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Medial malleolus

Eren Cansü, Mehmet B Unal, Serkan Gurcan, Fatih Parmaksizoglu
Background Lateral malleolar fractures (Weber type B or OTA 44-B) account for 60% of all ankle fractures. To achieve anatomic restoration, surgical stabilization provides better results than conservative treatment. Various fixation methods are available to treat these fractures; however, the best method is still unknown. Our objectives were to present a new, useful, and efficient surgical technique for stabilizing lateral malleolar fractures and to analyze the outcomes of patients treated with the compression cerclage system...
September 2, 2016: Journal of the American Podiatric Medical Association
Guangtao Xu, Ruibing Su, Junyao Lv, Xiaoping Lai, Xianxian Li, Jiayan Wu, Bo Hu, Long Xu, Ruilin Shen, Jiang Gu, Xiaojun Yu
Specific morphological changes may be absent in some cases of electrocution shocked by the voltage of 220 V or lower. In this study, we attempted to demonstrate that the anterior wrist and medial malleolus were the optimal sites with promising and significant changes in electric death through the hand-to-foot circuit pathway. We established an electric shock rat model and observed histopathologic changes in the anterior wrist and medial malleolus. The results showed that the current intensities in the left anterior wrist and right medial malleolus were remarkably higher than those in the other sites, and the nuclei long/short (L/S) axis ratios of the arterial endotheliocyte and the skeletal muscle cell in these two areas were significantly higher than those in other parts of the body...
October 17, 2016: International Journal of Legal Medicine
Thomas G McPoil, Jessica Ford, Joel Fundaun, Chelsea Gallegos, Andrew Kinney, Peter McMillan, Jessica Murphy, Elliot Sky, Derrick Torba, Michael Bade
Previous studies have successfully used the longitudinal arch angle (LAA) to assess foot posture, but the measurement consistency and ability of the LAA to predict dynamic foot posture during activity in a variety of foot types have not been evaluated. The purpose of this study was to determine the reliability of the LAA as well as if the clinical method of assessing the LAA could be used to predict the LAA at midstance during walking for supinated, normal, and pronated foot types. The Arch Height Ratio was used to select 35 participants with 12 supinated, 46 normal, and 12 pronated feet...
September 20, 2016: Foot
Urszula Bogacka, Dawid Dziedzic, Iulian Komarnitki, Bogdan Ciszek
BACKGROUND: The aim of the work was to perform a morphometric analysis of the long peroneal muscle of the leg and explore the relationship between muscle belly and tendon. MATERIALS AND METHODS: Ten lower limbs (8 right and 2 left) were fixed in formaldehyde and dissected using standard technique. The long peroneal muscle was exposed from the proximal attachment to the top of a lateral malleolus. RESULTS: The tendon was subsequently freed and various measurements were taken...
October 7, 2016: Folia Morphologica (Warsz)
Atilla Suleyman Dikici, Fethi Emre Ustabasioglu, Sakir Delil, Mecbure Nalbantoglu, Bektas Korkmaz, Selim Bakan, Osman Kula, Nurten Uzun, Ismail Mihmanli, Fatih Kantarci
Purpose To evaluate the value of shear-wave elastography (SWE) in the detection of diabetic peripheral neuropathy (DPN) of the tibial nerve. Materials and Methods This study was approved by the institutional review board, and written informed consent was obtained from all study participants. The study included 20 diabetic patients with DPN (10 men, 10 women), 20 diabetic patients without DPN (eight men, 12 women), and 20 healthy control subjects (nine men, 11 women). The tibial nerve was examined at 4 cm proximal to the medial malleolus with gray-scale ultrasonography and SWE...
September 19, 2016: Radiology
A Jubel, C Faymonville, J Andermahr, S Boxberg, G Schiffer
Background: Ankle fractures are extremely common in the elderly, with an incidence of up to 39 fractures per 100,000 persons per year. We found a discrepancy between intraoperative findings and preoperative X-ray findings. It was suggested that many relevant lesions of the ankle joint in the elderly cannot be detected with plain X-rays. Methods: Complete data sets and preoperative X-rays of 84 patients aged above 60 years with ankle fractures were analysed retrospectively. There were 59 women and 25 men, with a mean age of 69...
