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https://www.readbyqxmd.com/read/29287221/ankle-fractures-getting-it-right-first-time
#1
Anna S Walsh, Victoria Sinclair, Patrick Watmough, Alistair A Henderson
INTRODUCTION: Ankle fractures are common injuries presenting to trauma departments and ankle open reduction and internal fixation (ORIF2) is one of the first procedures targeted in early orthopaedic training. Failure to address the fracture pattern with the appropriate surgical technique and hardware may lead to early failure, resulting in revision procedures or premature degenerative change. Patients undergoing revision ORIF are known to be at much greater risk of complications and many of these secondary procedures may be preventable...
November 28, 2017: Foot
https://www.readbyqxmd.com/read/29274598/transmissibility-and-waveform-purity-of-whole-body-vibrations-in-older-adults
#2
Freddy Man Hin Lam, Chak-Yin Tang, Timothy Chi Yui Kwok, Marco Yiu Chung Pang
BACKGROUND: This study examined the transmission power and waveform purity of vertical (synchronous) whole-body vibrations upon its propagation in the human body among older adults. METHODS: Forty community-dwelling older adults participated in the study (33 women; mean age: 60.3 (SD 5.7) years). Four vibration frequencies (25, 30, 35, 40Hz), two amplitudes (0.6 and 0.9mm), and six different postures were tested. Skin-mounted tri-axial accelerometers were placed at the medial malleolus, tibial tuberosity, greater trochanter, third lumbar vertebra, and forehead...
December 15, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/29237543/diagnosis-and-management-of-mcfarland-fractures-a-case-report-and-review-of-the-literature
#3
M Birt, B Vopat, P Schroeppel, A Tarakemeh, B Everist, S Mullen
BACKGROUND: McFarland fracture is the eponym for a rare Salter Harris III or IV fracture involving the medial distal tibia. These fractures can be difficult to diagnose without a high index suspicion and appropriate radiographic imaging. These fractures may result in significant growth disturbances to the pediatric patient. When diagnosed and treated acutely, these fractures can be managed with cast immobilization and close follow up. If diagnoses in a delayed fashion they can result in significant morbidity including prolonged casting and possible surgical treatment...
December 9, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29202995/an-evaluation-of-the-herscovici-classification-for-fractures-of-the-medial-malleolus
#4
Stuart A Aitken, Ian Johnston, Angus C Jennings, Ivan T H Chua, Richard E Buckley
BACKGROUND: Despite its use in the literature, the application of the Herscovici classification system for medial malleolus fractures has not been evaluated. METHODS: We aimed to determine the reliability and accuracy of the Herscovici classification. The blinded radiographs of 130 patients were independently classified by four orthopaedic trauma surgeons. We held a consensus meeting where observers agreed on a final classification and this served as our reference standard...
December 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29183896/paediatric-salter-harris-type-iv-injury-of-distal-tibia-with-talus-fracture
#5
Swapnil Kothadia, Umesh Birole, Ashish Ranade
Fracture of talus with Salter-Harris injury of the distal end of tibia is a rare injury in paediatric age group. The authors report a case of a 13-year-old male child who sustained type IV Salter-Harris injury to the medial malleolus with coronal spilt along with spilt and depressed fracture of the neck of talus and fracture of the lateral process of talus with stable compression fracture of spine sustained due to fall from 6 meters height. CT scan delineated the morphology of fracture pattern and helped in preoperative planning...
November 27, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29183574/assessment-of-a-novel-equine-tarsocrural-experimental-joint-disease-model-using-recombinant-interleukin-1%C3%AE-and-arthroscopic-articular-sampling-of-the-medial-malleolus-of-the-tibia-on-the-standing-sedated-horse
#6
B B Nelson, M R King, D D Frisbie
Joint disease and osteoarthritis are common problems in the horse and numerous experimental studies have been developed to determine the safety and efficacy of new therapies. Synovitis, a critical component of joint disease, has been experimentally induced using recombinant interleukin-1 beta (reIL-1β) to investigate new joint therapies in a controlled environment, although the use of reIL-1β has not been reported in the equine tarsocrural joint. A common consequence of performing controlled experiments is that articular tissue collection typically requires general anesthesia or euthanasia...
November 2017: Veterinary Journal
https://www.readbyqxmd.com/read/29181360/tension-band-wiring-is-as-effective-as-a-compression-screw-in-a-neglected-medial-maleolus-non-union-a-case-based-discussion-literature-review
#7
Rakesh John, Mandeep Singh Dhillon, Ankit Khurana, Sameer Aggarwal, Prasoon Kumar
Introduction: Isolated, neglected medial malleolus nonunion cases are a rare entity in orthopedic literature. All studies (except one) have described the use of compression screws (with or without plates) for medial malleolar nonunion management. In acute fractures, tension band wiring (TBW) has shown excellent results both in biomechanical and in clinical studies. On the contrary, it has seldom been used in nonunion or in neglected cases. Case Report: We describe a 6-month-old neglected medial malleolus gap nonunion case who presented with progressive pain and limp...
