WorldWideScience

Sample records for ankle arthroscopic implications

  1. Arthroscopic Ankle Arthrodesis for Treating Osteoarthritis in a Patient with Kashin-Beck Disease

    Directory of Open Access Journals (Sweden)

    Kenjiro Iwasa

    2014-01-01

    Full Text Available Kashin-Beck disease (KBD is an endemic degenerative osteoarthritis. Death of cartilage and growth plate is the pathologic feature; therefore, KBD involves skeletal deformity and often results in osteoarthritis. Deficiency of selenium, high humic acid levels in water, and fungi on storage gains are considered the cause of KBD. The most frequently involved joints are ankles, knees, wrists, and elbows and symptoms are pain and limited motions of those joints. The main treatments for KBD are rehabilitation and osteotomy to correct the deformities because preventive treatment has not been established. In this report, we present a case of ankle osteoarthritis due to KBD and first describe arthroscopic ankle arthrodesis for treating osteoarthritis of KBD.

  2. [Arthroscopic treatment of chondral lesions of the ankle joint. Evidence-based therapy].

    Science.gov (United States)

    Thomas, M; Jordan, M; Hamborg-Petersen, E

    2016-02-01

    Ankle sprains are the most relevant injuries of the lower extremities and can lead to damage to ligaments and osteochondral lesions. Up to 50 % of patients with a sprained ankle later develop a lesion of the cartilage in the ankle joint or an osteochondral lesion of the talus. This can lead to osteoarthritis of the injured ankle joint. Spontaneous healing is possible in all age groups in cases of a bone bruise in the subchondral bone but in isolated chondral injuries is only useful in pediatric patients. In many cases chondral and osteochondral injuries lead to increasing demarcation of the affected area and can result in progressive degeneration of the joint if not recognized in time. There also exist a certain number of osteochondral changes of the articular surface of the talus without any history of relevant trauma, which are collectively grouped under the term osteochondrosis dissecans. Perfusion disorders are discussed as one of many possible causes of these alterations. Nowadays, chondral and osteochondral defects can be treated earlier due to detection using very sensitive magnetic resonance imaging (MRI) and computed tomography (CT) techniques. The use of conservative treatment only has a chance of healing in pediatric patients. Conservative measures for adults should only be considered as adjuvant treatment to surgery.Based on a comprehensive analysis of the current literature, this article gives an overview and critical analysis of the current concepts for treatment of chondral and osteochondral injuries and lesions of the talus. With arthroscopic therapy curettage and microfracture of talar lesions are the predominant approaches or retrograde drilling of the defect is another option when the chondral coating is retained. Implantation of autologous chondral cells or homologous juvenile cartilage tissue is also possible with arthroscopic techniques. Osteochondral fractures (flake fracture) are usually performed as a mini-open procedure supported by

  3. Impingement syndrome of the ankle following supination external rotation trauma: MR imaging findings with arthroscopic correlation

    International Nuclear Information System (INIS)

    Our objective was to identify MR imaging findings in patients with syndesmotic soft tissue impingement of the ankle and to investigate the reliability of these imaging characteristics to predict syndesmotic soft tissue impingement syndromes of the ankle. Twenty-one ankles with chronic pain ultimately proven to have anterior soft tissue impingement syndrome were examined by MR imaging during January 1996 to June 2001. The MR imaging protocol included sagittal and coronal short tau inversion recovery (STIR), sagittal T1-weighted spin echo, axial and coronal proton-density, and T2-weighted spin-echo sequences. Nineteen ankles that underwent MR imaging during the same period of time and that had arthroscopically proven diagnosis different than impingement syndrome served as a control group. Fibrovascular scar formations distinct from the syndesmotic ligaments possibly related to syndesmotic soft tissue impingement were recorded. Arthroscopy was performed subsequently in all patients and was considered the gold standard. The statistical analysis revealed an overall frequency of scarred syndesmotic ligaments of 70% in the group with ankle impingement. Fibrovascular scar formations distinct from the syndesmotic ligaments presented with low signal intensity on T1-weighted images and remained low to intermediate in signal intensity on T2-weighted MR imaging. Compared with arthroscopy, MR imaging revealed a sensitivity of 89%, a specificity of 100%, and a diagnostic accuracy of 93% for scarred syndesmotic ligaments. The frequency of scar formation distinct from the syndesmotic ligaments in patients with impingement syndrome of the ankle was not statistically significantly higher than in the control group. In contrast to that, anterior tibial osteophytes and talar osteophytes were statistically significantly higher in the group with anterior impingement than in the control group. Conventional MR imaging was found to be insensitive for the diagnosis of syndesmotic soft tissue

  4. Impingement syndrome of the ankle following supination external rotation trauma: MR imaging findings with arthroscopic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Schaffler, Gottfried J. [Department of Radiology, University of California San Francisco, 350 Parnassus Avenue, Suite 150, San Francisco, CA 94117 (United States); Department of Radiology, University Hospital Graz, Auenbruggerplatz 9, 8036 Graz (Austria); Tirman, Phillip F.J.; Stoller, David W. [San Francisco Magnetic Resonance Center, 3333 California Street, Suite 105, San Francisco, CA 94118 (United States); Genant, Harry K. [Department of Radiology, University of California San Francisco, 350 Parnassus Avenue, Suite 150, San Francisco, CA 94117 (United States); Ceballos, Cecar; Dillingham, Michael F. [Sports Orthopedics and Rehabilitation, 2884 Sand Hill Rd., Suite 110, Menlo Park, CA 94025 (United States)

    2003-06-01

    Our objective was to identify MR imaging findings in patients with syndesmotic soft tissue impingement of the ankle and to investigate the reliability of these imaging characteristics to predict syndesmotic soft tissue impingement syndromes of the ankle. Twenty-one ankles with chronic pain ultimately proven to have anterior soft tissue impingement syndrome were examined by MR imaging during January 1996 to June 2001. The MR imaging protocol included sagittal and coronal short tau inversion recovery (STIR), sagittal T1-weighted spin echo, axial and coronal proton-density, and T2-weighted spin-echo sequences. Nineteen ankles that underwent MR imaging during the same period of time and that had arthroscopically proven diagnosis different than impingement syndrome served as a control group. Fibrovascular scar formations distinct from the syndesmotic ligaments possibly related to syndesmotic soft tissue impingement were recorded. Arthroscopy was performed subsequently in all patients and was considered the gold standard. The statistical analysis revealed an overall frequency of scarred syndesmotic ligaments of 70% in the group with ankle impingement. Fibrovascular scar formations distinct from the syndesmotic ligaments presented with low signal intensity on T1-weighted images and remained low to intermediate in signal intensity on T2-weighted MR imaging. Compared with arthroscopy, MR imaging revealed a sensitivity of 89%, a specificity of 100%, and a diagnostic accuracy of 93% for scarred syndesmotic ligaments. The frequency of scar formation distinct from the syndesmotic ligaments in patients with impingement syndrome of the ankle was not statistically significantly higher than in the control group. In contrast to that, anterior tibial osteophytes and talar osteophytes were statistically significantly higher in the group with anterior impingement than in the control group. Conventional MR imaging was found to be insensitive for the diagnosis of syndesmotic soft tissue

  5. Arthroscopic-assisted fibular synthesis and syndesmotic stabilization of a complex unstable ankle injury.

    Science.gov (United States)

    Salvi, Andrea Emilio; Metelli, Giovanni Pietro; Bettinsoli, Rosita; Hacking, Steven Adam

    2009-03-01

    Traditional treatment of complex ankle fracture consists of open reduction and internal fixation. Nevertheless, this treatment can delay fracture healing and cause prolonged oedema. The surgeon should consider necessity of early recovery when treating athletes, especially football players. In this light, it was decided to perform an arthroscopy-assisted percutaneous minimal osteosynthesis of a fibular fracture together with a syndesmotic disruption in order to permit the patient, a 24-year-old male, to resume quicker and easier full sport activities. The outcome was good and allowed patient to play soccer since 6 months following surgery. The complete and detailed articular evaluation provided by the arthroscope permitted to manage carefully a complex articular traumatism, avoiding the necessity of plating the fracture and improving a rapid full recovery of the joint function. PMID:18368413

  6. Arthroscopic treatment of impingement of the ankle reduces pain and enhances function

    DEFF Research Database (Denmark)

    Rasmussen, S; Hjorth Jensen, C

    2002-01-01

    pain. Gait was improved in 30/41 patients and 22 resumed sporting activities. The results were graded excellent in 67, good in 25, fair in six and poor in seven patients. There were four deep infections and one synovial fistula in this series. The deep infections all responded well to arthroscopic...

  7. Ankle mechanics during sidestep cutting implicates need for 2-degrees of freedom powered ankle-foot prostheses

    OpenAIRE

    Evandro M. Ficanha; Mohammad Rastgaar, PhD; Kenton R. Kaufman, PhD

    2015-01-01

    The ankle joint of currently available powered prostheses is capable of controlling one degree of freedom (DOF), focusing on improved mobility in the sagittal plane. To increase agility, the requirements of turning in prosthesis design need to be considered. Ankle kinematics and kinetics were studied during sidestep cutting and straight walking. There were no significant differences between the ankle sagittal plane mechanics when comparing sidestep cutting and straight walking; however, signi...

  8. Effectiveness of Microinvasive Arthroscopic Therapy of Bony Ankle Impingent Symdrome%踝关节镜微创治疗踝关节前方骨性撞击的疗效分析

    Institute of Scientific and Technical Information of China (English)

    陈继铭; 钟环; 陈海聪; 冯柏淋

    2015-01-01

    目的:探讨关节镜在踝关节骨性撞击综合症中的诊治效果。方法收集18例踝关节骨性撞击综合征患者,行关节镜检查及镜下手术,其中男14例,女4例,平均年龄27.6岁(17~55岁)。14例患者有踝关节扭伤史,踝关节疼痛持续时间7~66个月,平均22.5个月。所有患者都有踝关节前方疼痛、关节活动度降低、肿胀、踝关节撞击试验阳性。关节镜下治疗包括清除骨赘、清除疤痕组织和滑膜组织,去除骨软骨碎片,修整损伤的关节软骨面。结果18例患者获5~18个月随访,平均10个月,术后踝关节功能评估根据美国足踝外科协会足踝关节评分系统(AOFAS):优10例;良6例;中2例;优良率88.9%。1例出现足背麻木,1例出现足背动脉损伤。结论踝关节镜是治疗踝关节骨性撞击综合征的有效方法。%Objective To explore the effectiveness of Microinvasive arthroscopy for bony ankle impingement syn-drome. Methods 18 patients with bony ankle impingement syndrome were treated with arthroscopy surgery. Among them, there were 14 males and 4 females with an average age of 27. 6 years(range,16~55 years). Fourteen patients had a history of obvious ankle sprains. The disease duration was 7~66 months(mean,22. 5 months). All cases had ankle pain,limitation of activity,and positive results of ankle impact test. Arthroscopic intervention included removing osteophytes,debriding fabric scars and synovial membrane tissues,and removing osteochondral fragments,mending the damage of articular cartilage surface. Results All patients were followed for 5~18(mean 10. 0) months. The efficacy was evaluated by the American Orthopedic Foot and Ankle Society ( AOFAS) . There were 10 cases in excellent,6 cases in good grade,and 2 cases in medium grade. The excellent and good rate was up to 88. 9%. Among the 18 cases,there were no complications such as postoperative infection, neurologic damage,and injury of blood vessel. One case showed foot

  9. Ankle mechanics during sidestep cutting implicates need for 2-degrees of freedom powered ankle-foot prostheses

    Directory of Open Access Journals (Sweden)

    Evandro M. Ficanha

    2015-04-01

    Full Text Available The ankle joint of currently available powered prostheses is capable of controlling one degree of freedom (DOF, focusing on improved mobility in the sagittal plane. To increase agility, the requirements of turning in prosthesis design need to be considered. Ankle kinematics and kinetics were studied during sidestep cutting and straight walking. There were no significant differences between the ankle sagittal plane mechanics when comparing sidestep cutting and straight walking; however, significant differences were observed in ankle frontal plane mechanics. During straight walking, the inversion-eversion (IE angles were smaller than with sidestep cutting. The ankle that initiated the sidestep cutting showed progressively increasing inversion from 2 to 13 degrees while the following contralateral step showed progressively decreasing inversion from 8 to –4 degrees during normal walking speed. The changes in IE kinematics were the most significant during sidestep cutting compared with straight walking. The IE moments of the step that initiated the sidestep cutting were always in eversion, acting as a braking moment opposing the inverting motion. This suggests that an ankle-foot prosthesis with active DOFs in the sagittal and frontal planes will increase the agility of gait for patients with limb loss.

  10. Ankle pain

    Science.gov (United States)

    Pain - ankle ... Ankle pain is often due to an ankle sprain. An ankle sprain is an injury to the ligaments, which ... the joint. In addition to ankle sprains, ankle pain can be caused by: Damage or swelling of ...

  11. Multimodal pain management after arthroscopic surgery

    DEFF Research Database (Denmark)

    Rasmussen, Sten

    Multimodal Pain Management after Arthroscopic Surgery By Sten Rasmussen, M.D. The thesis is based on four randomized controlled trials. The main hypothesis was that multimodal pain treatment provides faster recovery after arthroscopic surgery. NSAID was tested against placebo after knee arthroscopy...... ankle arthroscopy. Oral NSAID reduced time to work from 17 to 14 days after knee arthroscopy. Intra-articular treatment with bupivacaine plus morphine and bupivacaine plus morphine plus steroid after arthroscopic knee meniscectomy reduced time to work from 10 to 5 to 3 days. Intraarticular treatment...... return to work after knee and ankle arthroscopy with the use of oral NSAIDs combined with bupivacaine plus morphine or combined with bupivacaine, morphine plus steroid....

  12. Arthroscopic microdiskectomy.

    Science.gov (United States)

    Kambin, P

    1991-03-01

    Arthroscopic microdiskectomy through a posterolateral approach has opened a new window of opportunity in the treatment of lumbar disk disorders. Radiographic identification of the triangular working zone has permitted the safe introduction of instruments with an external diameter of 7-8 mm into the intervertebral disk. The technique allows not only evacuation and decompression of contained herniated disks, but also the introduction of instruments for decortication of the vertebral plates and bone grafting for percutaneous interbody fusion. Endoscopic laser nucleolysis, currently under investigation, may also enhance existing technological achievement in the field of minimal-intervention spinal surgery. Arthroscopic microdiskectomy has proven to be safe, effective, and cost efficient. In properly selected patients, satisfactory results of approximately 85% have been realized. PMID:1857361

  13. Ankle Cheilectomy

    Science.gov (United States)

    ... removes a bone spur from the talus or tibia, which are bones of the ankle joint. X- ... Tendon Rupture Surgery Ankle Arthrodesis Ankle Arthroscopy Ankle Fracture Surgery Bulk Allograft Transplantation for Osteochondral Lesions of ...

  14. Ankle Fractures

    Science.gov (United States)

    ... during a car accident Symptoms Because a severe ankle sprain can feel the same as a broken ankle, ... the ligament -- this is also known as high ankle sprain. Depending on how unstable the ankle is, these ...

  15. ANKLE JOINT CONTROL DURING SINGLE-LEGGED BALANCE USING COMMON BALANCE TRAINING DEVICES - IMPLICATIONS FOR REHABILITATION STRATEGIES

    DEFF Research Database (Denmark)

    Strøm, Mark; Thorborg, Kristian; Bandholm, Thomas;

    2016-01-01

    BACKGROUND: A lateral ankle sprain is the most prevalent musculoskeletal injury in sports. Exercises that aim to improve balance are a standard part of the ankle rehabilitation process. In an optimal progression model for ankle rehabilitation and prevention of future ankle sprains, it is importan...

  16. Ankle arthroscopy

    Science.gov (United States)

    ... Failure of repair to heal Weakness of the ankle Injury to tendon, blood vessel, or nerve Before the ... A.M. Editorial team. Related MedlinePlus Health Topics Ankle Injuries and Disorders Endoscopy Browse the Encyclopedia A.D. ...

  17. Iatrogenic posterior tibial nerve division during a combined anterior ankle arthroscopy with an additional posterolateral portal.

    Science.gov (United States)

    Abdul-Jabar, Hani B; Bhamra, Jagmeet; Quick, Tom J; Fox, Michael

    2016-01-01

    Ankle arthroscopy is an important diagnostic and therapeutic technique in the management of ankle disorders. Nowadays ankle arthroscopy provides good to excellent results (up to 90%) in the treatment of certain intra-articular disorders. Due to the superficial location of ankle joint and the abundance of overlying neurovascular structures, complications reported in ankle arthroscopy are greater than those reported in other joints. We present the first reported case of a complete division of the posterior tibial nerve during an anterior ankle arthroscopy combined with an additional posterolateral portal. This was due to a poorly controlled use of the arthroscopic instruments. PMID:27197613

  18. Iatrogenic posterior tibial nerve division during a combined anterior ankle arthroscopy with an additional posterolateral portal

    Science.gov (United States)

    Abdul-Jabar, Hani B; Bhamra, Jagmeet; Quick, Tom J; Fox, Michael

    2016-01-01

    Ankle arthroscopy is an important diagnostic and therapeutic technique in the management of ankle disorders. Nowadays ankle arthroscopy provides good to excellent results (up to 90%) in the treatment of certain intra-articular disorders. Due to the superficial location of ankle joint and the abundance of overlying neurovascular structures, complications reported in ankle arthroscopy are greater than those reported in other joints. We present the first reported case of a complete division of the posterior tibial nerve during an anterior ankle arthroscopy combined with an additional posterolateral portal. This was due to a poorly controlled use of the arthroscopic instruments. PMID:27197613

  19. Arthroscopic subacromial decompression

    OpenAIRE

    Akpinar, Sercan; Demirhan, Mehmet

    2004-01-01

    Arthroscopic subacromial decompression is the arthroscopic equivalent of a standart open procedure. Although technically demanding, it has several advantages to the open procedure. Overall it facilitates early and rapid rehabilitation. The results in stage II and in selected stage III patients are equal or better than those achieved through open surgery. In this study we reviewed the literature with our small case group experience.

  20. ANKLE JOINT CONTROL DURING SINGLE-LEGGED BALANCE USING COMMON BALANCE TRAINING DEVICES - IMPLICATIONS FOR REHABILITATION STRATEGIES

    DEFF Research Database (Denmark)

    Strøm, Mark; Thorborg, Kristian; Bandholm, Thomas;

    2016-01-01

    voluntary contraction (MVC), and in addition amplitude probability distribution function (APDF) between 90 and 10% was calculated as a measure of muscle activation variability. RESULTS: Balancing on BOSU® Ball and wobble board generally resulted in increased ankle kinematic and muscle activity variables......BACKGROUND: A lateral ankle sprain is the most prevalent musculoskeletal injury in sports. Exercises that aim to improve balance are a standard part of the ankle rehabilitation process. In an optimal progression model for ankle rehabilitation and prevention of future ankle sprains, it is important...... to characterize different balance exercises based on level of difficulty and sensori-motor training stimulus. PURPOSE: The purpose of this study was to investigate frontal-plane ankle kinematics and associated peroneal muscle activity during single-legged balance on stable surface (floor) and three...

  1. Arthroscopic Synovectomy for Zone 2 Flexor Hallucis Longus Tenosynovitis

    OpenAIRE

    Lui, Tun Hing

    2015-01-01

    Tenosynovitis of the flexor hallucis longus tendon is a condition typically found in ballet dancers and sometimes in soccer players and is related to chronic overuse. It mostly involves the portion of the tendon behind the ankle joint. However, the portion of the tendon under the sustentaculum tali can also be involved. Open synovectomy requires extensive dissection. We report the technique of arthroscopic synovectomy of the deep portion of the flexor hallucis longus.

  2. Arthroscopic Synovectomy for Zone 2 Flexor Hallucis Longus Tenosynovitis.

    Science.gov (United States)

    Lui, Tun Hing

    2015-10-01

    Tenosynovitis of the flexor hallucis longus tendon is a condition typically found in ballet dancers and sometimes in soccer players and is related to chronic overuse. It mostly involves the portion of the tendon behind the ankle joint. However, the portion of the tendon under the sustentaculum tali can also be involved. Open synovectomy requires extensive dissection. We report the technique of arthroscopic synovectomy of the deep portion of the flexor hallucis longus. PMID:26697294

  3. Ankle sprain (image)

    Science.gov (United States)

    An ankle sprain is a common injury to the ankle. The most common way the ankle is injured is when ... swelling, inflammation, and bruising around the ankle. An ankle sprain injury may take a few weeks to many ...

  4. Chronic Ankle Instability

    Science.gov (United States)

    ... ankle surgeon will ask you about any previous ankle injuries and instability. Then s/he will examine your ankle ... Weak ankles may be a result of previous ankle injuries, but in some cases they are a congenital ( ...

  5. Human distal sciatic nerve fascicular anatomy: Implications for ankle control using nerve-cuff electrodes

    Directory of Open Access Journals (Sweden)

    Kenneth J. Gustafson, PhD

    2012-04-01

    Full Text Available The design of neural prostheses to restore standing balance, prevent foot drop, or provide active propulsion during ambulation requires detailed knowledge of the distal sciatic nerve anatomy. Three complete sciatic nerves and branches were dissected from the piriformis to each muscle entry point to characterize the branching patterns and diameters. Fascicle maps were created from serial sections of each distal terminus below the knee through the anastomosis of the tibial and common fibular nerves above the knee. Similar branching patterns and fascicle maps were observed across specimens. Fascicles innervating primary plantar flexors, dorsiflexors, invertors, and evertors were distinctly separate and functionally organized in the proximal tibial, common fibular, and distal sciatic nerves; however, fascicles from individual muscles were not apparent at these levels. The fascicular organization is conducive to selective stimulation for isolated and/or balanced dorsiflexion, plantar flexion, eversion, and inversion through a single multicontact nerve-cuff electrode. These neuroanatomical data are being used to design nerve-cuff electrodes for selective control of ankle movement and improve current lower-limb neural prostheses.

  6. Sprained Ankles

    Science.gov (United States)

    ... Body I think my child has sprained her ankle. How can I tell for sure? Sprains are injuries to the ligaments that connect bones ... away before the ligament is injured. Types of Sprains In young children, the ankle is the most commonly sprained joint, followed by ...

  7. Ankle replacement

    Science.gov (United States)

    ... Ankle weakness, stiffness, or instability Loosening of the artificial joint over time Skin not healing after surgery Nerve damage Blood vessel damage Bone break during surgery Dislocation of the ...

  8. Ankle replacement

    Science.gov (United States)

    ... to the cut bony surfaces. A special glue/bone cement may be used to hold them in place. A piece of plastic is then inserted between the two metal parts. Screws maybe placed to stabilize your ankle. The surgeon ...

  9. Ankle sprain

    OpenAIRE

    Struijs, Peter AA; Kerkhoffs, Gino MMJ

    2010-01-01

    Injury of the lateral ligament complex of the ankle joint occurs in about one in 10,000 people a day, accounting for a quarter of all sports injuries. Pain may be localised to the lateral side of the ankle.Residual complaints include joint instability, stiffness, and intermittent swelling, and are more likely to occur after more extensive cartilage damage.Recurrent sprains can add new damage and increase the risk of long-term degeneration of the joint.

  10. Arthroscopic treatment of gonarthrosis

    OpenAIRE

    Taser, Omer; Alturfan, Aziz; Pinar, Halit; Gogus, Abdullah

    2004-01-01

    59 cases, who had arthroscopic debridement or arthroscopic abrasion arthroplasty (±drilling) for gonarthrosis between June 1988 and December 1990 were evaluated. Follow-up period was 1 ,5 to 30 months (average 9,2 months) in the debridement group (Group I) and 1, 5 to 24 months (average 7,5 months) in the abrasion arthroplas group (Group II). All patients became subjectively well In the first group (39 patients in total) activity level increased in 30 patients, stayed the same in 6 patients a...

