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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
#1
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...
November 17, 2016: Injury
https://www.readbyqxmd.com/read/27902645/effect-of-nerve-stimulation-use-on-the-success-rate-of-ultrasound-guided-subsartorial-saphenous-nerve-block-a-randomized-controlled-trial
#2
Shaylyn H Montgomery, Colleen M Shamji, Grace S Yi, Cynthia H Yarnold, Stephen J Head, Scott C Bell, Stephan K W Schwarz
BACKGROUND AND OBJECTIVES: Ultrasound-guided subsartorial saphenous nerve block is commonly used to provide complete surgical anesthesia of the foot and ankle in combination with a popliteal sciatic nerve block. However, in part owing to its small caliber and absence of a prominent vascular landmark in the subsartorial plane distal to the adductor canal, the saphenous nerve is more difficult to reliably block than the sciatic nerve in the popliteal fossa. Although the saphenous nerve is a sensory nerve only, neurostimulation can be used to elicit a "tapping" sensation on the anteromedial aspect of the lower leg extending toward the medial malleolus...
November 29, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27900312/posterior-tibial-tendon-displacement-behind-the-tibia-and-its-interposition-in-an-irreducible-isolated-ankle-dislocation-a-case-report-and-literature-review
#3
Alessandro Ortolani, Roberto Bevoni, Alessandro Russo, Maurilio Marcacci, Mauro Girolami
Isolated posteromedial ankle dislocation is a rare condition thanks to the highly congruent anatomical configuration of the ankle mortise, in which the medial and lateral malleoli greatly reduce the rotational movement of the talus, and the strength of the ligaments higher than the malleoli affords protection against fractures. However, other factors, like medial malleolus hypoplasia, laxity of the ligaments, peroneal muscle weakness and previous ankle sprains, could predispose to pure dislocation. In the absence of such factors, only a complex high-energy trauma, with a rotational component, can lead to this event...
July 2016: Joints
https://www.readbyqxmd.com/read/27897183/sensory-thresholds-at-different-sites-of-the-foot-a-valuable-reference-for-neurologic-examinations
#4
J-W Zhang, Q Wang, X-F Wang, M-M Gao, X-P Yun, H-F Wu, Y Hong
STUDY DESIGN: Prospective healthy volunteer study for sensory thresholds. OBJECTIVES: The aim of this study was to test sensory thresholds at different sites of the foot to provide a reference for diagnosis and neurologic classification. SETTING: A university hospital for the research and clinical practice of rehabilitation. METHODS: Thirty healthy volunteers were recruited, and quantitative sensory testing was performed on three sites of the foot (medial malleolus (for the L4 dermatome), dorsum of the foot at the third metatarsal phalangeal joint (for the L5 dermatome) and lateral heel (for the S1 dermatome))...
November 29, 2016: Spinal Cord
https://www.readbyqxmd.com/read/27886685/posterior-malleolus-fractures
#5
REVIEW
Shay Tenenbaum, Nachshon Shazar, Nathan Bruck, Jason Bariteau
Posterior malleolus fractures vary in morphology. A computed tomography scan is imperative to evaluate fragment size, comminution, articular impaction, and syndesmotic disruption. Despite an increasing body of literature regarding posterior malleolus fractures, many questions remain unanswered. Although, historically, fragment size guided surgical fixation, it is becoming evident that fragment size should not solely dictate treatment. Surgical treatment should focus on restoring ankle joint structural integrity, which includes restoring articular congruity, correcting posterior talar translation, addressing articular impaction, removing osteochondral debris, and establishing syndesmotic stability...
