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Medial malleolus

A B M Boni Rietveld, F M T Hagemans
Posterior ankle impingement syndrome (PAIS) is a painful, usually limited plantar flexion of the ankle joint due to soft tissue impingement or a bony impediment often coinciding with tendinopathy of the flexor hallucis longus (FHL) behind the medial malleolus. In persistent complaints, the bony impediment is removed, the tunnel of the FHL tendon is released, or a combination of both procedures has traditionally been performed by open surgery. In 2000, an endoscopic surgical technique for PAIS and FHL tendinopathy was introduced...
March 15, 2018: Journal of Dance Medicine & Science
Sang Hyun Nam, Jung Yeon Kim, Jaeki Ahn, Yongbum Park
Plexiform neurofibromas of the foot are rare, benign tumors of the peripheral nerves. Diagnosis can be challenging if they present with symptoms mimicking other peripheral nerve pathologies. Tarsal tunnel syndrome is an entrapment syndrome of the entire tibial nerve behind the medial malleolus and under the flexor retinaculum. The clinical presentation typically includes posteromedial pain, positive Tinel's sign, and neurogenic signs, including both the sensation of numbness and the actual hypoesthesia and clawing of the toes...
January 2018: The surgery journal
Tenna Klit, Marie Dahl, Kim Christian Houlind, Hans Ravn
BACKGROUND: In patients with critical leg ischemia (CLI), the standard operative choice is an in situ bypass to the lower extremity to improve the patients´ prognosis and quality of life. Postoperative complications after surgery occur in 18 % of the patients, prolonging hospitalization and convalescence. The main operative complication is edema. This can be prevented by early mobilization or stimulation of the natural venous pump in the leg. OBJECTIVE: To investigate whether compression therapy with foot pump reduces postoperative edema, facilitates wound healing of the operation wounds, promotes healing of ischemic ulcers, and shortens hospitalization, increasing and improving the patient's subjective quality of life faster...
February 20, 2018: JMIR Research Protocols
Oded Coifman, Jason T Bariteau, Nachshon Shazar, Shay A Tenenbaum
BACKGROUND: Ankle fractures are extremely common and represent nearly one quarter of all lower-limb fractures. Techniques for fixation of displaced fractures of the lateral malleolus have remained essentially unchanged in recent decades. The current gold standard of treating unstable fractures is with open reduction and internal fixation (ORIF), using plates and screws construct. This study evaluates the use of fibula intramedullary nailing based on minimal invasive surgical approach...
September 7, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Elizabeth Fitzpatrick, Jessica E Goetz, Tinnart Sittapairoj, Vinay Hosuru Siddappa, John E Femino, Phinit Phisitkul
BACKGROUND: Syndesmotic malreduction and fractures of the posterior malleolus negatively influence outcomes of rotational ankle fractures. Recent data have shown that posterior malleolus fixation contributes to the stability of the syndesmosis. The purpose of this study was to analyze syndesmotic reduction within the context of different sizes of posterior malleolus fracture fragments and different qualities of reduction. METHODS: A model of stage-IV supination-external rotation injury was created in 9 through-the-knee cadaveric specimens...
February 7, 2018: Journal of Bone and Joint Surgery. American Volume
Ki Hyuk Sung, Young Choi, Gyeong Hee Cho, Chin Youb Chung, Moon Seok Park, Kyoung Min Lee
OBJECTIVE: This study evaluated the correlation between central and peripheral bone mineral density (BMD) of the ankle joint, using dual-energy X-ray absorptiometry (DXA). We also investigated whether peripheral ankle BMD could be used to identify individuals who were diagnosed with osteoporosis, using central DXA. METHODS: We recruited 134 volunteers aged 20-90 years who agreed to participate in this study. Central BMD of the lumbar spine and left femur, and peripheral BMD of the medial malleolus, distal tibia, lateral malleolus, and talus were measured with DXA...
February 5, 2018: Skeletal Radiology
Ashley E Levack, Stephen J Warner, Elizabeth B Gausden, David L Helfet, Dean G Lorich
OBJECTIVES: To evaluate the effect of posterior bony versus ligamentous injury pattern on functional outcomes in operatively treated rotational ankle fractures DESIGN:: Retrospective cohort analysis of prospective registry SETTING:: Academic level I trauma center PATIENTS/PARTICIPANTS:: Operatively treated supination external rotation (SER) IV and pronation external rotation (PER) IV ankle fractures INTERVENTION:: Lateral malleolus plate fixation with either posterior malleolus (PM) plate fixation or posterior inferior tibiofibular ligament (PITFL) repair MAIN OUTCOME MEASUREMENTS:: Foot and ankle outcome scores (FAOS) at minimum 12 months post-operatively RESULTS:: 178 fractures were treated with injury-specific anatomic fixation of a PM fracture (n=122) or torn PITFL (n=56)...
