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Posterior malleolar

Daniel S Chan, Paul M Balthrop, Brian White, David Glassman, Roy W Sanders
OBJECTIVE: To determine whether multiple approaches pose an increased risk to fracture healing when compared to a standard single approach in the treatment of pilon (OTA 43C) fractures. DESIGN: Retrospective review of a prospective database. SETTING: Level I academic trauma center and level II community trauma center. METHODS: From January 1, 2005 to December 31, 2011, all records of patients treated for OTA 43C fractures of the distal tibia were reviewed...
October 1, 2016: Journal of Orthopaedic Trauma
P Clavert, G Koch, L Neyton, P Metais, J Barth, G Walch, L Lafosse
BACKGROUND: Standard radiography with an antero-posterior view and Bernageau's glenoid profile view is the method most widely reported in the literature to assess coracoid bone block position and fusion. OBJECTIVE: The aim of this cadaver study was to determine whether the antero-posterior and Bernageau's radiographs provide a reliable and reproducible evaluation of the position of a coracoid bone block and its fixation screws. METHOD: An isolated scapula showing no evidence of osteoarthritis or other abnormalities was used...
October 4, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
S Y Lee, S-S Kwon, M S Park, M K Chung, K B Kim, S Koo, K M Lee
This study aimed to investigate the relationship between bone morphology and injured ligaments on imaging studies and laxity on ankle stress radiographs in patients with lateral ankle instability. In total, 115 patients who had undergone ankle MRI, ankle radiography, and stress radiography were included. Distal tibial articular surface angle, bimalleolar tilt, medial and lateral malleolar relative length, medial malleolar slip angle, anterior inclination of the tibia, and fibular position were measured on ankle radiographs...
September 27, 2016: International Journal of Sports Medicine
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
K H Leung, C Xs Fang, T W Lau, F Kl Leung
PURPOSE: To review preoperative radiography and computed tomography (CT) of the ankle in 69 patients who underwent surgery for ankle fractures to determine the value of CT in diagnosis and surgical planning. METHODS: Preoperative radiography and CT of the ankle of 46 women and 23 men aged 17 to 90 (mean, 48.8) years were reviewed. CT was deemed necessary when radiographs showed the following features: (1) comminuted fracture of the medial malleolus involving the tibial plafond, (2) comminuted fracture of the posterior malleolus, (3) presence of loose bodies, and/or (4) suspected Chaput or Volkman fracture fragment...
August 2016: Journal of Orthopaedic Surgery
Yukai Wang, Jianwei Wang, Cong Feng Luo
BACKGROUND: Posterior pilon variant fracture is a recently described posterior malleolus fracture characterized by the involvement of both posterolateral and posteromedial malleolar fragment. The associated surgical approach remains controversial. The aim of this study was to present the application of modified posteromedial approach in the treatment for posterior pilon variant fracture. METHODS: Sixteen patients were identified with posterior pilon variant fractures...
2016: BMC Musculoskeletal Disorders
Robert-Jan O de Muinck Keizer, Diederik T Meijer, Bonheur A T D van der Gronde, Teun Teunis, Sjoerd A S Stufkens, Gino M Kerkhoffs, J Carel Goslings, Job N Doornberg
OBJECTIVES: Despite advanced imaging techniques, classic measurements of fracture reduction have not been revisited to date.The purpose of this study was to evaluate reliability of innovative measurement techniques to quantify operative fragment reduction of posterior malleolar fractures by quantification of three-dimensional computed tomography (Q3DCT). METHODS: Twenty-eight ankle fractures including a posterior malleolar fragment (AO/OTA type 44) were evaluated using 2DCT and Q3DCT to postoperatively quantify fragment reduction...
July 29, 2016: Journal of Orthopaedic Trauma
Jun Endo, Satoshi Yamaguchi, Masahiko Saito, Tsuguo Morikawa, Ryuichiro Akagi, Takahisa Sasho
INTRODUCTION: To evaluate time-dependent changes in the syndesmotic reduction after syndesmotic screw fixation and one year after screw removal for ankle malleolar fractures, and to assess whether the incidence of syndesmotic malreduction changes depending on the measurement method. METHODS: We assessed twenty patients who underwent syndesmotic screw fixation for ankle fractures. The syndesmotic screws were removed after six weeks of the fracture surgery. Syndesmotic reduction was assessed within two weeks of the fracture surgery and one year after the screw removal using the axial computer tomographic images...
October 2016: Injury
Ali Maqdes, Camille Steltzlen, Nicolas Pujol
This is a report of a rare case of recurrent traumatic peroneal tendon dislocation in a patient with open physes. Through fibular tendon endoscopy, an intramuscular needle was introduced under direct visualisation and implanted inferiorly to the growth plate while reclining the tendons posteriorly. A fibular groove deepening was performed in order to stabilize the tendons. The patient was able to return to full activity after 3 months. MRI taken 12 months after surgery showed neither signs of recurrence of the lesion nor growth plate disturbance...
June 17, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Jike Lu, Masumi Maruo Holledge, Jac Trappel, Mehul Mayank
BACKGROUND: The irreducible trimalleolar fracture case we describe is different from the Bosworth fracture, defined as a fixed posterior fracture-dislocation of the distal part of the fibula, in which the proximal fibular shaft fragment locks behind posterior tibial tubercle. This fracture is frequently irreducible by closed means as well. METHODS: We describe a rare case of trimalleolar fracture/dislocation that cannot be reduced by closed means, and review the relevant literature...
June 2016: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Ewout S Veltman, Jelle J Halma, Arthur de Gast
INTRODUCTION: The objective of the present study was to review the current data on the long-term outcomes of posterior malleolar fractures, with special emphasis on the role of the type of treatment, surgical approach, and reduction and internal fixation. METHODS: The search was limited to skeletally mature patients. Major databases were searched from 1978 to 2014 to identify studies relating to functional outcome, subjective outcome, and radiographic evaluation at least 2 years after either surgical or conservative treatment of posterior malleolar fractures...
