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Ankle surgery

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https://www.readbyqxmd.com/read/28538459/patient-comprehension-and-compliance-survey-to-assess-postoperative-pain-regimens-in-the-orthopaedic-trauma-population
#1
Anup K Gangavalli, Ajith Malige, Saqib Rehman, Chinenye O Nwachuku
OBJECTIVE: This study aims to determine the groups of patients who are at risk for noncompliance and misunderstanding of their pain regimen. DESIGN: Survey-based cohort study. SETTING: Suburban Level-I trauma center. PATIENTS/PARTICIPANTS: A total of 171 patients between the ages of 18-89 years who underwent surgical fixation of fractures involving the pelvis, long bones, or periarticular regions of the knee, ankle, elbow, and wrist...
June 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28534175/-aseptic-loosening-of-total-ankle-replacement-two-stage-revision-with-bone-augmentation-of-osseous-defects-and-secondary-prosthesis-implantation
#2
A Barg, M Wiewiorski, V Valderrabano
OBJECTIVE: To remove loosened ankle prosthesis components, perform osseous defect augmentation, and reimplant definitive prosthesis components to preserve ankle range of motion. INDICATIONS: Aseptic loosening of the tibial and/or talar ankle prosthesis components with substantial bone defect. CONTRAINDICATIONS: General surgical/anesthesiological risks, infections, critical soft tissue conditions, nonmanageable hindfoot instability, neurovascular impairment of the lower extremity, neuroarthropathy, substantial nonreconstructable osseous defects with or without cysts on the tibial and/or talar side, noncompliance, primary total ankle replacement (TAR) using intramedullary fixation (stem fixation), severely reduced bone quality, insulin-dependent diabetes mellitus, smoking, unrealistic patients' expectations, high activity in sports...
May 22, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28529013/bipolar-fresh-total-osteochondral-allograft-in-the-ankle-is-it-a-successful-long-term-solution
#3
S Giannini, A Mazzotti, F Vannini
INTRODUCTION: Severe post-traumatic ankle arthritis poses a reconstructive challenge in young and active patients. Although technically demanding and despite unsolved immunological issues, bipolar fresh total osteochondral allograft (BFTOA) represent an intriguing option to arthrodesis and prosthetic replacement. The purpose of this paper is to evaluate the outcomes of a series of 48 ankle BFTOA at 10 years follow up and to investigate the rate of survival long term. METHODS: 58 patients underwent BFTOA, of these 48 were available for follow up...
May 11, 2017: Injury
https://www.readbyqxmd.com/read/28528482/evertor-muscle-activity-as-a-predictor-for-recurrence-in-idiopathic-clubfoot
#4
Perajit Eamsobhana, Pipat Kongwachirapaitoon, Kamolporn Kaewpornsawan
BACKGROUND: Clubfoot is a complex three-dimensional deformity. Although brace compliance after initial correction was previously found to be significantly associated with recurrence in clubfoot, few previous studies have specifically examined evertor muscle function as a factor that contributes to recurrence in children with idiopathic and non-idiopathic clubfoot. The aim of this study was to investigate the relationship among brace compliance, evertor muscle grading, and recurrence rate in pediatric clubfoot patients...
May 20, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28525667/functional-results-in-periacetabular-osteotomy-is-it-possible-to-obtain-a-normal-gait-after-the-surgery
#5
Aydın Gahramanov, Fatma İnanıcı, Ömür Çağlar, Cemalettin Aksoy, Ahmet Mazhar Tokgözoğlu, Senem Güner, Aysun Baki, Bülent Atilla
INTRODUCTION: Gait analysis is one of the poorly understood dimensions of the functional results obtained after periacetabular osteotomy (PAO) due to dysplasia of the hip. MATERIALS AND METHODS: Spatiotemporal parameters as well as coronal and sagittal plane kinematics and moments were compared among three demographically similar groups of subjects: (i) 23 patients with excellent results according to the Harris Hip Score (HHS) (mean 6.6 years of follow-up); (ii) 12 patients with good and fair results according to the HHS (mean 9...
May 19, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28524751/pseudogout-of-the-cervical-and-thoracic-spine-mimicking-infection-after-lumbar-fusion-case-report
#6
Kelly J Bridges, Carli L Bullis, Ajay Wanchu, Khoi D Than
Pseudogout is a form of acute calcium pyrophosphate deposition (CPPD) disease that typically afflicts the elderly. CPPD commonly involves larger joints, such as the knees, wrists, shoulders, and hips, and has been known to involve the spine. The authors report the case of a 66-year-old woman with a recent history of lumbar laminectomy and fusion who presented 5 weeks postprocedure with a clinical and radiographic picture consistent with multilevel skip lesions involving the cervical and thoracic spine, thoracic discitis, and epidural abscess...