January 26, 2018: Journal of Orthopaedic Trauma
Atsushi Teramoto, Hiroaki Shoji, Yuzuru Sakakibara, Tomoyuki Suzuki, Kota Watanabe, Toshihiko Yamashita
PURPOSE: The purpose of this study was to evaluate the relationship between the lateral malleolus view under ankle arthroscopy and the anterior talofibular ligament (ATFL) attachment site. METHODS: Seven normal ankles from Thiel-embalmed cadavers were investigated. Ankle arthroscopy was performed using a 2.7 mm-diameter, 30-degree, oblique-viewing endoscope. An antero-medial portal (AM), a medial midline portal (MML), and an antero-central portal (AC) were created in order, and the ankle arthroscope was inserted...
January 22, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Tsukasa Teramoto, Shota Harada, Motoyuki Takaki, Tomohiko Asahara, Narutaka Kato, Nobuyuki Takenaka, Takasi Matsushita, Yosiaki Makino, Kouitiro Tasiro, Ootuka Kazutaka, Yukinobu Nishi, Kiyoto Kinugsa
We have devised a medial peri-articular osteotomy, the distal tibial oblique osteotomy (DTOO), and have used this technique since 1994 for ankle osteoarthritis of advanced and late stages associated with varus inclination. This report describes the surgical technique and its applicability. DTOO can be used for cases of varus ankle osteoarthritis with a range of the ankle joint movement of at least 10° or more. The osteotomy is obliquely directed cut across the distal tibia from proximal-medial to distal lateral and is of an opening-wedge type with the centre of rotation coincident with the centre of the tibiofibular joint...
January 29, 2018: Strategies in Trauma and Limb Reconstruction
Kunwarpal Singh, Kamlesh Gupta, Sukhdeep Kaur
Aim of the study: High-resolution ultrasonography of the tibial nerve is a fast and non invasive tool for diagnosis of diabetic peripheral neuropathy. Our study was aimed at finding out the correlation of the cross sectional area and maximum thickness of nerve fascicles of the tibial nerve with the presence and severity of diabetic peripheral neuropathy. Material and methods: 75 patients with type 2 diabetes mellitus clinically diagnosed with diabetic peripheral neuropathy were analysed, and the severity of neuropathy was determined using the Toronto Clinical Neuropathy Score...
December 2017: Journal of Ultrasonography
Orhan Beger, Özlem Elvan, Mert Keskinbora, Burçin Ün, Deniz Uzmansel, Zeliha Kurtoğlu
OBJECTIVE: The objective of this study was to evaluate the features of flexor hallucis longus (FHL), flexor digitorum longus (FDL) and flexor digitorum accessorius (FDA) muscles with relevance to the tendon grafts and to reveal the location of Master Knot of Henry (MKH). METHODS: Twenty feet from ten formalin fixed cadavers were dissected, which were in the inventory of Anatomy Department of Medicine Faculty, Mersin University. The location of MKH was identified...
January 20, 2018: Acta Orthopaedica et Traumatologica Turcica
Michinori Nariai, Kyongsong Kim, Masaaki Kawauchi, Akihiro Ishii, Misa Kido, Toyohiko Isu, Rinko Kokubo, Daijiro Morimoto, Naotaka Iwamoto, Akio Morita
BACKGROUND: Tarsal tunnel syndrome(TTS)is an entrapment neuropathy of the posterior tibial nerve within the tarsal tunnel below the medial malleolus. An accurate diagnosis is difficult, and TTS is usually diagnosed from clinical symptoms due to the lack of accurate diagnostic tools. We aimed to standardize the diagnosis of TTS using MRI, and report the MRI conditions for clear visualization of the tarsal tunnel. METHODS: We investigated which sequences and MRI conditions would be appropriate for the imaging of the tarsal tunnel in a healthy volunteer...
January 2018: No Shinkei Geka. Neurological Surgery
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
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
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
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
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
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
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
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...
January 2018: Revista Española de Cirugía Ortopédica y Traumatología
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