleolar-ankle-fractures-in-diabetic-neuropathy
#9
Nicholas J Vaudreuil, Mitchell S Fourman, Dane K Wukich
BACKGROUND: Ankle fractures in patients with diabetes mellitus (DM) can be difficult to manage, especially in the presence of peripheral neuropathy. In patients who fail initial operative management, attempts at limb salvage can be challenging, and no clear treatment algorithm exists. This study examined outcomes of different procedures performed for limb salvage in this population. METHODS: This study retrospectively reviewed 17 patients with DM complicated by peripheral neuropathy who sustained a bimalleolar ankle fracture and failed initial operative management...
November 7, 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/27676145/is-there-a-relationship-between-bone-morphology-and-injured-ligament-on-imaging-studies-and-laxity-on-ankle-stress-radiographs
#10
S Y Lee, S-S Kwon, M S Park, M K Chung, K B Kim, S Koo, K M Lee
This study aimed to investigate the relationship between bone morphology and injured ligaments on imaging studies and laxity on ankle stress radiographs in patients with lateral ankle instability. In total, 115 patients who had undergone ankle MRI, ankle radiography, and stress radiography were included. Distal tibial articular surface angle, bimalleolar tilt, medial and lateral malleolar relative length, medial malleolar slip angle, anterior inclination of the tibia, and fibular position were measured on ankle radiographs...
December 2016: International Journal of Sports Medicine
https://www.readbyqxmd.com/read/27580319/wide-variation-of-surgical-cost-in-the-treatment-of-peri-articular-lower-extremity-injuries-between-six-fellowship-trained-trauma-surgeons
#11
Robert J Wetzel, Laurence B Kempton, Edwin S Lee, Michal Zlowodzki, Todd O McKinley, Walter W Virkus
OBJECTIVES: We hypothesized that negligible surgical material cost variation exists between traumatolgists for treatment of bimalleolar ankle and bicondylar tibial plateau fractures. DESIGN: Retrospective medical record review. SETTING: Academic Level 1 Trauma Center; 2-year period. PATIENTS/PARTICIPANTS: Common Procedure Terminology (CPT) codes for open treatment of bimalleolar ankle and bicondylar tibial plateau fractures identified patients...
August 23, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27446782/optimal-needle-placement-for-extensor-hallucis-longus-muscle-a-cadaveric-study
#12
In Yae Cheong, Do Kyun Kim, Ye Jeong Oh, Byung Kyu Park, Ki Hoon Kim, Dong Hwee Kim
OBJECTIVE: To determine the midpoint (MD) of extensor hallucis longus muscle (EHL) and compare the accuracy of different needle electromyography (EMG) insertion techniques through cadaver dissection. METHODS: Thirty-eight limbs of 19 cadavers were dissected. The MD of EHL was marked at the middle of the musculotendinous junction and proximal origin of EHL. Three different needle insertion points of EHL were marked following three different textbooks: M1, 3 fingerbreadths above bimalleolar line (BML); M2, junction between the middle and lower third of tibia; M3, 15 cm proximal to the lower border of both malleoli...
June 2016: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/27441940/open-reduction-internal-fixation-of-a-bimalleolar-ankle-fracture-with-syndesmotic-injury
#13
Robert F Ostrum, Matthew C Avery
Rotational ankle fractures are incredibly common, resulting in a wide spectrum of bony and ligamentous injury patterns. After open reduction of an ankle fracture, the treating surgeon must always evaluate syndesmotic stability. If the syndesmosis is determined to be unstable, a reduction of the distal tibiofibular joint should be performed. Failure to adequately identify and treat injuries to the syndesmosis may result in continued ankle instability and poor patient outcomes. Lateral fluoroscopic images are necessary to assess a closed reduction of the syndesmosis before stabilization, although the accuracy of this tool has been questioned in several studies...
August 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27434488/gait-analysis-and-functional-outcomes-after-twelve-week-rehabilitation-in-patients-with-surgically-treated-ankle-fractures
#14
Oana Suciu, Roxana Ramona Onofrei, Alina Daniela Totorean, Silviu Cristian Suciu, Elena Constanta Amaricai
Ankle fractures are the most common type of lower extremity fractures. The objective of our study was to analyse the changes of temporal and spatial gait parameters and functional outcomes in patients with bimalleolar fractures who followed surgery and rehabilitation compared to healthy controls. 49 patients with ankle fractures and 21 age-matched healthy volunteers were recruited. There were two assessments for the study group: T1 - once weight-bearing was allowed and T2 - twelve weeks after exercise-based rehabilitation programme...
