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Medial malleolus

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https://www.readbyqxmd.com/read/28416851/-one-of-the-pitfalls-in-the-surgical-treatment-of-maisonneuve-fractures-a-case-report
#1
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
#2
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...
April 12, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28398291/fine-dissection-of-the-tarsal-tunnel-in-60-cases
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/28247597/-effects-of-1-8-mt-sinusoidal-alternating-electromagnetic-fields-of-different-frequencies-on-bone-biomechanics-of-young-rats
#10
Yanfeng Zhou, Yuhai Gao, Ping Zhen, Keming Chen
Objective: To study the effects of 1.8 mT sinusoidal electromagnetic fields of different frequencies on bone mineral density (BMD) and biomechanical properties in young rats. Methods: A total of 32 female SD rats (6-week-old) were randomly divided into 4 groups (8 in each):control group, 10 Hz group, 25 Hz group and 40 Hz group. The experimental groups were given 1.8 mT sinusoidal electromagnetic field intervention 90 min per day. The whole body BMD of rats was detected with dual-energy X-ray absorptiometry after 4 and 8 weeks of intervention...
November 25, 2016: Zhejiang da Xue Xue Bao. Yi Xue Ban, Journal of Zhejiang University. Medical Sciences
https://www.readbyqxmd.com/read/28169040/os-subtibiale-mimicking-medial-malleolar-fracture-a-report-of-three-cases-and-review-of-literature
#11
Murat Topal, Ahmet Köse, Recep Dinçer, Tuncay Baran, Mehmet Köse, M Çağatay Engin
There are numerous sesamoids and accessory ossicles around the foot which can easily be misdiagnosed as fractures. Os subtibiale is a very rare normal variant of the medial malleolus which is usually diagnosed incidentally in routine ankle radiographs. In this report, we present a case series of 3 patients with os subtibiale who were admitted to the emergency department with ankle sprains and misdiagnosed as medial malleolar fractures. We would like to raise awareness to the very rare and usually asymptomatic os subtibiale as a diagnostic pitfall...
December 31, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28159037/percutaneous-screw-fixation-of-unstable-ankle-fractures-in-patients-with-poor-soft-tissues-and-significant-co-morbidities
#12
Matthew Smith, Gareth Medlock, Alan J Johnstone
INTRODUCTION: We describe a minimally invasive technique to stabilise unstable ankle fractures by inserting a 100mm screw up the fibula medullary canal along with percutaneous screw fixation of the medial malleolus if required. This technique is utilised in patients with poor soft tissues and significant co-morbidities where the fracture cannot be adequately controlled by a cast alone. PATIENTS AND METHODS: Retrospective review of 23 patients the average age being 70 years (29-89) and 74% had significant co-morbidities...
March 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28131604/os-subtibiale-and-secondary-ossification-center-of-medial-malleolus-are-two-different-entities
#13
Adil Turan, Omer Faruk Kilicaslan, Ozkan Kose
No abstract text is available yet for this article.
January 24, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28121362/anatomy-pathophysiology-and-classification-of-posterior-tibial-tendon-dysfunction
#14
M Guelfi, A Pantalone, R M Mirapeix, D Vanni, F G Usuelli, M Guelfi, V Salini
OBJECTIVE: Adult acquired flatfoot deformity is generally associated with a collapsing medial longitudinal arch and a progressive loss of strength of the posterior tibial tendon (PTT). This condition is commonly associated with PTT dysfunction or rupture, which can have an arthritic or a traumatic etiology. Several causes have been proposed to explain the clinical evidence of tendon degeneration observed at the time of surgery including trauma, anatomical, mechanical, inflammatory and ischemic factors...
January 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28119205/sled-fixation-for-horizontal-medial-malleolus-fractures
#15
Adam M Wegner, Philip R Wolinsky, Robin Z Cheng, Michael A Robbins, Tanya C Garcia, Derek F Amanatullah
BACKGROUND: Horizontal fractures of the medial malleolus occur through exertion of various rotational forces on the ankle, including supination--external rotation, pronation--external rotation, and pronation-abduction. Many methods of fixation are employed for these fractures, but the optimal fixation construct remains unclear. METHODS: Horizontal medial malleolus osteotomies were performed in synthetic distal tibiae and randomized into two fixation groups: 1) two parallel unicortical cancellous screws or 2) medial malleolar sled fixation...
