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https://www.readbyqxmd.com/read/28539054/anatomic-structures-at-risk-when-utilizing-an-intramedullary-nail-for-distal-fibular-fractures-a-cadaveric-study
#1
David A Goss, Christopher W Reb, Terrence M Philbin
BACKGROUND: Retrograde intramedullary fibular nail fixation is being utilized with increasing frequency, particularly in patients at higher risk of wound complications. The purpose of this anatomic study was to assess the relative risk to nearby anatomic structures when implanting a contemporary retrograde locked intramedullary fibular nail. METHODS: Ten human cadaveric lower extremities were instrumented with a fibular nail. The cadavers were dissected. The shortest distance, in millimeters (mm), between the site of procedural steps and nearby named structures of interest (ie, sural nerve, superficial peroneal nerve, and the peroneal tendons) was measured and recorded...
May 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28508007/five-year-outcomes-after-treatment-for-acute-instability-of-the-tibiofibular-syndesmosis-using-a-suture-button-fixation-system
#2
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/28473957/syndesmotic-internalbrace-tm-for-anatomic-distal-tibiofibular-ligament-augmentation
#3
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/28471914/medial-clamp-tine-positioning-affects-ankle-syndesmosis-malreduction
#4
Christopher T Cosgrove, Sara M Putnam, Steven M Cherney, William M Ricci, Amanda Spraggs-Hughes, Christopher M McAndrew, Michael J Gardner
OBJECTIVES: The purpose of this study was to determine if the position of the medial clamp tine during syndesmotic reduction affected reduction accuracy. DESIGN: Prospective Cohort. SETTING: Urban level 1 trauma center. PATIENTS: Seventy-two patients with operatively treated syndesmotic injuries. INTERVENTION: Patients underwent operative fixation of their ankle syndesmotic injuries using reduction forceps...
April 29, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28462686/midterm-outcome-of-the-agility-total-ankle-arthroplasty
#5
Steven M Raikin, Kristin Sandrowski, Justin M Kane, David Beck, Brian S Winters
BACKGROUND: Ankle arthritis is a debilitating condition that causes severe functional impairment. While arthrodesis has been the gold standard of surgical treatment for this condition, significant improvements in total ankle arthroplasty have made it a viable alternative. The purpose of this study was to look at the midterm follow-up of the Agility total ankle. METHODS: A retrospective review of prospectively collected data was conducted on 127 consecutive Agility total ankles implanted between 2002 and 2009...
April 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28457169/arthroscopic-correlates-of-subtle-syndesmotic-injury
#6
Gregory P Guyton, Kenneth DeFontes, Cameron R Barr, Brent G Parks, Lyn M Camire
BACKGROUND: Arthroscopic criteria for identifying syndesmotic disruption have been variable and subjective. We aimed to quantify syndesmotic disruption arthroscopically using a standardized measurement device. METHODS: Ten cadaveric lower extremity specimens were tested in intact state and after serial sectioning of the syndesmotic structures (anterior inferior tibiofibular ligament [AiTFL], interosseous ligament [IOL], posterior inferior tibiofibular ligament [PiTFL], deltoid)...
May 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28439310/syndesmosis-injuries-in-the-pediatric-and-adolescent-athlete-an-analysis-of-risk-factors-related-to-operative-intervention
#7
D E Kramer, M X Cleary, P E Miller, Y-M Yen, B J Shore
PURPOSE: To review all paediatric ankle syndesmotic injuries occurring at our institution and identify risk factors associated with operative intervention. METHODS: Among 22 873 evaluations for ankle trauma, we found 220 children suffering from syndesmotic injuries (incidence: 0.96%). We recorded demographic data, details of the injury, features on examination and treatment variables. Univariable and multivariable logistic regression modelling was performed to identify risk factors associated with operative intervention...
2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28416851/-one-of-the-pitfalls-in-the-surgical-treatment-of-maisonneuve-fractures-a-case-report
#8
H Q Ji, F Zhou, Y Tian, Z S Zhang, Y Guo, Y Lv, Z W Yang, G J Hou
There exist controversies in the surgical treatment of maisonneuve injury with regard to reduction and fixation of syndesmosis and management of proximal fibular fracture. It is very important for the orthopaedic surgeons to learn more techniques and avoid pitfalls from clinical practice. We summarized the clinical data of 1 failed case, a 20-year-old girl with big body weight who underwent a primary surgery for the treatment of maisonneuve fracture with minimally invasive reduction and fixation of ankle syndesmosis and posterior malleolus and open reduction and internal fixation of medial malleolus, then a revision surgery for the treatment of iatrogenic syndesmotic malreduction with open reduction and re-stabilization of ankle syndesmosis supplemented with open reduction and internal fixation of proximal fibular facture...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28391516/management-of-acute-injuries-of-the-tibiofibular-syndesmosis
#9
REVIEW
Nicholas M Fort, Amiethab A Aiyer, Jonathan R Kaplan, Niall A Smyth, Anish R Kadakia
The syndesmosis is important for ankle stability and load transmission and is commonly injured in association with ankle sprains and fractures. Syndesmotic disruption is associated with between 5 and 10% of ankle sprains and 11-20% of operative ankle fractures. Failure to recognize and appropriately treat syndesmotic disruption can portend poor functional outcomes for patients; therefore, early recognition and appropriate treatment are critical. Syndesmotic injuries are difficult to diagnose, and even when identified and treated, a slightly malreduced syndesmosis can lead to joint destruction and poor functional outcomes...