  11. ANKLE JOINT CONTROL DURING SINGLE-LEGGED BALANCE USING COMMON BALANCE TRAINING DEVICES – IMPLICATIONS FOR REHABILITATION STRATEGIES

    Science.gov (United States)

    Strøm, Mark; Thorborg, Kristian; Bandholm, Thomas; Tang, Lars; Zebis, Mette; Nielsen, Kristian

    2016-01-01

    ABSTRACT Background A lateral ankle sprain is the most prevalent musculoskeletal injury in sports. Exercises that aim to improve balance are a standard part of the ankle rehabilitation process. In an optimal progression model for ankle rehabilitation and prevention of future ankle sprains, it is important to characterize different balance exercises based on level of difficulty and sensori-motor training stimulus. Purpose The purpose of this study was to investigate frontal-plane ankle kinematics and associated peroneal muscle activity during single-legged balance on stable surface (floor) and three commonly used balance devices (Airex®, BOSU® Ball and wobble board). Design Descriptive exploratory laboratory study. Methods Nineteen healthy subjects performed single-legged balance with eyes open on an Airex® mat, BOSU® Ball, wobble board, and floor (reference condition). Ankle kinematics were measured using reflective markers and 3-dimensional recordings and expressed as inversion-eversion range of motion variability, peak velocity of inversion and number of inversion-eversion direction changes. Peroneus longus EMG activity was averaged and normalized to maximal activity during maximum voluntary contraction (MVC), and in addition amplitude probability distribution function (APDF) between 90 and 10% was calculated as a measure of muscle activation variability. Results Balancing on BOSU® Ball and wobble board generally resulted in increased ankle kinematic and muscle activity variables, compared to the other surfaces. BOSU® Ball was the most challenging in terms of inversion-eversion variability while wobble board was associated with a higher number of inversion-eversion direction changes. No differences in average muscle activation level were found between these two surfaces, but the BOSU® Ball did show a more variable activation pattern in terms of APDF. Conclusion The results showed large kinematic variability among different balance training devices and

  12. ANKLE JOINT CONTROL DURING SINGLE-LEGGED BALANCE USING COMMON BALANCE TRAINING DEVICES - IMPLICATIONS FOR REHABILITATION STRATEGIES

    DEFF Research Database (Denmark)

    Strøm, Mark; Thorborg, Kristian; Bandholm, Thomas;

    2016-01-01

    to characterize different balance exercises based on level of difficulty and sensori-motor training stimulus. PURPOSE: The purpose of this study was to investigate frontal-plane ankle kinematics and associated peroneal muscle activity during single-legged balance on stable surface (floor) and three...... commonly used balance devices (Airex®, BOSU® Ball and wobble board). DESIGN: Descriptive exploratory laboratory study. METHODS: Nineteen healthy subjects performed single-legged balance with eyes open on an Airex® mat, BOSU® Ball, wobble board, and floor (reference condition). Ankle kinematics were...... voluntary contraction (MVC), and in addition amplitude probability distribution function (APDF) between 90 and 10% was calculated as a measure of muscle activation variability. RESULTS: Balancing on BOSU® Ball and wobble board generally resulted in increased ankle kinematic and muscle activity variables...

  13. Arthroscopic tibiotalar and subtalar joint arthrodesis.

    Science.gov (United States)

    Roussignol, X

    2016-02-01

    Arthroscopy has become indispensable for performing tibiotalar and subtalar arthrodesis. Now in 2015, it is the gold-standard surgical technique, and open surgery is reserved only for cases in which arthroscopy is contraindicated: material ablation after consolidation failure, osteophytes precluding a work chamber, excentric talus, severe malunion, bone defect requiring grafting, associated midfoot deformity, etc. The first reports of arthroscopic tibiotalar and subtalar arthrodesis date from the early 1990s. Consolidation rates were comparable to open surgery, but with significantly fewer postoperative complications: infection, skin necrosis, etc. Arthroscopy was for many years reserved to moderate deformity, with frontal or sagittal deviation less than 10°. The recent literature, however, seems to extend indications, the only restriction being the surgeon's experience. Tibiotalar arthrodesis on a posterior arthroscopic approach remains little used. And yet the posterior work chamber is much larger, and initial series showed consolidation rates similar to those of an anterior approach. The surgical technique for posterior tibiotalar arthrodesis was described by Van Dijk et al., initially using a posterior para-Achilles approach. This may be hampered by posterior osteophytes or ankylosis of the subtalar joint line (revision of non-consolidated arthrodesis, sequelae of calcaneal thalamus fracture) and is now used only by foot and ankle specialists. Posterior double tibiotalar-subtalar arthrodesis, described by Devos Bevernage et al., is facilitated by transplantar calcaneo-talo-tibial intramedullary nailing. PMID:26797006

  14. Arthroscopic partial medial meniscectomy

    Directory of Open Access Journals (Sweden)

    Dašić Žarko

    2011-01-01

    Full Text Available Background/Aim. Meniscal injuries are common in professional or recreational sports as well as in daily activities. If meniscal lesions lead to physical impairment they usually require surgical treatment. Arthroscopic treatment of meniscal injuries is one of the most often performed orthopedic operative procedures. Methods. The study analyzed the results of arthroscopic partial medial meniscectomy in 213 patients in a 24-month period, from 2006, to 2008. Results. In our series of arthroscopically treated medial meniscus tears we noted 78 (36.62% vertical complete bucket handle lesions, 19 (8.92% vertical incomplete lesions, 18 (8.45% longitudinal tears, 35 (16.43% oblique tears, 18 (8.45% complex degenerative lesions, 17 (7.98% radial lesions and 28 (13.14% horisontal lesions. Mean preoperative International Knee Documentation Committee (IKDC score was 49.81%, 1 month after the arthroscopic partial medial meniscectomy the mean IKDC score was 84.08%, and 6 months after mean IKDC score was 90.36%. Six months after the procedure 197 (92.49% of patients had good or excellent subjective postoperative clinical outcomes, while 14 (6.57% patients subjectively did not notice a significant improvement after the intervention, and 2 (0.93% patients had no subjective improvement after the partial medial meniscectomy at all. Conclusion. Arthroscopic partial medial meniscetomy is minimally invasive diagnostic and therapeutic procedure and in well selected cases is a method of choice for treatment of medial meniscus injuries when repair techniques are not a viable option. It has small rate of complications, low morbidity and fast rehabilitation.

  15. Ankle clonus

    OpenAIRE

    Fareedy, Shoaib Bilal; Pathak, Ranjan

    2015-01-01

    Key Clinical Message Clonus is a series of involuntary, rhythmic, muscular contractions, and relaxations. It may be caused by interruption of the upper motor neuron fibers such as stroke, multiple sclerosis, or by metabolic alterations such as severe hepatic failure or serotonin syndrome. We present a video case of impressive left ankle clonus in a patient with old right middle cerebral artery stroke.

  16. Magnetic resonance imaging findings in anterolateral impingement of the ankle

    International Nuclear Information System (INIS)

    Objective. To demonstrate the MR imaging findings of anterolateral impingement (ALI) of the ankle.Design and patients. Nine patients with a history of ankle inversion injury and chronic lateral ankle pain were imaged with MR imaging, and the findings correlated with the results of arthroscopy. Three additional patients with clinically suspected ALI of the ankle were also included. Ankle MR imaging studies from 20 control patients in whom ALI was not suspected clinically were examined for similar findings to the patient group.Results. MR imaging findings in the patients with ALI included a soft tissue signal mass in the anterolateral gutter of the ankle in 12 of 12 (100%) cases, corresponding to the synovial hypertrophy and soft tissue mass found at arthroscopy in the nine patients who underwent arthroscopy. Disruption, attenuation, or marked thickening of the anterior talofibular ligament was seen in all cases. Additional findings included signs of synovial hypertrophy elsewhere in the tibiotalar joint in seven of 12 patients (58%) and bony and cartilaginous injuries to the tibiotalar joint in five of 12 (42%). None of the control patients demonstrated MR imaging evidence of a soft tissue mass in the anterolateral gutter.Conclusions. ALI of the ankle is a common cause for chronic lateral ankle pain. It has been well described in the orthopedic literature but its imaging findings have not been clearly elucidated. The MR imaging findings, along with the appropriate clinical history, can be used to direct arthroscopic examination and subsequent debridement. (orig.)

  17. Magnetic resonance imaging findings in anterolateral impingement of the ankle

    Energy Technology Data Exchange (ETDEWEB)

    Jordan, L.K. III.; Cooperman, A.E. [Department of Radiology, Duke University Medical Center, Durham, NC (United States); Helms, C.A. [Department of Radiology, Duke University Medical Center, Durham, NC (United States); Duke University Medical Center, Durham, NC (United States); Speer, K.P. [Division of Orthopaedic Surgery, Duke University Medical Center, Durham, NC (United States)

    2000-01-01

    Objective. To demonstrate the MR imaging findings of anterolateral impingement (ALI) of the ankle.Design and patients. Nine patients with a history of ankle inversion injury and chronic lateral ankle pain were imaged with MR imaging, and the findings correlated with the results of arthroscopy. Three additional patients with clinically suspected ALI of the ankle were also included. Ankle MR imaging studies from 20 control patients in whom ALI was not suspected clinically were examined for similar findings to the patient group.Results. MR imaging findings in the patients with ALI included a soft tissue signal mass in the anterolateral gutter of the ankle in 12 of 12 (100%) cases, corresponding to the synovial hypertrophy and soft tissue mass found at arthroscopy in the nine patients who underwent arthroscopy. Disruption, attenuation, or marked thickening of the anterior talofibular ligament was seen in all cases. Additional findings included signs of synovial hypertrophy elsewhere in the tibiotalar joint in seven of 12 patients (58%) and bony and cartilaginous injuries to the tibiotalar joint in five of 12 (42%). None of the control patients demonstrated MR imaging evidence of a soft tissue mass in the anterolateral gutter.Conclusions. ALI of the ankle is a common cause for chronic lateral ankle pain. It has been well described in the orthopedic literature but its imaging findings have not been clearly elucidated. The MR imaging findings, along with the appropriate clinical history, can be used to direct arthroscopic examination and subsequent debridement. (orig.)

  18. Long Term Follow up Results of the Arthroscopic Treatment of the Talus Osteochondral Lesions (Tol) and the Factors that Effect Results

    OpenAIRE

    Gökkuş, Kemal; Aydın, Ahmet Turan

    2014-01-01

    Objectives: The arthroscopic debritment, curettage and multidrilling /microfracture is well known and established method of treatment. However the factors that effect prognosis is still controversy at recent literature. The aim of this study is to present and evaluate the factors that effects the long term follow up results of our patients. Methods: 56 patients who admitted to our clinic with chronic ankle pain and diagnosed as TOL treated with arthroscopic debritement, curettage and multidri...

  19. Ankle and subtalar synovitis in a ball-and-socket ankle joint causing posterolateral painful coarse crepitus: a case report.

    Science.gov (United States)

    Fan, Ka Yuk; Lui, Tun Hing

    2014-01-01

    A 17-year-old girl with bilateral ball-and-socket ankles reported left medial heel pain. Her left heel had gone into a varus position on tiptoeing, and a painful clunk had occurred when returning to normal standing. The clunk persisted after physiotherapy and treatment with an orthosis. Subtalar arthroscopy and peroneal tendoscopy showed mild diffuse synovitis of the ankle joint, especially over the posterior capsule, and a patch of inflamed and fibrotic synovium at the posterolateral corner of the subtalar joint. The clunk subsided immediately after arthroscopic synovectomy and had not recurred during 5 years of follow-up. We found no other reported cases of ankle and subtalar synovitis occurring in patients with a ball-and-socket ankle joint. PMID:25179452

  20. Ankle sprain - aftercare

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000574.htm Ankle sprain - aftercare To use the sharing features on this ... help them move in the right ways. An ankle sprain occurs when the ligaments in your ankle are ...

  1. THE VALUE OF THE ARTHROSCOPY IN ACUTE AND CHRONIC ANKLE INJURY

    Directory of Open Access Journals (Sweden)

    B. Voicu

    2010-02-01

    Full Text Available This paper wants to demonstrate the value of the arthroscopy in the diagnosis and treatment of the ankle sprain and cronic ankle instability. Between January 2005 and March 2009, there were studied 25 patients, to whom there was made ankle arthroscopy with the purpose to diagnose and the treatment. The mean age was 26 years, with a range from 19 to 42 years, 19 from them were men and 6 women. The final evaluation was made to 23 patient, with a medium six month follow-up. The functional results after arthroscopy were evaluate using Mc Cullough Score. In 78% of cases the pain disapeared significantly. There was made in all cases debridation with shaver, in 12 cases microabrasive chondroplasty and in 7 cases ligamentoplasty of the anterior talofibular ligament and/or deltoid ligament. In 76% there was, at least an associated, „hiden”, lesion, wich need also arthroscopic treatment. We have one complication (4,3% represented by a superficial chondral lesion, wich was treated by microabrasive chondroplasty. There were any neurological, vascular or other complications. The results show us that ankle arthroscopy remain a certain, mini-invazive method to diagnose and for the treatment of the ankle lesions. Arthroscopic ligamentoplasty of the ankle is still in confirmation. Arthrocopy is the main procedure for treating the impingement syndrom of the ankle and osteochondral lesion – injury that are frecventely associated with chronic ankle instability.

  2. Use of an Irrigation Pump System in Arthroscopic Procedures.

    Science.gov (United States)

    Hsiao, Mark S; Kusnezov, Nicholas; Sieg, Ryan N; Owens, Brett D; Herzog, Joshua P

    2016-05-01

    Since its inception, arthroscopic surgery has become widely adopted among orthopedic surgeons. It is therefore important to have an understanding of the basic principles of arthroscopy. Compared with open techniques, arthroscopic procedures are associated with smaller incisions, less structural damage, improved intra-articular visualization, less pain in the immediate postoperative period, and faster recovery for patients. Pump systems used for arthroscopic surgery have evolved over the years to provide improved intraoperative visualization. Gravity flow systems were described first and are still commonly used today. More recently, automated pump systems with pressure or dual pressure and volume control have been developed. The advantages of automated irrigation systems over gravity irrigation include a more consistent flow, a greater degree of joint distention, improved visualization especially with motorized instrumentation, decreased need for tourniquet use, a tamponade effect on bleeding, and decreased operative time. Disadvantages include the need for additional equipment with increased cost and maintenance, the initial learning curve for the surgical team, and increased risk of extra-articular fluid dissection and associated complications such as compartment syndrome. As image quality and pump systems improve, so does the list of indications including diagnostic and treatment modalities to address intra-articular pathology of the knee, shoulder, hip, wrist, elbow, and ankle joints. This article reviews the current literature and presents the history of arthroscopy, basic science of pressure and flow, types of irrigation pumps and their functions, settings, applications, and complications. [Orthopedics. 2016; 39(3):e474-e478.]. PMID:27135450

  3. A Review of Arthroscopic Bone Marrow Stimulation Techniques of the Talus

    OpenAIRE

    Murawski, Christopher D.; Foo, Li Foong; Kennedy, John G

    2010-01-01

    Osteochondral lesions of the talus are common injuries following acute and chronic ankle sprains. Numerous surgical treatment strategies have been employed for treating these lesions; arthroscopic bone marrow stimulation is recognized as the first-line technique to provide fibrocartilage infill of the defect site. While the short- and medium-term outcomes of this technique are good, the long-term outcomes are not yet known. An increasing number of studies, however, show a cause for concern in...

  4. Arthroscopic Release of Flexor Hallucis Longus Tendon Sheath in Female Ballet Dancers: Dynamic Pathology, Surgical Technique, and Return to Dancing Performance

    OpenAIRE

    Funasaki, Hiroki; Hayashi, Hiroteru; Sakamoto, Kanako; Tsuruga, Rei; Marumo, Keishi

    2015-01-01

    Stenosing tenosynovitis of the flexor hallucis longus (FHL) tendon is known as a major overuse lesion in female dancers. We describe arthroscopic surgical techniques in relation to the dynamic pathology of the disease. Crepitus and pain on moving the great toe with the ankle in plantar flexion on preoperative examination confirm the diagnosis of FHL stenosing tenosynovitis even if the os trigonum is not evident. The ankle is approached through standard posterolateral and posteromedial portals...

  5. Ngram time series model to predict activity type and energy cost from wrist, hip and ankle accelerometers: implications of age

    Science.gov (United States)

    Strath, Scott J; Kate, Rohit J; Keenan, Kevin G; Welch, Whitney A; Swartz, Ann M

    2016-01-01

    To develop and test time series single site and multi-site placement models, we used wrist, hip and ankle processed accelerometer data to estimate energy cost and type of physical activity in adults. Ninety-nine subjects in three age groups (18–39, 40–64, 65 + years) performed 11 activities while wearing three triaxial accelereometers: one each on the non-dominant wrist, hip, and ankle. During each activity net oxygen cost (METs) was assessed. The time series of accelerometer signals were represented in terms of uniformly discretized values called bins. Support Vector Machine was used for activity classification with bins and every pair of bins used as features. Bagged decision tree regression was used for net metabolic cost prediction. To evaluate model performance we employed the jackknife leave-one-out cross validation method. Single accelerometer and multi-accelerometer site model estimates across and within age group revealed similar accuracy, with a bias range of −0.03 to 0.01 METs, bias percent of −0.8 to 0.3%, and a rMSE range of 0.81–1.04 METs. Multi-site accelerometer location models improved activity type classification over single site location models from a low of 69.3% to a maximum of 92.8% accuracy. For each accelerometer site location model, or combined site location model, percent accuracy classification decreased as a function of age group, or when young age groups models were generalized to older age groups. Specific age group models on average performed better than when all age groups were combined. A time series computation show promising results for predicting energy cost and activity type. Differences in prediction across age group, a lack of generalizability across age groups, and that age group specific models perform better than when all ages are combined needs to be considered as analytic calibration procedures to detect energy cost and type are further developed. PMID:26449155

  6. Ngram time series model to predict activity type and energy cost from wrist, hip and ankle accelerometers: implications of age.

    Science.gov (United States)

    Strath, Scott J; Kate, Rohit J; Keenan, Kevin G; Welch, Whitney A; Swartz, Ann M

    2015-11-01

    To develop and test time series single site and multi-site placement models, we used wrist, hip and ankle processed accelerometer data to estimate energy cost and type of physical activity in adults. Ninety-nine subjects in three age groups (18-39, 40-64, 65 +  years) performed 11 activities while wearing three triaxial accelereometers: one each on the non-dominant wrist, hip, and ankle. During each activity net oxygen cost (METs) was assessed. The time series of accelerometer signals were represented in terms of uniformly discretized values called bins. Support Vector Machine was used for activity classification with bins and every pair of bins used as features. Bagged decision tree regression was used for net metabolic cost prediction. To evaluate model performance we employed the jackknife leave-one-out cross validation method. Single accelerometer and multi-accelerometer site model estimates across and within age group revealed similar accuracy, with a bias range of -0.03 to 0.01 METs, bias percent of -0.8 to 0.3%, and a rMSE range of 0.81-1.04 METs. Multi-site accelerometer location models improved activity type classification over single site location models from a low of 69.3% to a maximum of 92.8% accuracy. For each accelerometer site location model, or combined site location model, percent accuracy classification decreased as a function of age group, or when young age groups models were generalized to older age groups. Specific age group models on average performed better than when all age groups were combined. A time series computation show promising results for predicting energy cost and activity type. Differences in prediction across age group, a lack of generalizability across age groups, and that age group specific models perform better than when all ages are combined needs to be considered as analytic calibration procedures to detect energy cost and type are further developed. PMID:26449155

  7. Arthroscopic hip labral repair.

    Science.gov (United States)

    Philippon, Marc J; Faucet, Scott C; Briggs, Karen K

    2013-05-01

    Labral tears in the hip may cause painful clicking or locking of the hip, reduced range of motion, and disruption to sports and daily activities. The acetabular labrum aids stabilization of the hip joint, particularly during hip motion. The fibrocartilaginous structure extends the acetabular rim and provides a suction seal around the femoroacetabular interface. Treatment options for labral tears include debridement, repair, and reconstruction. Repair of the labrum has been shown to have better results than debridement. Labral refixation is achieved with sutures anchored into the acetabular rim. The acetabular rim is trimmed either to correct pincer impingement or to provide a bleeding bed to improve healing. Labral repair has shown excellent short-term to midterm outcomes and allows patients to return to activities and sports. Arthroscopic rim trimming and labral refixation comprise an effective treatment for labral tears with an underlying diagnosis of femoroacetabular impingement and are supported by the peer-reviewed literature. PMID:23875153

  8. Differences in injury pattern and prevalence of cartilage lesions in knee and ankle joints: a retrospective cohort study

    OpenAIRE

    Matthias Aurich; Hofmann, Gunther O; Bernd Rolauffs; Florian Gras

    2014-01-01

    Osteoarthritis (OA) is more common in the knee compared to the ankle joint. This can not be explained exclusively by anatomical and biomechanical differences. The aim of this study is to analyze and compare the injury pattern (clinically) and the cartilage lesions (arthroscopically) of knee and ankle joints in a cohort of patients from the same catchment area. A retrospective study of the clinical data of 3122 patients (2139 outpatients and 983 inpatients) was performed, who were treated due ...

  9. 21 CFR 888.1100 - Arthroscope.

    Science.gov (United States)

    2010-04-01

    ... ORTHOPEDIC DEVICES Diagnostic Devices § 888.1100 Arthroscope. (a) Identification. An arthroscope is an... accessories also is intended to perform surgery within a joint. (b) Classification. (1) Class II...

  10. Arthroscopic treatment for osteochondral lesions of the talus: analysis of outcome predictors

    Institute of Scientific and Technical Information of China (English)

    GUO Qin-wei; HU Yue-lin; JIAO Chen; YU Chang-long; AO Ying-fang

    2010-01-01

    Background Compared with traditional arthrotomy procedures, arthroscopic treatment for osteochondral lesions of the talus has some advantages. However, there has been considerable debate about the outcome predictors for this surgical technique. This study aimed to investigate the outcomes of arthroscopic treatment for osteochondral lesions of the talus, and analyze its outcome predictors.Methods Clinical data of 48 patients with osteochondral lesions of the talus who underwent ankle arthroscopy were studied. Arthroscopic debridement was performed on all patients, and microfracture was also performed in 36 cases. Scores on a subjective satisfaction questionnaire, visual analog scale (VAS) for pain, and the American Orthopedic Foot & Ankle Society (AOFAS) ankle and hindfoot scores were obtained before and after surgery.Results Five patients lost to follow up. The other forty-three patients, 8 of whom were athletes, were followed up for an average of 23.9 months. The average AOFAS post-operative score was 90.16±9.96, compared with 70.81±6.96 before surgery (t=9.353, P <0.001). The VAS pain score after the operation (2.51±9.45) was significantly lower than that before the operation (6.95±1.40) (t=8.647, P<0.001). Of the 43 patients, 35 (81.4%) had good or excellent results. There was no significant difference in outcome between the medial and lateral groups (z=0.205, P=0.838), while a better outcome was found with lesions smaller than 10 mm than those with larger lesions (z=2.199, P=0.028). Age, sex, athletic profession and location of the lesion did not significantly correlate with outcomes.Conclusions Arthroscopic treatment is effective and safe for osteochondral lesions of the talus. A strong correlation was found between the size of the lesion and successful outcome.

  11. Ankle Sprain Treatment

    Science.gov (United States)

    ... Ankle Sprain Treatment Page Content Article Body Acute ankle and foot injuries are common in athletes and other active young ... Phase I treatment involves resting and protecting the ankle to permit healing, to prevent further injury, and to control pain and swelling. Rest, protection ( ...

  12. Assessment of Ankle Injuries

    Science.gov (United States)

    Mai, Nicholas; Cooper, Leslie

    2009-01-01

    School nurses are faced with the challenge of identifying and treating ankle injuries in the school setting. There is little information guiding the assessment and treatment of these children when an injury occurs. It is essential for school nurses to understand ankle anatomy, pathophysiology of the acute ankle injury, general and orthopedic…

  13. Ottawa ankle rules.

    OpenAIRE

    Stiell, I.

    1996-01-01

    The Ottawa ankle rule project demonstrated that more than 95% of patients with ankle injuries had radiographic examinations but that 85% of the films showed no fractures. A group of Ottawa emergency physicians developed two rules to identify clinically important fractures of the malleoli and the midfoot. Use of these rules reduced radiographic examinations by 28% for the ankle and 14% for the foot.

  14. Total ankle joint replacement.

    Science.gov (United States)

    2016-02-01

    Ankle arthritis results in a stiff and painful ankle and can be a major cause of disability. For people with end-stage ankle arthritis, arthrodesis (ankle fusion) is effective at reducing pain in the shorter term, but results in a fixed joint, and over time the loss of mobility places stress on other joints in the foot that may lead to arthritis, pain and dysfunction. Another option is to perform a total ankle joint replacement, with the aim of giving the patient a mobile and pain-free ankle. In this article we review the efficacy of this procedure, including how it compares to ankle arthrodesis, and consider the indications and complications. PMID:26868932

  15. Fiber-optics couple arthroscope to TV

    Science.gov (United States)

    Franke, J. M.; Rhodes, D. B.

