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https://www.readbyqxmd.com/read/28419034/complications-and-functional-outcomes-after-pantalar-dislocation
#1
Kaeleen A Boden, Douglas S Weinberg, Heather A Vallier
BACKGROUND: Pantalar dislocations without associated talar fracture are rare and have high risks of complications, including infection, osteonecrosis, and posttraumatic osteoarthrosis. Limited information on later function exists. This study evaluated complications and outcomes following pantalar dislocation without talar fracture. METHODS: Nineteen patients were identified with open (n = 14) or closed (n = 5) pantalar dislocations without talar fracture. Ten male and 9 female patients with a mean age of 39...
April 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28409107/a-transosseous-bone-bridge-repair-for-posterior-horn-meniscal-root-tears-during-anterior-cruciate-ligament-reconstruction
#2
Jonathan M Frank, Daniel J Liechti, Jack Anavian, Thomas R Hackett
Meniscal root tears occur in isolation or concurrently with ligamentous knee injury and cause significantly altered knee mechanics with the loss of normal meniscus hoop stress. This loss of normal meniscus function can result in abnormal knee kinematics and, subsequently, more rapid degenerative changes of the knee articular surface. In the setting of anterior cruciate ligament tear, the posterolateral meniscus root is most commonly damaged. Several techniques exist for meniscus root repair; however, none have been shown to be clearly superior...
February 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28409105/anatomic-single-bundle-anterior-cruciate-ligament-reconstruction-using-the-modified-transtibial-technique
#3
Dhong Won Lee, Jin Goo Kim
We present a technique for anterior cruciate ligament (ACL) reconstruction using hamstring tendon autograft with a modified transtibial technique. Our modified transtibial technique has the advantages of the conventional transtibial technique that is familiar to surgeons and that allows the press-fit fixing and enables us to make a relatively long femoral tunnel. To make the femoral tunnel at the anatomic position, the triangular, funnel-shaped bony trough was made to slip the eccentrically positioned guide pin into the anticipated anatomic center with a free-hand technique after marking the anatomic ACL footprint using a microfracture awl through the anteromedial portal...
February 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28399873/influence-of-functional-task-oriented-mental-practice-on-the-gait-of-transtibial-amputees-a-randomized-clinical-trial
#4
Rodrigo Gontijo Cunha, Paulo José Guimarães Da-Silva, Clarissa Cardoso Dos Santos Couto Paz, Ana Carolina da Silva Ferreira, Carlos Julio Tierra-Criollo
BACKGROUND: Mental practice (MP) through motor imagery is a cognitive training strategy used to improve locomotor skills during rehabilitation programs. Recent works have used MP tasks to investigate the neurophysiology of human gait; however, its effect on functional performance has not been evaluated. In the present study, the influence of gait-oriented MP tasks on the rehabilitation process of gait in transtibial amputees was investigated by assessing the vertical (V), anterior-posterior (AP), and medio-lateral (ML) ground reaction forces (GRFs) and the time duration of the support phase of the prosthetic limb...
April 11, 2017: Journal of Neuroengineering and Rehabilitation
https://www.readbyqxmd.com/read/28399654/long-term-outcomes-following-syme-s-amputation
#5
Elissa S Finkler, Daniel A Marchwiany, Adam P Schiff, Michael S Pinzur
BACKGROUND: The metabolic cost of walking after Syme's ankle disarticulation amputation is minimally more than that for nonamputation. The ability to end weightbearing makes prosthetic fitting relatively simple, and very few patients require extensive rehabilitation or placement in a skilled nursing or rehabilitation facility. In spite of these potential benefits, there is a paucity of objective information on the actual long-term outcomes. METHODS: Fifty-one patients were identified who underwent single-stage Syme's ankle disarticulation amputation with excision of the lateral and medial malleoli by a single surgeon during a 23-year period...
April 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28399324/comparison-of-anteromedial-and-transtibial-acl-reconstruction-using-expandable-fixation
#6
Omer Ozel, Bulent Yucel, Osman Orman, Emre Demircay, Serhat Mutlu
The influence of anatomical or nonanatomical femoral tunnel position on tunnel widening and clinical outcomes in patients undergoing anterior cruciate ligament (ACL) reconstruction is not fully understood. This retrospective study examined the influence of tunnel width and placement on anterior knee stability and clinical outcomes after ACL reconstruction using the AperFix System (Cayenne Medical Inc, Scottsdale, Arizona), a direct expandable fixation technique with autologous hamstring grafts. The records of 80 patients (79 men and 1 woman) who underwent ACL reconstruction were evaluated...
April 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/28396957/-transcutaneous-osseointegrated-prosthesis-top-after-limb-amputation-status-quo-and-perspectives
#7
Christian Willy, Christian Krettek
The majority of transfemoral and transtibial amputees can be functionally fitted with conventional suspension sockets; however, due to socket problems using conventional stump care, 60% of the patients have limited function and even in younger patients approximately one sixth are unable to wear the prosthesis daily. After the introduction of transcutaneous osseointegrated prostheses (TOP) the inherent problems of socket-stump care can be avoided for these patients. Against this background this article reviews the recent clinical development of TOP in Sweden, Germany, the Netherlands, Australia and USA currently in nine centers...
