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https://www.readbyqxmd.com/read/28511569/weightbearing-vs-gravity-stress-radiographs-for-stability-evaluation-of-supination-external-rotation-fractures-of-the-ankle
#1
Angela Seidel, Fabian Krause, Martin Weber
BACKGROUND: Isolated lateral malleolar fractures may result from a supination-external rotation (SER) injury of the ankle. Stable fractures maintain tibiotalar congruence due to competent medial restraints and can be treated nonoperatively with excellent functional results and long-term prognosis. Stability might be assessed with either stress radiographs or weightbearing radiographs. METHODS: A consecutive series of patients with closed SER fractures (presumed AO 44-B1) were prospectively enrolled from 2008 to 2015...
May 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28503349/medial-malleolar-fractures-an-anatomic-survey-determining-the-ideal-screw-length
#2
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
#3
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/28473957/syndesmotic-internalbrace-tm-for-anatomic-distal-tibiofibular-ligament-augmentation
#4
Markus Regauer, Gordon Mackay, Mirjam Lange, Christian Kammerlander, Wolfgang Böcker
Reconstruction of unstable syndesmotic injuries is not trivial, and there is no generally accepted treatment guidelines. Thus, there still remain considerable controversies regarding diagnosis, classification and treatment of syndesmotic injuries. Syndesmotic malreduction is the most common indication for early re-operation after ankle fracture surgery, and widening of the ankle mortise by only 1 mm decreases the contact area of the tibiotalar joint by 42%. Outcome of ankle fractures with syndesmosis injury is worse than without, even after surgical syndesmotic stabilization...
April 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28459426/osteochondral-autograft-transfer-system-procedure-for-posterior-osteochondral-lesions-of-the-talus-through-prone-position-midline-achilles-tendon-splitting-approach
#5
Justin D Orr, Kenneth A Heida
Posteriorly based osteochondral lesions of the talus (OCLTs) are relatively rare, and when they are symptomatic and not amenable to traditional arthroscopic treatment techniques, they may require osteochondral graft transfer procedures, such as the osteochondral autograft transfer system (OATS) procedure. Historically described osteotomies to gain perpendicular access to these OCLTs, while excellent techniques, present many possible postoperative morbidities. This technical tip describes the use of a prone position midline Achilles tendon-splitting approach, a well-described approach to the posterior ankle and hindfoot, to perform osteochondral autograft transfer without need for any malleolar osteotomies...
2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/28438029/posterior-tibialis-tendon-rupture-in-a-closed-bimalleolar-equivalent-ankle-fracture-case-report
#6
Richard M Wardell, Andrew E Hanselman, Scott D Daffner, Robert D Santrock
Ankle fractures with an associated posterior tibialis tendon (PTT) rupture are rare injuries and have only been described in a number of case reports. These prior reports include patients that had an open fracture and/or an associated medial malleolar fracture component. In this unique case report, we present a patient that sustained a closed bimalleolar-equivalent ankle fracture/dislocation without medial malleolar involvement which was irreducible due to a PTT rupture and subsequent distal segment interposition in the tibiotalar joint...
April 1, 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28425054/can-a-three-component-prosthesis-be-used-for-conversion-of-painful-ankle-arthrodesis-to-total-ankle-replacement
#7
Markus Preis, Travis Bailey, Lucas S Marchand, Alexej Barg
BACKGROUND: In patients with painful ankle arthrodesis, the surgical treatment is challenging, and may include takedown of ankle arthrodesis and conversion to a total ankle replacement (TAR). This procedure is technically demanding given the altered anatomy after arthrodesis. Few studies have evaluated TAR in the setting of prior arthrodesis. QUESTIONS/PURPOSES: (1) What intraoperative and perioperative complications were observed in patients who underwent conversion of an ankle arthrodesis to a TAR? (2) Was durable fixation achieved at short term, and what was the alignment of the components? (3) What subsequent surgical procedures were performed, including revisions? (4) What improvements were observed in pain, tibiotalar range of motion (ROM), and quality of life? METHODS: Between January 2007 and December 2014, 18 patients with a painful ankle arthrodesis underwent conversion to TAR at our tertiary referral center...
