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Medial malleolus

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https://www.readbyqxmd.com/read/28920487/unilateral-dislocation-of-the-posterior-tibialis-tendon-ptt-and-flexor-digitorum-longus-tendon-with-contralateral-ptt-subluxation-in-a-patient-with-congenitally-shallow-flexor-groove
#1
Jacob E Waldron, Andrew S Bernhardson, Todd A Fellars
INTRODUCTION: Flexor tendon dislocation from the flexor tendon groove posterior of the medial malleolus has been previously described, and may be difficult to diagnose initially, but is amendable to surgical treatment with good outcomes. We present a unique case of unilateral dislocation of the posterior tibialis and flexor digitorum longus tendons with contralateral flexor digitorum longus subluxation that was treated surgically with a good outcome. CASE PRESENTATION: A 37-year-old active duty male sustained a dislocation and subluxation of the flexor tendons bilaterally after a forced dorsiflexion injury...
October 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28903975/proximal-avulsion-rupture-of-the-flexor-digitorum-longus-tendon-associated-with-a-medial-malleolus-ankle-fracture
#2
Naoki Yoshida, Yoshihiko Tsuchida
No abstract text is available yet for this article.
September 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28877594/a-medial-malleolar-fleck-sign-may-predict-ankle-instability-in-ligamentous-supination-external-rotation-ankle-fractures
#3
Kenneth Nwosu, Brian Andrew Schneiderman, Stephen Joseph Shymon, Thomas Harris
BACKGROUND: Ankle joint stability dictates treatment in ligamentous supination external rotation ankle injuries (LSERAI). Investigation of the medial structures that support the ankle mortise is critical, and a small avulsion fracture, or "fleck", of the medial malleolus is occasionally encountered. This study aimed to assess the utility of this medial malleolus fleck sign (MMFS) in diagnosing instability requiring surgery in LSERAI. METHODS: This retrospective observational study examined 166 LSERAI at a single level I trauma center...
September 1, 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28874066/the-role-of-the-accessory-malleolar-ossicles-and-malleolar-avulsion-fractures-in-lateral-ankle-ligament-reconstruction
#4
Matthew M Reiner, Jonathan J Sharpe
While it is well known that ankle sprains are one of the most common injuries in the United States, predictive factors regarding failure of conservative treatment are not well known. There are many biomechanical and epidemiological factors that play a role in recurrence and failure of conservative treatment, but most cases are able to be treated with immobilization and/or rest, ice, elevation, physical therapy, and bracing. We propose that one important risk factor is often overlooked simply due to the fact that a vast majority of these cases resolve without the need for surgery...
September 1, 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28854764/extramedullary-tibial-bone-cutting-using-medial-cortical-line-in-total-knee-arthroplasty
#5
Ju-Hyung Yoo, Chang-Dong Han, Hyun-Cheol Oh, Sang-Hoon Park, Se-Han Jung, Yun-Jae Lee
Purpose: This study aims to identify the effectiveness of the medial cortical line for attaining a more accurate tibial component alignment in proximal tibial resection using an extramedullary alignment rod. Materials and Methods: The study examined 100 cases of total knee arthroplasty performed from December 2013 to February 2014 in a retrospective manner. On a preoperative anteroposterior (AP) radiograph of the entire tibia, we identified the medial cortical line that runs parallel to the tibial anatomical axis and passes the medial tibial spine, and measured the point where the medial cortical line crosses between the medial malleolus and the lateral malleolus in the ankle joint...
September 1, 2017: Knee Surgery & related Research
https://www.readbyqxmd.com/read/28758439/pathoanatomy-and-associated-injuries-of-posterior-malleolus-fracture-of-the-ankle
#6
Lyndon W Mason, William J Marlow, James Widnall, Andrew P Molloy
BACKGROUND: We present a classification system that progresses in severity, indicates the pathomechanics that cause the fracture and therefore guides the surgeon to what fixation will be necessary by which approach. METHODS: The primary posterior malleolar fracture fragments were characterized into 3 groups. A type 1 fracture was described as a small extra-articular posterior malleolar primary fragment. Type 2 fractures consisted of a primary fragment of the posterolateral triangle of the tibia (Volkmann area)...
July 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28758064/bifurcated-great-saphenous-vein-a-report-on-its-therapeutic-and-diagnostic-perspectives
#7
Naveen Kumar, Ashwini P Aithal, Ravindra S Swamy, Satheesha B Nayak, Mohandas K G Rao, P Abhinitha
The great saphenous vein (GSV) is the longest superficial vein in the body extending from the medial malleolus to groin skin crease level. The clinical usage of GSV has made its anatomical variations noteworthy. Since many tributaries accompany it, GSV is often mistaken with the variant vein. Duplication and persistence of accessory GSV are the two major clinically significant anatomical variations of the GSV which is frequently misinterpreted as a synonym. In the present case, we report a unique variation of GSV wherein it bifurcated into anterior and posterior divisions of two uneven calibers at knee region, which then reunited at thigh region to form a single vein before its termination into the femoral vein...