January 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/27885101/giant-cell-tumor-of-talus-t-construct-method-of-bone-grafting
#6
Abhijeet B Kadam, Anoop C Dhamangaonkar
: Giant cell tumor (GCT) or osteoclastoma is a benign, locally aggressive tumor with a tendency to recur. Giant cell tumors typically occur in the epiphysis of long bones, including the distal femur and proximal tibia. They are uncommonly found in the small bones of the foot or ankle, and involvement of talus is rare. The authors present a case of GCT of the talar body in a 21-year-old man, which was diagnosed radiologically by the presence of a well-defined osteolytic lesion involving more than half of the talar body with thinning of the cortices...
November 23, 2016: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/27871101/morphomics-of-the-talus
#7
David Gorman, Ebram Handy, Sikui Wang, Annette L Irwin, Stewart Wang
Previous studies of frontal crash databases reported that ankle fractures are among the most common lower extremity fractures. While not generally life threatening, these injuries can be debilitating. Laboratory research into the mechanisms of ankle fractures has linked dorsiflexion with an increased risk of tibia and fibula malleolus fractures. However, talus fractures were not produced in the laboratory tests and appear to be caused by more complex loading of the joint. In this study, an analysis of the National Automotive Sampling System - Crashworthiness Data System (NASS-CDS) for the years 2004-2013 was conducted to investigate foot-ankle injury rates in front seat occupants involved in frontal impact crashes...
November 2016: Stapp Car Crash Journal
https://www.readbyqxmd.com/read/27814856/assessment-of-the-posture-of-adolescents-in-everyday-clinical-practice-intra-rater-and-inter-rater-reliability-and-validity-of-a-posture-index
#8
Oliver Ludwig, Annette Hammes, Jens Kelm, Eduard Schmitt
OBJECTIVES: The assessment of the posture of children and adolescents using photometric methods has a long tradition in paediatrics, manual therapy and physiotherapy. It can be well integrated into the clinical routine and enables objective documentation. One-dimensional parameters such as angle sizes are mostly used in the diagnosis of postural defects in children and adolescents by means of photogrammetry. This study examined the posture index, a complex parameter, which evaluates the alignment of several trunk segments in the sagittal plane and is suitable for use as a screening parameter in everyday clinical practice...
October 2016: Journal of Bodywork and Movement Therapies
https://www.readbyqxmd.com/read/27810033/fracture-of-the-os-trigonum-a-report-of-two-cases-and-review-of-the-literature
#9
Yet Yen Yan, Kinjal Vidyut Mehta, Tien Jin Tan
We report two cases of acute fractures of the os trigonum. The os trigonum fracture related to the first case was sustained following a hyper-plantar flexion injury during a game of soccer. The second case involved a patient who fell from height and also sustained open fractures of the left distal tibia and lateral malleolus as well as the right calcaneus. In both cases, a preliminary diagnosis of a posterior talar process fracture was made from the initial radiographs of the ankle. The correct diagnosis of an os trigonum fracture rather than a fracture of the posterior talar process was only made following further assessment with CT imaging...
December 2016: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/27800538/screening-characteristics-of-ultrasonography-in-detection-of-ankle-fractures
#10
Majid Shojaee, Farhad Hakimzadeh, Parisa Mohammadi, Anita Sabzghabaei, Mohammad Manouchehrifar, Ali Arhami Dolatabadi
INTRODUCTION: Ankle fracture is one of the most common joint fractures. X-ray and physical examination are its main methods of diagnosis. Recently, ultrasonography (US) is considered as a simple and non-invasive method of fracture diagnosis. This study evaluated the diagnostic accuracy of US in detection of ankle fracture in comparison to plain radiography. METHODS: In this diagnostic accuracy study, which was done in emergency departments of Imam Hossein and Shohadaye Tajrish hospitals, Tehran, Iran, during 2014, 141 patients with suspected diagnosis of distal leg or ankle fracture were examined by US and radiography (gold standard), independently...