May 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28390687/overtightening-of-the-syndesmosis-revisited-and-the-effect-of-syndesmotic-malreduction-on-ankle-dorsiflexion
#10
Tyler Gonzalez, Jonathan Egan, Mohammad Ghorbanhoseini, Micah Blais, Aron Lechtig, Brian Velasco, Ara Nazarian, John Y Kwon
BACKGROUND: Ankle syndesmotic injuries are a significant source of morbidity and require anatomic reduction to optimize outcomes. Although a previous study concluded that maximal dorsiflexion during syndesmotic fixation was not required, methodologic weaknesses existed and several studies have demonstrated improved ankle dorsiflexion after removal of syndesmotic screws. The purposes of the current investigation are: (1) To assess the effect of compressive syndesmotic screw fixation on ankle dorsiflexion utilizing a controlled load and instrumentation allowing for precise measurement of motion...
June 2017: Injury
https://www.readbyqxmd.com/read/28336099/direct-fixation-of-fractures-of-the-posterior-pilon-via-a-posteromedial-approach
#11
Harm Hoekstra, Wouter Rosseels, Stefan Rammelt, Stefaan Nijs
The treatment of fractures of the posterior pilon is a timely issue. Restoration of the integrity of the incisura fibularis and subsequent anatomic reduction of the fibula are essential for reconstruction of the ankle mortise after trauma, and syndesmotic stability. Inappropriate treatment ultimately will lead to a poor functional outcome and quality of life. Open reduction and direct internal fixation through a posterolateral or posteromedial approach are increasingly preferred over indirect reduction and anteroposterior screw fixation...
March 19, 2017: Injury
https://www.readbyqxmd.com/read/28321479/novel-anatomical-reconstruction-of-distal-tibiofibular-ligaments-restores-syndesmotic-biomechanics
#12
Jian Che, Chunbao Li, Zhipeng Gao, Wei Qi, Binping Ji, Yujie Liu, Ming Han Lincoln Liow
PURPOSE: To date, there is a paucity of literature on syndesmotic reconstruction techniques that restore both anatomic stability and physiologic syndesmotic biomechanics. In this cadaveric study, (1) a novel syndesmotic reconstruction surgical technique using autogenous peroneus brevis tendon was described and (2) the biomechanical properties of the reconstruction was investigated. METHODS: Ten fresh-frozen lower extremities were used in this study. Reconstruction of the anterior and posterior, as well as the interosseous tibiofibular ligaments was performed with a halved peroneus brevis tendon...
March 20, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28298142/effect-of-complete-syndesmotic-disruption-and-deltoid-injuries-and-different-reduction-methods-on-ankle-joint-contact-mechanics
#13
Jeremy LaMothe, Josh R Baxter, Susannah Gilbert, Conor I Murphy, Sydney C Karnovsky, Mark C Drakos
BACKGROUND: Syndesmotic injuries can be associated with poor patient outcomes and posttraumatic ankle arthritis, particularly in the case of malreduction. However, ankle joint contact mechanics following a syndesmotic injury and reduction remains poorly understood. The purpose of this study was to characterize the effects of a syndesmotic injury and reduction techniques on ankle joint contact mechanics in a biomechanical model. METHODS: Ten cadaveric whole lower leg specimens with undisturbed proximal tibiofibular joints were prepared and tested in this study...