April 10, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28389757/can-the-outside-in-half-tunnel-technique-reduce-femoral-tunnel-widening-in-anterior-cruciate-ligament-reconstruction-a-ct-study
#8
Riccardo Maria Lanzetti, Domenico Lupariello, Angelo De Carli, Edoardo Monaco, Matteo Guzzini, Mattia Fabbri, Antonio Vadalà, Andrea Ferretti
BACKGROUND: There are different techniques for drilling the femoral tunnel in the anterior cruciate ligament reconstruction (ACLR), but their influence in the bone tunnel enlargement in unknown. The purpose of this study was to compare two different surgical techniques for evaluating femoral tunnel enlargement in ACLR. The hypothesis was that tunnel placement using the outside-in technique leads to less tunnel enlargement compared to the transtibial technique. METHODS: Forty-four patients treated for ACLR between March 2013 and March 2014 were prospectively enrolled in this study...
April 7, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28387657/the-importance-of-orthoses-on-activities-of-daily-living-in-patients-with-unilateral-lower-limb-amputations
#9
Sule Sahin Onat, Sibel Ünsal-Delialioğlu, Sumru Özel
BACKGROUND: The role of the selected prothesis on activities of daily living (ADL). OBJECTIVE: To evaluate the impact of prothesis on ADL in patients with lower-limb amputations. METHODS: The data of 500 patients with unilateral lower limb amputation were recorded. The activity level was defined based on the Medicare Functional Classification Level. Old and new prescribed prosthesis were recorded. Nottingham Extended Activities of daily living activities Daily Living Scale was used to evaluate ADL...
March 31, 2017: Journal of Back and Musculoskeletal Rehabilitation
https://www.readbyqxmd.com/read/28382211/paraplegia-and-transtibial-amputation-successful-ambulation-after-dual-disability-a-retrospective-case-report
#10
Thangavelu Senthilvelkumar, Bobeena R Chandy
INTRODUCTION: This is a single-subject case report. The objective is to describe the unique rehabilitation outcome of an individual with motor complete T12 paraplegia and a right transtibial amputation. This study was conducted at the Department of Physical Medicine and Rehabilitation of Christian Medical College in India. CASE PRESENTATION: A 42-year-old policeman presented to our rehabilitation centre with motor complete T12 paraplegia and right transtibial amputation, 3 months following a road traffic accident...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28373954/an-alternative-technique-to-avoid-injury-to-the-medial-femoral-condyle-when-reaming-the-femoral-tunnel-during-anterior-cruciate-ligament-reconstruction
#11
Kevin F Bonner, Angelo Mannino
Contemporary anterior cruciate ligament reconstruction attempts to replicate the anatomical insertion sites on both the femoral and tibial sides to restore knee stability. Creation of the femoral tunnel by independently reaming through an anteromedial portal may allow surgeons to more reproducibly place the tunnel within the anatomic femoral footprint relative to a transtibial approach. However, inherent to the technique is the risk of iatrogenic injury to the articular cartilage of the medial femoral condyle as the reamers are passed adjacent to the condyle...
February 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28373946/anteromedial-portal-anterior-cruciate-ligament-reconstruction-with-tibialis-anterior-allograft
#12
Steven Shamah, Daniel Kaplan, Eric J Strauss, Brian Singh
In an effort to better restore normal joint function and kinematics, recent emphasis has been placed on surgical techniques that provide a more anatomic reconstruction of the anterior cruciate ligament (ACL). With femoral tunnel placement shown to play a vital role in the biomechanics, stability, and clinical outcomes after ACL reconstruction, approaches that better approximate the ACL's native femoral origin have been adopted. The independent anteromedial portal technique is thought to better position the femoral tunnel within the native ACL footprint and leave the graft more posteroinferior on the wall of the lateral femoral condyle than the more traditional transtibial approach...
February 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28373945/technique-for-arthroscopic-assisted-primary-anterior-cruciate-ligament-reconstruction-using-doubled-tibialis-anterior-tendon
#13
Michael Rose, Dennis Crawford
Advances in surgical technique and our knowledge of anterior cruciate ligament (ACL) anatomy have resulted in a marked increase in options for ACL reconstruction. Currently, patient age and activity level, surgeon preference and experience, and cost are factors influencing the type of reconstruction recommended to address knee instability. We present a simplified transtibial method of ACL reconstruction using a single-bundle, doubled tibialis anterior allograft. This method uses fixation with a suspensory device on the femur and a bio-composite interference screw on the tibia...
February 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28362519/salvage-of-combat-hindfoot-fractures-in-2003-2014-uk-military
#14
Philippa M Bennett, Thomas Stevenson, Ian D Sargeant, Alistair Mountain, Jowan G Penn-Barwell
BACKGROUND: Hindfoot fractures pose a considerable challenge to military orthopaedic surgeons, as combat injuries are typically the result of energy transfers not seen in civilian practice. This study aimed to characterize the pattern of hindfoot injuries sustained by UK military casualties in recent conflicts, define the early amputation and infection rate, and identify factors associated with poor early outcomes. METHODS: The UK Joint Theatre Trauma Registry was searched for British military casualties sustaining a hindfoot fracture from Iraq and Afghanistan between 2003 and 2014...