September 19, 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
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
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
Yvonne R A Kerkhoff, Nienke M Kosse, Wieneke P Metsaars, Jan Willem K Louwerens
BACKGROUND: Total ankle arthroplasty is an accepted alternative to arthrodesis of the ankle. However, complication and failure rates remain high. Long-term results of the Scandinavian Total Ankle Replacement (STAR) are limited, with variable complication and failure rates observed. This prospective study presents the long-term survivorship and postoperative complications of the STAR prosthesis. METHODS: Between May 1999 and June 2008, 134 primary total ankle arthroplasties were performed using the STAR prosthesis in 124 patients...
August 18, 2016: Foot & Ankle International
Bryce A Basques, Adam Bitterman, Kevin J Campbell, Bryan D Haughom, Johnny Lin, Simon Lee
BACKGROUND: Increased surgeon volume may be associated with improved outcomes following operative procedures. However, there is a lack of information on the effect of surgeon volume on inpatient adverse events and resource utilization following total ankle arthroplasty (TAA). METHODS: A retrospective cohort study of TAA patients was performed using the Nationwide Inpatient Sample (NIS) from 2003 to 2009. High-volume surgeons were considered as those with volume ≥90th percentile of surgeons performing TAA...
October 2016: Foot & Ankle International
Justin Brantley, Aditi Majumdar, J Taylor Jobe, Antony Kallur, Christina Salas
BACKGROUND: Percutaneous pin fixation is often used in conjunction with closed-reduction and cast immobilization to treat pediatric distal tibia fractures. The goal of this procedure is to maintain reduction and provide improved stabilization, in effort to facilitate a more anatomic union. We conducted a biomechanical study of the torsional and bending stability of three commonly used pin configurations in distal tibia fracture fixation. METHODS: A transverse fracture was simulated at the metaphyseal/diaphyseal junction in 15 synthetic tibias...
2016: Iowa Orthopaedic Journal
Pablo Wagner, Cristian Ortiz, Omar Vela, Paul Arias, Diego Zanolli, Emilio Wagner
BACKGROUND: Tibialis posterior (TP) tendon transfer through the interosseous membrane is commonly performed in Charcot-Marie-Tooth disease. In order to avoid entrapment of this tendon, no clear recommendation relative to the interosseous membrane (IOM) incision size has been made. OBJECTIVE: Analyze the TP size at the transfer level and therefore determine the most adequate IOM window size to avoid muscle entrapment. METHODS: Eleven lower extremity magnetic resonances were analyzed...
September 2016: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
N Tümer, L Blankevoort, M van de Giessen, M P Terra, P A de Jong, H Weinans, G J M Tuijthof, A A Zadpoor
OBJECTIVE: The etiology of osteochondral defects (OCDs), for which the ankle (talocrural) joint is one of the common sites, is not yet fully understood. In this study, we hypothesized that bone shape plays a role in development of OCDs. Therefore, we quantitatively compared the morphology of the talus and the distal tibia between an OCD group and a control group. METHODS: The shape variations of the talus and distal tibia were described separately by constructing two statistical shape models (SSMs) based on the segmentation of the bones from ankle computed tomography (CT) scans obtained from control (i...
August 3, 2016: Osteoarthritis and Cartilage
S Hejazi, G Rouhi, J Rasmussen
This paper presents a finite element model of the ankle, taking into account the effects of muscle forces, determined by a musculoskeletal analysis, to investigate the contact stress distribution in the tibio-talar joint in patients with triple arthrodesis and in normal subjects. Forces of major ankle muscles were simulated and corresponded well with the trend of their EMG signals. These forces were applied to the finite element model to obtain stress distributions for patients with triple arthrodesis and normal subjects in three stages of the gait cycle, i...