    1981-01-01

    Convenient, hand-held coupler images output of arthroscope onto coherent fiber bundle. Arthroscope allows surgeons to examine internal organs through any small opening in body. Coupler is also used for engine inspection, instrument repair, and around-corner visual inspection. Image from arthroscope travels along flexible bundle and appears at other cable end where it is recollimated by lens. Image is read from lens or projected on color TV camera.

  16. Foot, leg, and ankle swelling

    Science.gov (United States)

    Swelling of the ankles - feet - legs; Ankle swelling; Foot swelling; Leg swelling; Edema - peripheral; Peripheral edema ... Foot, leg, and ankle swelling is common when the person also: Is overweight Has a blood clot ...

  17. How to Tape an Ankle

    Science.gov (United States)

    ... to Tape a Toe How to Stretch Your Ankle After A Sprain How to Strengthen Your Ankle After a Sprain How to Prepare for Orthopaedic Foot or Ankle Surgery: Part III How to Prepare for Orthopaedic ...

  18. Ankle Sprains. A Round Table.

    Science.gov (United States)

    Physician and Sportsmedicine, 1986

    1986-01-01

    Types of ankle sprains, surgical versus nonsurgical treatment, tape versus brace for support, rehabilitation, exercise, and prevention of ankle sprains are discussed by a panel of experts. An acute ankle taping technique is illustrated. (MT)

  19. Anterior Tibial Artery Pseudoaneurysm following Ankle Arthroscopy in a Hemophiliac Patient.

    Science.gov (United States)

    Chamseddin, Khalil H; Kirkwood, Melissa L

    2016-07-01

    Arthroscopy of the foot and ankle is a common orthopedic procedure with low complication rates. Arterial injuries from these procedures are an even more rare subset of the complications. Hemophilia A is a genetic disorder of aberrant coagulation, which leads to increased risk of bleeding even after minor trauma. We present the second case of anterior tibial artery pseudoaneurysm formation secondary to ankle arthroscopy in a hemophiliac patient and suggest that these individuals are at higher risk for developing complications associated with arterial injury. Furthermore, potential risk factors include port placement, anatomic variation of the vessels, and nature of the arthroscopic procedure. We recommend steps to prevent complications in hemophiliac patients. PMID:27174350

  20. Arthroscopic surgery for degenerative knee

    DEFF Research Database (Denmark)

    Thorlund, J B; Juhl, C B; Roos, E M;

    2015-01-01

    OBJECTIVE: To determine benefits and harms of arthroscopic knee surgery involving partial meniscectomy, debridement, or both for middle aged or older patients with knee pain and degenerative knee disease. DESIGN: Systematic review and meta-analysis. MAIN OUTCOME MEASURES: Pain and physical function....... DATA SOURCES: Systematic searches for benefits and harms were carried out in Medline, Embase, CINAHL, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL) up to August 2014. Only studies published in 2000 or later were included for harms. ELIGIBILITY CRITERIA FOR SELECTING...... STUDIES: Randomised controlled trials assessing benefit of arthroscopic surgery involving partial meniscectomy, debridement, or both for patients with or without radiographic signs of osteoarthritis were included. For harms, cohort studies, register based studies, and case series were also allowed...

  1. Arthroscopic findings after shoulder dislocation

    OpenAIRE

    Medenica Ivica; Radunović Aleksandar; Madžarac Dragan; Zorić Miodrag; Bokonjić Dubravko; Stojković Bratislav

    2009-01-01

    Background/Aim. Recurrent instability of the shoulder joint is frequently difficult to differentiate from diseased or injured rotator cuff or tendon of the forearm flexor (m. biceps brachii). Shoulder joint arthroscopy has been only recently introduced into instable shoulder joint lesion examination. The aim of this study was to present and analyze an arthroscopic finding on instable shoulder joint in order to determine causes and mechanisms of instability, as well as principles of surgical t...

  2. The foot and ankle

    International Nuclear Information System (INIS)

    Imaging of the foot and ankle can be difficult because of the complex anatomy. Familiarity with the bony and ligamentous anatomy is essential for proper evaluation of radiographic findings. Therefore, pertinent anatomy is discussed as it applies to specific injuries. Special views, tomography, arthrography, and other techniques may be indicated for complete evaluation of foot and ankle trauma

  3. Ankle sprain - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100209.htm Ankle sprain - Series To use the sharing features on this page, please enable JavaScript. Go to slide 1 out of 4 Go to slide 2 ... 4 out of 4 Normal anatomy Overview The ankle joint connects the foot with the leg. The ...

  4. Update on anterior ankle impingement

    OpenAIRE

    Vaseenon, Tanawat; Amendola, Annunziato

    2012-01-01

    Anterior ankle impingement results from an impingement of the ankle joint by a soft tissue or osteophyte formation at the anterior aspect of the distal tibia and talar neck. It often occurs secondary to direct trauma (impaction force) or repetitive ankle dorsiflexion (repetitive impaction and traction force). Chronic ankle pain, swelling, and limitation of ankle dorsiflexion are common complaints. Imaging is valuable for diagnosis of the bony impingement but not for the soft tissue impingemen...

  5. Arthrography of the ankle

    International Nuclear Information System (INIS)

    As part of a clinical prospective investigation 102 patients with fresh ankle injuries underwent ankle arthrography and surgery for rupture of the lateral ligaments of the ankle. Three hypotheses concerning the improvement of the arthrographic diagnosis of rupture of the calcaneofibular ligament were tested. Two were rejected. Improvement in the diagnostic specificity was possible by combining arthrography with a stress inversion test, but the sensitivity of this combination was low. It was demonstrated that absence of peroneus sheath filling was a better diagnostic sign with good rather than with poor recess filling. (Auth.)

  6. Arthrography of the ankle

    International Nuclear Information System (INIS)

    The contribution of artrography in the diagnosis of acute ligaments injuries of the ankle is discussed. The technique of examination is described. An anatomic review, diagnostic elements and the proceeding are presented emphasizing the lateral ligaments. (M.A.C.)

  7. Ankle fracture - aftercare

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000548.htm Ankle fracture - aftercare To use the sharing features on this ... Sit with your foot elevated higher than your knee at least 4 times a day Apply an ...

  8. Ankle injuries in basketball players.

    Science.gov (United States)

    Leanderson, J; Nemeth, G; Eriksson, E

    1993-01-01

    We carried out a retrospective study of the frequency of ankle sprains in basketball players. A questionnaire about previous ankle injuries, time off after such injuries, current ankle problems, personal data, number of practice hours and the use of prophylactic measures was sent out to 102 basketball players in a second division league in Sweden. Ninety-six players answered. 92% of them had suffered an ankle sprain while playing basketball, and of these 83% reported repeated sprains of one ankle. In the last two seasons, 78% of the players had injured at least one ankle. The injury frequency in the investigation was 5.5 ankle injuries per 1000 activity hours. 22% of the players used some kind of prophylactic support of their ankle joints. Because of the great number of ankle sprains and the disability in terms of time away from sports that they cause, prevention of these injuries is essential. PMID:8536029

  9. What Is a Foot and Ankle Surgeon?

    Science.gov (United States)

    ... Foot & Ankle Surgeon? A A A | Print | Share What is a Foot & Ankle Surgeon? Foot and ankle ... of conditions that affect people of every age. What education has a foot and ankle surgeon received? ...

  10. Ankle ligament injuries

    Directory of Open Access Journals (Sweden)

    Per A.F.H. Renström

    1998-06-01

    Full Text Available Acute ankle ligament sprains are common injuries. The majority of these occur during athletic participation in the 15 to 35 year age range. Despite the frequency of the injury, diagnostic and treatment protocols have varied greatly. Lateral ligament complex injuries are by far the most common of the ankle sprains. Lateral ligament injuries typically occur during plantar flexion and inversion, which is the position of maximum stress on the anterotalofibular liagment (ATFL. For this reason, the ATFL is the most commonly torn ligament during an inversion injury. In more severe inversion injuries the calcaneofibular (CFL, posterotalofibular (PTFL and subtalar ligament can also be injured. Most acute lateral ankle ligament injuries recover quickly with nonoperative management. The treatment program, called "functional treatment," includes application of the RICE principle (rest, ice, compression, and elevation immediately after the injury, a short period of immobilization and protection with an elastic or inelastic tape or bandage, and early motion exercises followed by early weight bearing and neuromuscular ankle training. Proprioceptive training with a tilt board is commenced as soon as possible, usually after 3 to 4 weeks. The purpose is to improve the balance and neuromuscular control of the ankle. Sequelae after ankle ligament injuries are very common. As much as 10% to 30% of patients with a lateral ligament injury may have chronic symptoms. Symptoms usually include persistent synovitis or tendinitis, ankle stiffness, swelling, and pain, muscle weakness, and frequent giving-way. A well designed physical therapy program with peroneal strengthening and proprioceptive training, along with bracing and/or taping can alleviate instability problems in most patients. For cases of chronic instability that are refractory to bracing and external support, surgical treatment can be explored. If the chronic instability is associated with subtalar instability

  11. Discoid lateral meniscus and its arthroscopic treatment

    OpenAIRE

    Asik, Mehmet; Sen, Cengiz; Dikici, Fatih; Sozen, Yunus V.; Taser, Omer F.; Alturfan, Aziz

    2004-01-01

    Objectives: We evaluated the results of arthroscopic meniscectomy in patients with lateral discoid menisci of the knee. Methods: Lateral discoid menisci were documented in 274 patients, of whom 183 patients (110 males, 73 females; mean age 34.8 years; range 6-67 years) were clinically and arthroscopically found to be symptomatic and underwent total, subtotal, or partial meniscectomy. The most common complaints were pain, lurch, feeling of giving way, locking, limited extension, and marked ...

  12. Pulsed electromagnetic fields after arthroscopic treatment for osteochondral defects of the talus: double-blind randomized controlled multicenter trial

    Directory of Open Access Journals (Sweden)

    Krips Rover

    2009-07-01

    Full Text Available Abstract Background Osteochondral talar defects usually affect athletic patients. The primary surgical treatment consists of arthroscopic debridement and microfracturing. Although this is mostly successful, early sport resumption is difficult to achieve, and it can take up to one year to obtain clinical improvement. Pulsed electromagnetic fields (PEMFs may be effective for talar defects after arthroscopic treatment by promoting tissue healing, suppressing inflammation, and relieving pain. We hypothesize that PEMF-treatment compared to sham-treatment after arthroscopy will lead to earlier resumption of sports, and aim at 25% increase in patients that resume sports. Methods/Design A prospective, double-blind, randomized, placebo-controlled trial (RCT will be conducted in five centers throughout the Netherlands and Belgium. 68 patients will be randomized to either active PEMF-treatment or sham-treatment for 60 days, four hours daily. They will be followed-up for one year. The combined primary outcome measures are (a the percentage of patients that resume and maintain sports, and (b the time to resumption of sports, defined by the Ankle Activity Score. Secondary outcome measures include resumption of work, subjective and objective scoring systems (American Orthopaedic Foot and Ankle Society – Ankle-Hindfoot Scale, Foot Ankle Outcome Score, Numeric Rating Scales of pain and satisfaction, EuroQol-5D, and computed tomography. Time to resumption of sports will be analyzed using Kaplan-Meier curves and log-rank tests. Discussion This trial will provide level-1 evidence on the effectiveness of PEMFs in the management of osteochondral ankle lesions after arthroscopy. Trial registration Netherlands Trial Register (NTR1636

  13. Arthroscopic intralesional curettage for large benign talar dome cysts

    Directory of Open Access Journals (Sweden)

    El Shazly Ossama

    2015-01-01

    Full Text Available Introduction: Surgical management of large talar dome cysts is challenging due to increased morbidity by associated cartilage damage and malleolar osteotomy. The purpose of this study is to evaluate the clinical and radiological outcome of endoscopic curettage and bone graft for large talar dome cysts. Methods: This is a retrospective analysis of data for eight patients (eight feet who were treated by arthroscopic curettage and grafting for large talar dome cysts. Seven cases were treated by posterior ankle arthroscopy as the lesion was located posteriorly while one case was treated by anterior ankle arthroscopy as the lesion was breached anteriorly. Results: The final diagnosis, was; large osteochondral lesion of talus (two cases, aneurysmal bone cyst (ABC (two case, intra-osseous ganglion (two cases, Chronic infection in talus (one case and angiomatous lesion of the talus (one case. The mean follow up period was 18.3 (±3.06 SD months (range 16–25 months. The median preoperative AOFAS score was 74.5 (±5.34 SD points. The mean postoperative AOFAS score at one year follow up was 94.6 (±2.97 SD points. None of the patient had recurrence of the lesion during follow up. Return to normal daily activity was achieved at 11.25 (±2.37 SD weeks. Discussion: In this short case series study, large talar dome bony cysts of different pathologies including aneurysmal bone cysts could be treated effectively by endoscopic curettage and bone grafting with no recurrence no complications during the follow-up period.

  14. Ankle Fractures Often Not Diagnosed

    Science.gov (United States)

    ... Not Diagnosed A A A | Print | Share Ankle Fractures Often Not Diagnosed Long-term complications result from ... patients: Total ankle replacements--similar to hip and knee replacements--were once reserved for geriatric patients but ...

  15. Doctor, I sprained my ankle.

    Science.gov (United States)

    How, Choon How; Tan, Ken Jin

    2014-10-01

    Ankle sprains constitute the majority of ankle injuries, and result in pain, limited mobility/exercise and loss of school/work days. Ankle sprains involve at least one of the ankle ligaments and range from a micro tear to complete tear of the ligament or group of ligaments. The most common mechanism of ankle sprains is inversion stress of a plantar-flexed foot, while the most frequently injured ligament is the anterior talofibular ligament. The attending clinician needs to stratify the risk of fracture through history-taking and physical examination, manage the pain, assess long‑term complications and provide certification for rest and recovery. The Ottawa ankle rules may be useful. Graduated exercises to maintain the ankle's range of motion should be started early, after the resolution of initial pain and swelling. The risk of recurrent ankle injuries is often a combination of both mechanical and functional disabilities. PMID:25631892

  16. Arthroscopic findings after shoulder dislocation

    Directory of Open Access Journals (Sweden)

    Medenica Ivica

    2009-01-01

    Full Text Available Background/Aim. Recurrent instability of the shoulder joint is frequently difficult to differentiate from diseased or injured rotator cuff or tendon of the forearm flexor (m. biceps brachii. Shoulder joint arthroscopy has been only recently introduced into instable shoulder joint lesion examination. The aim of this study was to present and analyze an arthroscopic finding on instable shoulder joint in order to determine causes and mechanisms of instability, as well as principles of surgical treatment. Methods. Arthroscopy of the shoulder joint was performed in 158 patients with at least one documented shoulder joint dislocation. These patients were divided into two groups. The group I included the patients with one to three dislocations, while the group II those with more than three dislocations. Preoperative diagnosis was based on anamnestic data and clinical examination using specific tests, and on the diagnosis of shoulder joint using radiography or computed tomography. Results. Out of the total number of the patients 138 (87.34% had injury of the anterior patellar brim, 119 (75.32% had failure of the anterior capsule, 126 (79.75% had compressive cartilage injury of the posterior part of the head of the upper arm bone (Hill-Sachs lesion, 102 (64.56% had insufficiency of glenohumeral tendon, 11 (6.96 had complete cut of the rotator cuff, 23 (14.56% had injury of the posterior patellar brim, 12 (7.59% had injury of the upper anterior-posterior patellar brim (SLAP. Conclusion. According to the obtained results it could be concluded that there is no a unique injury that leads to shoulder joint instability. It is necessary to point out to the significance of anamnesis and clinical examination in making diagnosis. Arthroscopic diagnostics is indicated in clinically unreliable findings as an additional method for determining operative treatment.

  17. Application of low field intensity joint MRI in ankle injury

    International Nuclear Information System (INIS)

    Objective: To observe the diagnostic value of the low field intensity joint magnetic resonance imaging (MRI) in traumatic ankles. Methods: Through a retrospective examination and collection of 50 cases with complete information and checked by arthroscope or/and operated from Jan 2007 to Jun 2010, the diagnostic value ligament of the ankle joint, bone contusion,occult fracture, talus cartilage, and tendon could be evaluated. Cases of fracture for which could be diagnosed by X rays and CT were not included in this research. Results: The special low field intensity joint MRI had a high diagnostic sensitivity of 88.9% to ligamentum talofibulare anterius, but was only 50% sensitive to ligamentum calcaneofibulare. Its sensitivity to injury of ligamentum deltoideum and distal tibiofibular syndesmosis was up to 100%. Tendon injury, bone contusion and occult fracture could be exactly diagnosed. Its total sensitivity on talus cartilage traumatism was 70.6%. Its diagnosis sensitivity to talus cartilage traumatism at the 3rd-5th period by Mintz was 90%, with a lower one of 42.9% at the 1st-2nd period. Talus cartilage traumatism could be exactly predicted by osseous tissue dropsy below cartilage. Conclusion: The special low field intensity joint MRI is highly applicable to the diagnosis on ankle joint traumatism and facilitates clinical treatment. (authors)

  18. Diagnostic imaging of ankle impingement syndromes in athletes.

    Science.gov (United States)

    Spiga, S; Vinci, V; Tack, S; Macarini, L; Rossi, M; Coppolino, F; Boi, C; Genovese, E A

    2013-08-01

    The chronic ankle pain is a very frequent clinical problem, which is often characterized by a painful mechanical limitation of full-range ankle movement. A large amount of causes are involved in its pathogenesis, but the most common forms are secondary to an osseous or soft tissue abnormality. Especially for professional athletes, impingement lesions are the most important causes of chronic pain; however, this symptomatology can also affect ordinary people, mostly in those who work in environments that cause severe mechanical stress on the joints. This group of pathologies is characterized by a joint conflict secondary to an abnormal contact among bone surfaces or between bones and soft tissues. Diagnosis is mainly clinic and secondly supported by imaging in order to localize the critical area of impingement and determine the organic cause responsible for the joint conflict. Treatments for different forms of impingement are similar. Usually, the first step is a conservative approach (rest, physiotherapy, ankle bracing, shoe modification and local injection of corticosteroids), and only in case of unsuccessful response, the second step is the operative treatment with open and arthroscopic techniques. The aim of the study is to describe different MR imaging patterns, comparing our data with those reported in the literature, in order to identify the best accurate diagnostic protocol. PMID:23949936

  19. Anterolateral ankle impingement: findings and diagnostic accuracy with ultrasound imaging

    International Nuclear Information System (INIS)

    The objective was to evaluate the findings and diagnostic accuracy of ultrasound in antero-lateral ankle impingement (ALI) with clinical and arthroscopic correlation. Seventeen elite footballers with chronic ankle pain were referred for ultrasound with a clinical diagnosis of ALI (n = 8) or a control condition (n = 9; lateral mechanical instability, osteochondral defect, intra-articular bodies and osteoarthritis). Ultrasound examination included the antero-lateral gutter for abnormal synovial tissue (synovitic lesion), lateral ligament integrity, tibiotalar joint and osseous spurs of the distal tibia and talus. Ultrasound findings were correlated with subsequent arthroscopic appearance. Ultrasound examination detected a synovitic mass in the antero-lateral gutter in all 8 footballers with clinical ALI (100%) and in 2 patients with a control diagnosis (22%). Arthroscopic correlation of antero-lateral synovitis and fibrosis was present in all 10 cases (100%). The synovitic lesion was seen at ultrasound as a nodular soft tissue mass of mixed echogenicity within the antero-lateral gutter, which extruded anteriorly with manual compression of the distal fibula against the tibia. Increased blood supply was detected using power Doppler imaging in only 1 patient. The synovitic lesion measured >10 mm in its maximum dimension in 7 footballers with clinical ALI and <10 mm in the control group. Additional ultrasound findings in patients with abnormal antero-lateral synovial tissue included an anterior talofibular ligament injury in all patients (n = 10), a tibiotalar joint effusion (n = 6) and osseous spurs (n = 4). Antero-lateral synovitic tissue was accurately identified at ultrasound in the absence of an effusion (n = 4). No synovitic lesion was detected at ultrasound or arthroscopy in the remaining 7 patients with a control diagnosis. Ultrasound is accurate in detecting synovitic lesions within the antero-lateral gutter, demonstrating associated ligamentous injuries and in

  20. Anterolateral ankle impingement: findings and diagnostic accuracy with ultrasound imaging

    Energy Technology Data Exchange (ETDEWEB)

    McCarthy, C.L.; Wilson, D.J. [Nuffield Orthopaedic Centre, Department of Radiology, Oxford (United Kingdom); Coltman, T.P. [Nuffield Orthopaedic Centre, Department of Orthopaedic Surgery, Oxford (United Kingdom)

    2008-03-15

    The objective was to evaluate the findings and diagnostic accuracy of ultrasound in antero-lateral ankle impingement (ALI) with clinical and arthroscopic correlation. Seventeen elite footballers with chronic ankle pain were referred for ultrasound with a clinical diagnosis of ALI (n = 8) or a control condition (n = 9; lateral mechanical instability, osteochondral defect, intra-articular bodies and osteoarthritis). Ultrasound examination included the antero-lateral gutter for abnormal synovial tissue (synovitic lesion), lateral ligament integrity, tibiotalar joint and osseous spurs of the distal tibia and talus. Ultrasound findings were correlated with subsequent arthroscopic appearance. Ultrasound examination detected a synovitic mass in the antero-lateral gutter in all 8 footballers with clinical ALI (100%) and in 2 patients with a control diagnosis (22%). Arthroscopic correlation of antero-lateral synovitis and fibrosis was present in all 10 cases (100%). The synovitic lesion was seen at ultrasound as a nodular soft tissue mass of mixed echogenicity within the antero-lateral gutter, which extruded anteriorly with manual compression of the distal fibula against the tibia. Increased blood supply was detected using power Doppler imaging in only 1 patient. The synovitic lesion measured >10 mm in its maximum dimension in 7 footballers with clinical ALI and <10 mm in the control group. Additional ultrasound findings in patients with abnormal antero-lateral synovial tissue included an anterior talofibular ligament injury in all patients (n = 10), a tibiotalar joint effusion (n = 6) and osseous spurs (n = 4). Antero-lateral synovitic tissue was accurately identified at ultrasound in the absence of an effusion (n = 4). No synovitic lesion was detected at ultrasound or arthroscopy in the remaining 7 patients with a control diagnosis. Ultrasound is accurate in detecting synovitic lesions within the antero-lateral gutter, demonstrating associated ligamentous injuries and in

  1. X-Ray Exam: Ankle

    Science.gov (United States)

    ... Tropical Delight: Melon Smoothie Pregnant? Your Baby's Growth X-Ray Exam: Ankle KidsHealth > For Parents > X-Ray Exam: Ankle Print A A A Text Size ... español Radiografía: tobillo What It Is An ankle X-ray is a safe and painless test that uses ...

  2. Arthroscopic subacromial decompression: one- to seven-year results

    OpenAIRE

    Atalar, Ata Can; Demirhan, Mehmet; Kocabey, Yavuz; Akalin, Yilmaz

    2004-01-01

    Objectives: Impingement syndrome is one of the most important causes of pain in the shoulder region. Advances in arthroscopic techniques allowed acromioplasty to be performed arthroscopically. In this study, we evaluated the results of arthroscopic subacromial decompression in patients with impingement syndrome. Methods: Seventy patients who were treated with arthroscopic subacromial decompression and who had a follow-up period of at least a year were retrospectively evaluated. There were ...

  3. Footballer's ankle: a case report

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    @@ Footballer' s ankle is anterior bony spur or anterior impingement symptom of the ankle with anterior ankle pain, limited and painful dorsiflexion. The cause is commonly seen in athletes and dancers, and is probably due to repetitive minor trauma. The condition was firstly described by Morris;1 McMurray2 reported good results from excision of the spurs, naming it footballer's ankle. Opening resection of osteophytes of the anterior tibial and superior talar is an effective treatment for anterior impingement of the ankle.

  4. Ankle Injuries and Disorders

    Science.gov (United States)

    ... are sprains and fractures. A sprain is an injury to the ligaments. It may take a few weeks to many months to heal completely. A fracture is a break in a bone. You can also ... your joints. Ankle sprains and fractures are common sports injuries.