March 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28253941/arthrodesis-of-the-ankle
#14
H Zwipp
About 90 % of all cases of painful posttraumatic ankle arthritis can be very successfully treated with a minor invasive ankle arthrodesis technique by using a small anterior approach and a fixation with four 6. 5 mm screws of which the posteromedial and transfibular one are inserted percutaneously. The results with this standardized procedure have been reported previously as excellent and good in a mid-term run of 6 years (34). This technique leads to a high union rate of 99% (92 of 93) with rapid bone healing within 8 ± 2 weeks, it causes a low minor complication rate of 8 % and enables a significant increase of the AOFAS ankle/hindfoot score (17) from 36 preoperatively to 85 postoperatively as well as a midtarsal movement of 24° ± 16°...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28219637/malreduction-of-syndesmosis-injury-associated-with-malleolar-ankle-fracture-can-be-avoided-using-weber-s-three-indexes-in-the-mortise-view
#15
Kentaro Futamura, Tomonori Baba, Atsuhiko Mogami, Itaru Morohashi, Akio Kanda, Osamu Obayashi, Kazuo Sato, Yasuhisa Ueda, Yoshiaki Kurata, Hideki Tsuji, Kazuo Kaneko
PURPOSE: Malalignment of syndesmosis is generally associated with a poor outcome, yet occurs at a high rate in malleolar ankle fractures. In this study, we examine whether malreduction of syndesmosis injury associated with malleolar ankle fracture can be avoided using Weber's three indexes in the mortise view. MATERIALS AND METHODS: Of 156 patients with malleolar ankle fracture who underwent surgery from December 2012 to March 2016 at two medical facilities, 24 patients who received syndesmotic screw fixation were included in the study...
February 14, 2017: Injury
https://www.readbyqxmd.com/read/28167065/late-treatment-of-syndesmotic-injuries
#16
REVIEW
Michael P Swords, Andrew Sands, John R Shank
Normal syndesmosis anatomy and alignment are essential to ankle function. Although injuries to the syndesmosis are common with ankle injuries, accurate diagnosis and reduction continue to be a challenge. Late reconstruction for syndesmosis is reviewed. A surgical technique for late reconstruction is outlined in detail.
March 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28160934/arthroscopic-quantification-of-syndesmotic-instability-in-a-cadaveric-model
#17
Ross Feller, Todd Borenstein, Amanda J Fantry, Roy Bradley Kellum, Jason T Machan, Florian Nickisch, Brad Blankenhorn
PURPOSE: To investigate whether arthroscopy or stress radiography can identify instability resulting from single-ligament injury of the ankle syndesmosis and to determine whether either modality is capable of differentiating between various levels of ligament injury. METHODS: Syndesmotic/deltoid ligament sectioning was performed in 10 cadaver legs. Arthroscopic evaluation and fluoroscopic stress testing were completed after each sectioning. In group 1 (n = 5), sectioning began with anteroinferior tibiofibular ligament (AITFL), then interosseous membrane (IOM), posteroinferior tibiofibular ligament (PITFL), and deltoid...
February 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28159044/a-simplified-validated-protocol-for-measuring-fibular-reduction-on-ankle-ct
#18
Christopher Patrick Prior, James Christopher Widnall, Amer Kemall Rehman, David Marc Weller, Edward Vaughan Wood
BACKGROUND: Inadequate ankle syndesmotic reduction is a common and important cause of poor outcome after surgery. It is not clear what magnitude or planes of displacement impact most. Many computerised tomography (CT) measurement techniques rely on landmarks that are difficult to reproduce, and none measure all types of mal-positioning in a single protocol. The purpose of this study was to design and validate a protocol for measuring the distal tibio-fibular relationship. METHODS: We devised a method for measuring fibular diastasis, antero-posterior translation (APT) and fibular length on CT images...
March 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28142266/inflammatory-microenvironment-persists-after-bone-healing-in-intra-articular-ankle-fractures
#19
Samuel B Adams, Elizabeth M Leimer, Lori A Setton, Richard D Bell, Mark E Easley, Janet L Huebner, Thomas V Stabler, Virginia B Kraus, Steven A Olson, Dana L Nettles
BACKGROUND: Post-traumatic osteoarthritis (PTOA) is responsible for the majority of cases of ankle arthritis. While acute and end-stage intra-articular inflammation has previously been described, the state of the joint between fracture healing and end-stage PTOA remains undefined. This study characterized synovial fluid (SF) composition of ankles after bone healing of an intra-articular fracture to identify factors that may contribute to the development of PTOA. METHODS: Of an original 21 patients whose SF was characterized acutely following intra-articular ankle fractures, 7 returned for planned hardware (syndesmotic screw) removal after bone healing (approximately 6 months) and consented to a second bilateral SF collection...
May 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28134962/common-foot-and-ankle-injuries-what-not-to-miss-and-how-best-to-manage
#20
Jessica Reissig, Adam Bitterman, Simon Lee
Injuries to the foot and ankle are commonly encountered, especially among athletes, and can lead to morbidity if not managed appropriately. Health care professionals must have a firm understanding of injury anatomy, diagnoses, and management. This article provides a review of lateral talus process fractures, os trigonum injuries, Lisfranc injuries, turf toe, navicular stress fractures, and syndesmotic injuries.
February 1, 2017: Journal of the American Osteopathic Association
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