November 2016: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/27762616/surgical-treatment-of-lateral-malleolar-fractures-using-the-compression-cerclage-system
#11
Eren Cansü, Mehmet B Unal, Serkan Gurcan, Fatih Parmaksizoglu
Background Lateral malleolar fractures (Weber type B or OTA 44-B) account for 60% of all ankle fractures. To achieve anatomic restoration, surgical stabilization provides better results than conservative treatment. Various fixation methods are available to treat these fractures; however, the best method is still unknown. Our objectives were to present a new, useful, and efficient surgical technique for stabilizing lateral malleolar fractures and to analyze the outcomes of patients treated with the compression cerclage system...
September 2, 2016: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/27755282/buttress-plating-versus-anterior-to-posterior-lag-screws-for-fixation-of-the-posterior-malleolus-a-biomechanical-study
#12
Chase Bennett, Anthony Behn, Adam Daoud, Sean Nork, Bruce Sangeorzan, Gregory Dikos, Julius Bishop
OBJECTIVES: The preferred method of fixation for posterior malleolus fractures remains controversial, and practices vary widely among surgeons. The purpose of this study was to compare anterior-to-posterior (AP) lag screws with posterior buttress plating for fixation of posterior malleolus fractures in a human cadaveric model. METHODS: Posterior malleolus fractures involving 30% of the distal tibial articular surface were created in 7 pairs of fresh frozen cadaveric ankles...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27752779/anterior-wrist-and-medial-malleolus-the-optimal-sites-for-tissue-selection-in-electric-death-through-hand-to-foot-circuit-pathway
#13
Guangtao Xu, Ruibing Su, Junyao Lv, Xiaoping Lai, Xianxian Li, Jiayan Wu, Bo Hu, Long Xu, Ruilin Shen, Jiang Gu, Xiaojun Yu
Specific morphological changes may be absent in some cases of electrocution shocked by the voltage of 220 V or lower. In this study, we attempted to demonstrate that the anterior wrist and medial malleolus were the optimal sites with promising and significant changes in electric death through the hand-to-foot circuit pathway. We established an electric shock rat model and observed histopathologic changes in the anterior wrist and medial malleolus. The results showed that the current intensities in the left anterior wrist and right medial malleolus were remarkably higher than those in the other sites, and the nuclei long/short (L/S) axis ratios of the arterial endotheliocyte and the skeletal muscle cell in these two areas were significantly higher than those in other parts of the body...
October 17, 2016: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/27736722/the-use-of-a-static-measure-to-predict-foot-posture-at-midstance-during-walking
#14
Thomas G McPoil, Jessica Ford, Joel Fundaun, Chelsea Gallegos, Andrew Kinney, Peter McMillan, Jessica Murphy, Elliot Sky, Derrick Torba, Michael Bade
Previous studies have successfully used the longitudinal arch angle (LAA) to assess foot posture, but the measurement consistency and ability of the LAA to predict dynamic foot posture during activity in a variety of foot types have not been evaluated. The purpose of this study was to determine the reliability of the LAA as well as if the clinical method of assessing the LAA could be used to predict the LAA at midstance during walking for supinated, normal, and pronated foot types. The Arch Height Ratio was used to select 35 participants with 12 supinated, 46 normal, and 12 pronated feet...
September 20, 2016: Foot
https://www.readbyqxmd.com/read/27714727/anatomy-of-the-long-peroneal-muscle-of-the-leg
#15
Urszula Bogacka, Dawid Dziedzic, Iulian Komarnitki, Bogdan Ciszek
BACKGROUND: The aim of the work was to perform a morphometric analysis of the long peroneal muscle of the leg and explore the relationship between muscle belly and tendon. MATERIALS AND METHODS: Ten lower limbs (8 right and 2 left) were fixed in formaldehyde and dissected using standard technique. The long peroneal muscle was exposed from the proximal attachment to the top of a lateral malleolus. RESULTS: The tendon was subsequently freed and various measurements were taken...
