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Foot and Ankle Fractures

Ahmad M Radaideh, Ziad A Audat, Abdullah A Saleh
BACKGROUND Fractures of the talus are uncommon injuries that usually involve the talar neck, rather than the talar body. This report is of a rare case of combined left talar neck fracture and adjacent joint dislocation with an ipsilateral bimalleolar ankle fracture. CASE REPORT A 37-year-old man presented with an injury to his left foot following a motor vehicle accident. When he presented to the hospital emergency department, his left foot and ankle were swollen, the overlying skin was intact but badly contused, and there was no neurovascular deficit...
March 20, 2018: American Journal of Case Reports
Tugrul Bulut, Merve Gursoy
The aim of the present study was to evaluate the clinical and radiologic results of surgically treated isolated medial malleolar fractures and compare the clinical and radiologic results of the fixation methods of headless cannulated fully threaded compression screws and cancellous lag screws and tension band wiring. We included 32 patients who attended the final follow-up examination. Group 1 consisted of 11 patients (34.4%) treated with headless cannulated fully threaded compression screws. Group 2 consisted of 10 patients (31...
March 15, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Piyush Mahapatra, Ben Rudge, Paul Whittingham-Jones
The case we present suggests that it might be possible to overcompress the syndesmosis, causing subluxation of the talus within the ankle mortise. A 26-year-old female patient had had a Weber Type C ankle fracture internally fixed with a lateral plate and syndesmosis screws. Despite the fibula appearing well reduced and computed tomography imaging showing a well-aligned fibula within the fibular notch, anteromedial subluxation of the talus was present in the ankle mortise. Examination with the patient under anesthesia revealed a stable syndesmosis fixation; however, talar malpositioning was not affected by the foot position...
March 13, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Aoife Healy, Sybil Farmer, Anand Pandyan, Nachiappan Chockalingam
BACKGROUND: Assistive products are items which allow older people and people with disabilities to be able to live a healthy, productive and dignified life. It has been estimated that approximately 1.5% of the world's population need a prosthesis or orthosis. OBJECTIVE: The objective of this study was to systematically identify and review the evidence from randomized controlled trials assessing effectiveness and cost-effectiveness of prosthetic and orthotic interventions...
2018: PloS One
Jen-Ta Shih, Chun-Lin Kuo, Tsu-Te Yeh, Hsain-Chung Shen, Ru-Yu Pan, Chia-Chun Wu
BACKGROUND: The ideal treatment for comminuted intraarticular calcaneal fractures is still debated. Open reduction and internal fixation (ORIF) is the most popular surgical procedure; however, wound complications, implant choice, and infection remain major concerns. This study aimed to demonstrate the results of an innovative, minimally invasive surgical procedure, namely, a closed reduction technique using large-diameter Steinmann pins and percutaneous calcaneoplasty using injectable calcium sulfate cement (MIIG X3, Wright Medical Technology, Inc...
March 9, 2018: BMC Musculoskeletal Disorders
Jose A Blanco, Gemma Slater, Jitendra Mangwani
The incidence of venous thromboembolic (VTE) events (deep vein thrombophlebitis [DVT] or pulmonary embolism [PE]) in foot and ankle trauma has been low, and the risk/benefit ratio associated with chemoprophylaxis is controversial. We compared the 90-day incidence of VTE events in 3 cohorts: group 1, tendo-Achillis (TA) ruptures managed with full weightbearing in a walker boot; group 2, ankle fractures immobilized non-weightbearing in a below-the-knee cast; and group 3, ankle fractures managed surgically, followed by non-weightbearing in a below-the-knee cast...
March 1, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
David Drynan, Milford McArthur, Ashray Vohora, Darren Hinton, Grant Menegon, Matthew P R Wilkinson
BACKGROUND: Surgical planning in trauma is essential for optimal patient care and best patient outcomes. Digital radiography has improved the availability, convenience and access to radiographs worldwide as used in every trauma centre in Australia. One shortcoming, however, is the variability in magnification error associated with different anatomic regions. Accurate assessment of radiographs is paramount to proper surgical planning. METHODS: A retrospective review of 513 post-operative trauma radiographs of implants at a single centre, collected from January 2015 to August 2016, was measured by the four individual investigators...
March 1, 2018: ANZ Journal of Surgery
A Siebe De Boer, Esther M M Van Lieshout, Gerson Van Moolenbroek, Dennis Den Hartog, Michael H J Verhofstad
BACKGROUND: Post-operative weightbearing guidelines for displaced intra-articular calcaneal fractures (DIACF) have been pragmatically developed in the past, however hardly adapted to current health care insights. A period of six to nine weeks of non-weightbearing is usually recommended. It is unknown whether an earlier start of weightbearing is advisable. OBJECTIVES: The primary aim was to evaluate the effect of time to post-operative weightbearing on Böhler's angle...
February 21, 2018: Injury
Michael W Downey, Ted C Lai, Justin J Fleming
At present there is controversy regarding the appropriate treatment of severely comminuted fractures of the lower extremity. Even with near-perfect anatomic reduction of severely comminuted fractures, development of posttraumatic arthritis is still present at an increased rate. Primary fusion of comminuted fractures of the foot and ankle creates successful and predictable outcomes, which dismisses the chance of developing posttraumatic arthritis and decreases complications and the need for revisional procedures...
