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Talus fractures

Jasmin Diallo, Joe Wagener, Christine Schweizer, Tamara Horn Lang, Roxa Ruiz, Beat Hintermann
BACKGROUND: An acute ankle sprain can result in a bony avulsion of the lateral ankle ligaments. The extent of concomitant lesions and subsequent instability patterns are not clearly understood. The high incidence of old avulsion fractures found in symptomatic chronic ankle instability may indicate the need for primary fixation. METHODS: Ten patients (5 male, 5 female; mean age, 34 years; range, 15-64 years) with bony avulsion fractures of the fibula after acute ankle sprains were included...
March 1, 2018: Foot & Ankle International
Christiane Kruppa, Tyler Snoap, Debra L Sietsema, Thomas A Schildhauer, Marcel Dudda, Clifford B Jones
The outcomes of pediatric talus fractures have been minimally reported in published studies. The purpose of the present retrospective study was to determine the clinical and radiographic outcomes after talus fractures in pediatric and adolescent patients and to define the differences among the different age groups in this population. A total of 52 children and adolescents (54 fractures) with 24 type 1 (44.44%), 13 type 2 (24.07%), 8 type 3 (14.81%), and 9 type 4 (16.67%) Marti-Weber fractures were considered...
March 2, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Mathilde Baumann, Claus Munk Jensen, Niels Andresen
Talus fractures are rare but often associated with complications and significant post-traumatic patient morbidity. They frequently occur at high-energy traumas such as traffic accidents. This is a case report of a young woman who after a fall from a roof, presented in an emergency department with a dislocated ankle which was initially misdiagnosed as a bimalleolar fracture and attempted repositioned as such before X-ray. Dislocated talus fractures, however, need urgent anatomic reduction after diagnostic imaging and often subsequent and acute osteosynthesis...
February 19, 2018: Ugeskrift for Laeger
Kwasi Y Kwaadu
Fractures of the talus are significant injuries with associated significant complications where the recovery zenith is less frequently good to excellent, and more commonly fair to satisfactory. These outcomes are a consequence of combinations of the inherent intrinsic and surrounding anatomy, technical and logistic difficulties in adequate fracture access, and the high-energy mechanisms typically associated with these injuries that further traumatize the surrounding tissues. This article reviews and provides current management recommendations for these devastating injuries...
April 2018: Clinics in Podiatric Medicine and Surgery
Ebrahim Izadi, Rahij Anwar, Sarah Phillips, Venu Kavarthapu
Displaced osteochondral fractures of the body of talus quite often require a malleolar osteotomy to gain access to the fracture fragment during internal fixation. We describe a case report in which access to a displaced osteochondral fracture of the lateral talar dome was achieved using an arthroscopy-assisted fibular tunnel approach. This technique resulted in satisfactory fracture healing and a satisfactory clinical outcome.
February 15, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Jin Park, Jin Ho Che
Talus fracture of the medial tubercle of the posterior process is rare. This type of fracture can be easily missed, because it is difficult to identify on plain radiographs of the ankle. Oblique radiographs with external rotation, computed tomography, and magnetic resonance imaging (MRI) of the ankle are useful for making an accurate diagnosis. However, even with an early diagnosis, the treatment guidelines for talus fractures of the posterior medial tubercle have not yet been established. The flexor hallucis longus (FHL) tendon, which passes through the groove between the medial and lateral tubercles of the posterior process of the talus, can interpose between the fracture sites and interrupt fracture reduction...
February 15, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Loes G M de Kruijff, M Prins, A van der Krans, R Hoencamp, P van der Wurff
INTRODUCTION: Prior to deployment of the Netherlands Army Task Force Urozgan in Afghanistan, the Dutch Military and civilian healthcare systems had limited experience in treating blast injuries and their long-term consequences. This meant that guidelines for treatment and rehabilitation were lacking. The aim of this cohort study was to quantify kinematic and kinetic abnormalities in service members with foot injuries in relation to functional outcome using gait analysis. METHOD: In nine service members with combat-related talus, calcaneus and/or navicular bone (TCN) fractures and nine controls, gait parameters were measured using Gait Real-Time Analysis Interactive Lab system...