October 7, 2016: Folia Morphologica (Warsz)
https://www.readbyqxmd.com/read/27709036/modified-arthroscopic-brostrom-procedure-with-bone-tunnels
#16
Tun Hing Lui
The open anatomic repair of the anterior talofibular and calcaneofibular ligaments (modified Brostrom procedure) is widely accepted as the standard surgical stabilization procedure for lateral ankle instability that does not respond to conservative measures. Arthroscopic Brostrom procedures with a suture anchor have been reported to achieve both anatomic repair of the lateral ankle ligaments and management of the associated intra-articular lesions. However, the complication rates are higher than open Brostom procedures...
August 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27692587/arthroscopic-anatomical-reconstruction-of-the-lateral-ankle-ligaments-a-technical-simplification
#17
R Lopes, C Decante, L Geffroy, K Brulefert, T Noailles
Anatomical reconstruction of the lateral ankle ligaments has become a pivotal component of the treatment strategy for chronic ankle instability. The recently described arthroscopic version of this procedure is indispensable to ensure that concomitant lesions are appropriately managed, yet remains technically demanding. Here, we describe a simplified variant involving percutaneous creation of the calcaneal tunnel for the distal attachment of the calcaneo-fibular ligament. The rationale for this technical stratagem was provided by a preliminary cadaver study that demonstrated a correlation between the lateral malleolus and the distal footprint of the calcaneo-fibular ligament...
September 27, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27688037/hydrodisplacement-of-sural-nerve-for-safety-and-efficacy-of-endovenous-thermal-ablation-for-small-saphenous-vein-incompetence
#18
Omar Rodriguez-Acevedo, Kristen E Elstner, Kui Martinic, Aaron Zea, Jenny Diaz, Rodrigo T Martins, Fernando Arduini, Alexandra Hodgkinson, Nabeel Ibrahim
BACKGROUND: Endovenous radio frequency ablation for small saphenous vein incompetence by and large appears to be superior and safer than conventional open surgery. Small saphenous vein ablation from approximately mid-calf to the point proximally where the small saphenous vein dives into the popliteal fossa is considered to be safe, as the sural nerve is in most cases separated from this segment of the small saphenous vein by the deep fascia. The outcome of the distal incompetent small saphenous vein remains unclear...
September 29, 2016: Phlebology
https://www.readbyqxmd.com/read/27643671/evaluation-of-the-tibial-nerve-with-shear-wave-elastography-a-potential-sonographic-method-for-the-diagnosis-of-diabetic-peripheral-neuropathy
#19
Atilla Suleyman Dikici, Fethi Emre Ustabasioglu, Sakir Delil, Mecbure Nalbantoglu, Bektas Korkmaz, Selim Bakan, Osman Kula, Nurten Uzun, Ismail Mihmanli, Fatih Kantarci
Purpose To evaluate the value of shear-wave elastography (SWE) in the detection of diabetic peripheral neuropathy (DPN) of the tibial nerve. Materials and Methods This study was approved by the institutional review board, and written informed consent was obtained from all study participants. The study included 20 diabetic patients with DPN (10 men, 10 women), 20 diabetic patients without DPN (eight men, 12 women), and 20 healthy control subjects (nine men, 11 women). The tibial nerve was examined at 4 cm proximal to the medial malleolus with gray-scale ultrasonography and SWE...
September 19, 2016: Radiology
https://www.readbyqxmd.com/read/27642700/-conventional-x-rays-of-ankle-joint-fractures-in-older-patients-are-not-always-predictive
#20
A Jubel, C Faymonville, J Andermahr, S Boxberg, G Schiffer
Background: Ankle fractures are extremely common in the elderly, with an incidence of up to 39 fractures per 100,000 persons per year. We found a discrepancy between intraoperative findings and preoperative X-ray findings. It was suggested that many relevant lesions of the ankle joint in the elderly cannot be detected with plain X-rays. Methods: Complete data sets and preoperative X-rays of 84 patients aged above 60 years with ankle fractures were analysed retrospectively. There were 59 women and 25 men, with a mean age of 69...
September 19, 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
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