September 2016: Gait & Posture
https://www.readbyqxmd.com/read/27299109/outcome-analysis-following-operative-skeletal-stabilization-in-established-non-unions-of-malleolar-fractures-a-series-of-11-cases
#15
Navin Balasubramanian, Ganesh Babu, Sindhuja Prakasam
INTRODUCTION: Established non-unions pose a real nightmare for even the most accomplished surgeon. The variations in anatomy due to extensive fibrous tissue growth, soft tissue contractures around the fracture site and bony alterations like smoothening and sclerosis of the fracture ends must each be addressed as a whole if good outcome is to be expected. CASE SERIES: Here we present a series of 11 patients who had bimalleolar fracture of the ankle following which they had native splinting...
October 2015: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/27274130/double-free-flap-for-a-bimalleolar-defect-of-lower-leg-and-ankle
#16
Naren Shetty, Narendra S Mashalkar, Sunder Raj Ellur, Karishma Kagodu
Double free-flaps are necessary when tissue cover cannot be sufficed with a single flap. The other factors to be considered when using two free flaps for resurfacing of distal limb defects are the availability of more than one recipient vessel, the risk of distal limb ischaemia and the donor site morbidity of double flap harvest. If these factors are adequately addressed, double free-flaps can be safely executed for resurfacing distal limb defects with minimal morbidity. We report the simultaneous harvest and transfer of the anterolateral and anteromedial thigh flaps inset and vascularised as double free-flaps to resurface a large bimalleolar defect in a 14-year-old boy with no additional morbidity as compared to that of a single free tissue transfer...
January 2016: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/27086177/predictors-of-adverse-events-for-ankle-fractures-an-analysis-of%C3%A2-6800%C3%A2-patients
#17
Ashley C Dodd, Nikita Lakomkin, Basem Attum, Catherine Bulka, Aditya V Karhade, Diana G Douleh, Hassan Mir, A Alex Jahangir, William T Obremskey, Manish K Sethi
Ankle fractures are one of the most common injuries seen by orthopedic surgeons. It is therefore essential to understand the risks associated with their treatment. Using the American College of Surgeons National Surgical Quality Improvement Program(®) database from 2006 to 2013, the patient demographics, comorbidities, and 30-day complications were collected for 5 types of ankle fractures. A bivariate analysis was used to compare the patient demographics, comorbidities, and complications across all Common Procedural Terminology codes...
July 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/27082888/locking-versus-nonlocking-implants-in-isolated-lower-extremity-fractures-analysis-of-cost-and-complications
#18
COMPARATIVE STUDY
Thomas J An, Rachel V Thakore, Sarah E Greenberg, Vasanth Sathiyakumar, Harrison F Kay, Michael Gerasimopoulos, William T Obremskey, Manish K Sethi
The purpose of this study was to investigate operative costs and postoperative complication rates in relation to utilization of locking versus nonlocking implants in isolated, lower limb fractures. Seventy-seven patients underwent plate fixation of isolated bicondylar tibial plateau, bimalleolar ankle, and trimalleolar ankle fractures at a large tertiary care center. Fixation with locking versus nonlocking implants was compared to incidence of postsurgical complications. Costs of these implants were directly compared...
2016: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/26843223/muscular-tendinous-junction-rupture-of-the-posterior-tibial-tendon-after-closed-bimalleolar-ankle-fracture
#19
Salomon Jasqui-Remba, Ruy Ernesto Rodriguez-Corlay
In this case report, we present an acute rupture in the muscular tendinous junction of a posterior tibialis muscle in a bimalleolar closed ankle fracture after a high-energy trauma in a 30-year-old patient with no significant medical history. Fracture was confirmed by simple X-rays, and was treated with an open reduction in which both of the fractures were treated with osteosynthesis material and reparation of the syndesmosis. If left untreated, this uncommon finding can result in a bad postsurgical outcome; we believe this injury is more common but under-reported in the literature...
February 3, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/26802427/early-weightbearing-after-operatively-treated-ankle-fractures-a-biomechanical-analysis
#20
Eric W Tan, Norachart Sirisreetreerux, Adrian G Paez, Brent G Parks, Lew C Schon, Erik A Hasenboehler
BACKGROUND: No consensus exists regarding the timing of weightbearing after surgical fixation of unstable traumatic ankle fractures. We evaluated fracture displacement and timing of displacement with simulated early weightbearing in a cadaveric model. METHODS: Twenty-four fresh-frozen lower extremities were assigned to Group 1, bimalleolar ankle fracture (n=6); Group 2, trimalleolar ankle fracture with unfixed small posterior malleolar fracture (n=9); or Group 3, trimalleolar ankle fracture with fixed large posterior malleolar fracture (n=9) and tested with axial compressive load at 3 Hz from 0 to 1000 N for 250 000 cycles to simulate 5 weeks of full weightbearing...
June 2016: Foot & Ankle International
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