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Posterior malleolar

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https://www.readbyqxmd.com/read/29232164/effect-of-ct-on-management-plan-in-malleolar-ankle-fractures
#1
Ashwani Kumar, Puneet Mishra, Anupama Tandon, Rajesh Arora, Manish Chadha
BACKGROUND: Conventionally ankle fractures have been classified using plain radiographs. Because of complex 3-dimensional anatomy and complexity of injuries, plain radiographs may not always be able to clearly depict the complete fracture pattern. There is a paucity of studies regarding the utility of computed tomography (CT) scanning in malleolar ankle fractures (MAFs). Hence, we conducted this study to further understand the role of the CT scan in MAFs. METHODS: A prospective study of 56 consecutive malleolar ankle fractures was conducted...
November 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/29158644/injury-mechanism-fracture-characteristics-and-clinical-treatment-of-pilon-fracture-with-intact-fibula-a-retrospective-study-of-23-pilon-fractures
#2
Jiang Liangjun, Zheng Qiang, Li Hang, Pan Zhijun
Objective: The effect of intact fibula on pilon fracture is not completely elucidated. We retrospectively analysed pilon fractures with intact fibula at our hospital over a 4 year period to understand the injury mechanism, fracture characteristics, treatment strategy and prognosis of this fracture. Methods: Pilon fracture patients with intact fibula treated in our hospital from January 2010 to December 2014 were observed. OA/ATO fracture type, Ruedi-Allgower classification and fracture characteristics were summarised...
November 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29149741/the-isolated-posterior-malleolar-fracture-and-syndesmotic-instability-a-case-report-and-review-of-the-literature
#3
Diederik P J Smeeing, Roderick M Houwert, Moyo C Kruyt, Falco Hietbrink
INTRODUCTION: Ankle fractures are among the most common type of fractures in the lower extremity. A posterior malleolar fracture is frequently part of a more complex ankle fracture and only in rare cases it occurs as isolated injury. Posterior malleolar fractures often occur with associated injuries, such as a Maisonneuve fracture or with bi- or trimalleolar ligamentous injuries. Knowledge about these associated injuries is essential to prevent missed diagnoses. The aim of this article is to describe the isolated posterior malleolar fracture, the possible associated injuries, the diagnostic work-up and therapeutic consequences...
November 13, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29092989/an-evolution-in-the-management-of-fractures-of-the-ankle-safety-and-efficacy-of-posteromedial-approach-for-haraguchi-type-2-posterior-malleolar-fractures
#4
N Bali, I Aktselis, A Ramasamy, S Mitchell, P Fenton
AIMS: There has been an evolution recently in the management of unstable fractures of the ankle with a trend towards direct fixation of a posterior malleolar fragment. Within these fractures, Haraguchi type 2 fractures extend medially and often cannot be fixed using a standard posterolateral approach. Our aim was to describe the posteromedial approach to address these fractures and to assess its efficacy and safety. PATIENTS AND METHODS: We performed a review of 15 patients with a Haraguchi type 2 posterior malleolar fracture which was fixed using a posteromedial approach...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29058951/stability-of-the-syndesmosis-after-posterior-malleolar-fracture-fixation
#5
Matthew A Miller, Tyler C McDonald, Matthew L Graves, Clay A Spitler, George V Russell, LaRita C Jones, William Replogle, Jeremy A Wise, Josie Hydrick, Patrick F Bergin
BACKGROUND: We sought to define the rate of syndesmotic instability after anatomic reduction of the posterior malleolus when posterior stabilization of a trimalleolar or trimalleolar equivalent ankle fracture was chosen vs when a supine position and initially conservative management of the posterior elements was chosen. METHODS: The types of syndesmotic and posterior malleolar fixation used to treat adult patients with ankle fractures involving the posterior malleolus at our level I trauma center were retrospectively assessed (N = 198)...
October 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28979587/operative-treatment-of-posterior-malleolar-fractures
#6
Xiaojun Duan, Anish R Kadakia
Fractures of the posterior malleolus can occur in conjunction with fibular and medial malleolar fractures or in isolation. The indications for fixation of the posterior malleolus remain controversial except for the fragment sizes. A number of different surgical approaches and techniques for internal fixation of posterior malleolar fractures have been reported. Newer techniques such as direct exposure and plating of the posterior malleolus are chosen more frequently than traditional techniques of indirect reduction and percutaneous screw fixation...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28952792/comparison-of-ankle-joint-visualization-between-the-70%C3%A2-and-30%C3%A2-arthroscopes-a-cadaveric-study
#7
Ichiro Tonogai, Fumio Hayashi, Yoshihiro Tsuruo, Koichi Sairyo
Ankle arthroscopy is an important diagnostic and therapeutic tool. Arthroscopic ankle surgery for anterior ankle impingement or osteochondral lesions (OCLs) is mostly performed with a 30° arthroscope; however, visualization of lesions is sometimes difficult. This study sought to compare ankle joint visualization between 70° and 30° arthroscopes and clarify the effectiveness of 70° arthroscopy. Standard anterolateral and anteromedial portals were placed with 4-mm 70° or 30° angled arthroscopes in a fresh 77-year-old male cadaveric ankle...