April 19, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28416839/-a-correlation-analysis-of-the-ankle-ct-and-ankle-fracture-classification
#8
X F Gong, Y W Lyu, J H Wang, Y Wang, Y Wu, M Y Wang
OBJECTIVE: To summarize the CT features of ankle fracture and to analyze the relationship between the CT images and the most commonly used ankle fracture classification. METHODS: With 369 cases of adult ankle fractures analyzed retrospectively, the CT images 1 cm above the ankle joint and its characteristics, the Danis-Weber classification of ankle fracture were studied, and so was the relationship between CT images and the fracture classification. RESULTS: There were 8 forms of CT images...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28410782/posterior-arthroscopic-tibiotalar-arthrodesis-anatomic-feasibility-study
#9
Louis Malekpour, Said Rahali, Damien Potage, Fabrice Duparc, Franck Dujardin, Xavier Roussignol
Anterior arthroscopic tibiotalar arthrodesis has been well codified. A posterior approach with the patient in prone position is indicated when the anterior approach is precluded by soft tissue issues or for a 1-step procedure associated with posterior subtalar fusion. In an anatomic study, we assessed the feasibility of posterior arthroscopic tibiotalar fusion and sought to determine the arthroscopy entry points, mortise cartilage freshening quality, and risk of osseous, tendinous, vascular, and neural complications...
April 11, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28373933/arthroscopic-curettage-and-bone-grafting-of-bone-cysts-of-the-talar-body
#10
Tun Hing Lui
Talar bone cysts can develop as a result of osteochondral lesions of the talus. This can be a source of deep ankle pain. Open debridement and bone grafting of the bone cysts requires extensive soft tissue dissection and malleolar osteotomy. Removal of normal cartilage of the talus is frequently required to approach the bone cysts. Alternatively, the cysts can be grafted arthroscopically with minimal disruption of the normal cartilage surface. The key to success is careful preoperative planning with a computed tomogram of the ankle...
February 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28371502/comparison-of-posteromedial-versus-posterolateral-approach-for-posterior-malleolus-fixation-in-trimalleolar-ankle-fractures
#11
Sheng Zhong, Lin Shen, Jia-Guo Zhao, Jie Chen, Jin-Feng Xie, Qi Shi, Ying-Hua Wu, Xian-Tie Zeng
OBJECTIVE: To compare clinical and radiographic outcomes of posterior malleolar fractures (PMF) treated with lag screws from anterior to posterior versus posterior to anterior approach. METHODS: We retrospectively analyzed 48 patients with trimalleolar fractures who underwent open reduction and internal fixation (ORIF) with either posteromedial (PM) or posterolateral (PL) approaches between January 2012 and December 2014. Fixation of the posterior malleolus was made with anteroposterior screws in 20 patients using the PM approach and posteroanterior screws in 28 patients using the PL approach...
February 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28366469/comparison-between-carbon-peek-plate-and-conventional-stainless-steal-plate-in-ankle-fractures-a-prospective-study-of-two-years-follow-up
#12
Matteo Guzzini, Riccardo Maria Lanzetti, Domenico Lupariello, Federico Morelli, Giorgio Princi, Dario Perugia, Andrea Ferretti
INTRODUCTION: The aim of our study is to compare the clinical and radiological outcomes of the treatment of distal fibular fracture with the traditional stainless steel or the new radiolucent CFR-PEEK plates. The hypothesis is that there are no differences in clinical and radiological outcomes at the final follow-up between the two fixation devices. METHODS: All consecutive patients aged from 18 or over, who had undergone operative treatment for malleolar fracture between 2013 and 2014, have been included in the study...