July 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29162365/ankle-fracture-controversies-do-the-foot-and-ankle-specialists-have-a-different-vision
#8
G González-Lucena, D Pérez-Prieto, A López-Alcover, A Ginés-Cespedosa
OBJECTIVE: To analyse the differences in the management of ankle fractures between orthopaedic/trauma surgeons and foot and ankle specialists. MATERIAL AND METHOD: An e-mail survey was performed asking some of the country's orthopaedic surgeons controversial questions regarding the analysis of 5 clinical cases of different ankle fractures. RESULTS: Seventy-two surgeons responded to the questionnaire (response rate of 24.2%): 37 foot and ankle specialists and 35 non-specialist orthopaedic surgeons...
November 18, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/29162248/predicting-syndesmotic-injuries-in-ankle-fractures-a-new-system-based-on-the-medial-malleolar-focus
#9
Enrique Sánchez-Morata, José Carlos Martínez-Ávila, Elena Vacas Sánchez, Verónica Jiménez Díaz, Jaime Zorrilla Sánchez de Neyra, Jesús Vilá Y Rico
The early establishment of the diagnosis of a syndesmotic injury is essential for treatment selection. However, such injuries may not be apparent radiographically. Previous studies have attempted to describe correlations between medial malleolar fracture geometry and syndesmotic disruption. The main objective of this study was to create predictive models for assessing syndesmotic injuries based on an originally described angle, i.e., the medial crural-focal angle (MCFA). This study included 138 ankle fractures involving the medial malleolus...
November 2017: Injury
https://www.readbyqxmd.com/read/29158644/injury-mechanism-fracture-characteristics-and-clinical-treatment-of-pilon-fracture-with-intact-fibula-a-retrospective-study-of-23-pilon-fractures
#10
Jiang Liangjun, Zheng Qiang, Li Hang, Pan Zhijun
Objective: The effect of intact fibula on pilon fracture is not completely elucidated. We retrospectively analysed pilon fractures with intact fibula at our hospital over a 4 year period to understand the injury mechanism, fracture characteristics, treatment strategy and prognosis of this fracture. Methods: Pilon fracture patients with intact fibula treated in our hospital from January 2010 to December 2014 were observed. OA/ATO fracture type, Ruedi-Allgower classification and fracture characteristics were summarised...
November 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29126047/clinico-sonographical-evaluation-of-idiopathic-clubfoot-and-its-correction-by-ponseti-method-a-prospective-study
#11
Sumit Chawla, Mallika Gupta, Varun Pandey, Abhishek Jain, Manoj Kumar
BACKGROUND: Objective evaluation of infant with clubfoot is required as conventional imaging modality is of limited usefulness. Ultrasound shows to be a promising technique for assessing deformity and monitoring of clubfoot correction. AIM: Study was done to evaluate the deformity sonographically; to assess the changes in these parameters after treatment by Ponseti method and to correlate these ultrasonographic variables with clinical Pirani score. MATERIALS AND METHODS: 82 feet in 54 children were observed...
December 2017: Foot
https://www.readbyqxmd.com/read/29079366/quality-of-fracture-reduction-assessed-by-radiological-parameters-and-its-influence-on-functional-results-in-patients-with-pilon-fractures-a-prospective-multicentre-study
#12
Christoph Sommer, Sean E Nork, Matthew Graves, Michael Blauth, Mark Rudin, Karl Stoffel
INTRODUCTION: The management of pilon fractures remains a challenging issue. Due to the complexity of factors that influence the outcome, it has been questioned if anatomical reductions of articular fracture are relevant. The lack of a commonly accepted assessment of quality of fracture reduction compounded the uncertainty of the importance of anatomical reduction in pilon fracture. The current study aimed to define parameters that can better assess the reduction quality and to investigate the influence of reduction quality on functional outcomes...
October 20, 2017: Injury
https://www.readbyqxmd.com/read/29079241/ankle-fracture-associated-with-rupture-of-the-achilles-tendon-case-report-and-review-of-the-literature
#13
Mohammed Elmajee, Asan Rafee, Tolupe Williams
Solitary ankle fracture or Achilles Tendon (AT) rupture might not be an uncommon injury. However, concomitant ipsilateral ankle fracture with AT rupture is rare. The present report discusses this rare combination. A 30-year-old female had fallen while rock climbing and sustained a closed fracture of the medial malleolus with an ipsilateral complete AT rupture. Most of the reported cases had similar patterns, not only in terms of history, but also in terms of a similar fracture pattern. This rare combination of orthopedic injuries tends to occur when an abrupt excessive force is applied to the forefoot, with subsequent ankle hyperextension or hindfoot inversion...