  5. Arthroscopic Quadriceps Tendon Repair: Two Case Reports

    Directory of Open Access Journals (Sweden)

    Hidetomo Saito

    2015-01-01

    Full Text Available Recently, although some studies of open repair of the tendon of the quadriceps femoris have been published, there have been no reports in the literature on primary arthroscopic repair. In our present study, we present two cases of quadriceps tendon injury arthroscopically repaired with excellent results. Case 1 involved a 68-year-old man who was injured while shifting his weight to prevent a fall. MRI showed complete rupture at the insertion of the patella of the quadriceps tendon. The rupture was arthroscopically repaired using both suture anchor and pull-out suture fixation methods via bone tunnels (hereafter, pull-out fixation. Two years after surgery, retearing was not observed on MRI and both Japan Orthopedic Association (JOA Knee and Lysholm scores had recovered to 100. Case 2 involved a 50-year-old man who was also injured when shifting his weight to prevent a fall. MRI showed incomplete superficial rupture at the insertion of the patella of the quadriceps tendon. The rupture was arthroscopically repaired using pull-out fixation of six strand sutures. One year after surgery, MRI revealed a healed tendon and his JOA and Lysholm scores were 95 and 100, respectively. Thus, arthroscopic repair may be a useful surgical method for repairing quadriceps tendon injury.

  6. Augmented virtuality for arthroscopic knee surgery.

    Science.gov (United States)

    Li, John M; Bardana, Davide D; Stewart, A James

    2011-01-01

    This paper describes a computer system to visualize the location and alignment of an arthroscope using augmented virtuality. A 3D computer model of the patient's joint (from CT) is shown, along with a model of the tracked arthroscopic probe and the projection of the camera image onto the virtual joint. A user study, using plastic bones instead of live patients, was made to determine the effectiveness of this navigated display; the study showed that the navigated display improves target localization in novice residents. PMID:22003616

  7. Ankle impingement syndromes

    International Nuclear Information System (INIS)

    Soft-tissue and osseous impingement syndromes can be an important cause of chronic ankle pain, particularly in the professional athlete. The classification of ankle impingement syndromes is based to their anatomical location around the tibiotalar joint. The most important impingement syndromes are anterolateral, anterior and posterior impingement with more recent studies describing posteromedial and anteromedial impingement. Usually conventional radiography is the first imaging technique to be performed as it allows assessment of potential bone abnormalities, particularly in anterior and posterior joint compartments. Computed tomography (CT) only plays a role in the assessment of the posterior impingement. Magnetic resonance (MR) imaging is regarded as the modality of choice as it is able to demonstrate both osseous and soft tissue changes, such as bone marrow edema, capsular and ligametous thickening, and localized synovitis. (orig.)

  8. Arthrography of the ankle

    International Nuclear Information System (INIS)

    Arthrography was performed in 105 cases with freshly sprained ankles and signs of rupture of the anterior talofibular ligament. They were subsequently operated upon. The arthrographic films were examined retrospectively to assess the value of different criteria for the differential diagnosis between rupture of the anterior talofibular ligament and combined rupture of this and the calcaneofibular ligament. The diagnostic value of arthrography was found to be high in isolated rupture of the anterior talofibular ligament, and is acceptable in the combined ruptures. (Auth.)

  9. Arthroscopic Release of Flexor Hallucis Longus Tendon Sheath in Female Ballet Dancers: Dynamic Pathology, Surgical Technique, and Return to Dancing Performance.

    Science.gov (United States)

    Funasaki, Hiroki; Hayashi, Hiroteru; Sakamoto, Kanako; Tsuruga, Rei; Marumo, Keishi

    2015-12-01

    Stenosing tenosynovitis of the flexor hallucis longus (FHL) tendon is known as a major overuse lesion in female dancers. We describe arthroscopic surgical techniques in relation to the dynamic pathology of the disease. Crepitus and pain on moving the great toe with the ankle in plantar flexion on preoperative examination confirm the diagnosis of FHL stenosing tenosynovitis even if the os trigonum is not evident. The ankle is approached through standard posterolateral and posteromedial portals. A 4.0-mm-diameter 30° arthroscope is used. Soft tissues around the talus are cleared with a motorized shaver and a radiofrequency device. The posterior aspects of the talus, os trigonum, and FHL tendon surrounded by the tendon sheath are visualized. The dynamic pathology of the FHL tendon is well observed on passive motion of the great toe. The prominent bone fragment of the talus is removed and the tendon sheath is cut with a retrograde knife and a motorized shaver from the superior border down to the entrance of the fibro-osseous tunnel. Arthroscopic release of the FHL tendon sheath is a useful and easy method to directly approach the dynamic pathology of FHL tenosynovitis in female ballet dancers. PMID:27284509

  10. Update on acute ankle sprains.

    Science.gov (United States)

    Tiemstra, Jeffrey D

    2012-06-15

    Ankle sprains are a common problem seen by primary care physicians, especially among teenagers and young adults. Most ankle sprains are inversion injuries to the lateral ankle ligaments, although high sprains representing damage to the tibiofibular syndesmosis are becoming increasingly recognized. Physicians should apply the Ottawa ankle rules to determine whether radiography is needed. According to the Ottawa criteria, radiography is indicated if there is pain in the malleolar or midfoot zone, and either bone tenderness over an area of potential fracture (i.e., lateral malleolus, medial malleolus, base of fifth metatarsal, or navicular bone) or an inability to bear weight for four steps immediately after the injury and in the emergency department or physician's office. Patients with ankle sprain should use cryotherapy for the first three to seven days to reduce pain and improve recovery time. Patients should wear a lace-up ankle support or an air stirrup brace combined with an elastic compression wrap to reduce swelling and pain, speed recovery, and protect the injured ligaments as they become more mobile. Early mobilization speeds healing and reduces pain more effectively than prolonged rest. Pain control options for patients with ankle sprain include nonsteroidal anti-inflammatory drugs, acetaminophen, and mild opioids. Because a previous ankle sprain is the greatest risk factor for an acute ankle sprain, recovering patients should be counseled on prevention strategies. Ankle braces and supports, ankle taping, a focused neuromuscular training program, and regular sport-specific warm-up exercises can protect against ankle injuries, and should be considered for patients returning to sports or other high-risk activities. PMID:22962897

  11. MR imaging of the ankle

    International Nuclear Information System (INIS)

    To define the clinical role of MRI of the ankle joint, a total of 98 patients were investigated. In the evaluation of ligamentous injuy, MRI was inferior to established imaging methods. By contrast, it provided additional therapy-relevant information in the assessment of hemophilic arthropathy, osteochondritis dissecans, and inflammatory and neoplastic diseases of the ankle joint. In the latter conditions, MRI may make other more conventional methods of examining the ankle joint unnecessary. (orig.)

  12. Syndesmosis injuries of the ankle

    OpenAIRE

    Del Buono, Angelo; Florio, Antonietta; Boccanera, Michele Simone; Maffulli, Nicola

    2013-01-01

    Ankle syndesmosis injuries are relatively frequent in sports, especially skiing, ice hockey, and soccer, accounting for 1 %–18 % of all ankle sprains. The evolution is unpredictable: When missed, repeated episodes of ankle instability may predispose to early degenerative changes, and frank osteoarthritis may ensue. Diagnosis is clinical and radiological, but arthroscopy may provide a definitive response, allowing one to address secondary injuries to bone and cartilage. Obvious diastasis needs...

  13. How to Care for a Sprained Ankle

    Science.gov (United States)

    ... to Care for a Sprained Ankle Page Content Ankle sprains are very common injuries. There's a good chance ... to make sure no bones are broken. Most ankle sprains do not require surgery, and minor sprains are ...

  14. Differences in injury pattern and prevalence of cartilage lesions in knee and ankle joints: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Matthias Aurich

    2014-12-01

    Full Text Available Osteoarthritis (OA is more common in the knee compared to the ankle joint. This can not be explained exclusively by anatomical and biomechanical differences. The aim of this study is to analyze and compare the injury pattern (clinically and the cartilage lesions (arthroscopically of knee and ankle joints in a cohort of patients from the same catchment area. A retrospective study of the clinical data of 3122 patients (2139 outpatients and 983 inpatients was performed, who were treated due to an injury of the knee and ankle joint. Statistical analysis was performed using SigmaStat 3.0 (SPSS Inc, Chicago, USA. There is a higher prevalence of injuries in the ankle as compared to the knee joint in this population from the same catchment area. In contrast, high-grade cartilage lesions are more prevalent in the knee, whereas low grade cartilage lesions are equally distributed between knee and ankle. From this data it can be concluded that the frequency of injuries and the injury pattern of knee versus ankle joints do not correlate with the severity of cartilage lesions and may therefore have no direct influence on the differential incidence of OA in those two joints.

  15. Acute ankle sprain: an update.

    Science.gov (United States)

    Ivins, Douglas

    2006-11-15

    Acute ankle injury, a common musculoskeletal injury, can cause ankle sprains. Some evidence suggests that previous injuries or limited joint flexibility may contribute to ankle sprains. The initial assessment of an acute ankle injury should include questions about the timing and mechanism of the injury. The Ottawa Ankle and Foot Rules provide clinical guidelines for excluding a fracture in adults and children and determining if radiography is indicated at the time of injury. Reexamination three to five days after injury, when pain and swelling have improved, may help with the diagnosis. Therapy for ankle sprains focuses on controlling pain and swelling. PRICE (Protection, Rest, Ice, Compression, and Elevation) is a well-established protocol for the treatment of ankle injury. There is some evidence that applying ice and using nonsteroidal antiinflammatory drugs improves healing and speeds recovery. Functional rehabilitation (e.g., motion restoration and strengthening exercises) is preferred over immobilization. Superiority of surgical repair versus functional rehabilitation for severe lateral ligament rupture is controversial. Treatment using semirigid supports is superior to using elastic bandages. Support devices provide some protection against future ankle sprains, particularly in persons with a history of recurrent sprains. Ankle disk or proprioceptive neuromuscular facilitation exercise regimens also may be helpful, although the literature supporting this is limited. PMID:17137000

  16. Open Versus Arthroscopic Tennis Elbow Release

    Science.gov (United States)

    Leiter, Jeff; Clark, Tod; McRae, Sheila; Dubberley, James; MacDonald, Peter B.

    2016-01-01

    Objectives: The primary objective of this study was to determine if quality of life and function are different following arthroscopic versus open tennis elbow release surgery. Based on retrospective studies, both approaches have been found to be beneficial, but no prospective randomized comparison has been conducted to date. Methods: Following a minimum six-months of conservative treatment, seventy-one patients (>16 yrs old) were randomized intraoperatively to undergo either arthroscopic or open lateral release. Outcome measures were the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH), a 5-question VAS Pain Scale, and grip strength. Study assessments took place pre-, and 6-week, 3-, 6-, and 12-months post-surgery. Comparisons between groups and within groups over time were conducted using repeated measures ANOVA. A minimal clinically significant difference for the DASH had been previously identified as 15 points, and was used to compare groups as well at 12-months post-operative (Beaton et al. 2001). Results: Fifteen women and 19 men underwent the open procedure with a mean age of 47.1 years (6.7) and 13 women and 21 men were in the arthroscopic group with a mean age of 45.0 (6.9). No pre-surgery differences were found between groups based on age, sex, DASH or VAS scores. Both groups demonstrated a significant improvement in subjective measures and grip strength by 12-months post-surgery, and no significant differences were found between groups at any time point. The DASH, our primary outcome, decreased from a mean (SD) of 47.5 (14.5) pre-surgery to 21.9 (21.8) at 12-months post-surgery in the Open group and from 52.7 (16.0) to 22.6 (21.1) in the Arthroscopic group. VAS-pain scores (%) decreased in the Open group from 62.5 (17.2) pre-operatively to 30.0 (26.5) at 12-months. In the arthroscopic group, scores decreased from 63.7 (15.9) to 26.2 (24.6). Grip strength (kg) increased on the affected side from 23.6 (14.9) to 29.3 (16.3) and 21.4 (15.4) to

  17. Talofibular compartment of the ankle joint after recent ankle sprain

    International Nuclear Information System (INIS)

    The validity of predicting the condition of the anterior talofibular ligament from the shape of the lateral compartment of the ankle joint was investigated in patients with recent ankle sprain. The diagnostic value of the method was found to be restricted. (Auth.)

  18. Ultrasonography of ankle ligaments

    International Nuclear Information System (INIS)

    The lateral collateral ligament of the ankle is a complex of 3 ligaments: The anterior and posterior talofibular ligaments and the calcaneofibular ligament; these ligaments work together to support the lateral aspect of the ankle. The anterior talofibular (ATF) ligament (Fig. 1) runs from the anterior of the talus. The probe is placed in a slightly oblique position from the malleolus toward the forefoot. The ligament is hyperechoic when its fibres are perpendicular to the ultrasound beam (anisotropy artifact is present in ligaments as well as in tendons). It is approximately 2 mm thick and, during examination, must be straight and tight from one insertion point to the other, as seen in Fig. 2. The posterior talofibular (PTF) ligament, which runs from the posterior part of the malleolus to the posterior part of the talus, is difficult to see on US, being partially or sometimes completely hidden by the malleolus. The calcaneofibular ligament forms the middle portion of the lateral collateral ligament. It is tight between the inferior part of the lateral malleolus and the calcaneus, and runs in a slightly posterior oblique direction toward the heel (Fig. 3). The ligament lies on the deep surface of the fibular tendons, forming a hammock to fall deep on the calcaneus surface (Fig. 4). The calcaneofibular ligament is approximately 2-3 nun thick and is hyperechoic in the distal two-thirds only because of the obliquity of the proximal part. When examining this ligament, it is mandatory that the ankle be flexed dorsally; this stretches the ligament so that it can be seen clearly. (author)

  19. Comparison of two arthroscopic pump systems based on image quality

    OpenAIRE

    Tuijthof, G. J. M.; van den Boomen, H.; van Heerwaarden, R. J.; Dijk, C. N. Van

    2008-01-01

    The effectiveness of arthroscopic pump systems has been investigated with either subjective measures or measures that were unrelated to the image quality. The goal of this study is to determine the performance of an automated pump in comparison to a gravity pump based on objective assessment of the quality of the arthroscopic view. Ten arthroscopic operations performed with a gravity pump and ten performed with an automated pump (FMS Duo system) were matched on duration of the surgery and sha...

  20. Increased Post-Operative Stiffness after Arthroscopic Suprapectoral Biceps Tenodesis

    OpenAIRE

    Werner, Brian C.; Pehlivan, Hakan C.; Hart, Joseph M.; Carson, Eric W.; Diduch, David R.; Miller, Mark D.; Brockmeier, Stephen F.

    2014-01-01

    Objectives: Biceps tenodesis can be performed open or arthroscopically and can be positioned in a suprapectoral or subpectoral position. Suprapectoral tenodesis can be carried out arthroscopically, whereas the subpectoral tenodesis is performed as an open procedure. The goal of this study is to compare the incidence of postoperative stiffness between arthroscopic suprapectoral and open subpectoral biceps tenodesis and evaluate risk factors for its occurrence. Methods: Study Design: The charts...

  1. Arthroscopically Assisted Treatment of Acute Dislocations of the Acromioclavicular Joint

    Science.gov (United States)

    Braun, Sepp; Beitzel, Knut; Buchmann, Stefan; Imhoff, Andreas B.

    2015-01-01

    Arthroscopically assisted treatments for dislocations of the acromioclavicular joint combine the advantages of exact and visually controlled coracoid tunnel placement with the possibility of simultaneous treatment of concomitant injuries. The clinical results of previous arthroscopically assisted techniques have been favorable at midterm and long-term follow-up. The presented surgical technique combines the advantages of arthroscopically positioned coracoclavicular stabilization with an additional suture cord cerclage of the acromioclavicular joint capsule for improved horizontal stability. PMID:26870646

  2. Can Chronic Ankle Instability be Prevented? Rethinking Management of Lateral Ankle Sprains.

    Science.gov (United States)

    Denegar, Craig R.; Miller, Sayers J., III

    2002-01-01

    Investigates whether chronic ankle instability can be prevented, discussing: the relationship between mechanical and functional instability; normal ankle mechanics, sequelae to lateral ankle sprains, and abnormal ankle mechanics; and tissue healing, joint dysfunction, and acute lateral ankle sprain management. The paper describes a treatment model…

  3. Ankle Bracing, Plantar-Flexion Angle, and Ankle Muscle Latencies During Inversion Stress in Healthy Participants

    OpenAIRE

    Kernozek, Thomas; Durall, Christopher J; Friske, Allison; Mussallem, Matthew

    2008-01-01

    Context: Ankle braces may enhance ankle joint proprioception, which in turn may affect reflexive ankle muscle activity during a perturbation. Despite the common occurrence of plantar-flexion inversion ankle injuries, authors of previous studies of ankle muscle latencies have focused on inversion stresses only.

  4. MRI of ankle sprain

    International Nuclear Information System (INIS)

    We reviewed MR (magnetic resonance) studies in 54 patients with a sprained ankle. MR examination was able to depict the following injuries: lateral collateral ligamentous injuries, fluid collection in the peroneal tendon sheath, injury to the peroneal tendon, deltoid ligamentous injuries, the extent of subcutaneous soft tissue swelling, and various kinds of osseous injuries. A total of 21 patients underwent repair or reconstructive surgery to the lateral collateral ligaments, the findings of which were correlated with those on MR examination. MR diagnosis of anterior talofibular ligamentous injury was confirmed in 16/21; the discrepancy could be attributed to remodeling and/or reorganization which progressed during the time lapse between the MR examination and surgery in three, while the misdiagnosis resulted from the difficulty in distinguishing the acute tear from the injured scar in two. The calcaneofibular ligamentous injury was confirmed in 10/12; two false negatives were responsible for the difficulty in delineating its entire length on a single image and/or in differentiating between the attenuated star and the normal calcaneofibular ligament. MR imaging is a useful tool to use in deciding the surgical indication and predicting the prognosis of the patients with ankle sprain. (author)

  5. MRI of ankle sprain

    Energy Technology Data Exchange (ETDEWEB)

    Nishimura, Gen [Dokkyo Univ., Mibu, Tochigi (Japan). School of Medicine

    1995-06-01

    We reviewed MR (magnetic resonance) studies in 54 patients with a sprained ankle. MR examination was able to depict the following injuries: lateral collateral ligamentous injuries, fluid collection in the peroneal tendon sheath, injury to the peroneal tendon, deltoid ligamentous injuries, the extent of subcutaneous soft tissue swelling, and various kinds of osseous injuries. A total of 21 patients underwent repair or reconstructive surgery to the lateral collateral ligaments, the findings of which were correlated with those on MR examination. MR diagnosis of anterior talofibular ligamentous injury was confirmed in 16/21; the discrepancy could be attributed to remodeling and/or reorganization which progressed during the time lapse between the MR examination and surgery in three, while the misdiagnosis resulted from the difficulty in distinguishing the acute tear from the injured scar in two. The calcaneofibular ligamentous injury was confirmed in 10/12; two false negatives were responsible for the difficulty in delineating its entire length on a single image and/or in differentiating between the attenuated star and the normal calcaneofibular ligament. MR imaging is a useful tool to use in deciding the surgical indication and predicting the prognosis of the patients with ankle sprain. (author)

  6. Outcomes after Arthroscopic Bankart Repair

    Science.gov (United States)

    Marshall, Tyler James; Vega, Jose F.; Siqueira, Marcelo BP; Gelber, Jonathan David; Cagle, Robert; Saluan, Paul M.

    2016-01-01

    Objectives: The shoulder is the most common joint dislocation effecting roughly 2% of the general population. Males are effected to a higher degree that females at a ratio of 3:1.1-2 The young, athletic population make up the largest portion of shoulder instability, and treated nonoperatively have a recurrent dislocation rate approaching 50%.3-5 Owens et. al recently published a cohort looking at 45 college athletes with an in season shoulder instability event. 73% of athletes returned to play in season. Only 36% of athletes completed the season without re-injury and 64% of athletes had a recurrent instability event.6 It is unknown how the outcomes of those who go on to have a recurrent dislocation in season are effected versus those who have a stabilization procedure after a first time dislocation. The objective of the current study is to report the postoperative outcomes of first time dislocators versus patients with recurrent dislocations prior to surgery. Methods: CPT codes were used to identify patients who had arthroscopic Bankart repair between 2003-2013. 439 patients aged 16-30 years were identified across 8 fellowship trained surgical practices. The first phase of the study was a retrospective chart review to obtain patient demographics, number of reported preoperative dislocations, review imaging, and number of anchors placed. Patients were identified as first time dislocators or as recurrent dislocators when they had more than one dislocation prior to surgical intervention. The second phase consisted of a survey to obtain a simple shoulder test score, whether they returned to sport, postoperative instability events and further surgery on the shoulder. Postoperative instability was defined as a subluxation or dislocation reported by the patient survey in the postoperative period. Of the 439 patients identified, 296 were excluded for revision surgery, open repair, posterior instability, multidirectional instability, HAGL lesion, labral tears involving the

  7. Sports Injuries to the Foot and Ankle

    Science.gov (United States)

    ... FootNotes Newsletter Current Issue Archive Subscribe Home » Foot & Ankle Conditions » Sports Injuries to the Foot and Ankle A A A | ... page. Please enable Javascript in your browser. Sports Injuries to the Foot and Ankle Depending on the sport, your feet and ankles ...

  8. Arthroscopic anatomy of the subdeltoid space

    Directory of Open Access Journals (Sweden)

    Michael J. Salata

    2013-09-01

    Full Text Available From the first shoulder arthroscopy performed on a cadaver in 1931, shoulder arthroscopy has grown tremendously in its ability to diagnose and treat pathologic conditions about the shoulder. Despite improvements in arthroscopic techniques and instrumentation, it is only recently that arthroscopists have begun to explore precise anatomical structures within the subdeltoid space. By way of a thorough bursectomy of the subdeltoid region, meticulous hemostasis, and the reciprocal use of posterior and lateral viewing portals, one can identify a myriad of pertinent ligamentous, musculotendinous, osseous, and neurovascular structures. For the purposes of this review, the subdeltoid space has been compartmentalized into lateral, medial, anterior, and posterior regions. Being able to identify pertinent structures in the subdeltoid space will provide shoulder arthroscopists with the requisite foundation in core anatomy that will be required for challenging procedures such as arthroscopic subscapularis mobilization and repair, biceps tenodesis, subcoracoid decompression, suprascapular nerve decompression, quadrangular space decompression and repair of massive rotator cuff tears.

  9. Arthroscopic decompression for subacromial impingement syndrome.

    OpenAIRE

    S. J. Kim; Lee, J. W.; Kim, B. S.

    1997-01-01

    Arthroscopic decompression and cuff debridement was performed on 47 cases in 45 consecutive patients with either stage II or stage III impingement syndrome: 19 with no actual tear of the cuff (stage II); 13 with a partial thickness tear (stage IIIa); 10 with complete tear less than 3 cm long (stage IIIb); and 5 with complete tear longer than 3 cm (stage IIIc). Patients were classified into impingement syndrome without tear (Group I), impingement syndrome with partial thickness tear (Group II)...

  10. Arthroscopic management of distal radius fractures.

    Science.gov (United States)

    Wiesler, Ethan R; Chloros, George D; Mahirogullari, Mahir; Kuzma, Gary R

    2006-11-01

    Arthroscopy has the advantage of providing a direct and accurate assessment of the articular surfaces and detecting the presence of injuries associated with distal radius fractures. Current indications, although numerous and potentially expanding, also are controversial. This report presents a global view of the current status of arthroscopy in the management of distal radius fractures. The rationale of arthroscopic treatment, the available evidence, and finally the diagnosis and treatment are discussed. PMID:17095385

  11. Stem cell procedures in arthroscopic surgery

    OpenAIRE

    Dyrna, Felix; Herbst, Elmar; Hoberman, Alexander; Imhoff, Andreas B.; Schmitt, Andreas

    2016-01-01

    The stem cell as the building block necessary for tissue reparation and homeostasis plays a major role in regenerative medicine. Their unique property of being pluripotent, able to control immune process and even secrete a whole army of anabolic mediators, draws interest. While new arthroscopic procedures and techniques involving stem cells have been established over the last decade with improved outcomes, failures and dissatisfaction still occur. Therefore, there is increasing interest in wa...