May 19, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28523427/-total-ankle-arthroplasty-with-simultaneous-subtalar-fusion
#7
J Mainzer, P Rippstein
OBJECTIVE: Pain free weight bearing ability with orthograde hindfoot position and preserved tibiotalar motion. INDICATIONS: Symptomatic arthritis of the ankle and subtalar joint, additional subtalar hindfoot malalignment. CONTRAINDICATIONS: Absolute: acute infection, noncorrectable ligamentous instability or bony defects, restricted perfusion, diabetic foot syndrome. Relative: inability to comply with postoperative partial weight bearing, only moderate symptoms of subtalar arthritis, smoking, intricate soft tissue situation...
May 18, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28520679/knee-recurvatum-in-children-with-spastic-diplegic-cerebral-palsy
#8
Jeremy Bauer, K Patrick Do, Jing Feng, Rosemary Pierce, Michael Aiona
BACKGROUND: The purpose of this study is to determine which factors drive patients with diplegic cerebral palsy to walk without knee recurvatum despite hyperextension of the knee on physical examination. METHODS: A retrospective review was conducted of all data collected in the Gait Analysis Laboratory between 1999 and 2014. Patients with spastic diplegic cerebral palsy and at least 5 degrees of knee extension on clinical examination were identified for the study...
May 17, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28515749/thromboembolic-complications-after-an-ankle-joint-open-fracture-in-a-patient-with-a-history-of-deep-vein-thrombosis-in-the-lower-limbs
#9
Tomasz Stankowski, Sleiman Sebastian Aboul-Hassan, Piotr Stępiński, Anna Szymańska, Jakub Marczak, Romuald Cichoń
A 55-year-old patient was admitted to the Department of Orthopedics due to an open fracture in the right ankle joint. On the seventh day of hospitalization the patient experienced a transient ischemic attack. During the next day, dyspnea, chest pain and a 'rider' type pulmonary embolism in the pulmonary trunk occluding both pulmonary arteries and its branches were diagnosed. The patient was transferred to the Department of Cardiac Surgery. He underwent pulmonary embolectomy for massive pulmonary, right and left atrial embolism, and left ventricular embolism...
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28514526/direct-medial-approach-in-surgical-fixation-of-fractures-in-the-posterior-aspect-of-the-medial-malleolus
#10
Ang Chay-You, Ling Marcus, Koh Joyce Suang-Bee, Howe Tet-Sen
BACKGROUND: Fractures in the posterior aspect of the medial malleolus form an important subset of ankle fractures and the indications for fixation include involvement of > 25% of the articular surface or an articular step off by > 2mm. Several approaches have been described but there has been no recent study on the direct medial approach. METHODS: Five fresh frozen cadaveric ankles were dissected using the direct medial approach. A longitudinal incision of 10cm was centered directly over the medial malleolus and deepened straight down to the bone...
May 17, 2017: Clinical Anatomy
https://www.readbyqxmd.com/read/28512689/long-term-results-of-fibular-achilles-tenodesis-westin-s-tenodesis-for-paralytic-pes-calcaneus-is-hypercorrection-avoidable-a-longitudinal-retrospective-study
#11
Helder Henzo Yamada, Patricia Maria Moraes de Barros Fucs
PURPOSE: The purpose of this study was to review all cases of patients submitted to Westin's tenodesis, who had calcaneus feet secondary to myelomeningocele sequel, in order to evaluate the anatomical change provided by surgery and also to verify, in a long-term follow-up, the inversion of the deformity depending on the patient's age. METHODS: In this longitudinal retrospective study, all medical records of patients with myelomeningocele sequelae submitted to Westin's tenodesis from 1993 to 2013 in a public university hospital were reviewed...
May 16, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28509825/vascularized-pedicle-bone-grafting-from-the-cuboid-for-talar-osteonecrosis-results-of-a-novel-salvage-procedure
#12
James A Nunley, Kamran S Hamid
BACKGROUND: Osteonecrosis of the talar body represents a complex clinical challenge with treatment options currently limited to core decompression, vascularized and nonvascularized bone-grafting, total talar replacement, and hindfoot arthrodesis. Vascularized pedicle bone-grafting from the cuboid to the talus is a potential alternative to contemporary operative options for replacement of necrotic talar tissue with viable bone. We aimed to analyze functional and radiographic outcomes of vascularized pedicle bone-grafting from the cuboid for the treatment of talar osteonecrosis in a consecutive series of patients spanning a 12-year period...
May 17, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28508007/five-year-outcomes-after-treatment-for-acute-instability-of-the-tibiofibular-syndesmosis-using-a-suture-button-fixation-system
#13
Paul F Förschner, Knut Beitzel, Andreas B Imhoff, Stefan Buchmann, Georg Feuerriegel, Felix Hofmann, Dimitrios C Karampinos, Pia Jungmann, Jonas Pogorzelski
BACKGROUND: Suture-button repair is a widely accepted surgical treatment for acute and isolated ankle syndesmosis injuries. To our knowledge, midterm results have not previously been reported. PURPOSE: To evaluate the clinical, qualitative, and quantitative radiological midterm outcomes of suture-button repair after acute isolated ankle syndesmosis injuries. STUDY DESIGN: Retrospective case series; Level of evidence, 4. METHODS: Clinical outcomes were measured using the Foot and Ankle Disability Index (FADI) and the American Orthopaedic Foot and Ankle Society (AOFAS) score...