September 1, 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28758439/pathoanatomy-and-associated-injuries-of-posterior-malleolus-fracture-of-the-ankle
#8
Lyndon W Mason, William J Marlow, James Widnall, Andrew P Molloy
BACKGROUND: We present a classification system that progresses in severity, indicates the pathomechanics that cause the fracture and therefore guides the surgeon to what fixation will be necessary by which approach. METHODS: The primary posterior malleolar fracture fragments were characterized into 3 groups. A type 1 fracture was described as a small extra-articular posterior malleolar primary fragment. Type 2 fractures consisted of a primary fragment of the posterolateral triangle of the tibia (Volkmann area)...
November 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28758422/biomechanical-study-of-screw-fixation-and-plate-fixation-of-a-posterior-malleolar-fracture-in-a-simulation-of-the-normal-gait-cycle
#9
Xu Wang, Jianwen Yin, Chao Zhang, Chen Wang, Xiang Geng, Xin Ma, Jiazhang Huang, Chengwei Wang, Xue Wang
BACKGROUND: Fixation of posterior malleolar fractures with plates or screws is under debate. A fatigue loading system and a spatial motion capture system were used in this study to evaluate a posterior malleolar fracture model. METHODS: Thirty-six below-knee specimens with a single posterolateral fragment (Haraguchi I) type posterior malleolar fracture models were randomly divided into 2 groups. Two parallel-placed 3.5-mm partially threaded titanium alloy screws were used in Group A to fix the fractures, while anatomical plates were used in Group B...
October 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28714535/neandertal-talus-bones-from-el-sidr%C3%A3-n-site-asturias-spain-a-3d-geometric-morphometrics-analysis
#10
Antonio Rosas, Anabel Ferrando, Markus Bastir, Antonio García-Tabernero, Almudena Estalrrich, Rosa Huguet, Daniel García-Martínez, Juan Francisco Pastor, Marco de la Rasilla
OBJECTIVES: The El Sidrón tali sample is assessed in an evolutionary framework. We aim to explore the relationship between Neandertal talus morphology and body size/shape. We test the hypothesis 1: talar Neandertal traits are influenced by body size, and the hypothesis 2: shape variables independent of body size correspond to inherited primitive features. MATERIALS AND METHODS: We quantify 35 landmarks through 3D geometric morphometrics techniques to describe H...
October 2017: American Journal of Physical Anthropology
https://www.readbyqxmd.com/read/28697881/incarceration-of-the-posterior-tibial-tendon-in-an-isolated-comminuted-medial-malleolus-fracture
#11
David Jaffe, Matthew W Christian, Annie Weber, R Frank Henn
Isolated medial malleolar fractures are a less common presentation of an ankle fracture. Treatment is not universally accepted, although many have agreed that any displacement warrants anatomic reduction and fixation. We present a case of an isolated, comminuted medial malleolar fracture that was displaced secondary to entrapment of the posterior tibial tendon between the fracture fragments requiring surgical intervention. The patient was treated with prompt open reduction and internal fixation and had an excellent functional outcome at 1 year...
November 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28633768/comparing-different-surgical-techniques-for-addressing-the-posterior-malleolus-in-supination-external-rotation-ankle-fractures-and-the-need-for-syndesmotic-screw-fixation
#12
Mengnai Li, Rachel C Collier, Brian W Hill, Nathaniel Slinkard, Thuan V Ly
Trimalleolar ankle fractures are unstable injuries with possible syndesmotic disruption. Recent data have described inherent morbidity associated with screw fixation of the syndesmosis, including the potential for malreduction, hardware irritation, and post-traumatic arthritis. The posterior malleolus is an important soft tissue attachment for the posterior inferior syndesmosis ligament. We hypothesized that fixation of a sizable posterior malleolar (PM) fracture in supination external rotation type IV (SER IV) ankle fractures would act to stabilize the syndesmosis and minimize or eliminate the need for trans-syndesmotic fixation...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28632507/tibialis-posterior-tenosynovitis-a-unique-musculoskeletal-manifestation-of-gout
#13
Peter Shupper, Todd P Stitik
Extra-articular manifestations of gout can present in several ways, including tenosynovitis. We present a rare case of acute tibialis posterior gouty tenosynovitis. An 82-year-old man with a history of well-controlled gout presented with acute onset of left ankle pain, occurring without inciting event. The medial ankle was slightly erythematous with moderate dorsal-medial swelling and mild dorsal-lateral swelling, with severe tenderness to palpation over the medial retro-malleolar region. Range of motion and manual muscle testing were pain limited throughout...
June 20, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28606840/open-reduction-in-pilon-variant-posterior-malleolar-fractures-radiological-and-clinical-evaluation
#14
E Sukur, Y E Akman, H B Gokcen, E C Ozyurek, A Senel, Y Ozturkmen
BACKGROUND: Pilon variant posterior malleolar (PVPM) fractures significantly disrupt joint congruency and cause tibiotalar instability. They are often underestimated and inadequately treated. PURPOSE: This study assessed the outcomes of surgical treatment of this subtype of malleolar fracture, and examined the importance of computed tomography (CT) in diagnosis and surgical treatment. MATERIAL AND METHODS: CT images and radiographs of 67 patients with trimalleolar ankle fractures were retrospectively analyzed...
June 9, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28473957/syndesmotic-internalbrace-tm-for-anatomic-distal-tibiofibular-ligament-augmentation
#15
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
#16
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...
December 0: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/28438029/posterior-tibialis-tendon-rupture-in-a-closed-bimalleolar-equivalent-ankle-fracture-case-report
#17
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
#18
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...
September 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28416839/-a-correlation-analysis-of-the-ankle-ct-and-ankle-fracture-classification
#19
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
#20
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...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
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