  12. Arthroscopic management of painful first metatarsophalangeal joint

    Directory of Open Access Journals (Sweden)

    Debnath U

    2005-01-01

    Full Text Available Background: Arthroscopy of the great toe MTP joint has been practiced with favourable outcomes. A range of indications have been described ranging from synovitis to osteochondral defects. The purpose of the present study was to describe our technique and to assess the functional outcome following arthroscopic management of Hallux MTP disorders using AOFAS scoring system. Methods: We describe the technique of Hallux MTP joint arthroscopy in twenty patients. Indications included hallux rigidus with osteophytes, chondromalacia, OCDs, loose bodies, arthrofibrosis, synovitis, tophaceous gout arthritis and intra-articular fractures of MTP joint. All patients had been evaluated clinically and radiologically with record of their AOFAS scores pre-operatively. At a minimum follow-up of two years the clinical assessment was carried out with AOFAS scores. Results: The mean pre-operative and post-operative AOFAS score were 47 (range 10-78 and 97 (87 -100 respectively. The patient with intra-articular fracture had an excellent outcome following arthroscopic reduction of the fracture. Conclusion: Arthroscopic management of painful hallucial MTP joint is a specialized technique, which if performed for the right indications, gives a favourable outcome with minimal complications.

  13. Fractures of the ankle Fractures of the ankle

    OpenAIRE

    Taser, Omer; Goksan, Alp; Asik, Mehmet

    2004-01-01

    In this study 151 patients who were operated for the ankle fracture between 1980 and 1988 and also 277 patients who were conservatively treated between January 1987 and April 1988 in Orthopaedics and Traumatology Department of Istanbul Medical Faculty were taken into consideration. It has been seen that ankle fractures which comprised a high percent (%1.6) in all patients who applied to our emergency department. We showed that the ratio of patients who had operative treatment had been steadi...

  14. Arthrography of the ankle sprains

    International Nuclear Information System (INIS)

    Ankle arthrography, by direct puncture of joint cavity, is considered to be a simple and accurate diagnostic method for a precise evaluation of ligamentous injury. Forty-seven cases of ankle arthrography were successively performed in the patients of acute ankle sprains. The purpose of this study is to demonstrate how ankle arthrography can delineate the pathologic anatomy in such cases. The results are as follows: 1. Thirty cases among forty seven revealed the findings of ligament tears. 2. For better diagnostic accuracy, the arthrography should be performed within 72 hrs. after injury. 3. The anterior talofibular ligament tears were the most common (twenty-nine cases) of all and seventeen of them revealed tears without association of any other ligament tears. 4. There were ten cases of calcaneofibular ligament tears and nine of them were associated with anterior talofibular ligament tears. 5. Three cases of anterior tibiofibular and one deltoid ligament tears were demonstrated

  15. Outcomes of Open Subacromial Decompression after Failed Arthroscopic Acromioplasty

    OpenAIRE

    Gavin Nimon; Joby Malal; Anand Pillai; Vivek Eranki

    2012-01-01

    Aim. To prospectively assess the effectiveness of revision with open subacromial decompression in patients who had a previous unsatisfactory outcome with the arthroscopic procedure. Methods. 11 patients were identified for the study, who did not demonstrate expected improvement in symptoms after arthroscopic acromioplasty. All patients underwent structured rehabilitation. Functional evaluation was conducted using the Hospital for Special Surgery, New York, shoulder rating questionnaire. Resul...

  16. Arthroscopic Assessment and Treatment of Dancers' Knee Injuries.

    Science.gov (United States)

    Silver, Daniel M.; Campbell, Pat

    1985-01-01

    Arthroscopic examination of 16 dancers with dance-related knee injuries which defied conservative treatment showed 15 meniscal tears and 4 cases of chondromalacia patellae. Partial arthroscopic meniscectomy was used to treat the tears. The results were excellent, with 13 of the 16 returning to preoperative levels of dance activity. (MT)

  17. Complications in Ankle Fracture Surgery

    OpenAIRE

    Ovaska, Mikko

    2014-01-01

    Mikko Ovaska. Complications in Ankle Fracture Surgery. Helsinki Bone and Joint Research Group, Department of Orthopaedic Surgery and Traumatology, Faculty of Medicine, University of Helsinki, Finland. Helsinki 2014. Ankle fractures are among the most frequently encountered surgically treated fractures. The operative treatment of this fracture may be associated with several complications. The most frequently encountered complications are related wound healing, and deep infection may have d...

  18. Total ankle arthroplasty in France

    OpenAIRE

    Besse, Jean-Luc; Colombier, Jean-Alain; ASENCIO, Joseph; Bonnin, Michel; Gaudot, Fabrice; JARDE, Olivier; Judet, Thierry; MAESTRO, Michel; LEMRIJSE, Thibaut; LEONARDI, Christian; TOULLEC, Eric

    2010-01-01

    Objectives: After more than 10 years' experience in France, the French Foot Surgery Association (Association francaise de chirurgie du pied [AFCP]) presents an update on mobile-bearing ankle prostheses, based on a multicenter study. Meta-analysis - Biomechanics - Assessment and indications: A preliminary comparative metaanalysis of the literature studies on ankle and prosthesis biomechanics, reviews validated indications and contra-indications, and details clinical and radiological outcomes a...

  19. Arthroscopic treatment for chronic lateral epicondylitis

    Directory of Open Access Journals (Sweden)

    Bernardo Barcellos Terra

    2015-08-01

    Full Text Available ABSTRACTOBJECTIVE: To report the clinical and functional results from arthroscopic release of the short radial extensor of the carpus (SREC in patients with chronic lateral epicondylitis that was refractory to conservative treatment. METHODS: Over the period from January 2012 to November 2013, 15 patients underwent arthroscopic treatment. The surgical technique used was the one described by Romeo and Cohen, based on anatomical studies on cadavers. The inclusion criteria were that the patients needed to present lateral epicondylitis and that conservative treatment (analgesics, anti-inflammatory agents, corticoid infiltration or physiotherapy had failed over a period of more than six months. The patients were evaluated based on the elbow functional score of the Mayo Clinic, Nirschl's staging system and a visual analog scale (VAS for pain. RESULTS: A total of 15 patients (9 men and 6 women were included. The mean Mayo elbow functional score after the operation was 95 (ranging from 90 to 100. The pain VAS improved from a mean of 9.2 before the operation to 0.64 after the operation. On Nirschl's scale, the patients presented an improvement from a mean of 6.5 before the operation to approximately one. There were significant differences from before to after the surgery for the three functional scores used ( p 0.05. CONCLUSION: Arthroscopic treatment for lateral epicondylitis was shown to be a safe and effective therapeutic option when appropriately indicated and performed, in refractory cases of chronic lateral epicondylitis. It also allowed excellent viewing of the joint space for diagnosing and treating associated pathological conditions, with a minimally invasive procedure.

  20. Ankle Brachial Index

    Energy Technology Data Exchange (ETDEWEB)

    Wikstroem, J.; Hansen, T.; Johansson, L.; Lind, L.; Ahlstroem, H. (Dept. of Radiology and Dept. of Medical Sciences, Uppsala Univ. Hospital, Uppsala (SE))

    2008-03-15

    Background: Whole-body magnetic resonance angiography (WBMRA) permits noninvasive vascular assessment, which can be utilized in epidemiological studies. Purpose: To assess the relation between a low ankle brachial index (ABI) and high-grade stenoses in the pelvic and leg arteries in the elderly. Material and Methods: WBMRA was performed in a population sample of 306 subjects aged 70 years. The arteries below the aortic bifurcation were graded after the most severe stenosis according to one of three grades: 0-49% stenosis, 50-99% stenosis, or occlusion. ABI was calculated for each side. Results: There were assessable WBMRA and ABI examinations in 268 (right side), 265 (left side), and 258 cases (both sides). At least one >=50% stenosis was found in 19% (right side), 23% (left side), and 28% (on at least one side) of the cases. The corresponding prevalences for ABI <0.9 were 4.5%, 4.2%, and 6.6%. An ABI cut-off value of 0.9 resulted in a sensitivity, specificity, and positive and negative predictive value of 20%, 99%, 83%, and 84% on the right side, and 15%, 99%, 82%, and 80% on the left side, respectively, for the presence of a >= 50% stenosis in the pelvic or leg arteries. Conclusion: An ABI <0.9 underestimates the prevalence of peripheral arterial occlusive disease in the general elderly population

  1. The origin of the ankle

    CERN Document Server

    Codino, A; Codino, Antonio; Plouin, Francois

    2007-01-01

    The differential intensity of cosmic radiation shows a sequence of depressions referred to as "knees" in a large energy band above 10^15 eV. The global depression entailed in the complete spectrum with respect to the extrapolated intensity based on low energy data amounts to a maximum factor of 8, occurring at 5 x 10^18 eV, where flux measurements exhibit a relative minimum, referred to as the "ankle". It is demonstrated by a full simulation of cosmic ray trajectories in the Galaxy that the intensity minimum around the ankle energy is primarily due to the nuclear interactions of the cosmic ions with the interstellar matter and to the galactic magnetic field. "Ankles" signal the onset energies of the rectilinear propagation in the Milky Way at the Earth, being for example, 4 x 10^18 eV for helium and 6 x 10^19 eV for iron. The ankle, in spite of its notable importance at the Earth, is a local perturbation of the universal spectrum which, between the knee and the ankle, decreases by a round factor 10^9, regaini...

  2. Posterior Ankle Structure Injury During Total Ankle Replacement.

    Science.gov (United States)

    Reb, Christopher W; McAlister, Jeffrey E; Hyer, Christopher F; Berlet, Gregory C

    2016-01-01

    Total ankle replacement studies have focused on reporting complications that are directly observed clinically or radiographically, including wound problems, technical errors, implant loosening, subsidence, infection, bone fractures, and heterotopic ossification. However, patients can still experience unresolved pain even when these problems have been ruled out. We initiated a study to more clearly define the relative risk of injury to the anatomic structures in the posterior ankle during total ankle replacement using a third-generation implant system. Ten fresh-frozen adult cadaveric below-the-knee specimens were positioned in the intraoperative positioning frame of an approved total ankle replacement system and adjusted to achieve proper foot alignment using fluoroscopic imaging. The relationship between the tibial cutting guide pins and the posterior neurovascular and tendon structures was measured using digital calipers. High rates of posterior structural injury were found. Nearly all proximal-medial pins encountered a posteromedial neurovascular structure, most commonly the tibial nerve. The distal-medial pins mainly encountered posteromedial tendinous structures, in particular, the flexor digitorum longus tendon. The proximal lateral pins were highly likely to encounter the Achilles tendon and the sural nerve. Our results support our hypothesis that the tibial neurovascular structures are at the greatest risk when preparing for and completing the bony resection, particularly with the medial and proximal cuts. Posterior ankle soft tissue structure injuries can occur during implantation but currently with unknown frequency and undetermined significance. Further study of posterior structural injuries could result in a more informed approach to post-total ankle replacement complications and management. PMID:27291681

  3. American Orthopaedic Foot and Ankle Society

    Science.gov (United States)

    ... education site of the American Orthopaedic Foot & Ankle Society. Patients Visit the official patient education site of the American Orthopaedic Foot & Ankle Society. Patients Visit the official patient education site of ...

  4. Long term outcomes of inversion ankle injuries

    OpenAIRE

    Anandacoomarasamy, A; Barnsley, L; Grujic, L

    2005-01-01

    Background: Ankle sprains are common sporting injuries generally believed to be benign and self limiting. However, some studies report a significant proportion of patients with ankle sprains having persistent symptoms for months or even years.

  5. Effects of ankle eversion taping using kinesiology tape in a patient with ankle inversion sprain

    OpenAIRE

    Lee, Sun-Min; Lee, Jung-Hoon

    2016-01-01

    [Purpose] The aim of this study was to report the effects of ankle eversion taping using kinesiology tape on ankle inversion sprain. [Subject] The subject was a 21-year-old woman with Grade 2 ankle inversion sprain. [Methods] Ankle eversion taping was applied to the sprained left ankle using kinesiology tape for 4 weeks (average, 15 h/day). [Results] Ankle instability and pain were reduced, and functional dynamic balance was improved after ankle eversion taping for 4 weeks. The Cumberland Ank...

  6. Effects of ankle eversion taping using kinesiology tape in a patient with ankle inversion sprain.

    Science.gov (United States)

    Lee, Sun-Min; Lee, Jung-Hoon

    2016-01-01

    [Purpose] The aim of this study was to report the effects of ankle eversion taping using kinesiology tape on ankle inversion sprain. [Subject] The subject was a 21-year-old woman with Grade 2 ankle inversion sprain. [Methods] Ankle eversion taping was applied to the sprained left ankle using kinesiology tape for 4 weeks (average, 15 h/day). [Results] Ankle instability and pain were reduced, and functional dynamic balance was improved after ankle eversion taping for 4 weeks. The Cumberland Ankle Instability Tool score and reach distances in the Y-Balance and lunge tests were increased. [Conclusion] Repeated ankle eversion taping may be an effective treatment intervention for ankle inversion sprain. PMID:27064668

  7. Rehabilitation of Syndesmotic (High) Ankle Sprains

    OpenAIRE

    Williams, Glenn N; Allen, Eric J.

    2010-01-01

    Context: High ankle sprains are common in athletes who play contact sports. Most high ankle sprains are treated nonsurgically with a rehabilitation program. Evidence Acquisition: All years of PUBMED, Cochrane Database of Systematic Reviews, CINAHL PLUS, SPORTDiscuss, Google Scholar, and Web of Science were searched to August 2010, cross-referencing existing publications. Keywords included syndesmosis ankle sprain or high ankle sprain and the following terms: rehabilitation, treatment, cryothe...

  8. Osteoligamentous injuries of the medial ankle joint

    OpenAIRE

    Lötscher, P.; Lang, T. H.; Zwicky, L.; Hintermann, B; Knupp, M

    2015-01-01

    Injuries of the ankle joint have a high incidence in daily life and sports, thus, playing an important socioeconomic role. Therefore, proper diagnosis and adequate treatment are mandatory. While most of the ligament injuries around the ankle joint are treated conservatively, great controversy exists on how to treat deltoid ligament injuries in ankle fractures. Missed injuries and inadequate treatment of the medial ankle lead to inferior outcome with instability, progressive deformity, and ank...

  9. Arthroscopic decompression for subacromial impingement syndrome.

    Science.gov (United States)

    Kim, S. J.; Lee, J. W.; Kim, B. S.

    1997-01-01

    Arthroscopic decompression and cuff debridement was performed on 47 cases in 45 consecutive patients with either stage II or stage III impingement syndrome: 19 with no actual tear of the cuff (stage II); 13 with a partial thickness tear (stage IIIa); 10 with complete tear less than 3 cm long (stage IIIb); and 5 with complete tear longer than 3 cm (stage IIIc). Patients were classified into impingement syndrome without tear (Group I), impingement syndrome with partial thickness tear (Group II), and impingement syndrome with full thickness tear (Group III). Group I had 19 cases, group II had 13 cases, and group III had 15 cases. Patients were followed up for an average of 39.3 months (24 approximately 62 months). In group I, postoperative UCLA ratings improved in 18 cases (95%) to satisfactory result rate. In group II, 11 patients (85%) had improvement to satisfactory result rate. In group III, 12 cases (80%) had improvement to satisfactory result rate. The arthroscopic subacromial decompression and rotator cuff debridement was effective in the treatment of subacromial impingement syndrome. PMID:9170017

  10. [Arthroscopic treatment of distal radius fracture].

    Science.gov (United States)

    Lindau, T

    2006-11-01

    The orthopaedic surgeons cannot predict the functional results after a distal intra articular radius fracture. The intra-articular incongruity of more than 1 mm is associated with the development of secondary osteoarthrosis. The wrist arthroscopy became an essential help for the reduction of these fractures. The hand is normally in an upright position with a traction of approximately 4-5 kg which facilitates the reduction of the extra-articular fracture component. It is possible to use a technique of horizontal traction. The arthroscopy allows the reduction and control of the fixing of the various fragments, but also the treatment associated lesions associated. One randomized study, which compared 34 arthroscopically treated fractures with 48 openly treated, concluded that the arthroscopy-treated group had better outcome, better reduction, better grip strength and better range of motion than the openly treated group. The treatment of intra articular distal radius fractures with arthroscopic assistance is thus the guaranteeing of the most anatomical reduction of articular surface. It allows the diagnosis and the treatment of the associated lesions, decreases the peripheral fibrous scars of soft tissues by avoiding initially extensive approaches and finally gives better functional results. PMID:17361885

  11. Primary Frozen Shoulder Syndrome: Arthroscopic Capsular Release.

    Science.gov (United States)

    Arce, Guillermo

    2015-12-01

    Idiopathic adhesive capsulitis, or primary frozen shoulder syndrome, is a fairly common orthopaedic problem characterized by shoulder pain and loss of motion. In most cases, conservative treatment (6-month physical therapy program and intra-articular steroid injections) improves symptoms and restores shoulder motion. In refractory cases, arthroscopic capsular release is indicated. This surgical procedure carries several advantages over other treatment modalities. First, it provides precise and controlled release of the capsule and ligaments, reducing the risk of traumatic complications observed after forceful shoulder manipulation. Second, release of the capsule and the involved structures with a radiofrequency device delays healing, which prevents adhesion formation. Third, the technique is straightforward, and an oral postoperative steroid program decreases pain and allows for a pleasant early rehabilitation program. Fourth, the procedure is performed with the patient fully awake under an interscalene block, which boosts the patient's confidence and adherence to the physical therapy protocol. In patients with refractory primary frozen shoulder syndrome, arthroscopic capsular release emerges as a suitable option that leads to a faster and long-lasting recovery. PMID:26870652

  12. Pseudoaneurysm after arthroscopic procedure in the knee☆

    Science.gov (United States)

    Filho, Edmar Stieven; Isolani, Guilherme Rufini; Baracho, Filipe Ribas; de Oliveira Franco, Ana Paula Gebert; Ridder Bauer, Luiz Antônio; Namba, Mario

    2015-01-01

    The aim of this study was to review all cases of pseudoaneurysm in the literature, in predominantly arthroscopic procedures on the knee, and to report on a case of pseudoaneurysm that we treated. A bibliographic search was conducted for scientific articles published in Brazilian and foreign periodicals over the last 23 years. Forty-seven cases were found, in 40 articles. In addition to these 47 cases, there was the case that we treated, which was also included in the data. Among the operations that progressed with formation of a pseudoaneurysm, 60% were cases of meniscal injuries and 23%, anterior cruciate ligament injuries. In 46% of the cases, the artery affected with the popliteal, and in 21%, the inferomedial genicular artery. The commonest clinical symptom was pain (37%), followed by pulsating tumor (31%), edema of the calf (12%) and hemarthrosis (11%). The median time taken to make the diagnosis was 11 days, but it ranged from one day to 10 weeks after the procedure. Although rare, pseudoaneurysms are a risk that is inherent to arthroscopic surgery. All patients should be made aware of the vascular risks, even in small-scale procedures. PMID:26229905

  13. The Incidence of Ankle Sprains in Orienteering.

    Science.gov (United States)

    Ekstrand, Jan; And Others

    1990-01-01

    Investigates relationship between ankle sprains and participation time in competitive orienteering. Examined 15,474 competitors in races in the Swedish O-ringen 5-day event in 1987. Injuries requiring medical attention were analyzed, showing 137 (23.9 percent) ankle sprains. Injury incidence was 8.4/10,000 hours. Incidence of ankle sprains was…

  14. Acute Ankle Sprains in Primary Care

    NARCIS (Netherlands)

    R.M. van Rijn (Rogier)

    2010-01-01

    textabstractOf all injuries of the musculoskeletal system, 25% are acute lateral ankle sprains.1 In the USA and the UK there are about 23,000 and 5000 ankle sprains, respectively, each day. In the Netherlands approximately 600,000 people sustain an ankle injury each year, of those 120,000 occur duri

  15. Sports Injuries to the Foot and Ankle

    Science.gov (United States)

    ... the Foot and Ankle Text Size Print Bookmark Sports Injuries to the Foot and Ankle Depending on the sport, your feet and ankles can certainly take a ... the injury risk factors while playing your favorite sport, see the topics listed below or read the ...

  16. Arthroscopically assisted autologous osteochondral transplantation for osteochondral lesions of the talar dome: an MRI and clinical follow-up study.

    Science.gov (United States)

    Assenmacher, J A; Kelikian, A S; Gottlob, C; Kodros, S

    2001-07-01

    Osteochondral Lesions of the Talar Dome (OLT) are common problems encountered in orthopedics. Although the etiology remains uncertain, a myriad of treatment options exists. The authors describe arthroscopically assisted autologous osteochondral graft (OCG) transplantation procedures in the treatment of unstable OLTs in nine patients. The patients underwent standard preoperative MRI examination to assess fragment stability (using De Smet criteria for stability). Intraoperative arthroscopy was used to correlate the preoperative MRI assessment (using Cheng/Ferkel grading). After transplantation procedures, MRI (using De Smet criteria for stability) assessed graft incorporation for stability at an average of 9.3 months after the procedure. Preoperative MRI correlated highly with arthroscopic findings of OLT instability (sensitivity = 1.0). This has been demonstrated in the current orthopedic literature. The post transplantation MRI demonstrated stable graft osteointegration by De Smet criteria in all patients. Postoperative visual analogue pain scales showed significant improvement from preoperative assessment. Postoperative AOFAS Ankle-Hindfoot scores averaged 80.2 (S.D. +/- 18.9). Our favorable early results and those of other authors using similar techniques may validate OCG transplantation as a viable alternative for treating unstable osteochondral defects in the talus that are refractive to more commonly used surgical techniques. PMID:11503978

  17. Expecting ankle tilts and wearing an ankle brace influence joint control in an imitated ankle sprain mechanism during walking.

    Science.gov (United States)

    Gehring, Dominic; Wissler, Sabrina; Lohrer, Heinz; Nauck, Tanja; Gollhofer, Albert

    2014-03-01

    A thorough understanding of the functional aspects of ankle joint control is essential to developing effective injury prevention. It is of special interest to understand how neuromuscular control mechanisms and mechanical constraints stabilize the ankle joint. Therefore, the aim of the present study was to determine how expecting ankle tilts and the application of an ankle brace influence ankle joint control when imitating the ankle sprain mechanism during walking. Ankle kinematics and muscle activity were assessed in 17 healthy men. During gait rapid perturbations were applied using a trapdoor (tilting with 24° inversion and 15° plantarflexion). The subjects either knew that a perturbation would definitely occur (expected tilts) or there was only the possibility that a perturbation would occur (potential tilts). Both conditions were conducted with and without a semi-rigid ankle brace. Expecting perturbations led to an increased ankle eversion at foot contact, which was mediated by an altered muscle preactivation pattern. Moreover, the maximal inversion angle (-7%) and velocity (-4%), as well as the reactive muscle response were significantly reduced when the perturbation was expected. While wearing an ankle brace did not influence muscle preactivation nor the ankle kinematics before ground contact, it significantly reduced the maximal ankle inversion angle (-14%) and velocity (-11%) as well as reactive neuromuscular responses. The present findings reveal that expecting ankle inversion modifies neuromuscular joint control prior to landing. Although such motor control strategies are weaker in their magnitude compared with braces, they seem to assist ankle joint stabilization in a close-to-injury situation. PMID:24365326

  18. PILL series. Doctor, I sprained my ankle

    OpenAIRE

    How, Choon How; Tan, Ken Jin

    2014-01-01

    Ankle sprains constitute the majority of ankle injuries, and result in pain, limited mobility/exercise and loss of school/work days. Ankle sprains involve at least one of the ankle ligaments and range from a micro tear to complete tear of the ligament or group of ligaments. The most common mechanism of ankle sprains is inversion stress of a plantar-flexed foot, while the most frequently injured ligament is the anterior talofibular ligament. The attending clinician needs to stratify the risk o...

  19. MR Imaging of Ankle Impingement Syndromes

    Directory of Open Access Journals (Sweden)

    Seyed Hassan Mostafavi

    2010-05-01

    Full Text Available Ankle impingement syndromes are characterized by painful friction of joint tissues. This is both the cause and the effect of altered joint biomechanics. The leading causes of impingement lesions are posttraumatic ankle injuries, usually ankle sprains, resulting in chronic ankle pain. "nBased on anatomic and clinical viewpoints, there are five types of ankle impingement syndromes:"n1. Anterolateral"n2. Anterior"n3. Anteromedial"n4. Posteromedial"n5. Posterior"nCareful analyses of patient history and signs and symptoms at physical examination can suggest a specific diagnosis in most patients. MR imaging and MR arthrography are the most useful imaging methods for detecting the osseous and soft-tissue abnormalities present in these syndromes and for ruling out other potential causes of chronic ankle pain. "nThis presentation summarizes the MR imaging, and MR arthrography findings of ankle impingement syndromes.