January 16, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28081534/enhanced-auditory-sensitivity-to-body-vibrations-in-superior-canal-dehiscence-syndrome
#16
Krister Brantberg, Luca Verrecchia, Magnus Westin
A key feature of superior canal dehiscence (SCD) syndrome is supranormal hearing of body sounds. The aim of the present study was to quantify this phenomenon and to ascertain whether auditory sensitivity to body vibrations can distinguish SCD patients. Hearing thresholds in response to vibration at the vertex, at the spinous process of the 7th cervical vertebra, and at the medial malleolus were tested in 10 SCD patients and 10 controls. Both patients and controls had insert earphones in both ears. The insert in the test ear was blocked while masking was presented to the other ear...
January 13, 2017: Audiology & Neuro-otology
https://www.readbyqxmd.com/read/28063094/stasis-dermatitis-pathophysiology-evaluation-and-management
#17
REVIEW
Swaminathan Sundaresan, Michael R Migden, Sirunya Silapunt
Stasis dermatitis commonly occurs in older age. It is caused by venous hypertension resulting from retrograde flow due to incompetent venous valves, valve destruction, or obstruction of the venous system. Further tissue changes arise from an inflammatory process mediated by metalloproteinases, which are up-regulated by ferric ion from extravasated red blood cells. Stasis dermatitis presents initially as poorly demarcated erythematous plaques of the lower legs bilaterally, classically involving the medial malleolus...
January 6, 2017: American Journal of Clinical Dermatology
https://www.readbyqxmd.com/read/28058573/anterior-wrist-and-medial-malleolus-as-the-novel-sites-of-tissue-selection-a-retrospective-study-on-electric-shock-death-through-the-hand-to-foot-circuit-pathway
#18
Guangtao Xu, Ruibing Su, Junyao Lv, Bo Hu, Huan Gu, Xianxian Li, Jiang Gu, Xiaojun Yu
Our previous work demonstrated that characteristic changes could occur in the anterior wrist and medial malleolus in electric deaths through the hand-to-foot electric circuit pathway in an electric shock rat model. However, whether the same phenomenon occurs in humans is unknown. The aim of the present retrospective study was to ascertain whether the anterior wrist and medial malleolus could also be selected as the promising and significant sites in electric death through the hand-to-foot circuit pathway. Nineteen human cases from the autopsy and one clinical survivor who sustained a severe electric shock through the hand-to-foot circuit pathway were analyzed...
January 6, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/28018067/a-rare-combination-of-sagittal-plane-fracture-of-talar-body-with-medial-malleolus-fracture-case-report-and-review-of-literature
#19
M Arkesh, Sahil Gaba, Saubhik Das, Jeya Venkatesh Palanisamy, Vivek Trikha
Fractures of talus are relatively uncommon injuries with majority of them involving the neck region. Talar body fracture in sagittal plane in combination with medial malleolus fracture is very rare with few cases being reported in the literature earlier. We report such an unusual combination in an adolescent, which was treated with open reduction and internal fixation with screws for both talus and medial malleolus. This was followed by physiotherapy and non-weight bearing till the fracture united.
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/27908492/fragility-fractures-of-the-ankle-in-the-elderly-open-reduction-and-internal-fixation-versus-tibio-talo-calcaneal-nailing-short-term-results-of-a-prospective-randomized-controlled-study
#20
D Georgiannos, V Lampridis, I Bisbinas
INTRODUCTION: The management of ankle fractures in the elderly remains unpredictable, secondary to their various co-morbidities. Although tibiotalocalcaneal (TTC) nailing has been an effective option for ankle arthrodesis due to ankle arthritis or Charcot arthropathy there are few reports regarding the use of TTC nail for the treatment of ankle fractures. PURPOSE: Aim of this study was to compare the results of ORIF versus TTC nailing for the treatment of unstable ankle fractures in the elderly...
February 2017: Injury
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