April 2018: Clinics in Podiatric Medicine and Surgery
Graham A Hamilton, Matthew D Doyle, Francesca M Castellucci-Garza
The indications for arthroscopy have expanded over the years. Arthroscopic-assisted open reduction internal fixation in the setting of acute trauma is gaining popularity with foot and ankle surgeons. It serves to facilitate direct visualization of fracture fragments and allows for precise articular reduction with minimal soft tissue insult. Current evidence reports a high incidence of chondral injury with ankle fractures. Arthroscopy performed at the time of open reduction internal fixation allows for joint inspection and potential treatment of these posttraumatic defects...
April 2018: Clinics in Podiatric Medicine and Surgery
Benjamin R Williams, Dylan L McCreary, Michael Chau, Brian P Cunningham, Fernando Pena, Marc F Swiontkowski
BACKGROUND: Orthopedic implant removal following open reduction internal fixation of a fracture is a common procedure, especially in the foot and ankle. The purpose of this study was to evaluate functional change after the removal of symptomatic implants following ankle fracture open reduction internal fixation (ORIF) using the Short Musculoskeletal Function Assessment (SMFA) outcome score. We hypothesized that implant removal after ankle fracture would result in improved functional outcomes...
February 1, 2018: Foot & Ankle International
Xue-Xun Bao, Chen-Jie Xia, Bi-Yun Zhao, De-Jun Shi, Guan-Hua Lan, Guo-Lin Ren, Zu-Hong Xie, Wen-Xi Du
OBJECTIVE: To study the feasibility and clinical efficacy of a minimally invasive sinus tarsi approach in the treatment of Sanders II calcaneus fractures. METHODS: From August of 2015 to July of 2016, 13 patients(totally 13 feet) with Sanders II intra-articular calcaneus fractures were treated via the minimally invasive sinus tarsi approach. The Böhler angle, Gissane angle and the length, width and height of calcaneus were compared between pre-operation and post-operation...
August 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
P M Bennett, T Stevenson, I D Sargeant, A Mountain, J G Penn-Barwell
OBJECTIVES: The surgical challenge with severe hindfoot injuries is one of technical feasibility, and whether the limb can be salvaged. There is an additional question of whether these injuries should be managed with limb salvage, or whether patients would achieve a greater quality of life with a transtibial amputation. This study aims to measure functional outcomes in military patients sustaining hindfoot fractures, and identify injury features associated with poor function. METHODS: Follow-up was attempted in all United Kingdom military casualties sustaining hindfoot fractures...
February 2018: Bone & Joint Research
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
Melissa Corso, Christopher DeGraauw, William Hsu
Introduction: Osteochondral lesions of the tibial plafond account for approximately 2.6% of osteochondral lesions in the ankle. There are few cases describing this lesion in the literature, with little information on mechanism of injury, history/physical findings or recommendations for management. Case Presentation: A 17-year-old male competitive soccer player presented with a 6-7 month history of medial ankle pain after an inversion sprain. He presented with locking and giving way of the ankle with weight-bearing and pushing off the foot to the contralateral side...
December 2017: Journal of the Canadian Chiropractic Association
Xian-Xun Wang, Chang-Tao Wan, Li Yu
OBJECTIVE: To investigate the clinical effects of compression hollow screws combined with external fixator in treating talar neck fracture of Hawkins III, IV type. METHODS: From March 2010 to August 2014, 15 patients with talar neck fractures of Hawkins III, IV type were treated by open reduction and compression hollow screws fixation complicated with external fixator fixation. Including 9 males and 6 females, aged from 17 to 65 years old with an average of 37.5 years old...
May 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Ryan R Richmond, Andrew D Henebry
Maisonneuve fractures are relatively well known in the sports medicine, and orthopedic communities, however, can be commonly missed among primary care providers. The following case outlines an active duty 35-yr-old female patient who presented with acute pain on the left ankle and lower leg after she misjudged a step. The injury is a combination of high fibular and medial malleolar fractures with a disruption of the tibiofibular syndesmosis ligaments. This is a result of extreme external rotation and pronation of a fixed foot...
February 5, 2018: Military Medicine
L Bai, Y Hou, G-H Lin, X Zhang, G-Q Liu, B Yu
INTRODUCTION: Our aim was to compare the effect of Sinus Tarsi Approach (STA) vs Extensile Lateral Approach(ELA) for Treatment of Closed Displaced Intra-Articular Calcaneal Fractures (DIACF.) is still being debated, MATERIALS AND METHODS: A thorough research was carried out in the MEDLINE, EMBASE, and Cochrane library databases from inception to December 2016. Only prospective or retrospective comparative studies was selected in this meta-analysis. Two independent reviewers conducted literature search, data extraction, and quality assessment...
February 1, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Daniel Pérez-Prieto, María E Portillo, Gemma González-Lucena, Alberto Ginés-Cespedosa
BACKGROUND: Infection after foot and ankle fractures is a major concern for orthopedic surgeons. It is widely believed that final osteosynthesis should be delayed until the infection is cured. However, there is no literature that supports this practice. In addition, the delay impairs patient function and quality of life (QoL). METHODS: In the present study, four cases of ankle infection treated with aggressive debridement, early fixation and antibiofilm antibiotics are described...
August 4, 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
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