  20. Ankle inversion taping using kinesiology tape for treating medial ankle sprain in an amateur soccer player.

    Science.gov (United States)

    Lee, Sun-Min; Lee, Jung-Hoon

    2015-07-01

    [Purpose] The purpose of this study was to report the effects of ankle inversion taping using kinesiology tape in a patient with a medial ankle sprain. [Subject] A 28-year-old amateur soccer player suffered a Grade 2 medial ankle sprain during a match. [Methods] Ankle inversion taping was applied to the sprained ankle every day for 2 months. [Results] His symptoms were reduced after ankle inversion taping application for 2 months. The self-reported function score, the reach distances in the Star Excursion Balance Test, and the weight-bearing ankle dorsiflexion were increased. [Conclusion] This study showed that ankle inversion taping using kinesiology tape may be an effective therapy for a patient with a medial ankle sprain. PMID:26311991

  1. Syndesmotic ankle sprains in athletes.

    Science.gov (United States)

    Williams, Glenn N; Jones, Morgan H; Amendola, Annunziato

    2007-07-01

    Ankle sprains are among the most common athletic injuries and represent a significant source of persistent pain and disability. Despite the high incidence of ankle sprains in athletes, syndesmosis injuries have historically been underdiagnosed, and assessment in terms of severity and optimal treatment has not been determined. More recently, a heightened awareness in sports medicine has resulted in more frequent diagnoses of syndesmosis injuries. However, there is a low level of evidence and a paucity of literature on this topic compared with lateral ankle sprains. As a result, no clear guidelines are available to help the clinician assess the severity of injury, choose an imaging modality to visualize the injury, make a decision in terms of operative versus nonoperative treatment, or decide when the athlete may return to play. Increased knowledge and understanding of these injuries by clinicians and researchers are essential to improve the prevention, diagnosis, and treatment of this significant condition. This review will discuss the anatomy, mechanism of injury, diagnosis, and treatment of syndesmosis sprains of the ankle while identifying controversies in management and topics for future research. PMID:17519439

  2. Arthroscopic Reverse Remplissage for Posterior Instability.

    Science.gov (United States)

    Lavender, Chad D; Hanzlik, Shane R; Pearson, Sara E; Caldwell, Paul E

    2016-02-01

    Posterior shoulder dislocation is an unusual injury often associated with electrical shock or seizure. As with anterior instability, patients frequently present with an impaction injury to the anterior aspect of the humeral head known as a "reverse Hill-Sachs lesion." The treatment of this bony defect is controversial, and multiple surgical procedures to fill the defect in an effort to decrease recurrence have been described. Most of the reports have focused on an open approach using variations of lesser tuberosity and subscapularis transfers, bone allograft, and even arthroplasty to assist with persistent instability. We advocate an arthroscopic technique that involves a suture anchor-based distal tenodesis of the subscapularis tendon or a reverse remplissage procedure. PMID:27073776

  3. Arthroscopic Reverse Remplissage for Posterior Instability

    Science.gov (United States)

    Lavender, Chad D.; Hanzlik, Shane R.; Pearson, Sara E.; Caldwell, Paul E.

    2016-01-01

    Posterior shoulder dislocation is an unusual injury often associated with electrical shock or seizure. As with anterior instability, patients frequently present with an impaction injury to the anterior aspect of the humeral head known as a “reverse Hill-Sachs lesion.” The treatment of this bony defect is controversial, and multiple surgical procedures to fill the defect in an effort to decrease recurrence have been described. Most of the reports have focused on an open approach using variations of lesser tuberosity and subscapularis transfers, bone allograft, and even arthroplasty to assist with persistent instability. We advocate an arthroscopic technique that involves a suture anchor–based distal tenodesis of the subscapularis tendon or a reverse remplissage procedure. PMID:27073776

  4. [Arthroscopic resection of dorsal wrist ganglia].

    Science.gov (United States)

    Borisch, N

    2014-10-01

    In arthroscopic wrist surgery, the resection of dorsal wrist ganglia has become a well accepted practice. As advantages for the minimally invasive procedure the low complication rate and low postoperative morbidity, less postoperative pain and faster recovery over open techniques are discussed. The possibility to assess accompanying joint pathology is considered as another advantage. The importance of identifying a so-called ganglion cyst stalk seems to have been overstated. Regarding the technique, the main discussion points are the size and localisation of the capsular window and the necessity of additional midcarpal arthroscopy. The possibility and results of treatment of recurrent ganglion cysts are still controversial. Our own experience and that of some authors are positive. Hardly mentioned in the literature is the treatment of occult dorsal wrist ganglia and its results, which is considered as very successful by the authors. PMID:25290273

  5. Open ankle fractures: who gets them and why?

    Science.gov (United States)

    Bugler, Kate E; Clement, Nicholas D; Duckworth, Andrew D; White, Timothy O; McQueen, Margaret M; Court-Brown, Charles M

    2015-03-01

    Open ankle fractures present a significant clinical challenge. The management and outcome of these injuries has been extensively reported, but there have been no reports of the epidemiology and how this has changed over time. We report 178 adult patients with open ankle fractures presenting to our unit over a twenty-three year period. The study centre is the only hospital receiving adult orthopaedic trauma in the region and has a defined population. The incidence of open ankle fractures was 1.5/10(5)/year, representing 1.5 % of all ankle fractures. The mean age was 55 years (range 16-96), with the highest incidence occurring in women over the age of 90. The most common mechanism was a simple fall with only 26 % of cases due to a motor vehicle collision (MVC). 82 % of cases were isolated injuries. Social deprivation had no significant influence on the incidence, but there was a difference in the mechanism with the majority of injuries in the most deprived quintile caused by MVCs and significantly fewer due to simple falls (p = 0.047). Over the twenty-three years, there was a significant increase in the mean age from 44 to 64 years (p = 0.03). The overall incidence remained constant over the two decades. In common with many traumatic injuries, open ankle fractures are increasingly low-energy insufficiency fractures affecting elderly patients, particularly older women. This has implications for service planning and training as well as the surgical intervention in these patients. PMID:25596941

  6. Application Value of 3.0 Tesla Magnetic Resonance Imaging in Evaluation of Ankle Sport's Injury%3.0T磁共振成像评价踝关节运动损伤的应用价值

    Institute of Scientific and Technical Information of China (English)

    谢筱晞; 曹桢斌; 徐莉萍; 姚彦文

    2012-01-01

    目的 探讨3.0T磁共振成像对踝关节运动损伤的应用价值.方法 回顾性分析临床确诊的28例踝关节损伤患者,以踝关节镜检/切开手术为标准,统计分析MRI检查对踝关节运动损伤的敏感性及诊断价值.结果 6例踝关节骨折MRI均正确诊断,对骨髓挫伤水肿的诊断敏感性达100%;19例临床确诊踝关节韧带损伤中,MRI诊断16例,总体敏感性达84%.8例跟腓韧带损伤MRI正确诊断6例,敏感性为75%.结论 3.0TMRI检奁对韧带、肌腱、软骨损伤具有较高的敏感性,可以很好显示踝关节损伤,为临床早期治疗及康复提供客观依据.%Objective To investigatie the application value of 3.0 Tesla magnetic resonance imaging in ankle sport's injury. Methods Twenty- eight cases of ankle sports injury confirmed by clinical operation or ankle arthroscope and underwent magnetic resonance imaging were analyzed retrospectively. Regarding clinical operation or ankle arthroscope as the standard, the sensitivity and diagnostic value of magnetic resonance imaging in ankle sport's injury was statistically analyzed. Results Six cases of ankle fracture were correctlly diagnosed by MRI, and bone marrow edema was confirmed by MRI meanwhile, MRI showed 100% sensitivity in diagnosis of ankle fracture and bone marrow edema. In nineteen cases of ankle ligaments injury confirmed by clinic, MRI detected sixteen cases, the sensitivity of diagnosis was 84%. MRI detected six cases in eight cases of calcaneofibular ligament injury, the diagnostic sensitivity was 75%. Conclusions 3.0 Tesla MRI has high sensitivity in diagnosis of ankle fracture, bone marrow edema, Ligament and tendons and cartilage damage, can discover ankle's injury in earlier stage, and provide objective basis for earlier therapy and rehabilitation of an ankle fracture.

  7. Ankle inversion taping using kinesiology tape for treating medial ankle sprain in an amateur soccer player

    OpenAIRE

    Lee, Sun-Min; Lee, Jung-Hoon

    2015-01-01

    [Purpose] The purpose of this study was to report the effects of ankle inversion taping using kinesiology tape in a patient with a medial ankle sprain. [Subject] A 28-year-old amateur soccer player suffered a Grade 2 medial ankle sprain during a match. [Methods] Ankle inversion taping was applied to the sprained ankle every day for 2 months. [Results] His symptoms were reduced after ankle inversion taping application for 2 months. The self-reported function score, the reach distances in the S...

  8. Anatomy of the ankle ligaments: a pictorial essay

    NARCIS (Netherlands)

    P. Golanó; J. Vega; P.A.J. de Leeuw; F. Malagelada; M.C. Manzanares; V. Götzens; C.N. van Dijk

    2010-01-01

    Understanding the anatomy of the ankle ligaments is important for correct diagnosis and treatment. Ankle ligament injury is the most frequent cause of acute ankle pain. Chronic ankle pain often finds its cause in laxity of one of the ankle ligaments. In this pictorial essay, the ligaments around the

  9. SYNDESMOTIC ANKLE INJURY REHABILITATION EXERCISE PACKAGE FOR ICE HOCKEY PLAYERS

    OpenAIRE

    Kuznetsov, Vitali

    2013-01-01

    SYNDESMOTIC ANKLE INJURY REHABILITATION EXERCISE PACKAGE FOR ICE HOCKEY PLAYERS Kuznetsov, Vitali Satakunnan ammattikorkeakoulu, Satakunta University of Applied Sciences Degree Programme in Physiotherapy November 2013 Supervisor: Bärlund, Esa Number of pages: 42 Appendices: 2 Keywords: ankle, ice hockey, ice hockey injuries, high ankle sprain, ankle sprain rehabilitation, ankle injury prevention __________________________________________________________________ ...

  10. Effectiveness of an outside-the-boot ankle brace in reducing parachuting related ankle injuries

    OpenAIRE

    Schmidt, M.; Sulsky, S; Amoroso, P.

    2005-01-01

    Objectives: To examine the efficacy of an outside-the-boot parachute ankle brace (PAB) in reducing risk of ankle injury to army paratrooper trainees and to identify inadvertent risks associated with PAB use.

  11. Hydrocolonotherapy ankle joints after injuries

    Directory of Open Access Journals (Sweden)

    Volodymyr Muchin

    2016-02-01

    Full Text Available Purpose: to improve efficiency of gydrokinesitherapy by means of specially designed devices and monolasts for patients after ankle joint injuries. Material & Methods: there are pedagogical methods, clinical and radiological methods, anthropometric measurements and goniometry were used. Results: the author's technique of hydrokinesitherapy with application hydrokinesimechanotherapy device in the program of physical rehabilitation which provides optimum conditions for the recovery process was developed. Conclusions: the specially designed hydrokinesomechanotherapeutic device and monolasts are allow strictly controlled movement in all planes of the ankle joint, which contributes to the acceleration of the recovery; the conducted anthropometric and goniometric studies were indicate more rapid elimination of edema, increase movement amplitude, carries opposition to the development of contractures and muscle atrophy.

  12. Safety and efficiency of the Ottawa Ankle Rule in a Swiss population with ankle sprains

    OpenAIRE

    Can, U; Ruckert, R; Held, U; Buchmann, P; Platz, A; Bachmann, L M

    2008-01-01

    OBJECTIVES: We examined the accuracy of the Ottawa Ankle Rule (OAR) to rule out ankle and mid-foot fractures in patients presenting with acute ankle sprain and differences of accuracy between surgeons and non-surgeons. DESIGN: Prospective cohort study. SETTING: Swiss urban secondary care centre. PARTICIPANTS: Between September 2001 and October 2002 359 patients presented with a case of ankle sprain. Of these, 251 patients both met recruitment criteria and provided data for this study. A group...

  13. Ottawa Ankle Rules and Subjective Surgeon Perception to Evaluate Radiograph Necessity Following Foot and Ankle Sprain

    OpenAIRE

    Pires, RES; Pereira, AA; Abreu-e-Silva, GM; Labronici, PJ; Figueiredo, LB; Godoy-Santos, AL; Kfuri, M

    2014-01-01

    Background: Foot and ankle injuries are frequent in emergency departments. Although only a few patients with foot and ankle sprain present fractures and the fracture patterns are almost always simple, lack of fracture diagnosis can lead to poor functional outcomes. Aim: The present study aims to evaluate the reliability of the Ottawa ankle rules and the orthopedic surgeon subjective perception to assess foot and ankle fractures after sprains. Subjects and Methods: A cross-sectional study was ...

  14. Sonographic anatomy of the ankle

    OpenAIRE

    Precerutti, M.; Bonardi, M.; Ferrozzi, G.; Draghi, F.

    2013-01-01

    Ankle sonography is one of the most commonly ordered examinations in the field of osteoarticular imaging, and it requires intimate knowledge of the anatomic structures that make up the joint. For practical purposes, the examination can be divided into four compartments, which are analyzed in this pictorial essay: the anterior compartment, which includes the tibialis anterior, extensor hallucis longus, and extensor digitorum longus tendons; the accessory peroneus tertius tendon; and the extens...

  15. Hydrocolonotherapy ankle joints after injuries

    OpenAIRE

    Volodymyr Muchin; Oleksandr Zviriaka

    2016-01-01

    Muchin V., Zviriaka O. Purpose: to improve efficiency of gydrokinesitherapy by means of specially designed devices and monolasts for patients after ankle joint injuries. Material & Methods: there are pedagogical methods, clinical and radiological methods, anthropometric measurements and goniometry were used. Results: the author's technique of hydrokinesitherapy with application hydrokinesimechanotherapy device in the program of physical rehabilitation which provides optimum conditions for...

  16. Ankle reconstruction in type II fibular hemimelia

    OpenAIRE

    El-Tayeby, Hazem Mossad; Ahmed, Amin Abdel Razek Youssef

    2012-01-01

    Ankle reconstruction prior to limb lengthening for was performed in 13 patients with fibular hemimelia with complete radiological absence of the fibula (type II). There were different degrees of absence of metatarsal rays. The hindfoot deformity was a heel valgus in 12 patients and equinovarus in 1 patient. The patients’ ages ranged from 9 to 26 months. Excision of the fibular anlage was performed with lateral subtalar and ankle soft tissue releases to restore the ankle and subtalar joint rel...

  17. Predicting Functional Recovery after Acute Ankle Sprain

    OpenAIRE

    Sean R O'Connor; Bleakley, Chris M; Tully, Mark A; McDonough, Suzanne M

    2013-01-01

    INTRODUCTION:Ankle sprains are among the most common acute musculoskeletal conditions presenting to primary care. Their clinical course is variable but there are limited recommendations on prognostic factors. Our primary aim was to identify clinical predictors of short and medium term functional recovery after ankle sprain.METHODS:A secondary analysis of data from adult participants (N = 85) with an acute ankle sprain, enrolled in a randomized controlled trial was undertaken. The predictive v...

  18. How to Stretch Your Ankle After a Sprain

    Science.gov (United States)

    ... Ankle After A Sprain How to Stretch Your Ankle After A Sprain Page Content You should perform the following stretches ... Consider these home exercises when recuperating from an ankle sprain. Perform them twice per day. While seated, bring ...

  19. Methylene blue-enhanced arthroscopic resection of dorsal wrist ganglions.

    Science.gov (United States)

    Lee, Byung Joo; Sawyer, Gregory A; Dasilva, Manuel F

    2011-12-01

    The ganglion is the most common soft tissue mass of the hand and wrist. Over the past 10 to 15 years, there has been a growing interest in arthroscopic treatment of dorsal wrist ganglions. Proposed advantages of arthroscopy include greater motion (particularly wrist flexion), improved cosmesis, and potential to identify/treat other intra-articular pathology. Despite the documented clinical success of arthroscopic ganglion excision, limitations include inconsistent identification of the ganglion stalk. Our described technique offers a means by which to improve visualization of the ganglion stalk intra-articularly to produce a more effective and efficient arthroscopic ganglion excision. During the procedure, a small volume of methylene blue solution is injected into the cyst. Its communication with the joint is apparent arthroscopically, thus identifying the location of the stalk. With the ability to precisely identify the ganglion stalk using an injection of methylene blue, the surgeon can direct the arthroscopic debridement toward the appropriate pathologic tissue. Unnecessary debridement of uninvolved tissue can be avoided with the technique. This also allows for optimal portal placement and, in particular, indicates whether a midcarpal portal should be employed. This should result in fewer recurrences, decreased operative time, and less iatrogenic injury. PMID:22105637

  20. Total Ankle Arthroplasty: An Imaging Overview

    Science.gov (United States)

    Kim, Da-Rae; Potter, Hollis G.; Li, Angela E.; Chun, Ka-Young; Jung, Yoon Young; Kim, Jin-Su; Young, Ki-Won

    2016-01-01

    With advances in implant technology, total ankle arthroplasty (TAA) has become an increasingly popular alternative to arthrodesis for the management of end-stage ankle arthritis. However, reports in the literature do not focus on the imaging features of TAA. Through a literature review, we demonstrate basic design features of the current ankle arthroplasty system, and the normal and abnormal postoperative imaging features associated with such devices. Pre- and postoperative evaluations of ankle arthroplasty mainly include radiography; in addition, computed tomography and magnetic resonance imaging provide further characterization of imaging abnormalities. Familiarization with multimodal imaging features of frequent procedural complications at various postoperative intervals is important in radiological practice. PMID:27134529

  1. Surgical treatment of the arthritic varus ankle.

    Science.gov (United States)

    Easley, Mark E

    2012-12-01

    Within the past several years, the arthritic varus ankle has been addressed extensively in Foot and Ankle Clinics, with numerous excellent reviews by particularly knowledgeable authors. To support these outstanding contributions, this article provides a practical approach to this challenging constellation of foot and ankle abnormalities. Varus ankle arthritis exists on a continuum that prompts the treating surgeon to be familiar with a spectrum of surgical solutions, including joint-sparing realignment, arthroplasty, and arthrodesis. Each of these treatment options is addressed with several expanded case examples and supports the management approaches with the available pertinent literature. PMID:23158376

  2. Evidence-based treatment for ankle injuries: a clinical perspective

    OpenAIRE

    Lin, Chung-Wei Christine; Hiller, Claire E; de Bie, Rob A.

    2010-01-01

    The most common ankle injuries are ankle sprain and ankle fracture. This review discusses treatments for ankle sprain (including the management of the acute sprain and chronic instability) and ankle fracture, using evidence from recent systematic reviews and randomized controlled trials. After ankle sprain, there is evidence for the use of functional support and non-steroidal anti-inflammatory drugs. There is weak evidence suggesting that the use of manual therapy may lead to positive short-t...

  3. The Arthroscopic Ulnohumeral Arthroplasty: From Mini-Open to Arthroscopic Surgery

    Directory of Open Access Journals (Sweden)

    Ilse Degreef

    2011-01-01

    Full Text Available In cubarthritis—osteoarthritis of the elbow—surgical procedures may be considered to debride the elbow joint to reduce pain, to increase mobility, and to postpone joint replacement surgery. The ulnohumeral arthroplasty as described by Outerbridge and Kashiwagi was originally introduced to debride both anterior and posterior elbow compartments through a direct posterior mini-open approach. To achieve this, a distal humeral fenestration throughout the humeral fossa is performed. Although with an elbow arthroscopy, a technique that was obviously developed later on, all compartments can be easily visualized. The arthroscopic fenestration of the humerus preserves its advantages, with good clinical results focused on pain relief and gaining mobility. On top, future elbow joint locking based on degenerative loose bodies can be prevented. Therefore, this surgery is often done in young, more active patients and even in sportsmen. These patients, however, need to be prompted to restrict loading on the elbow in the immediate postoperative period, because the elbow is biomechanically weakened and may be prone to a fracture. However, both outcome and postoperative rehabilitation are promising and the arthroscopic Outerbridge procedure is a reliable procedure with an easy rehabilitation. Therefore, the threshold is relatively low in early cubarthritis and recurrent locking of the elbow. In this paper, we present a literature review and the author's experience and own research on the Outerbridge procedure.

  4. Outcomes of Open Subacromial Decompression after Failed Arthroscopic Acromioplasty

    Science.gov (United States)

    Pillai, Anand; Eranki, Vivek; Malal, Joby; Nimon, Gavin

    2012-01-01

    Aim. To prospectively assess the effectiveness of revision with open subacromial decompression in patients who had a previous unsatisfactory outcome with the arthroscopic procedure. Methods. 11 patients were identified for the study, who did not demonstrate expected improvement in symptoms after arthroscopic acromioplasty. All patients underwent structured rehabilitation. Functional evaluation was conducted using the Hospital for Special Surgery, New York, shoulder rating questionnaire. Results. M : F was 7 : 4. The mean age was 57 years. The average shoulder score improved from 49.6 preoperatively to 56 postoperatively at an average followup of 16 months. Two patients showed deterioration in their shoulder scores after revision while the rest showed only marginal improvement. All except one patient stated that they would opt for surgery again if given a second chance. Conclusion. In the group of patients that fail to benefit from the arthroscopic decompression, only a marginal improvement was noted after revision with open decompression. PMID:22649740

  5. Avascular osteonecrosis of the femoral condyle after arthroscopic surgery

    International Nuclear Information System (INIS)

    Avascular osteonecrosis of the femoral condyle after arthroscopic surgery. Retrospective review of 10 patients who presented with avascular necrosis of the ipsilateral femoral condyle following arthroscopic meniscectomy (9 medial, 1 lateral). The bone lesions were evaluated by radiography and MRI, which were repeated for few patients. MRI allows earlier diagnosis of avascular necrosis of the femoral condyle and offers an evaluation of extent of the lesions whose evolution is variable: 3 patients required a knee prosthesis, the other 7 patients were treated medically. (authors)

  6. Do ankle braces provide similar effects on ankle biomechanical variables in subjects with and without chronic ankle instability during landing?

    Institute of Scientific and Technical Information of China (English)

    Songning; Zhang; Michael; Wortley; Julia; Freedman; Silvernail; Daniel; Carson; Maxime; R.Paquette

    2012-01-01

    <正>Purpose:The purpose of this study was to examine effects of a sport version of a semi-rigid ankle brace(ElementTM) and a soft ankle brace (ASO) on ankle biomechanics and ground reaction forces(GRFs) during a drop landing activity in subjects with chronic ankle instability(CAD compared to healthy subjects with no history of CAI. Methods:Ten healthy subjects and 10 subjects who had multiple ankle sprains participated in the study as the control and unstable subjects, respectively.The CAI subjects were age,body mass index and gender matched with the control subjects.The arch index and ankle functions of the subjects were measured in a subject screening session.During the biomechanical test session,participants performed five trials of drop landing from 0.6 m,wearing no brace(NB).Element? brace and ASO brace.Simultaneous recording of three-dimensional kinematic(240 Hz) and GRF(1200 Hz) data were performed. Results:The CAI subjects had lower ankle functional survey scores.The arch index and deformity results showed greater arch deformity of ElementTM against a static load than in NB and ASO due to greater initial arch position held by the brace.CAI participants had greater eversion velocity than healthy controls.The ASO brace reduced the first peak vertical GRF whereas ElementTM increased 2nd peak vertical GRF. ElementTMbrace reduced eversion range of motion(ROM) and peak eversion velocity compared to NB and ASO.In addition,ElementTM reduced dorsiflexion ROM and increased peak plantarflexion moment compared to NB and ASO. Conclusion:Results of static arch measurements and dynamic ankle motion suggest that the restrictions offered by both braces are in part due to more dorsiflexed ankle positions at contact,and higher initial arch position and stiffer ankle for ElementTM.