March 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28360121/prosthetic-model-but-not-stiffness-or-height-affects-the-metabolic-cost-of-running-for-athletes-with-unilateral-transtibial-amputations
#15
Owen N Beck, Paolo Taboga, Alena Marie Grabowski
Running-specific prostheses enable athletes with lower limb amputations to run by emulating the spring-like function of biological legs. Current prosthetic stiffness and height recommendations aim to mitigate kinematic asymmetries for athletes with unilateral transtibial amputations. However, it's unclear how different prosthetic configurations influence the biomechanics and metabolic costs of running. Consequently, we investigated how prosthetic model, stiffness, and height affect the biomechanics and metabolic costs of running...
March 30, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28359669/anatomic-anterior-cruciate-ligament-reconstruction-via-independent-tunnel-drilling-a-systematic-review-of-randomized-controlled-trials-comparing-patellar-tendon-and-hamstring-autografts
#16
REVIEW
Michael C Ciccotti, Eric Secrist, Fotios Tjoumakaris, Michael G Ciccotti, Kevin B Freedman
PURPOSE: To collect the highest level of evidence comparing anatomic anterior cruciate ligament (ACL) reconstruction via independent tunnel drilling using bone-patellar tendon-bone (BTB) and hamstring tendon (HT) autografts in terms of clinical outcome and failure rate. METHODS: We performed a systematic review of clinical trials that randomized patients to ACL reconstruction with either BTB or HT autografts with a minimum 2-year follow-up. Only trials using independent tunnel drilling, including outside-in and anteromedial portal techniques, for both autografts were eligible for inclusion, whereas all transtibial studies were excluded...
March 27, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28326399/total-knee-replacement-for-tricompartmental-arthritis-in-a-patient-with-a-below-knee-amputation-after-a-previous-closing-wedge-high-tibial-osteotomy
#17
Mark A Fleming, Michael C Dixon
This is a report of a 64-year-old man who had undergone a high tibial osteotomy (HTO) 17 years ago of his right knee for medial compartment osteoarthritis; 5 days later, he received a below-knee amputation owing to a missed popliteal artery injury at the time of the HTO. We elected to perform a total knee replacement (TKR) for progressive arthritis of the ipsilateral knee 17 years after the transtibial amputation. Although there is a plethora of literature regarding TKR in the contralateral knee of amputees, there is a paucity of data of TKR in the ipsilateral knee...
June 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28324949/muscle-synergy-analysis-in-transtibial-amputee-during-ramp-ascending-activity
#18
P Mehryar, M S Shourijeh, H F Maqbool, M Torabi, A A Dehghani-Sanij
In developed countries, the highest number of amputees are elderly with transtibial amputation. Walking on inclined surfaces is difficult for amputees due to loss of muscle volume and strength thereby transtibial amputees (TA) rely on the intact limb to maintain stability. The aim of this study was to use the concatenated non-negative matrix factorization (CNMF) technique to calculate muscle synergy components and compare the difference in muscle synergies and their associated activation profiles in the healthy and amputee groups during ramp ascending (RA) activity...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28323804/transtibial-amputation-outcomes-study-taos-comparing-transtibial-amputation-with-and-without-a-tibiofibular-synostosis-ertl-procedure
#19
Michael J Bosse, Saam Morshed, Lisa Reider, William Ertl, James Toledano, Reeza Firoozabadi, Rachel B Seymour, Eben Carroll, Daniel O Scharfstein, Barbara Steverson, Ellen J MacKenzie
The optimal technique for a transtibial amputation in a young, active, and healthy patient is controversial. Proponents of the Ertl procedure (in which the cut ends of the tibia and fibula are joined with a bone bridge synostosis) argue that the residual limb is more stable which confers better prosthetic fit and improved function especially among high-performing individuals. At the same time, the Ertl procedure is associated with longer operative and healing time and may be associated with a higher complication rate compared with the standard Burgess procedure...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323802/outcomes-after-severe-distal-tibia-ankle-and-or-foot-trauma-comparison-of-limb-salvage-versus-transtibial-amputation-outlet
#20
Michael J Bosse, David Teague, Lisa Reider, Joshua L Gary, Saam Morshed, Rachel B Seymour, James Toledano, Lisa K Cannada, Barbara Steverson, Daniel O Scharfstein, Jason Luly, Ellen J MacKenzie
Severe foot and ankle injuries are complex and challenging to treat, often requiring multiple operations to salvage the limb contributing to a prolonged healing period. There is some evidence to suggest that early amputation for some patients may result in better long-term outcomes than limb salvage. The challenge is to identify the regional injury burden for an individual that would suggest a better outcome with an amputation. The OUTLET study is a prospective, multicenter observational study comparing 18-month outcomes after limb salvage versus early amputation among patients aged 18-60 years with severe distal tibia, ankle, and foot injuries...
April 2017: Journal of Orthopaedic Trauma
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