June 2016: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
S M Verhage, F Boot, I B Schipper, J M Hoogendoorn
AIMS: Involvement of the posterior malleolus in fractures of the ankle probably adversely affects the functional outcome and may be associated with the development of post-traumatic osteoarthritis. Anatomical reduction is a predictor of a successful outcome. The purpose of this study was to describe the technique and short-term outcome of patients with trimalleolar fractures, who were treated surgically using a posterolateral approach in our hospital between 2010 and 2014. PATIENTS AND METHODS: The study involved 52 patients...
June 2016: Bone & Joint Journal
David H Ballard, Kevin J Campbell, Lee E Blanton, Jason T Williams, Guillermo Sangster, Anne M Hollister, Alberto A Simoncini
The purpose of this study was to assess the incidence of tendon entrapments and tendon dislocations associated with ankle and hindfoot fractures in patients studied by multidetector computed tomography (MDCT). Additionally, we describe particular tendon injuries associated with specific fractures. This was a retrospective review of all individuals with a trauma-protocol CT for suspected ankle and/or hindfoot fractures during a consecutive 41-month time period at a single Level I Trauma Center. Each patient's images were evaluated by two radiologists and an orthopedic surgeon for tendon entrapment, tendon dislocation, and bone(s) fractured or dislocated...
August 2016: Emergency Radiology
Harish Kempegowda, Hemil H Maniar, Raveesh Richard, Akhil Tawari, Graham Jove, Michael Suk, Michael J Beebe, Chris Han, Paul Tornetta, Erik N Kubiak, Daniel S Horwitz
OBJECTIVES: The purpose of this study was to evaluate posterior malleolar injuries associated with nailed tibial fractures and to determine the quality of reduction based on the sequence of fixation in associated fracture patterns. DESIGN: Retrospective cohort study. PATIENTS: 1113 tibia fractures treated with an intramedullary nail at 3 level I trauma centers. INTERVENTION: Tibial shaft fractures with posterior malleolar injury were analyzed regarding type of fracture, mechanism of injury, energy of injury, fracture characteristic, surgical characteristics including sequence of fixation, obvious intraoperative displacement of the posterior malleolar fragment, and the quality of reduction...
October 2016: Journal of Orthopaedic Trauma
Bernard Mengiardi, Clinton Pinto, Marco Zanetti
Ankle ligament injuries are among the most common injuries in sports and recreational activities. Injuries of the medial collateral ligament or deltoid ligament complex account for ∼ 15% of ligamentous ankle trauma. They are usually associated with injuries of the lateral collateral ligaments and the tibiofibular syndesmosis, as well as malleolar fractures. The deltoid ligament complex consists of a superficial and a deep layer. The three main components of the superficial layer are the tibionavicular, tibiospring, and tibiocalcaneal ligaments...
February 2016: Seminars in Musculoskeletal Radiology
Gregory A Lundeen, Linda J Dunaway
BACKGROUND: Total ankle arthroplasty (TAA) has become a successful treatment for end-stage ankle arthritis. Some patients may still have pain or may present with new pain. Suggested sources of medial pain include tibialis posterior tendonitis, impingement, or medial malleolar stress fracture. Etiology and treatment remain unclear. The objective of our study was to evaluate patients with delayed-onset medial malleolar pain following TAA who underwent treatment with percutaneous medial malleolar screw placement and propose an etiology...
August 2016: Foot & Ankle International
Amanda Fantry, Craig Lareau, Bryan Vopat, Brad Blankenhorn
Management of posterior malleolus fractures continues to be controversial, with respect to both need for fixation and fixation methods. Fixation methods include an open posterior approach to the ankle as well as percutaneous reduction and fixation with or without arthroscopy for visualization of the articular surface. Plain radiographs are unreliable in identifying fracture pattern and intraoperative reduction, making arthroscopy a valuable adjunct to posterior malleolus fracture management. In this article, we report a case of tibialis posterior tendon entrapment within a posterior malleolus fracture, as identified by arthroscopy and managed with open reduction...
March 2016: American Journal of Orthopedics
Niall P McGoldrick, Evelyn P Murphy, Stephen R Kearns
Several surgical approaches to the posterior malleolus have been described. However, these approaches may make it difficult for fixation of associated lateral malleolar and anterior syndesmotic fractures. A single incision approach is described that allows safe access to the posterior malleolus while also facilitating access to the lateral malleolus and anterior syndesmosis.
May 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Ezequiel Palmanovich, Yaron S Brin, Benny Kish, Meir Nyska, Iftach Hetsroni
Previous investigators have questioned the reliability of plain radiographs in assessing the accuracy of ankle fracture reduction when these were compared with the computed tomography (CT) evaluation in the preoperative setting, in particular, in fractures with syndesmosis injuries or trimalleolar fragments. The role of CT assessment, however, has not been investigated in the early postoperative setting. In the early postoperative setting, reduction still relies most commonly on fluoroscopy and plain radiographs alone...
May 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Ali Abbas Ozdemir, Murat Altay, Aslan Celebi, Osman Mavis
BACKGROUND: Calciphylaxis is a serious disorder often observed in dialysis patients and less frequently in chronic renal failure patients with secondary hyperparathyroidism. Mortality rate increases following the development of calciphylaxis, immediate application of parathyroidectomy along with other treatment options may be lifesaving. CASE PRESENTATION: A 44-year-old male patient had been on regular hemodialysis three times per week, with 4-hour sessions since December 2003...
2016: Caspian Journal of Internal Medicine
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