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Medial malleolus

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https://www.readbyqxmd.com/read/28642651/bimalleolar-ankle-fracture-a-simple-fracture
#1
Junji Miller Fukuyama, Robinson Esteves Santos Pires, Pedro José Labronici, José Octávio Soares Hungria, Rodrigo Lopes Decusati
OBJECTIVE: To evaluate the frequency of deltoid ligament injury in bimalleolar supination-external rotation type fractures and whether there is a correlation between the size of the fractured medial malleolus and deltoid ligament injury . METHODS: Twenty six consecutive patients underwent magnetic resonance exams after clinical and radiographic diagnosis of bimalleolar supination-external rotation type ankle fractures . RESULTS: Thirteen patients (50%) presented deltoid ligament injury associated to bimalleolar ankle fracture...
January 2017: Acta Ortopedica Brasileira
https://www.readbyqxmd.com/read/28633800/two-view-gravity-stress-imaging-protocol-for-nondisplaced-type-ii-supination-external-rotation-ankle-fractures-introducing-the%C3%A2-gravity%C3%A2-stress-cross-table-lateral-view
#2
Troy J Boffeli, Rachel C Collier, Samuel J Gervais
Assessing ankle stability in nondisplaced Lauge-Hansen supination external rotation type II injuries requires stress imaging. Gravity stress mortise imaging is routinely used as an alternative to manual stress imaging to assess deltoid integrity with the goal of differentiating type II from type IV injuries in cases without a posterior or medial fracture. A type II injury with a nondisplaced fibula fracture is typically treated with cast immobilization, and a type IV injury is considered unstable and often requires operative repair...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28626319/short-term-effect-of-spiral-taping-on-the-pain-and-walking-performance-of-individuals-with-chronic-ankle-instability
#3
Chae-Gil Lim
[Purpose] This study was designed to investigate the effects of spiral taping (ST) on the pain and walking performance of individual with chronic ankle instability (CAI). [Subjects and Methods] 12 men and 13 women (mean: 21.52 years; range: 20-31 years) with unilateral CAI (Cumberland ankle instability score: ≤24) were included. All the participants received 3 mm-wide ST. The latter was applied in a 3 × 4 cross shape onto the medial malleolus, the lateral malleolus, and the anterior talotibial joint of the unstable ankle...
June 2017: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/28594506/high-risk-stress-fractures-in-elite-athletes
#4
Michael Isiah Sandlin, Andrew J Rosenbaum, Cyrus E Taghavi, Timothy P Charlton, Martin J O'Malley
Surgeons should understand common factors that predispose high-level athletes to stress injuries as well as the importance of vitamin D and specifics related to vascular supply, location of injury, biomechanics, and susceptibility factors in high-level athletes who have stress injuries. Surgeons should be aware of diagnostic- and management-based recommendations for and the outcomes of anterior tibia, medial malleolus, tarsal navicular, and proximal fifth metatarsal stress fractures in professional athletes...
February 15, 2017: Instructional Course Lectures
https://www.readbyqxmd.com/read/28514526/direct-medial-approach-in-surgical-fixation-of-fractures-in-the-posterior-aspect-of-the-medial-malleolus
#5
Ang Chay-You, Ling Marcus, Koh Joyce Suang-Bee, Howe Tet-Sen
BACKGROUND: Fractures in the posterior aspect of the medial malleolus form an important subset of ankle fractures and the indications for fixation include involvement of > 25% of the articular surface or an articular step off by > 2mm. Several approaches have been described but there has been no recent study on the direct medial approach. METHODS: Five fresh frozen cadaveric ankles were dissected using the direct medial approach. A longitudinal incision of 10cm was centered directly over the medial malleolus and deepened straight down to the bone...
May 17, 2017: Clinical Anatomy
https://www.readbyqxmd.com/read/28507971/lethal-necrotizing-fasciitis-triggered-by-plaster-case-report-and-review-of-literature
#6
Mohit J Jain, Kinjal Mavani
INTRODUCTION: Plasters have been frequently associated with known complications such as infection, and compartment syndrome or deep vein thrombosis. However, life-threatening complication of necrotizing fasciitis (NF) has not been frequently attributed to plaster. CASE REPORT: We had a case of a 62-year male developing a lethal NF triggered by a below knee plaster for undisplaced fracture medial malleolus after twisting injury. He had no history suggestive of diabetes, renal impairment, and predisposing allergic factors or any comorbidity...
November 2016: Journal of Orthopaedic Case Reports
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/28482365/mri-identification-of-the-fibular-and-talus-position-in-patients-with-mechanical-ankle-instability
#8
Hong-Yun Li, Ru-Shou Zhou, Ying-Hui Hua, Shi-Yi Chen
Specific anatomic variations of the ankle mortise may be found in people with ankle instability. The purpose was to evaluate the fibular and talus position in subjects with mechanical ankle instability (MAI). In this study, MR images of 54 patients with MAI and 51 patients from the author's institution for reasons unrelated to ankle instability were reviewed. The position of the fibular in relation to the talus (axial malleolar index, AMI) and medial malleolus (intermalleolar index, IMI) were evaluated at the axial plane...