July 2017: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/28746238/-sural-nerve-splitting-in-reverse-sural-artery-perforator-flap-anatomical-study-in-40-cadaver-legs
#8
Hyeonwoo Kim, Julong Hu, Hak Chang, Byung Jun Kim
BACKGROUND: The reverse sural artery perforator flap (RSAPF) has been widely used in reconstructions of the lower extremity. However, along with the high rate of flap necrosis, sural nerve (SN) injury is one of the most frequent complications. This cadaveric study investigated a simple SN preservation technique during RSAPF. METHODS: Anatomic dissection of the sural nerve was performed on 40 lower legs, from 20 cadavers, to investigate the pattern of SN distribution...
July 12, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28726265/how-to-havest-the-greatest-length-of-tibialis-posterior-tendon-in-tibialis-posterior-tendon-transfer-a-cadaveric-study
#9
Korakot Thamphongsri, Thos Harnroongroj, Atthakorn Jarusriwanna, Bavornrit Chuckpaiwong
INTRODUCTION: In anterior transfer of the tibialis posterior tendon, the tendon was harvested using two incisions, the first at its attachment point on the navicular bone and second on the medial side of the leg above the medial malleolus. To provide the maximum tendon length, the second incision needs to be as proximal as possible but injury to the muscle origin must be avoided. The purpose of this study is to establish the location of the second incision that yields the greatest tendon length...
July 20, 2017: Clinical Anatomy
https://www.readbyqxmd.com/read/28719778/medial-malleoli-fractures-clinical-comparison-between-newly-designed-sled-device-and-conventional-screws
#10
Hemil Maniar, Harish Kempegowda, Akhil A Tawari, Michael R Rutter, Amrut Borade, Gerard Cush, Daniel S Horwitz
BACKGROUND: The Trimed Medial Malleolar Sled is a newer device designed to treat medial malleolus fracture. The purpose of this study was to compare the outcome of medial malleolar fractures treated with the sled and conventional malleolar screws. METHODS: After obtaining an institutional review board approval, we conducted a retrospective study to identify all skeletally mature patients who sustained an ankle fracture with medial malleolar involvement treated with the sled and we identified a matched cohort treated with conventional malleolar screws...
August 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28697881/incarceration-of-the-posterior-tibial-tendon-in-an-isolated-comminuted-medial-malleolus-fracture
#11
David Jaffe, Matthew W Christian, Annie Weber, R Frank Henn
Isolated medial malleolar fractures are a less common presentation of an ankle fracture. Treatment is not universally accepted, although many have agreed that any displacement warrants anatomic reduction and fixation. We present a case of an isolated, comminuted medial malleolar fracture that was displaced secondary to entrapment of the posterior tibial tendon between the fracture fragments requiring surgical intervention. The patient was treated with prompt open reduction and internal fixation and had an excellent functional outcome at 1 year...
July 8, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28672913/amniotic-membrane-derived-stem-cells-help-repair-osteochondral-defect-in-a-weight-bearing-area-in-rabbits
#12
Zhijin Zhang, Linru Zeng, Jun Yang, Lin Guo, Qiao Hou, Fangbing Zhu
Our study evaluated the use of amniotic membrane-derived stem cells for repairing osteochondral defects in a weight-bearing area in rabbits. Twenty-four 3-month-old male or female New Zealand white rabbits were selected. The rabbits were randomly divided into 3 groups of eight, according to the treatment received for an experimentally inflicted femoral medial malleolus lesion, group I received a human acellular amniotic membrane seeded with bone marrow-derived mesenchymal stem cells (HAAM-BMSCs) implant; group II received a simple HAAM implant and the control group received no experimental lesion or treatment...
July 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28663388/when-is-a-simple-fracture-of-the-lateral-malleolus-not-so-simple-how-to-assess-stability-which-ones-to-fix-and-the-role-of-the-deltoid-ligament
#13
REVIEW
N Gougoulias, A Sakellariou
Stable fractures of the ankle can be safely treated non-operatively. It is also gradually being recognised that the integrity of the 'medial column' is essential for the stability of the fracture. It is generally thought that bi- and tri-malleolar fractures are unstable, as are pronation external rotation injuries resulting in an isolated high fibular fracture (Weber type-C), where the deltoid ligament is damaged or the medial malleolus fractured. However, how best to identify unstable, isolated, trans-syndesmotic Weber type-B supination external rotation (SER) fractures of the lateral malleolus remains controversial...
July 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28647197/characterizing-tissue-perfusion-after-lower-extremity-intervention-using-two-dimensional-color-coded-digital-subtraction-angiography
#14
Ann H Kim, Andrew J Shevitz, Katherine L Morrow, Daniel E Kendrick, Karem Harth, Henry Baele, Vikram S Kashyap
OBJECTIVE: Digital subtraction angiography (DSA) of the peripheral arterial vasculature provides lumenographic information but only a qualitative assessment of blood flow. The ability to quantify adequate tissue perfusion of the lower extremities would enable real-time perfusion assessment during DSA of patients with peripheral arterial disease (PAD). In this study, we used a novel real-time imaging software to delineate tissue perfusion parameters in the foot in PAD patients. METHODS: Between March 2015 and June 2016, patients (N = 31) underwent lower extremity angiography using a two-dimensional perfusion (2DP) imaging protocol (Philips Healthcare, Andover, Mass)...
June 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28642651/bimalleolar-ankle-fracture-a-simple-fracture
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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