April 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28507850/distally-based-sural-artery-peroneus-flap-dbspf-for-foot-and-ankle-reconstruction
#14
Ahmed Ali Ebrahiem, Raj Kumar Manas, Gustavo Vinagre
BACKGROUND: Reconstruction of soft-tissue defects in lower third of leg, ankle, and foot has been a challenge and reconstructive surgeons have been trying to innovate different flaps. To solve this issue, we propose a distally based sural artery peroneus flap (DBSPF) in which we include superficial portion of the peroneus brevis muscle and its blood supply with the peroneal artery distally. The aim of this study was to evaluate the functional outcome and its usefulness over conventional distal sural artery flap or other local options available...
April 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28502357/experience-with-navigation-in-total-ankle-arthroplasty-is-it-worth-the-cost
#15
REVIEW
Christopher W Reb, Gregory C Berlet
Optimal placement of correctly sized total ankle replacement (TAR) implants is elemental to prolonging the working life. The negative mechanical effects of implant malalignment are well characterized. There is one FDA-approved navigated TAR system with limited but encouraging outcomes data. Therefore, its value can be estimated only based on benefits other than a proven clinical outcomes improvement over conventional systems. These include unique preoperative planning through 3-dimensional templating and virtual surgery and the patient-specific cut guides, which also reduce overall instrumentation needed for the case...
June 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28502355/how-to-diagnose-and-treat-infection-in-total-ankle-arthroplasty
#16
REVIEW
Yousef Alrashidi, Ahmed E Galhoum, Martin Wiewiorski, Mario Herrera-Pérez, Raymond Y Hsu, Alexej Barg, Victor Valderrabano
Periprosthetic infection after total ankle arthroplasty (TAA) is a serious complication, often requiring revision surgery, including revision arthroplasty, conversion to ankle arthrodesis, or even amputation. Risk factors for periprosthetic ankle infection include prior surgery at the site of infection, low functional preoperative score, diabetes, and wound healing problems. The clinical presentation of patients with periprosthetic ankle joint infection can be variable and dependent on infection manifestation: acute versus chronic...
June 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28502348/osteolysis-in-total-ankle-replacement-how-does-it-work
#17
REVIEW
Norman Espinosa, Georg Klammer, Stephan H Wirth
Aseptic loosening of implants remains the most common reason for revision surgery for hip, knee, or ankle prostheses. Although a great scientific effort has been made to explain the underlying mechanisms it remains poorly understood, complex, and multifactorial. Many factors, including age, body weight, activity lesions, implant design, fixation methods, material proprieties, immunologic responses, and biomechanical adaptations to total ankle replacement all contribute to the development of periprosthetic osteolysis...
June 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28501960/a-modified-minimally-invasive-technique-for-intra-articular-displaced-calcaneal-fractures-fixed-by-transverse-and-axial-screws
#18
K C Kapil Mani, Parimal Acharya, R C Dirgha Raj, Bandhu Ram Pangeni, Arun Sigdel, Suman Babu Marahatta
The management of displaced, intra-articular calcaneal fracture represents a surgical challenge to even an experienced orthopedic surgeon. Plate osteosynthesis using an extended lateral approach is complicated by soft tissue problems, while those treated by closed reduction and percutaneous pinning cannot address all the intra-articular fragments sufficiently. The objective of our study is to evaluate restoration of subtalar joint and long-term functional outcomes in intra-articular displaced calcaneal fractures treated with transverse subcondral screws through a small incision on lateral aspect of calcaneus and percutaneously placed axial screws through the calcaneal tuberosity...
May 13, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28497248/-aseptic-loosening-of-total-ankle-replacement-one-stage-revision-ankle-arthroplasty
#19
G Pagenstert, M D Wimmer, M Jacxsens, C L Saltzman, A Barg
OBJECTIVE: To revise one or both loosened prosthesis components, to achieve postoperative pain relief, and preserve ankle range of motion. INDICATIONS: Aseptic loosening of the tibial and/or talar ankle prosthesis components without substantial bone defect of the tibial or talar bone stock. CONTRAINDICATIONS: General surgical or anesthesiological risks, infections, critical soft tissue conditions, nonmanageable hindfoot instability, neurovascular impairment of the lower extremity, neuroarthropathy (e...
May 11, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28481627/outcomes-after-percutaneous-reduction-and-fixation-of-low-energy-lisfranc-injuries
#20
Michael Vosbikian, Joseph T O'Neil, Christine Piper, Ronald Huang, Steven M Raikin
BACKGROUND: Lisfranc injuries are often missed initially or not anatomically reduced, leading to midfoot collapse, arthrosis, and pain. Operative management of these injuries is also fraught with complications, particularly with respect to the soft tissues. Wound dehiscence and infection are not uncommon. The goal of this study was to analyze the outcomes of a minimally invasive technique in reduction and percutaneous fixation of low-energy minimally displaced Lisfranc injuries and determine if it is a safe alternative to more traditional, open approaches...
May 1, 2017: Foot & Ankle International
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