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Posterior malleolar

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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
#1
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
#2
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
#3
Erhan Sukur, Yunus Emre Akman, Huseyin Bahadır Gokcen, Esra Circi Ozyurek, Ahmet Senel, Yusuf 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
#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...
July 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/28296225/treatment-of-medial-malleolus-or-pure-deltoid-ligament-injury-in-patients-with-supination-external-rotation-type-iv-ankle-fractures
#12
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
#13
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
#14
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/28291180/dynamic-stress-testing-is-unnecessary-for-unimalleolar-supination-external-rotation-ankle-fractures-with-minimal-fracture-displacement-on-lateral-radiographs
#15
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/28279427/finite-element-analysis-of-the-three-different-posterior-malleolus-fixation-strategies-in-relation-to-different-fracture-sizes
#16
Adeel Anwar, Decheng Lv, Zhi Zhao, Zhen Zhang, Ming Lu, Muhammad Umar Nazir, Wasim Qasim
PURPOSE: Appropriate fixation method for the posterior malleolar fractures (PMF) according to the fracture size is still not clear. Aim of this study was to evaluate the outcomes of the different fixation methods used for fixation of PMF by finite element analysis (FEA) and to compare the effect of fixation constructs on the size of the fracture computationally. MATERIALS AND METHODS: Three dimensional model of the tibia was reconstructed from computed tomography (CT) images...
April 2017: Injury
https://www.readbyqxmd.com/read/28203338/the-predictive-value-of-pulse-oximeters-for-pulse-improvement-after-angiography-in-infants-and-children
#17
Mohammad-Reza Alipour, Mazyar Rastegar, Mehdi Ghaderian, Seyedeh-Mahdieh Namayandeh, Reza Faraji, Zohreh Pezeshkpour
BACKGROUND: Information from pulse oximeter waves confirms the presence of a pulse and helps obtain waves from tissue when the supplying artery is not readily accessible. OBJECTIVES: This study determined the predictive value of pulse oximeters for detecting improved arterial pulses after angiography. PATIENTS AND METHODS: This cross-sectional, multi-center study included 467 4-day-old to 12-year-old patients and was conducted from January 2012 to January 2016...
October 2016: Iranian Journal of Pediatrics
https://www.readbyqxmd.com/read/28178851/corrigendum
#18
(no author information available yet)
Meijer DT, de Muinck Keizer R-JO, Doornberg JN, et al. Diagnostic accuracy of 2-dimensional computed tomography for articular involvement and fracture pattern of posterior malleolar fractures. Foot Ankle Int. 2016;37(1):75-82. (Original DOI: 10.1177/1071100715603999 ).
March 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28167058/posterior-malleolar-fractures-changing-concepts-and-recent-developments
#19
REVIEW
Jan Bartoníček, Stefan Rammelt, Michal Tuček
Injuries to the posterior malleolus are of prognostic relevance in ankle fracture-dislocations. The three-dimensional outline of the fragments as reflected by computed tomography classification, involvement of the fibular notch, and the presence of intercalary fragments seem to be of greater therapeutic relevance than the size of the fragment and amount of the articular surface involved. Operative treatment aims at reconstruction of the posterior tibial plafond, the fibular notch, and the integrity of the posterior inferior tibiofibular syndesmosis...
March 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28140829/the-petrosquamous-stalactite
#20
Michael D Puricelli, Maxwell D Newby, Andrew J Fishman, Arnaldo L Rivera
Objective To define the presence and relationship of the petrosquamous stalactite (PsS)-a condensation of the trabecular Korner's septum into a bony plate of the petrosquamous suture-to surrounding structures and understand its surgical implications. Study Design Series of cadaver dissections. Setting University of Missouri Alumni Temporal Bone and Microvascular Laboratory. Subjects and Methods Anatomic dissections were conducted on 15 consecutive formalin-preserved and frozen adult human temporal bones. A calibrated Dino-Lite Premier Digital Microscope was used to photograph dissections of each bone...
March 2017: Otolaryngology—Head and Neck Surgery
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