May 8, 2017: International Journal of Sports Medicine
https://www.readbyqxmd.com/read/28459126/localization-of-nerve-entry-points-as-targets-to-block-spasticity-of-the-deep-posterior-compartment-muscles-of-the-leg
#9
Shuaiyu Hu, Lifan Zhuo, Xiaoming Zhang, Shengbo Yang
To identify the optimal body surface puncture locations and the depths of nerve entry points (NEPs) in the deep posterior compartment muscles of the leg, 60 lower limbs of thirty adult cadavers were dissected in prone position. A curved line on the skin surface joining the lateral to the medial epicondyles of the femur was taken as a horizontal reference line (H). Another curved line joining the lateral epicondyle of the femur to the lateral malleolus was designated the longitudinal reference line (L). Following dissection, the NEPs were labeled with barium sulfate and then subjected to spiral computed tomography scanning...
April 29, 2017: Clinical Anatomy
https://www.readbyqxmd.com/read/28448709/-ankle-arthroscopy-in-treatment-of-bosworth-fracture
#10
D Saraiva, R Pereira, A Sarmento, R Lemos, X M Oliva
The Bosworth fracture is a pattern of fracture-dislocation of the ankle joint with fixed dislocation of the proximal part of the fibula behind the posterior malleolus. It is a rare injury, which requires high index of suspicion for diagnosis. Fixed dislocation of the fibula does not allow for closed reduction, so open reduction and fixation of fibula or tibia is required. We present a case report of a patient who suffered a Bosworth fracture, with associated medial malleolus fracture. She underwent surgical treatment with open reduction and internal fixation of the fibula and tibia...
September 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28447855/the-arterial-anatomy-of-the-deltoid-ligament-a-cadaveric-study
#11
Jacob A Haynes, Michelle Gosselin, Brian Cusworth, Jeremy McCormick, Jeffery Johnson, Sandra Klein
BACKGROUND: There is an increasing interest in the operative treatment of deltoid ligament disruption in the setting of chronic ankle instability. Understanding the vascular anatomy of the deltoid complex is beneficial when considering operative procedures on the medial ankle and may provide insight into factors that lead to chronic deltoid insufficiency and ankle instability. METHODS: Thirty-two pairs of cadaveric specimens (64 total legs) were amputated below the knee, and the tibialis anterior, tibialis posterior, and peroneal arteries were injected with India ink and Ward's blue latex...
April 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28416851/-one-of-the-pitfalls-in-the-surgical-treatment-of-maisonneuve-fractures-a-case-report
#12
H Q Ji, F Zhou, Y Tian, Z S Zhang, Y Guo, Y Lv, Z W Yang, G J Hou
There exist controversies in the surgical treatment of maisonneuve injury with regard to reduction and fixation of syndesmosis and management of proximal fibular fracture. It is very important for the orthopaedic surgeons to learn more techniques and avoid pitfalls from clinical practice. We summarized the clinical data of 1 failed case, a 20-year-old girl with big body weight who underwent a primary surgery for the treatment of maisonneuve fracture with minimally invasive reduction and fixation of ankle syndesmosis and posterior malleolus and open reduction and internal fixation of medial malleolus, then a revision surgery for the treatment of iatrogenic syndesmotic malreduction with open reduction and re-stabilization of ankle syndesmosis supplemented with open reduction and internal fixation of proximal fibular facture...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28403021/distally-based-medial-hemisoleus-muscle-flap-anatomic-and-angiographic-study-of-18-lower-limbs
#13
Aurélie Bourdais-Sallot, Arnaud Pare, Camille Herard, Marine Duclert-Bompaire, Julien Pucheux, Louis-Marie Terrier, Dominique Goga, Nathalie Forme, Richard Quignon
BACKGROUND: The distally based medial hemisoleus (MHS) flap was found useful for repairing soft-tissue defects of the lower third of the leg; however, its reliability is controversial. We used a combination of static and dynamic techniques to investigate the vascular supply of distally based MHS muscle flaps to better establish their use in repair of lower-third leg defects. METHODS: We performed an anatomic study of 18 cadaver legs. For 6 legs, we performed dynamic angiography, which allowed for obtaining MHS muscle radiographs after pulsed injection of contrast medium in distal pedicles...
July 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28398291/fine-dissection-of-the-tarsal-tunnel-in-60-cases
#14
Y Yang, M L Du, Y S Fu, W Liu, Q Xu, X Chen, Y J Hao, Z Liu, M J Gao
The fine dissection of nerves and blood vessels in the tarsal tunnel is necessary for clinical operations to provide anatomical information. A total of 60 feet from 30 cadavers were dissected. Two imaginary reference lines that passed through the tip of the medial malleolus were applied. A detailed description of the branch pattern and the corresponding position of the posterior tibial nerve, posterior tibial artery, medial calcaneal nerve and medial calcaneal artery was provided, and the measured data were analyzed...