November 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29076683/outcome-of-distally-based-sural-artery-flap-for-distal-third-of-leg-and-foot-defects
#14
Kuldeep Singh, Rajesh Rohilla, Raj Singh, Sarita Singh, Bikramjit Singh, Milind Tanwar
BACKGROUND: Due to precarious blood supply, skin coverage for defects of leg, heel, dorsum of foot and the ankle has been a complicated task for plastic surgeons & orthopaedic surgeons. The present study aimed to prospectively evaluate the outcome of distally based sural flap for coverage of defects distal third of leg, ankle & foot. METHODS: In this study 15 patients with soft tissue defects on distal third of leg in (n=2), heel (n=4), medial malleolus (n=3), lateral malleolus (n=1), Achillis tendon (n=2), anterior ankle (n=2) and in dorsum of foot (n=1) were operated for coverage of defect by distally based sural flap...
July 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29058951/stability-of-the-syndesmosis-after-posterior-malleolar-fracture-fixation
#15
Matthew A Miller, Tyler C McDonald, Matthew L Graves, Clay A Spitler, George V Russell, LaRita C Jones, William Replogle, Jeremy A Wise, Josie Hydrick, Patrick F Bergin
BACKGROUND: We sought to define the rate of syndesmotic instability after anatomic reduction of the posterior malleolus when posterior stabilization of a trimalleolar or trimalleolar equivalent ankle fracture was chosen vs when a supine position and initially conservative management of the posterior elements was chosen. METHODS: The types of syndesmotic and posterior malleolar fixation used to treat adult patients with ankle fractures involving the posterior malleolus at our level I trauma center were retrospectively assessed (N = 198)...
October 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/29023350/an-artificial-cadaveric-leg-blood-flow-system-for-endoscopic-vein-harvesting-simulation
#16
Constantine L Karras, Emily A DeDonato, Kaitlin K DiBartola, Jin-Cheng Zhao
Despite being the most common training model for endoscopic vein harvesting, cadaveric legs are limited by their absence of blood flow, resulting in a faded vascular appearance. Because the saphenous vein and the surrounding tissue seem less distinguishable, dissection of the saphenous vein and bipolar coagulation of its branches becomes increasingly inefficient and difficult. An inexpensive artificial blood flow system was developed to overcome this limitation. A cadaveric leg was thawed to a soft and yielding degree, and the saphenous vein was dissected medial and proximal to the medial malleolus...
September 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28983653/combined-arthroscopic-all-inside-repair-of-lateral-and-medial-ankle-ligaments-is-an-effective-treatment-for-rotational-ankle-instability
#17
Jordi Vega, Jörg Allmendinger, Francesc Malagelada, Matteo Guelfi, Miki Dalmau-Pastor
PURPOSE: When the anterior fascicle of the deltoid ligament is injured in patients with chronic ankle instability, the diagnosis of rotational ankle instability is supported. The aim of this study was to report the results of an all-arthroscopic technique to concomitantly repair the lateral collateral and deltoid ligaments to treat patients with rotational ankle instability. METHODS: Thirteen patients [12 men and 1 woman, median age 32 (15-54) years] with rotational ankle instability were treated by arthroscopic means after failing non-operative management...
October 5, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28979587/operative-treatment-of-posterior-malleolar-fractures
#18
Xiaojun Duan, Anish R Kadakia
Fractures of the posterior malleolus can occur in conjunction with fibular and medial malleolar fractures or in isolation. The indications for fixation of the posterior malleolus remain controversial except for the fragment sizes. A number of different surgical approaches and techniques for internal fixation of posterior malleolar fractures have been reported. Newer techniques such as direct exposure and plating of the posterior malleolus are chosen more frequently than traditional techniques of indirect reduction and percutaneous screw fixation...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28972661/sonography-guided-recording-for-superficial-peroneal-sensory-nerve-conduction-study
#19
Ki Hoon Kim, Byung Kyu Park, Dong Hwee Kim, Yuntae Kim
INTRODUCTION: We sought to establish the optimal recording position for antidromic conduction of the superficial peroneal nerve (SPN) by using ultrasonography (USG). METHODS: The sensory nerve action potentials (SNAPs) of the intermediate dorsal cutaneous nerve (IDCN) and medial dorsal cutaneous nerve (MDCN) in 64 limbs of 32 healthy participants were recorded (nerve conduction study [NCS]-1). Both nerves were identified by using USG, and the SNAPs were obtained from the USG-guided repositioned electrodes (NCS-2)...
October 3, 2017: Muscle & Nerve
https://www.readbyqxmd.com/read/28937801/clinical-implications-of-hand-position-and-lower-limb-length-measurement-method-on-y-balance-test-scores-and-interpretations
#20
Kim Hébert-Losier
CONTEXT:   The Lower Quarter Y-Balance Test (LQ-YBT) was developed to provide an effective and efficient screen for injury risk in sports. Earlier protocol recommendations for the LQ-YBT involved the athlete placing the hands on the hips and the clinician normalizing scores to lower limb length measured from the anterior-superior iliac spine to the lateral malleolus. The updated LQ-YBT protocol recommends the athlete's hands be free moving and the clinician measure lower limb length to the medial malleolus...
October 2017: Journal of Athletic Training
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