March 27, 2017: Injury
https://www.readbyqxmd.com/read/28361015/development-of-an-internally-braced-prosthesis-for-total-talus-replacement
#13
Markus Regauer, Mirjam Lange, Kevin Soldan, Steffen Peyerl, Sebastian Baumbach, Wolfgang Böcker, Hans Polzer
Total loss of talus due to trauma or avascular necrosis, for example, still remains to be a major challenge in foot and ankle surgery with severely limited treatment options. Implantation of a custom made total talar prosthesis has shown promising results so far. Most important factors for long time success are degree of congruence of articular surfaces and ligamentous stability of the ankle. Therefore, our aim was to develop an optimized custom made prosthesis for total talus replacement providing a high level of primary stability...
March 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28306181/total-ankle-replacement-in-patients-with-haemophilic-arthropathy-primary-arthroplasty-and-conversion-of-painful-ankle-arthrodesis-to-arthroplasty
#14
M Preis, T Bailey, M Jacxsens, A Barg
INTRODUCTION: There are two general surgical approaches for operative treatment of end-stage haemophilic ankle arthropathy: ankle arthrodesis and total ankle replacement (TAR). AIM: The aim of this study was to determine intraoperative and postoperative complications and evaluate the mid-term clinical and radiographic outcomes of TAR in patients with haemophilic arthropathy. METHODS: Fourteen patients with a mean age of 51.4 ± 10.2 years (range = 32...
March 17, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
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
#15
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/28293302/3-d-computer-modelling-of-malunited-posterior-malleolar-fractures-effect-of-fragment-size-and-offset-on-ankle-stability-contact-pressure-and-pattern
#16
Teresa Alonso-Rasgado, David Jimenez-Cruz, Michael Karski
BACKGROUND: The positioning of the fracture fragment of a posterior malleolus fracture is critical to healing and a successful outcome as malunion of a posterior malleolar fracture, a condition seen in clinical practice, can affect the dynamics of the ankle joint, cause posterolateral rotational subluxation of the talus and ultimately lead to destruction of the joint. Current consensus is to employ anatomic reduction with internal fixation when the fragment size is larger than 25 to 33% of the tibial plafond...
2017: Journal of Foot and Ankle Research
https://www.readbyqxmd.com/read/28292290/comparison-of-the-direct-and-indirect-reduction-techniques-during-the-surgical-management-of-posterior-malleolar-fractures
#17
Hong-Fei Shi, Jin Xiong, Yi-Xin Chen, Jun-Fei Wang, Xu-Sheng Qiu, Jie Huang, Xue-Yang Gui, Si-Yuan Wen, Yin-He Wang
BACKGROUND: The optimal method for the reduction and fixation of posterior malleolar fracture (PMF) remains inconclusive. Currently, both of the indirect and direct reduction techniques are widely used. We aimed to compare the reduction quality and clinical outcome of posterior malleolar fracture managed with the direct reduction technique through posterolateral approach or the indirect reduction technique using ligamentotaxis. METHODS: Patients with a PMF involving over 25% of the articular surface were recruited and assigned to the direct reduction (DR) group or the indirect reduction (IR) group...
March 14, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28291191/which-lateral-malleolar-fractures-do-not-need-an-operation-commentary-on-an-article-by-simo-nortunen-md-et-al-dynamic-stress-testing-is-unnecessary-for-unimalleolar-supination-external-rotation-ankle-fractures-with-minimal-fracture-displacement-on-lateral-radiographs
#18
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
#19
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/28283180/does-intra-articular-load-distribution-change-after-lateral-malleolar-fractures-an-in-vivo-study-comparing-operative-and-non-operative-treatment
#20
Christian Deml, Martin Eichinger, Wouter F van Leeuwen, Stefanie Erhart, Simon A Euler, Alexander Brunner
PURPOSE: The impact of isolated malleolar fractures on the intra-articular load distribution within the ankle joint has been studied in several biomechanical cadaver studies during the last decades. Recently, computed tomography osteoabsorptiometry (CT-OAM) has been proposed as a valuable tool to assess intra-articular joint load distribution in vivo. The purpose of this retrospective matched pair analysis was to apply CT-OAM to evaluate in vivo changes of talar load distribution after lateral malleolar fractures in patients treated with open anatomic reduction and internal fixation (ORIF) compared to patients treated non-operatively...
March 6, 2017: Injury
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