April 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28361017/lower-limb-stress-fractures-in-sport-optimising-their-management-and-outcome
#15
REVIEW
Greg A J Robertson, Alexander M Wood
Stress fractures in sport are becoming increasing more common, comprising up to 10% of all of sporting injuries. Around 90% of such injuries are located in the lower limb. This articles aims to define the optimal management of lower limb stress fractures in the athlete, with a view to maximise return rates and minimise return times to sport. Treatment planning of this condition is specific to the location of the injury. However, there remains a clear division of stress fractures by "high" and "low" risk. "Low risk" stress fractures are those with a low probability of fracture propagation, delayed union, or non-union, and so can be managed reliably with rest and exercise limitation...
March 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28343329/stress-fractures-of-the-foot-and-ankle-part-2-site-specific-etiology-imaging-and-treatment-and-differential-diagnosis
#16
Jacob C Mandell, Bharti Khurana, Stacy E Smith
Stress fractures of the foot and ankle are a commonly encountered problem among athletes and individuals participating in a wide range of activities. This illustrated review, the second of two parts, discusses site-specific etiological factors, imaging appearances, treatment options, and differential considerations of stress fractures of the foot and ankle. The imaging and clinical management of stress fractures of the foot and ankle are highly dependent on the specific location of the fracture, mechanical forces acting upon the injured site, vascular supply of the injured bone, and the proportion of trabecular to cortical bone at the site of injury...
March 25, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28296225/treatment-of-medial-malleolus-or-pure-deltoid-ligament-injury-in-patients-with-supination-external-rotation-type-iv-ankle-fractures
#17
Xu Wang, Chao Zhang, Jian-Wen Yin, Chen Wang, Jia-Zhang Huang, Xin Ma, Cheng-Wei Wang, Xue Wang
OBJECTIVE: To investigate the effect of internal fixation on postoperative ankle function in patients with supination-external rotation type IV ankle fractures, including medial malleolus fractures and deltoid ligament injury. METHODS: Between January 2012 and June 2014, patients with medial structure injuries were enrolled in this study and assigned to the medial malleolus fracture group or the deltoid ligament group. The surgical procedures for the two groups were documented...
February 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28291180/dynamic-stress-testing-is-unnecessary-for-unimalleolar-supination-external-rotation-ankle-fractures-with-minimal-fracture-displacement-on-lateral-radiographs
#18
Simo Nortunen, Hannu-Ville Leskelä, Heidi Haapasalo, Tapio Flinkkilä, Pasi Ohtonen, Harri Pakarinen
BACKGROUND: This study aimed to identify factors from standard radiographs that contributed to the stability of the ankle mortise in patients with isolated supination-external rotation fractures of the lateral malleolus (OTA/AO 44-B). METHODS: Non-stress radiographs of the mortise and lateral views, without medial clear space widening or incongruity, were prospectively collected for 286 consecutive patients (mean age, 45 years [range, 16 to 85 years]), including 144 female patients (mean age, 50 years [range, 17 to 85 years]) and 142 male patients (mean age, 40 years [range, 16 to 84 years]) from 2 trauma centers...
March 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28271932/mid-term-results-of-minimally-invasive-plate-osteosynthesis-and-circular-external-fixation-in-the-treatment-of-complex-distal-tibia-fractures
#19
Yunus Imren, Engin Eren Desteli, Mehmet Erdil, Hasan Hüseyin Ceylan, Ibrahim Tuncay, Cengiz Sen
BACKGROUND: The treatment of pilon tibia fractures is challenging. Anatomical reduction of the joint surface is essential. Excessive soft-tissue dissection may interfere with the blood supply and can result in nonunion. We sought to compare the outcomes of distal tibia fractures treated with medial locking plates versus circular external fixators. METHODS: We retrospectively evaluated 41 consecutive patients with closed pilon tibia fractures treated with either minimally invasive locking plate osteosynthesis (n = 21) or external fixation (EF) (n = 20)...
January 2017: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/28255943/posterior-tibial-tendon-impingement-due-to-os-subtibiale-a-case-report-and-up-to-date-review
#20
Adil Turan, Ozkan Kose, Baver Acar, Melih Unal
Os subtibiale is a rare accessory ossicle located at the tip of the medial malleolus. Although this small ossicle usually has no clinical significance, in some cases it may be a source of ankle pain. Symptomatic os subtibiale is an extremely rare diagnosis, and few cases have been reported to date. The case presented is of a 35-year-old female patient with symptomatic os subtibiale, with a discussion of the diagnosis, clinical findings, and treatment options.
March 2, 2017: Skeletal Radiology
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