February 7, 2018: Journal of the Royal Army Medical Corps
John A Buza, Philipp Leucht
Fractures of the talus are challenging to manage, with historically poor outcomes and a high rate of complications. The rare nature of this injury limits the number of studies available to guide treatment. Fortunately, a number of advancements have been made in the last decade. There is increased recognition regarding the importance of anatomic reconstruction of the osseous injury. Advanced imaging is used to assess the subtalar joint, where even slight displacement may predispose to arthritis. Increasing use of dual anteromedial and anterolateral approaches, along with plate fixation, has improved our ability to accurately restore the anatomy of the talus...
April 24, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Ming Zhang, Yun-Feng Chen, Lei Wang, Fan Li, Hai-Feng Wei, Zhong-Min Shi
BACKGROUND: The purpose of this study was to investigate clinical characteristics and surgical management of Type III Wagstaffe fracture. METHODS: From August 2012 to July 2015, 13 patients with Type III Wagstaffe fractures were surgically treated. During operation, the cartilage of joint surface was explored. Wagstaffe fragment was fixed with cannulated screw or suture, Chaput fragment was fixed with cannulated screw or plate, and Cotton test was performed to evaluate the stability of syndesmosis during the operation...
April 27, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Ki Hyuk Sung, Young Choi, Gyeong Hee Cho, Chin Youb Chung, Moon Seok Park, Kyoung Min Lee
OBJECTIVE: This study evaluated the correlation between central and peripheral bone mineral density (BMD) of the ankle joint, using dual-energy X-ray absorptiometry (DXA). We also investigated whether peripheral ankle BMD could be used to identify individuals who were diagnosed with osteoporosis, using central DXA. METHODS: We recruited 134 volunteers aged 20-90 years who agreed to participate in this study. Central BMD of the lumbar spine and left femur, and peripheral BMD of the medial malleolus, distal tibia, lateral malleolus, and talus were measured with DXA...
February 5, 2018: Skeletal Radiology
Hiroshi Sasai, Daisuke Fujita, Eiko Seto, Yuki Denda, Yutaro Imai, Kanako Okamoto, Kensaku Okamura, Masaru Furuya, Hiroyuki Tani, Kazumi Sasai
OBJECTIVE To evaluate outcome of limb fracture repair in rabbits. DESIGN Retrospective case series. ANIMALS 139 client-owned rabbits with limb fractures treated between 2007 and 2015. PROCEDURES Medical records were reviewed for information on fracture location, fracture treatment, and time to fracture healing. RESULTS 25 rabbits had fractures involving the distal aspects of the limbs (ie, metacarpal or metatarsal bones, phalanges, and calcaneus or talus). Fractures were treated in 23 of these 25 rabbits (external coaptation, n = 17; external skeletal fixation, 4; and intramedullary pinning, 2) and healed in all 23, with a median healing time of 28 days (range, 20 to 45 days)...
February 15, 2018: Journal of the American Veterinary Medical Association
Nigar Keles-Celik, Ozkan Kose, Rahime Sekerci, Gunes Aytac, Adil Turan, Ferhat Güler
Accessory ossicles of the foot and ankle are normal variants of bone development that usually remain asymptomatic. However, they may be involved in various disorders and become a source of pain such as in fractures, dislocations, degenerative changes, osteonecrosis, osteoarthritis, osteochondral lesions, avascular necrosis, and irritation or impingement of adjacent soft tissues. Hence, during the assessment of the situations above, knowledge about these little-known ossicles could be very important to reach the correct diagnosis...
November 26, 2017: Curēus
Katherine M Edenfield
The midfoot and forefoot are the regions of the foot distal to the talus and calcaneus and are critical to weight bearing and movement. They help support the arch of the foot, provide shock absorption, and convert vertically oriented forces into horizontal forward and propulsive movement. A spectrum of acute, subacute, and chronic conditions in these regions can cause pain and decreased function. A thorough history and physical examination should include foot and leg biomechanics, alignment, and posture in addition to palpation of painful areas...
February 2018: FP Essentials
Elisabeth R Garwood, Christopher J Burke, Laith M Jazrawi, Ronald S Adler
Emerging musculoskeletal applications for local administration of autologous bone marrow aspirate concentrate (BMAC) include treatment of fractures, osteonecrosis, osteochondral injuries, osteoarthritis, ligament injury, tendon injury, and tendonopathies. Ultrasound-guided technique for various BMAC injection sites is detailed in this technical report and our preliminary clinical experience outlined.Five patients, 1 woman and 4 men, were treated with 6 peri/intratendinous (n = 4) or intraarticular (n = 2) BMAC injections between July 5, 2015 and December 31, 2016 for the clinical indications of common hamstrings origin tendinosis (n = 4), hip labral tear (n = 1), and osteochondral lesion of the talus (n = 1)...