  7. Redefining prosthetic ankle mechanics: non-anthropomorphic ankle design.

    Science.gov (United States)

    LaPrè, Andrew K; Sup, Frank

    2013-06-01

    The moment transferred at the residual limb socket interface of transtibial amputees can be a limiting factor of the comfort and activity level of lower limb amputees. The high pressures seen can be a significant source of pain, as well as result in deep tissue damage. The compensation of the sound limbs causes an asymmetrical gait which can be a contributor of early onset osteoarthritis in the sound limbs. It has been shown that the moment transferred with conventional passive prostheses can be lowered in magnitude by aligning the tibia with ground reaction forces, but this limits the effectiveness of the device. With recent powered prosthetics designed to mimic the missing limb, power can be injected into the gait cycle, but can also be limited by this pressure threshold. This paper shows the results of calculations that suggest that altering the prosthetic ankle mechanism can reduce the socket interface moments by as much as 50%. This supports the development of an active non-anthropomorphic ankle prosthesis which reduces socket interface moments while still injecting substantial power levels into the gait cycle. PMID:24187257

  8. Chinese Massage Therapy for Ankle Injury

    Institute of Scientific and Technical Information of China (English)

    CHEN Ming-xia; LI Nian-qun; HUANG Guo-qi

    2003-01-01

    Purpose: To explore the therapeutic methods and effects in the treatment of acute and chronic injuries of the ankle joint by Chinese massage therapy in combination with external application of Chinese herbal drugs and functional exercises. Methods: Totally, 36 cases of the patients with acute soft tissue injury, chronic soft tissue injury and post-fracture sequelae of the ankle joint were treated by Chinese massage therapy, external application or external wash of Chinese herbal drugs, and exercises of dorsal flexion and extension of the ankle joint, to observe the restoration of the ankle functions.Results: In 36 cases of the patients, the results showed remarkable effect in 18 cases, effect in 16 cases, failure in 2 cases and the effective rate in 94.4%. Conclusion: The combined use of Chinese massage therapy, external application of Chinese herbal drugs and functional exercises can produce precise effect in the treatment of soft tissue injury of the ankle joint.

  9. Efficacy of arthroscopically placed pain catheter adjacent to the suprascapular nerve (continuous arthroscopically assisted suprascapular nerve block following arthroscopic rotator-cuff repair

    Directory of Open Access Journals (Sweden)

    Yamakado K

    2014-05-01

    Full Text Available Kotaro YamakadoDepartment of Orthopaedics, Fukui General Hospital, Fukui, JapanBackground: Rotator-cuff surgery is well recognized to be a painful procedure.Objectives: The purpose of this study was to examine the effectiveness of an arthroscopically placed perineural catheter at the scapular notch to provide a continuous block of the suprascapular nerve (continuous arthroscopically assisted suprascapular nerve block [ca-SSNB] following arthroscopic rotator-cuff repair (ARCR.Materials and methods: This level II, prospective, randomized, controlled trial without postoperative blinding included 40 patients, who had a 48-hour pain pump, with 0.2% ropivacaine infusion and a continuous rate of 3 mL/hour, placed via an arthroscopically placed catheter following ARCR with arthroscopic release of the superior transverse ligament: 21 patients had a ca-SSNB, and 19 patients had a continuous subacromial bursal block (SAB. The visual analog scale (at 6 hours and on the first, second, and third postoperative days and the total number of additional pain-reduction attempts during the 3 postoperative days were calculated.Results: The respective visual analog scale scores (mm obtained from the ca-SSNB and SAB groups were 62.4 and 67.6 (P=0.73 before surgery, 9.1 and 19.4 (P=0.12 at 6 hours after surgery, 24.4 and 44.6 (P=0.019 on the first postoperative day, 19.4 and 40.4 (P=0.0060 on the second postoperative day, and 18.5 and 27.8 (P=0.21 on the third postoperative day. Total additional pain-reduction attempts recorded for the ca-SSNB and SAB groups during the 3 postoperative days were 0.3 times and 1.2 times (P=0.0020, respectively.Conclusion: ca-SSNB was highly effective in controlling postoperative pain after ARCR.Keywords: shoulder, rotator cuff tear, postoperative pain control, continuous suprascapular nerve block, arthroscopic rotator cuff repair

  10. 距骨骨软骨损伤的诊断及关节镜治疗%Diagnosis and arthroscopic treatment of osteochondral lesions of the talus

    Institute of Scientific and Technical Information of China (English)

    郭秦炜; 胡跃林; 焦晨; 敖英芳; 于长隆

    2008-01-01

    目的 总结、分析距骨骨软骨损伤的症状、体征、影像学特点、关节镜下治疗方法及手术效果.方法 2000年至2005年共收治34例距骨骨软骨损伤患者,对其临床资料包括症状、体征、X线片、MRI表现、关节镜手术方法等进行回顾性分析,术后随访根据主观和客观评分判断疗效.术前美国足踝外科后足评分平均(71±8)分,术前主观疼痛程度评分(7.5±1.3)分.结果 34例患者MRI均有骨软骨损伤征象,其中21例通过X线片检查发现距骨骨软骨损伤.距骨骨软骨损伤的主要症状为负重疼痛以及运动后加重,MRI诊断准确率较X线片高(χ2=16.07,P<0.001).31例患者获得随访,平均随访时间为28个月.术后美国足踝外科后足评分(91±9)分,显著高于术前(t=9.147,P<0.001);术后主观疼痛程度评分(2.4±2.3)分,显著低于术前(t=10.853,P<0.001);临床疗效优良率为87.1%.结论 MRI检查能够提高诊断的正确率,关节镜微创手术治疗距骨骨软骨损伤效果良好.%Objective To summarize and analyze the diagnosis and arthroscopic treatment of osteochondral lesion of talus(OLT).Methods From 2000 to 2005 the data of 34 patients of OLT of the talus were retrospectively studied,including the symptom,physical examination,image,arthroscopic treatment.All patients took X-ray and MRI examination before the arthroscopic surgery.Arthroscopic debridement was performed for all patients,in addition to drilling in 5 cases,and microfracture in 18 cases.Before operation,ankle-hindfoot score of American Orthopaedic Foot and Ankle Society(AOFAS)was 71±8,and the score of pain(visual analogue scale,VAS)Was 7.5±1.3.Results Weight-bearing pain of the ankle joint aggravated after exercise was the predominant complaint of OLT.X-ray examination was negative in 13 cases,and all lesions were detected by MRI,which was signifcantly better than X-ray(χ2=16.07,P<0.001).Thirty-one patients were followed up for an average of 28

  11. The role of ankle bracing for prevention of ankle sprain injuries.

    Science.gov (United States)

    Gross, Michael T; Liu, Hsin-Yi

    2003-10-01

    Lateral ankle sprains are one of the most common injuries incurred in recreational and competitive athletics. These injuries have a significant impact in terms of cost, athletic participation, and activities of daily living. Prophylactic ankle braces are often used to reduce the risk of injury recurrence when individuals return to athletic participation. The purpose of this clinical commentary is to review the literature and provide our own experience relative to the use of prophylactic ankle bracing. Relatively high incidence rates of ankle sprain injury have been reported for basketball and soccer athletes, military trainees, and individuals with a previous history of ankle sprain injury. Semirigid and laced ankle braces have significantly reduced the incidence of initial and recurrent ankle sprain injuries in athletic and military samples. With few exceptions, these braces do not appear to affect functional performance adversely. The prophylactic use of semirigid ankle braces appears warranted to reduce the incidence of initial and, in particular, recurrent ankle sprain injuries for individuals who participate in activities that have the highest risk for these injuries. Additional research is needed to evaluate the many new braces that are available and in use and their influence on the incidence of ankle sprain injury and functional performance. PMID:14620786

  12. Arthroscopic treatment of bony loose bodies in the subacromial space

    Directory of Open Access Journals (Sweden)

    Wei Li

    2015-01-01

    Conclusion: The mechanism of formation of bony loose bodies is not clear, may be associated with synovial cartilage metaplasia. Arthroscopic removal of loose bodies and bursa debridement is a good option for treatment of the loose body in the subacromial space, which can receive good function.

  13. Arthroscopic management of the arthritic elbow: indications, technique, and results.

    Science.gov (United States)

    Savoie, F H; Nunley, P D; Field, L D

    1999-01-01

    Twenty-four patients with painful restricted motion of the elbow joint because of an arthritic process were treated with an arthroscopic modification of the open Outerbridge-Kashiwagi procedure. Average preoperative flexion was to 90 degrees (range 60 degrees to 140 degrees), and average extension loss was -40 degrees (range -5 degrees to -60 degrees). The average total arc of motion was 50 degrees. The procedure consisted of arthroscopic debridement, partial resection of the coronoid and olecranon processes, and fenestration of the olecranon fossa. The radial head was excised arthroscopically in 18 of the 24 patients. All patients were reexamined 24 to 60 months after operation (mean 32 months). All patients had a significant decrease in pain as described by a visual analog scale (preoperative 8.2; postoperative 2.2). Average flexion was to 139 degrees (range 95 degrees to 145 degrees), and average extension loss was -8 degrees (range 0 degree to 15 degrees). The average arc of motion was 131 degrees, an improvement of 81 degrees. Arthroscopic ulnohumeral arthroplasty provides satisfactory results in terms of pain control and improved motion. The complication rate is comparable to those reported in series of open ulnohumeral arthroplasties. This procedure seems to be a valuable adjunct in the management of the arthritic elbow, serving as an intermediate step between nonoperative management and elbow replacement surgery. PMID:10389075

  14. Plate presetting arthroscopic reduction technique for the distal radius fractures.

    Science.gov (United States)

    Abe, Yukio; Tsubone, Tetsu; Tominaga, Yasuhiro

    2008-09-01

    Wrist arthroscopy for the distal radius fractures is an effective adjunct to evaluate the reduction of intraarticular fragments and soft tissue injuries. In recent years, volar locking plate fixation has become popular, and arthroscopic procedures for distal radius fracture reduction have become problematic because vertical traction has to be both on and off during surgery. We developed a plate presetting arthroscopic reduction technique to simplify the combination of plating and arthroscopy. The fracture was reduced, and anatomic alignment was regained under an image intensifier, and then the volar locking plate was preset. Wrist arthroscopy was introduced under vertical traction, and the intraarticular condition was assessed. If dislocations of the intraarticular fragments were residual, they were reduced arthroscopically, and soft tissue injuries were treated subsequently. Finally, the traction was removed, and the plate was securely fixed. Since May 2005, the authors have used this technique in more than 50 patients. This article will review the history, indications, contraindications, technique, rehabilitation, and complications for the plate presetting arthroscopic reduction technique for distal radius fractures. PMID:18776773

  15. Isolated subacromial bursal fluid on MRI of the shoulder in symptomatic patients: correlation with arthroscopic findings

    Energy Technology Data Exchange (ETDEWEB)

    Monu, J.U.V. [Dept. of Radiology, Bowman Gray School of Medicine, Wake Forest Univ., Winston-Salem, NC (United States); Pruett, S. [Bowman Gray School of Medicine, Wake Forest Univ., Winston-Salem, NC (United States); Vanarthos, W.J. [Dept. of Radiology, Bowman Gray School of Medicine, Wake Forest Univ., Winston-Salem, NC (United States); Pope, T.L. Jr. [Dept. of Radiology, Bowman Gray School of Medicine, Wake Forest Univ., Winston-Salem, NC (United States)

    1994-10-01

    Fluid in the subacromial bursa (SAB) is a common finding on magnetic resonance (MR) images of the shoulder, and the implications of this finding have not been clarified. We retrospectively reviewed and correlated the MR features with arthroscopic findings in 21 symptomatic patients who had fluid in the SAB on MR imaging without demonstrable rotator cuff tear. Rotator cuff impingement was the most frequent surgical finding (42.9%). Other frequent surgical observations were glenbid labrum abnormality (28.6%), bursitis (19%), and supraspinatus tendinitis (14.3%). Distribution of acromial types was similar to that reported by Bigliani et al., and impingement was evenly distributed among acromial types in our study population. We conclude that in our patient population group the MR finding of isolated SAB fluid in symptomatic patients is highly likely to be associated with the finding of other abnormalities in the shoulder joint at surgery. (orig.)

  16. Isolated subacromial bursal fluid on MRI of the shoulder in symptomatic patients: correlation with arthroscopic findings

    International Nuclear Information System (INIS)

    Fluid in the subacromial bursa (SAB) is a common finding on magnetic resonance (MR) images of the shoulder, and the implications of this finding have not been clarified. We retrospectively reviewed and correlated the MR features with arthroscopic findings in 21 symptomatic patients who had fluid in the SAB on MR imaging without demonstrable rotator cuff tear. Rotator cuff impingement was the most frequent surgical finding (42.9%). Other frequent surgical observations were glenbid labrum abnormality (28.6%), bursitis (19%), and supraspinatus tendinitis (14.3%). Distribution of acromial types was similar to that reported by Bigliani et al., and impingement was evenly distributed among acromial types in our study population. We conclude that in our patient population group the MR finding of isolated SAB fluid in symptomatic patients is highly likely to be associated with the finding of other abnormalities in the shoulder joint at surgery. (orig.)

  17. Anaesthetic management of shoulder arthroscopic repair in Parkinson′s disease with deep brain stimulator

    Directory of Open Access Journals (Sweden)

    Ranju Gandhi

    2014-01-01

    Full Text Available We describe the anaesthetic management of arthroscopic repair for complete rotator cuff tear of shoulder in a 59-year-old female with Parkinson′s disease (PD with deep brain stimulator (DBS using a combination of general anaesthesia with interscalene approach to brachial plexus block. The DBS consists of implanted electrodes in the brain connected to the implantable pulse generator (IPG normally placed in the anterior chest wall subcutaneously. It can be programmed externally from a hand-held device placed directly over the battery stimulator unit. In our patient, IPG with its leads was located in close vicinity of the operative site with potential for DBS malfunction. Implications of DBS in a patient with PD for shoulder arthroscopy for anaesthesiologist are discussed along with a brief review of DBS.

  18. EFFECTS OF FATIGUE & GENDER ON PERONEAL REFLEXES AFTER ANKLE INVERSION

    OpenAIRE

    Wilson, Erin Lawall

    2005-01-01

    An estimated 23,000 ankle injuries occur every day in the U.S. Ankle sprains account for 85% of all ankle injuries and inversion ankle sprains account for 85% of all ankle sprains. There is growing evidence that suggests gender and fatigue may increase the risk for inversion ankle sprains. Investigating the effects of fatigue and gender on peroneal reflex response after ankle inversion may help explain the differences in sprain rates with fatigue and gender. Therefore, the purpose of this stu...

  19. Conversion of ankle autofusion to total ankle replacement using the Salto XT revision prosthesis.

    Science.gov (United States)

    Williamson, Emilie R C; Demetracopoulos, Constantine A; Ellis, Scott J

    2016-09-01

    Few reports in the literature have described the conversion of a surgically fused ankle to a total ankle replacement. The takedown of an autofusion and conversion to a prosthesis has not been described. We report the case of a patient with severe rheumatoid arthritis with an ankle autofusion fixed in equinus and severe talonavicular arthritis that was converted to ankle replacement using the Salto XT revision system. We describe the reasons why the decision was made to perform total ankle arthroplasty while concomitantly fusing the talonavicular joint, and discuss the rationale of the various surgical treatment options considered. We describe the clinical and radiographic outcomes achieved in this case. At 12 months post-operatively the patient reported significant reduction of pain, increased FAOS scores and had increased ankle range of motion. PMID:27502236

  20. Foot and Ankle Injuries in Runners.

    Science.gov (United States)

    Tenforde, Adam S; Yin, Amy; Hunt, Kenneth J

    2016-02-01

    Foot and ankle injuries account for nearly one-third of running injuries. Achilles tendinopathy, plantar fasciopathy, and ankle sprains are 3 of the most common types of injuries sustained during training. Other common injuries include other tendinopathies of the foot and ankle, bone stress injuries, nerve conditions including neuromas, and joint disease including osteoarthritis. This review provides an evidence-based framework for the evaluation and optimal management of these conditions to ensure safe return to running participation and reduce risk for future injury. PMID:26616180

  1. Effects of Nintendo Wii Fit Plus training on ankle strength with functional ankle instability

    OpenAIRE

    Kim, Ki-Jong; Jun, Hyun-Ju; Heo, Myoung

    2015-01-01

    [Purpose] The objective of this study was to examine the effects of a training program using the Nintendo Wii Fit Plus on the ankle muscle strengths of subjects with functional ankle instability. [Subjects and Methods] This study was conducted using subjects in their 20s who had functional ankle instability. They were randomized to a strengthening training group and a balance training group with 10 subjects in each, and they performed an exercise using Nintendo Wii Fit Plus for 20 minutes. In...

  2. Clinical Value of the Ottawa Ankle Rules for Diagnosis of Fractures in Acute Ankle Injuries

    OpenAIRE

    Xin Wang; Shi-min Chang; Guang-rong Yu; Zhi-tao Rao

    2013-01-01

    BACKGROUND: The Ottawa ankle rules (OAR) are clinical decision guidelines used to identify whether patients with ankle injuries need to undergo radiography. The OAR have been proven that their application reduces unnecessary radiography. They have nearly perfect sensitivity for identifying clinically significant ankle fractures. OBJECTIVES: The purpose of this study was to assess the applicability of the OAR in China, to examine their accuracy for the diagnosis of fractures in patients with a...

  3. Primary ankle arthrodesis for neglected open weber B ankle fracture dislocation.

    LENUS (Irish Health Repository)

    Thomason, Katherine

    2014-07-01

    Primary ankle arthrodesis used to treat a neglected open ankle fracture dislocation is a unique decision. A 63-year-old man presented to the emergency department with a 5-day-old open fracture dislocation of his right ankle. After thorough soft tissue debridement, primary arthrodesis of the tibiotalar joint was performed using initial Kirschner wire fixation and an external fixator. Definitive soft tissue coverage was later achieved using a latissimus dorsi free flap. The fusion was consolidated to salvage the limb from amputation. The use of primary arthrodesis to treat a compound ankle fracture dislocation has not been previously described.

  4. Lichen simplex chronicus on the ankle (image)

    Science.gov (United States)

    Lichen simplex chronicus on the ankle: Lichen simplex chronicus is also known as neurodermatitis. A minor itch may encourage scratching which increases the irritation, leading to more scratching. This ultimately results ...

  5. A novel dynamic ankle-supinating device.

    Science.gov (United States)

    Gutierrez, Gregory M; Kaminski, Thomas

    2010-02-01

    Lateral ankle sprains (LAS) are among the most common joint injuries, and although most are resolved with conservative treatment, others develop chronic ankle instability (AI). Considerable attention has been directed toward understanding the underlying causes of this pathology; however, little is known concerning the neuromuscular mechanisms behind AI. A biomechanical analysis of the landing phase of a drop jump onto a device that simulates the mechanism of a LAS may give insight into the dynamic restraint mechanisms of the ankle by individuals with AI. Furthermore, work evaluating subjects who have a history of at least one lateral ankle sprain, yet did not develop AI, may help elucidate compensatory mechanisms following a LAS event. Identifying proper neuromuscular control strategies is crucial in reducing the incidence of AI. PMID:20147765

  6. Osteoarthritis of the Foot and Ankle

    Science.gov (United States)

    ... joint. Diagnosis In diagnosing osteoarthritis, the foot and ankle surgeon will examine the foot thoroughly, looking for swelling in the joint, limited mobility, and pain with movement. In some cases, deformity ...

  7. Postoperative MR study of the ankle

    International Nuclear Information System (INIS)

    20 patients with acute traumatic rupture of the anterior talofibular ligament and ligamental suture were studied postoperatively by MRI. MR results were correlated with stress X-ray studies. We found a normal anterior talofibular ligament in eight cases. However, stress X-ray images showed normal stability of the ankle joint in eighteen cases. In six patients the anterior talofibular ligament was thickened, in another six cases it could not be separated from scar tissue. Therefore MR imaging of ankle ligaments did not allow a diagnosis of their function. Nevertheless, sequelae of the ankle trauma such as osteochondrosis, exsudation into the ankle joint and tendovaginitis of the flexor muscles were sensitively visualised by MR. (orig.)

  8. What Is a Foot and Ankle Surgeon?

    Science.gov (United States)

    ... school, the foot and ankle surgeon enters a postgraduate residency in podiatric medicine and surgery approved by ... disorders and injuries that affect people of all ages. They are uniquely qualified to detect the early ...

  9. The outcome study of arthroscopic repair with anchor suture for anterior shoulder instabilities

    OpenAIRE

    Guity MR; Sianati S

    2010-01-01

    "nBackground: Anterior glenohumeral instabilities can be corrected with open and arthroscopic surgery. The purpose of this study was to evaluate retrospectively the surgical outcomes of arthroscopic repair of anterior glenohumeral instabilities with use of suture anchors in a series of patients who were followed for twenty to fifty months."n "nMethods: The results of arthroscopic Bankart repair with use of suture anchors in 30 patients with traumatic recurrent anterior instabil...

  10. Functional outcome after open and arthroscopic Bankart repair for traumatic shoulder instability

    Directory of Open Access Journals (Sweden)

    Lützner J

    2009-01-01

    Full Text Available Abstract Purpose Both open and arthroscopic Bankart repair are established procedures in the treatment of anterior shoulder instability. While the open procedure is still considered as the "golden standard" functional outcome is supposed to be better in the arthroscopic procedure. The aim of this retrospective study was to compare the functional outcome between open and arthroscopic Bankart repair. Materials and methods In 199 patients a Bankart procedure with suture anchors was performed, either arthroscopically in presence of an detached, but not elongated capsulolabral complex (40 or open (159. After a median time of 31 months (12 to 67 months 174 patients were contacted and agreed to follow-up, 135 after open and 39 after arthroscopic Bankart procedure. Results Re-dislocations occurred in 8% after open and 15% after arthroscopic Bankart procedure. After open surgery 4 of the 11 re-dislocations occurred after a new adequate trauma and 1 of the 6 re-dislocations after arthroscopic surgery. Re-dislocations after arthroscopic procedure occured earlier than after open Bankart repair. An external rotation lag of 20° or more was observed more often (16% after open than after arthroscopic surgery (3%. The Rowe score demonstrated "good" or "excellent" functional results in 87% after open and in 80% patients after arthroscopic treatment. Conclusion In this retrospective investigation the open Bankart procedure demonstrated good functional results. The arthroscopic treatment without capsular shift resulted in a better range of motion, but showed a tendency towards more frequently and earlier recurrence of instability. Sensitive patient selection for arthroscopic Bankart repair is recommended especially in patients with more than five dislocations.

  11. Functional outcome after open and arthroscopic Bankart repair for traumatic shoulder instability

    OpenAIRE

    Lützner J; Krummenauer F; Lübke J; Kirschner S; Günther K-P; Bottesi M

    2009-01-01

    Abstract Purpose Both open and arthroscopic Bankart repair are established procedures in the treatment of anterior shoulder instability. While the open procedure is still considered as the "golden standard" functional outcome is supposed to be better in the arthroscopic procedure. The aim of this retrospective study was to compare the functional outcome between open and arthroscopic Bankart repair. Materials and methods In 199 patients a Bankart procedure with suture anchors was performed, ei...

  12. Postoperative infection in the foot and ankle.

    LENUS (Irish Health Repository)

    Chan, Victoria O

    2012-07-01

    Our discussion highlights the commonly performed surgical procedures in the foot and ankle and reviews the various imaging modalities available for the detection of infection with graphic examples to better enable radiologists to approach the radiological evaluation of postoperative infection in the foot and ankle. Discrimination between infectious and noninfectious inflammation remains a diagnostic challenge usually needing a combination of clinical assessment, laboratory investigations, and imaging studies to increase diagnostic accuracy.

  13. Is balance impaired by recurrent sprained ankle?

    OpenAIRE

    Isakov, E; Mizrahi, J.

    1997-01-01

    OBJECTIVE: To evaluate uninjured and recurrent sprained ankles during single leg standing, both with and without visual input, and the contribution of related proprioceptive feedback in this event. METHODS: A force measuring system was used for monitoring reaction forces in the anteroposterior and mediolateral directions during single leg standing. Differences between selected variables obtained in the uninjured and sprained ankles were analysed using two way analysis of variance. RESULTS: Fo...

