Tero Kortekangas, Tapio Flinkkilä, Jaakko Niinimäki, Sannamari Lepojärvi, Pasi Ohtonen, Olli Savola, Harri Pakarinen
BACKGROUND: Syndesmosis fixation of Lauge-Hansen SER IV, Weber B ankle fractures is controversial. This study compared a matched pair of SER IV patients with stress proven syndesmotic injuries with the same number without stress proven syndesmotic injury in terms of functional, pain, and radiologic result. METHODS: The study was based on a RCT-study comparing syndesmotic transfixation to no fixation in SER IV (Weber B)-type ankle fractures. Twenty-four patients with a syndesmosis injury found on the intraoperative 7...
February 2015: Foot & Ankle International
Scott E Sexton
Open fractures of the lower extremity cover a wide gamut of injuries ranging from the mangled, pulseless leg necessitating amputation to the more innocuous pinhole open wounds associated with simple fracture patterns. Prompt diagnosis and appropriate care can make a dramatic difference in decreasing complication rates and improving ultimate outcomes. Principles of management of open fractures have been created with the main goal of decreasing infection rates, while providing for stabilization of the bone and soft tissue injury...
October 2014: Clinics in Podiatric Medicine and Surgery
Olga Gonzalez, Justin J Fleming, Andrew J Meyr
The anatomy of the posterior tibial malleolus plays an important role in the structure and function of the ankle mortise. With specific respect to ankle fractures, the presence, size, and displacement of posterior malleolar fractures (Volkmann's fracture) helps determine which will be amendable to operative fixation. The objective of the present study was to increase the body of knowledge with respect to the ability of foot and ankle reconstructive surgeons to assess posterior malleolar ankle fractures using plain film radiography...
May 2015: Journal of Foot and Ankle Surgery
Mélissa Laflamme, Etienne L Belzile, Luc Bédard, Michel P J van den Bekerom, Mark Glazebrook, Stéphane Pelet
OBJECTIVES: To compare the clinical and radiographic outcome after stabilization of an acute syndesmosis rupture with either a static implant (a 3.5-mm metallic screw through 4 cortices) or a dynamic device (TightRope; Arthrex). DESIGN: Multicenter randomized double-blind controlled trial. SETTINGS: Study realized in 5 trauma centers (2 level 1 and 3 level 2) in 2 countries. PATIENTS/PARTICIPANTS: Seventy subjects admitted for an acute ankle syndesmosis rupture entered the study and were randomized into 2 groups (dynamic fixation = 34 and static fixation = 36)...
May 2015: Journal of Orthopaedic Trauma
M T Kennedy, O Carmody, S Leong, C Kennedy, M Dolan
Classical AO teaching recommends that a syndesmosis screw should be inserted at 25-30 degrees to the coronal plane of the ankle. Accurately judging the 25/30 degree angle can be difficult, resulting in poor operative reduction of syndesmosis injuries. The CT scans of 200 normal ankles were retrospectively examined. The centroid of the fibula and tibia in the axial plane 15mm proximal to the talar dome was calculated. A force vector between the centroid of the fibula and the tibia in the axial plane should not displace the fibula relative to the tibia when surfaces are parallel...
December 2014: Foot
Hao Chen, Wenzhou Liu, Lianfu Deng, Weidong Song
BACKGROUND: The early diagnosis of avascular necrosis of the talus (AVN) and prediction of ankle function for talar fractures are important. The Hawkins sign, as a radiographic predictor, could exclude the possibility of developing ischemic bone necrosis after talar neck fractures, but its relationship with ankle function remains unclear. The purpose of this study was to illustrate the prognostic effect of the Hawkins sign on ankle function after talar neck fractures and to study the value of early MRI in detecting the AVN changes after talus fractures...
December 2014: Foot & Ankle International
Nabil A Ebraheim, Todd Ludwig, John T Weston, Trevor Carroll, Jiayong Liu
BACKGROUND: Evaluation of operative techniques used for medial malleolar fractures by classifying fracture geometry has not been well documented. METHODS: One hundred eleven patients with medial malleolar fractures (transverse n = 63, oblique n = 29, vertical n = 7, comminuted n = 12) were included in this study. Seventy-two patients had complicating comorbidities. All patients were treated with buttress plate, lag screw, tension band, or K-wire fixation. Treatment outcomes were evaluated on the basis of radiological outcome (union, malunion, delayed union, or nonunion), need for operative revision, presence of postoperative complications, and AOFAS Ankle-Hindfoot score...
May 2014: Foot & Ankle International
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