January 23, 2018: Ultrasound Quarterly
Giuseppe Caracchini, Michele Pietragalla, Alioscia De Renzis, Michele Galluzzo, Mattia Carbone, Marcello Zappia, Anna Russo, Federico Greco, Vittorio Miele
INTRODUCTION: The talus is the second largest bone of the foot. It is fundamental to ensure normal ankle-foot movements as it connects the leg and the foot. Talar fractures are usually due to high energy traumas (road accidents, high level falls). They are not common as they account for 3-5% of ankle and foot fractures and 0.85% of all body fractures. However, talar fractures not correctly diagnosed and treated can lead to avascular necrosis of the astragalus, pseudoarthrosis, early osteoarthrisis and ankle instability, declining the quality of life of patients...
January 19, 2018: Acta Bio-medica: Atenei Parmensis
Jesús Más Martínez, Carmen Verdú Román, Enrique Martínez Giménez, Javier Sanz-Reig, David Bustamante Suárez de Puga, Manuel Morales Santías
Posteromedial ankle impingement is rare and uncommonly associated with a fracture. Bone resection of the fragment is the recommended treatment. In this report, we describe the step-by-step surgical technique of arthroscopic resection of a malunion of a posteromedial talus fracture to correct the impingement.
December 2017: Arthroscopy Techniques
Benedict Swartman, Dirk Frere, Wei Wei, Marc Schnetzke, Stephan Grechenig, Amir Matityahu, Nils Beisemann, Holger Keil, Jochen Franke, Paul Alfred Grützner, Sven Yves Vetter
BACKGROUND: Indirect screw fixation of the sustentaculum tali in the lateral-medial direction can be challenging due to the complex calcaneal anatomy. A novel 2-dimensional (2D) projection-based software application detects Kirschner wires (K-wires) and visualizes their intended direction as a colored trajectory. The aim of this prospectively randomized cadaver study was to investigate whether the software would facilitate the indirect K-wire placement in the sustentaculum tali. METHODS: In 20 cadaver foot specimens, K-wires were placed indirectly in the sustentaculum tali by an experienced and an inexperienced surgeon, with and without using the application...
January 1, 2018: Foot & Ankle International
Philippe Hernigou, Arnaud Dubory, Charles Henri Flouzat Lachaniette, Issam Khaled, Nathalie Chevallier, Helene Rouard
PURPOSE: Avascular necrosis of the talus is one of the most notable complications associated with talar neck fractures with frequent evolution of the osteonecrosis into a difficult arthrodesis. We tested whether the injection of bone marrow mesenchymal stem cells (MSCs) could improve the repair process of the osteonecrosis. MATERIAL AND METHODS: Forty-five early (without collapse) post-traumatic talus osteonecroses (group 1; study group) were treated between 1995 and 2012 with percutaneous injection of progenitor cells (autologous bone marrow concentrate from the iliac crest)...
January 5, 2018: International Orthopaedics
Benedikt J Braun, Patrick Pelz, Nils T Veith, Mika Rollmann, Moritz Klein, Steven C Herath, Jörg H Holstein, Tim Pohlemann
PURPOSE: The aim of the current study was to describe long-term gait changes after talus fractures, identify patterns associated with poor outcome and discuss possible treatment options based on dynamic gait analysis. METHODS: Twenty-seven patients were followed-up clinically and via gait analysis after talus fracture osteosynthesis. Continuous dynamic pedobarography with a gait analysis insole was performed on a standardized parcours consisting of different gait tasks and matched to the outcome...
January 2, 2018: International Orthopaedics
Jae-Man Kwak, Sung-Keun Heo, Gu-Hee Jung
BACKGROUND: Open total extrusion of the talus without concomitant fracture is an extremely rare injury. We present 6-year follow-up data of a patient treated using a temporary spanning external fixator and less invasive single K-wire fixation. CASE PRESENTATION: A 55-year-old Asian man who had a totally extruded talus without fracture underwent immediate reimplantation surgery. A spanning external fixator with single antegrade K-wire fixation was applied to maintain the reimplanted talus...
December 15, 2017: Journal of Medical Case Reports
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