July 11, 2016: Computer Methods in Biomechanics and Biomedical Engineering
Alexandar A Iliev, Georgi P Georgiev, Boycho V Landzhov, Svetoslav A Slavchev, Iva N Dimitrova, Wladimir А Ovtscharoff
An os subtibiale is a rare accessory bone located below or behind the medial malleolus. Herein we present a rare case of a painful os subtibiale in a young triathlete who presented with pain, redness and swelling below his left medial malleolus. Plain radiographs and three-dimensional computed tomography revealed a well-defined oval bone distal to the left medial malleolus. After conservative treatment failed, the ossicle was excised in an open surgery with complete resolution of symptoms. This case report emphasizes the need for clinical awareness of different anatomical variations of the bones of the foot...
March 1, 2016: Folia Medica
Renjit-Thomas Issac, Hitesh Gopalan, Mathew Abraham, Cherian John, Sujith-Mathew Issac, Diju Jacob
OBJECTIVE: To assess the correlation between five anthropometric parameters and the distance from tibial tuberosity to medial malleolus in 100 volunteers. METHODS: Six anthropometric parameters were measured in 50 male and 50 female medical students using a metallic scale: medial knee joint line to ankle joint line (K-A), medial knee joint line to medial malleolus (K-MM), tibial tuberosity to ankle joint (TT-A), tibial tuberosity to medial malleolus (TT- MM), olecranon to 5th metacarpal head (O-MH) and body height (BH)...
June 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Mukesh Tiwari, Hemant Chaturvedi, Vaibhav Patel, Rajarshi Matti
INTRODUCTION: Tumors of the medial malleolus are rare. Chondrogenic tumors of the medial malleolus are extremely rare. Chondroblastoma of the medial malleolus has not been reported previously in the English literature. The purpose is to present a rare tumor occurring at an unusual site and its successful management. CASE PRESENTATION: We report a case of a 30 years old female with chondroblastoma of the medial malleolus with its clinical features, radiographic features, differential diagnosis, and management at an unusual site...
January 2016: Journal of Orthopaedic Case Reports
Michael W Downey, Kyle Duncan, Victor Kosmopoulos, Travis A Motley, Brian B Carpenter, Fadeke Ogunyankin, Alan Garrett
The traditional stainless steel wire tension band (WTB) has been popularized for small avulsion fractures at the medial malleolus. Despite the tension band principle creating a stable construct, complications continue to arise utilizing the traditional stainless steel WTB with patients experiencing hardware irritation at the tension band site and subsequent hardware removal. Coupled with hardware irritation is fatigue failure with the wire. The goal of this investigation was to retrospectively compare this traditional wire technique to an innovative knotless tension band (KTB) technique in order to decrease costly complications...
2016: Scientifica
Vanna Rocchi, Ming-Tung Huang, James D Bomar, Scott Mubarak
PURPOSE: It has been the observation of the senior author that there is a bony fullness or "double medial malleolus" over the middle facet as a consistent finding with most talocalcaneal coalitions (TCC). To document this observation, we reviewed records and radiographs in 3 patient groups. METHODS: Part 1: retrospective chart review was completed for 111 feet to determine the clinical presence of a palpable "double medial malleolus." Part 2: computed tomography (CT) scans for evaluation of tarsal coalition or symptomatic flatfoot between January 2006 and December 2014 were retrospectively reviewed for the same cohort...
June 2, 2016: Journal of Pediatric Orthopedics
Derek T Bernstein, Joshua D Harris, Pedro E Cosculluela, Kevin E Varner
Tibialis posterior tendon rupture in the setting of pronation-type ankle fractures can lead to long-term debility as a result of chronic tendon dysfunction. This rare injury pattern presents a diagnostic challenge because thorough preoperative examination of the function of the tendon is limited by pain, swelling, and inherent instability of the fracture. As such, a high index of suspicion is necessary in ankle fractures with radiographs showing a medial malleolus fracture with an associated suprasyndesmotic fibula fracture...
September 1, 2016: Orthopedics
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