  14. An epidemiological survey on ankle sprain.

    OpenAIRE

    Yeung, M S; Chan, K. M.; So, C H; Yuan, W Y

    1994-01-01

    Ankle sprain is a common sports injury and is often regarded as trivial by athletes and coaches. This epidemiological study was conducted among three categories of Hong Kong Chinese athletes: national teams, competitive athletes and recreational athletes. This study shows that as much as 73% of all athletes had recurrent ankle sprain and 59% of these athletes had significant disability and residual symptoms which led to impairment of their athletic performance. This study indicates that a pro...

  15. Technical tips for (dry) arthroscopic reduction and internal fixation of distal radius fractures.

    Science.gov (United States)

    Del Piñal, Francisco

    2011-10-01

    Contrary to general belief, arthroscopic assisted reduction in distal radius fractures can be done in an expeditious manner and with minimal consumption of operating room resources. This article presents the steps for a pleasant arthroscopic experience in detail. The technique proposed combines the benefits of rigid fixation with volar locking plates (for the extra-articular component) and arthroscopic control of the reduction (for the articular component). It is important that the operation be carried out using the dry arthroscopic technique. However, arthroscopy is just an addition to conventional methods. Thorough knowledge of and facility with classic techniques of distal radius fracture treatment is essential for a good result. PMID:21971058

  16. Ankle flexibility and injury patterns in dancers.

    Science.gov (United States)

    Wiesler, E R; Hunter, D M; Martin, D F; Curl, W W; Hoen, H

    1996-01-01

    Lower-extremity injuries are common among dancers and cause significant absences from rehearsals and performances. For this study of lower-extremity injuries in 101 ballet and 47 modern dance students, injuries requiring medical attention sustained over 1 academic year were associated with the following data obtained at the beginning of the school year: ankle flexibility, sex, dance discipline, previous injury, body mass index, and years of training. Eighty-three of the 148 students (age range, 12 to 28 years) reported prior lower-limb injuries, the most common being ankle sprains (28% of all dancers). Previous leg injuries correlated significantly with lower dorsiflexion measurements and with more new injuries. Female students had greater ankle and first metatarsophalangeal flexibility. Modern dancers had greater ankle inversion. Ninety-four students sustained 177 injuries during the study, including 75 sprains or strains and 71 cases of tendinitis. Thirty-nine percent (N = 69) were ankle injuries; 18% (N = 33) were knee injuries; 23% (N = 40) were foot injuries; and 20% (N = 35) were either hip or thigh injuries. Sixty-seven percent (N = 78) of the injured students were ballet dancers. Age, years of training, body mass index, sex, and ankle range of motion measurement had no predictive value for injury; previous injury and dance discipline both correlated with increased risk of injury. PMID:8947396

  17. Change in Driving Performance following Arthroscopic Shoulder Surgery.

    Science.gov (United States)

    Hasan, S; McGee, A; Weinberg, M; Bansal, A; Hamula, M; Wolfson, T; Zuckerman, J; Jazrawi, L

    2016-08-01

    The current study aimed to measure perioperative changes in driving performance following arthroscopic shoulder surgery using a validated driving simulator.21 patients who underwent arthroscopic surgery for rotator cuff or labral pathology were tested on a driving simulator preoperatively, and 6 and 12 weeks postoperatively. An additional 21 subjects were tested to establish driving data in a control cohort. The number of collisions, centerline crossings, and off-road excursions were recorded for each trial. VAS and SPADI scores were obtained at each visit.The mean number of collisions in the study group significantly increased from 2.05 preoperatively to 3.75 at 6 weeks (pperformance is impaired for at least 6 weeks postoperatively, with a return to normal driving by 12 weeks. Driving is more profoundly affected in conditions that require avoiding a collision and when the dominant driving arm is involved. PMID:27487432

  18. Measurement of blood pressure, ankle blood pressure and calculation of ankle brachial index in general practice

    DEFF Research Database (Denmark)

    Nexøe, Jørgen; Damsbo, Bent; Lund, Jens Otto;

    2012-01-01

    BACKGROUND: Low ankle brachial index (ABI) is a sensitive measure of 'burden' of atherosclerosis, indicating cardiovascular risk of the asymptomatic patient. Conventionally, ABI values......BACKGROUND: Low ankle brachial index (ABI) is a sensitive measure of 'burden' of atherosclerosis, indicating cardiovascular risk of the asymptomatic patient. Conventionally, ABI values...

  19. Prospective study of ankle and foot fractures in elderly women

    Directory of Open Access Journals (Sweden)

    Yadagiri Surender Rao

    2015-01-01

    Full Text Available The epidemiology of ankle fractures in old people is changing as time passes on. The incidence of ankle fractures increases with advancing age. The study conducted was among a rural popula-tion which comprised of 68 women (32 women with ankle fractures & 36 women with foot fractures. Patients studied were in the age group more than 50 years. The study highlights the etiological & risk factors for fractures of ankle & foot. The commonest ankle fracture was the lateral malleolar fracture & the commonest foot fracture was the 5th Metatarsal fracture. Diabetes is a risk factor which increases the occurrence of ankle and foot injuries.

  20. Arthroscopic cartilage regeneration facilitating procedure for osteoarthritic knee

    Directory of Open Access Journals (Sweden)

    Lyu Shaw-Ruey

    2012-11-01

    Full Text Available Abstract Background The effectiveness of arthroscopic treatment for osteoarthritic knee is a controversy. This study presents the technique of a novel concept of arthroscopic procedure and investigates its clinical outcome. Method An arthroscopic procedure targeted on elimination of focal abrasion phenomenon and regaining soft tissue balance around patello-femoral joint was applied to treat osteoarthritis knees. Five hundred and seventy-one knees of 367 patients with osteoarthritis received this procedure. There were 70 (19% male and 297 (81% female and the mean age was 60 years (SD 10. The Knee Society score (KSS and the knee injury and osteoarthritis outcome score (KOOS were used for subjective outcome study. The roentgenographic changes of femoral-tibial angle and joint space width were evaluated for objective outcomes. The mean follow-up period was 38 months (SD 3. Results There were 505 knees in 326 patients available with more than 3 years follow-up and the mean follow-up period was 38 months (SD 3. The subjective satisfactory rate for the whole series was 85.5%. For 134 knees with comprehensive follow-up evaluation, the KSS and all subscales of the KOOS improved statistically. The femoral-tibial angle improved from 1.57 degrees (SD 3.92 to 1.93 degrees (SD 4.12 (mean difference: 0.35, SD 0.17. The joint space width increased from 2.02 millimeters (SD 1.24 to 2.17 millimeters (SD 1.17 (mean difference: 0.13, SD 0.05. The degeneration process of the medial compartment was found being reversed in 82.1% of these knees by radiographic evaluation. Conclusions Based on these observations arthroscopic cartilage regeneration facilitating procedure is an effective treatment for osteoarthritis of the knee joint and can be expected to satisfy the majority of patients and reverse the degenerative process of their knees.

  1. Arthroscopic subacromial decompression in the treatment of impingement syndrome

    OpenAIRE

    Guven, Osman; Bezer, Murat

    2004-01-01

    During the past decade, arthroscopy has become an accepted tool for the evaluation and management of shoulder disorders. The glenohumeral joint, subacromial space, acromioclavicular joint, and even the scapulothoracic articulation can be assessed through arthroscopy. Proper portal placement allows a safe access without risk for neurovascular, tendon, or articular injuries. Anterior acromioplasty is probably the most common arthroscopic procedure performed in the shoulder, with reported result...

  2. Open and Arthroscopic Surgical Treatment of Femoroacetabular Impingement

    Directory of Open Access Journals (Sweden)

    Benjamin D. Kuhns

    2015-12-01

    Full Text Available Femoroacetabular impingement (FAI is a common cause of hip pain, and when indicated, can be successfully managed through open surgery or hip arthroscopy. The goal of this review is to describe the different approaches to the surgical treatment of FAI. We present the indications, surgical technique, rehabilitation, and complications associated with (1 open hip dislocation, (2 reverse peri-acetabular osteotomy, (3 the direct anterior mini-open approach, and (4 arthroscopic surgery for femoroacetabular impingement.

  3. Arthroscopic Treatment of Intraosseous Ganglion Cyst of the Lunate Bone

    OpenAIRE

    Cerlier, Alexandre; Gay, André-Mathieu; Levadoux, Michel

    2015-01-01

    Intraosseous ganglion cysts are rare causes of wrist pain. Surgical treatment of this pathologic condition yields good results and a low recurrence rate. The main complications are joint stiffness and vascular disturbances of the lunate bone. Wrist arthroscopy is a surgical technique that reduces the intra-articular operative area and therefore minimizes postoperative stiffness. This article describes an arthroscopic technique used for lunate intraosseous cyst resection associated with an aut...

  4. Analysis of Direct Costs of Outpatient Arthroscopic Rotator Cuff Repair.

    Science.gov (United States)

    Narvy, Steven J; Ahluwalia, Avtar; Vangsness, C Thomas

    2016-01-01

    Arthroscopic rotator cuff surgery is one of the most commonly performed orthopedic surgical procedures. We conducted a study to calculate the direct cost of arthroscopic repair of rotator cuff tears confirmed by magnetic resonance imaging. Twenty-eight shoulders in 26 patients (mean age, 54.5 years) underwent primary rotator cuff repair by a single fellowship-trained arthroscopic surgeon in the outpatient surgery center of a major academic medical center. All patients had interscalene blocks placed while in the preoperative holding area. Direct costs of this cycle of care were calculated using the time-driven activity-based costing algorithm. Mean time in operating room was 148 minutes; mean time in recovery was 105 minutes. Calculated surgical cost for this process cycle was $5904.21. Among material costs, suture anchor costs were the main cost driver. Preoperative bloodwork was obtained in 23 cases, adding a mean cost of $111.04. Our findings provide important preliminary information regarding the direct economic costs of rotator cuff surgery and may be useful to hospitals and surgery centers negotiating procedural reimbursement for the increased cost of repairing complex tears. PMID:26761928

  5. ARTHROSCOPIC RECONSTRUCTION OF ANTERIO R CRUCIATE LIGAMENT TEARS: OUR EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Thimma Reddy

    2015-09-01

    Full Text Available BACKGROUND: Anterior knee instability associated with rupture of the ACL (Anterior Cruciate Ligament is a disabling clinical problem. The ACL has a poor capacity for intrinsic repair. Thus for patients who have knee symptoms related to ACL deficiency, one may consider ligament reconstruction as a means of stabilizing the T ibio - F emoral articulation and restoring high level function of the knee joint. Arthroscopically assisted ACLR ( ACL Reconstruction has the advantage of being minimally invasive, accurate graft placement, less disturbance of normal tissue resulting in quicker recovery and rehabilitation, minimal hospital stay and very less infection rate. MATERIAL AND METHODS: Between April 2012 to May 2013, 30 patients who underwent arthroscopic assisted ACL reconstructions using either bone - patellar tendon - bone auto graft ( BTB or Quadrupled hamstring auto graft ( QHG or Quadriceps tendon graft ( QTG in the Department of Orthopaedics and Traumatology, Osmania Medical College, Hyderabad, Andhra Pradesh is the material in our study. CONCLUSIONS : Arthroscopic reconstruction of Anterior Cruciate Ligament is a reliable, safe procedure. It helps in the early restoration of function and stability of the Knee joint and helps the patient to get back to his normal activity much earlier than with the traditional open surgical methods. The choice of the graft does not play a major role in the function of the knee in the long run.

  6. Arthroscopic Treatment of Intraosseous Ganglion Cyst of the Lunate Bone.

    Science.gov (United States)

    Cerlier, Alexandre; Gay, André-Mathieu; Levadoux, Michel

    2015-10-01

    Intraosseous ganglion cysts are rare causes of wrist pain. Surgical treatment of this pathologic condition yields good results and a low recurrence rate. The main complications are joint stiffness and vascular disturbances of the lunate bone. Wrist arthroscopy is a surgical technique that reduces the intra-articular operative area and therefore minimizes postoperative stiffness. This article describes an arthroscopic technique used for lunate intraosseous cyst resection associated with an autologous bone graft in a series of cases to prevent joint stiffness while respecting the scapholunate ligament. This study was based on a series of 4 patients, all of whom had wrist pain because of intraosseous ganglion cysts. Arthrosynovial cyst resection, ganglion curettage, and bone grafting were performed arthroscopically. Pain had totally disappeared within 2 months after the operation in 100% of patients. The average hand grip strength was estimated at 100% compared with the opposite side, and articular ranges of motion were the same on both sides in 100% of cases. No complications were reported after surgery. On the basis of these results, arthroscopic treatment of intraosseous synovial ganglion cysts seems to be more efficient and helpful in overcoming the limitations of classic open surgery in terms of complications. PMID:26697314

  7. Arthroscopically assisted treatment of intraosseous ganglions of the lunate.

    Science.gov (United States)

    Bain, Gregory I; Turner, Perry C; Ashwood, Neil

    2008-12-01

    Intraosseous ganglia (IOGs) of the lunate are a relatively rare, but by no means insignificant, condition because treatment by traditional open curettage and bone grafting can lead to ongoing pain and stiffness of the wrist.An arthroscopically assisted minimally invasive technique of debridement and grafting of the lunate IOG is discussed, as well as the history of the condition, indications and contraindications, surgical technique with postoperative rehabilitation, and potential complications.The outcomes of 8 patients with persistent symptoms and typical radiographic and bone scan findings were assessed independently preoperatively and postoperatively by using a modified Green and O'Brien wrist score. The intraosseous cyst was drilled under arthroscopic and fluoroscopic guidance via either a volar or dorsal portal, depending on the position identified on the computed tomography scan. Average follow-up time was 3.8 years (range, 1-5.6 yrs). All patients returned to employment within 4 months. Wrist scores improved 34 points, from 51 to 85 points, by 1 year after surgery, with trabeculation being noted within the grafting lunate. The greatest improvements were seen in visual and analog pain scores, reducing from 68.3 to 11.2, and flexion-extension arcs, which increased from 98 to 114 degrees.The technique of arthroscopically assisted debridement of IOGs of the lunate is safe, with minimal morbidity and recurrence of symptoms during the follow-up period. PMID:19060679

  8. Modified arthroscopic suture fixation of a displaced tibial eminence fracture.

    Science.gov (United States)

    Lehman, Ronald A; Murphy, Kevin P; Machen, M Shaun; Kuklo, Timothy R

    2003-02-01

    This study describes a new arthroscopic method using a whip-stitch technique for treating a displaced type III tibial eminence fracture. A 12-year-old girl who sustained a displaced type III tibial eminence fracture was treated with arthroscopic fixation using the Arthrosew disposable suture device (Surgical Dynamics, Norwalk, CT) to place a whip stitch into the anterior cruciate ligament (ACL). The Arthrex ACL guide (Arthrex, Naples, FL) was used to reduce the avulsed tibial spine fragment. Sutures were then passed through the tibial tunnel and secured over a bony bridge with the knee in 20 degrees of flexion. At 9 months, the patient has a full range of motion with normal Lachman and anterior drawer testing, and she has returned to competitive basketball. Radiographs show complete fracture healing. KT-1000 and isokinetic testing at 9-month follow-up show only minimal side-to-side differences. The Arthrosew device provides a significant advantage in the treatment of type III and IV fractures of the tibial eminence by obtaining arthroscopic fixation within the substance of the ACL, thus obviating arthrotomy and hardware placement. This technique also restores the proper length and tension to the ACL, and provides a simplified, reproducible method of treatment for this injury. PMID:12579135

  9. Large increase in arthroscopic meniscus surgery in the middle-aged and older population in Denmark from 2000 to 2011

    DEFF Research Database (Denmark)

    Thorlund, Jonas B; Hare, Kristoffer B; Lohmander, Stefan

    2014-01-01

    Background - Arthroscopic meniscal surgery is the most common orthopedic procedure, and the incidence has increased in Denmark over the last 10 years. Concomitantly, several randomized controlled trials have shown no benefit of arthroscopic procedures including arthroscopic partial meniscectomy in...... and 2011. Interpretation - The incidence of meniscal procedures performed in Denmark doubled from 2000 to 2011, with the largest increase in middle-aged and older patients. This increase contrasts with the mounting evidence showing no added benefit of arthroscopic partial meniscectomy over non...

  10. Clinical value of the Ottawa ankle rules for diagnosis of fractures in acute ankle injuries.

    Directory of Open Access Journals (Sweden)

    Xin Wang

    Full Text Available BACKGROUND: The Ottawa ankle rules (OAR are clinical decision guidelines used to identify whether patients with ankle injuries need to undergo radiography. The OAR have been proven that their application reduces unnecessary radiography. They have nearly perfect sensitivity for identifying clinically significant ankle fractures. OBJECTIVES: The purpose of this study was to assess the applicability of the OAR in China, to examine their accuracy for the diagnosis of fractures in patients with acute ankle sprains, and to assess their clinical utility for the detection of occult fractures. METHODS: In this prospective study, patients with acute ankle injuries were enrolled during a 6-month period. The eligible patients were examined by emergency orthopedic specialists using the OAR, and then underwent ankle radiography. The results of examination using the OAR were compared with the radiographic results to assess the accuracy of the OAR for ankle fractures. Patients with OAR results highly suggestive of fracture, but no evidence of a fracture on radiographs, were advised to undergo 3-dimensional computed tomography (3D-CT. RESULTS: 183 patients with ankle injuries were enrolled in the study and 63 of these injuries involved fractures. The pooled sensitivity, specificity, positive predictive value and negative predictive value of the OAR for detection of fractures of the ankle were 96.8%, 45.8%, 48.4% and 96.5%, respectively. Our results suggest that clinical application of the OAR could decrease unnecessary radiographs by 31.1%. Of the 21 patients with positive OAR results and negative radiographic findings who underwent 3D-CT examination, five had occult fractures of the lateral malleolus. CONCLUSIONS: The OAR are applicable in the Chinese population, and have high sensitivity and modest specificity for the diagnosis of fractures associated with acute ankle injury. They may detect some occult fractures of the malleoli that are not visible on

  11. Analysis of the Effects of Normal Walking on Ankle Joint Contact Characteristics After Acute Inversion Ankle Sprain.

    Science.gov (United States)

    Bae, Ji Yong; Park, Kyung Soon; Seon, Jong Keun; Jeon, Insu

    2015-12-01

    To show the causal relationship between normal walking after various lateral ankle ligament (LAL) injuries caused by acute inversion ankle sprains and alterations in ankle joint contact characteristics, finite element simulations of normal walking were carried out using an intact ankle joint model and LAL injury models. A walking experiment using a volunteer with a normal ankle joint was performed to obtain the boundary conditions for the simulations and to support the appropriateness of the simulation results. Contact pressure and strain on the talus articular cartilage and anteroposterior and mediolateral translations of the talus were calculated. Ankles with ruptured anterior talofibular ligaments (ATFLs) had a higher likelihood of experiencing increased ankle joint contact pressures, strains and translations than ATFL-deficient ankles. In particular, ankles with ruptured ATFL + calcaneofibular ligaments and all ruptured ankles had a similar likelihood as the ATFL-ruptured ankles. The push off stance phase was the most likely situation for increased ankle joint contact pressures, strains and translations in LAL-injured ankles. PMID:26077988

  12. Radiographic Evaluation of the Ankle Mortise

    Directory of Open Access Journals (Sweden)

    Hamid Mirbagheri

    2010-05-01

    Full Text Available The ankle joint is the most frequently injured joint in adults. Decisions on management are usually based on clinical examination and interpretation of the x-rays. Stability of the ankle mortise relies on the configuration of the osseous structures and the ligaments. A basic radiographic examination consists of a mortise-view and a lateral view. Some add the AP-view. The Mortise view is an AP-view with 15-25 degrees endorotation of the foot. "nThe view clearly demonstrates both lateral and medial joint spaces. On a true AP-view the talus overlaps a portion of the lateral malleolus obscuring the lateral aspect of the ankle joint. However, the AP-view will give you an extra view on both malleoli from a different angle. The lateral radiograph of the ankle should include the base of the fifth metatarsal because of the frequency of fractures at this side that clinically mimic a fracture of the ankle.

  13. Acute injury of the ankle joint

    International Nuclear Information System (INIS)

    The diagnosis of lateral collateral ankle ligament trauma is based on patient history, clinical examination, and clinical stress tests. If the clinical stress test is positive, stress radiography could be performed. There is no consensus about the usefulness of stress radiography in acute ankle sprain, particularly about the cut-off talar tilt angle beyond which a two-ligament rupture would be certain, ranging from 5 to 30 . Today MRI is not used for this indication, although it allows, with controlled positioning of the foot and with defined sections, visualization of injured lateral collateral ankle ligaments. In ankle injuries, plain radiographs form the established basis of diagnostic imaging and can provide definitive answers in most cases. CT is used in complex fractures for complete visualization. MRI is the method of choice for several diagnostic problem cases, including occult fractures and post-traumatic avascular necrosis. In tendon injuries, MRI is important if ultrasound is not diagnostic. Generally, for the evaluation of acute ankle injuries, MRI is the most important second-step procedure when radiographs are nondiagnostic. (orig.)

  14. Sprained Ankle Could Pose Longer-Term Harms to Health

    Science.gov (United States)

    ... them said they had sustained some kind of ankle injury at some point in their lives. Those who' ... taken more seriously, the researchers said. "In isolation, ankle injuries are seen as relatively benign and inconsequential injuries," ...

  15. Deep vein thrombosis and thromboprophylaxis in arthroscopic anterior cruciate ligament reconstruction

    Directory of Open Access Journals (Sweden)

    Raviraj Adala

    2011-01-01

    Conclusion: In our study the incidence of deep vein thrombosis in patients undergoing arthroscopic ACL reconstruction is 1.78%. We do not recommend routine thromboprophylaxis in patients, who are not high risk candidates for thrombosis and are of less than 45 years, in patients undergoing arthroscopic ACL reconstruction, with early postoperative rehabilitation.

  16. Deltoid ligament and tibiofibular syndesmosis injury in chronic lateral ankle instability: Magnetic resonance imaging evaluation at 3T and comparison with arthroscopy

    International Nuclear Information System (INIS)

    To evaluate the prevalence of deltoid ligament and distal tibiofibular syndesmosis injury on 3T magnetic resonance imaging (MRI) in patients with chronic lateral ankle instability (CLAI). Fifty patients (mean age, 35 years) who had undergone preoperative 3T MRI and surgical treatment for CLAI were enrolled. The prevalence of deltoid ligament and syndesmosis injury were assessed. The complexity of lateral collateral ligament complex (LCLC) injury was correlated with prevalence of deltoid or syndesmosis injuries. The diagnostic accuracy of ankle ligament imaging at 3T MRI was analyzed using arthroscopy as a reference standard. On MRI, deltoid ligament injury was identified in 18 (36%) patients as follows: superficial ligament alone, 9 (50%); deep ligament alone 2 (11%); and both ligaments 7 (39%). Syndesmosis abnormality was found in 21 (42%) patients as follows: anterior inferior tibiofibular ligament (AITFL) alone, 19 (90%); and AITFL and interosseous ligament, 2 (10%). There was no correlation between LCLC injury complexity and the prevalence of an accompanying deltoid or syndesmosis injury on both MRI and arthroscopic findings. MRI sensitivity and specificity for detection of deltoid ligament injury were 84% and 93.5%, and those for detection of syndesmosis injury were 91% and 100%, respectively. Deltoid ligament or syndesmosis injuries were common in patients undergoing surgery for CLAI, regardless of the LCLC injury complexity. 3T MRI is helpful for the detection of all types of ankle ligament injury. Therefore, careful interpretation of pre-operative MRI is essential

  17. Deltoid ligament and tibiofibular syndesmosis injury in chronic lateral ankle instability: Magnetic resonance imaging evaluation at 3T and comparison with arthroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Chun, Ka Young; Choi, Yun Sun; Lee, Seok Hoon; Kim, Jin Su; Young, Ki Won; Jeong, Min Sun; Kim, Dae Jung [Eulji Hospital, Eulji University, Seoul (Korea, Republic of)

    2015-10-15

    To evaluate the prevalence of deltoid ligament and distal tibiofibular syndesmosis injury on 3T magnetic resonance imaging (MRI) in patients with chronic lateral ankle instability (CLAI). Fifty patients (mean age, 35 years) who had undergone preoperative 3T MRI and surgical treatment for CLAI were enrolled. The prevalence of deltoid ligament and syndesmosis injury were assessed. The complexity of lateral collateral ligament complex (LCLC) injury was correlated with prevalence of deltoid or syndesmosis injuries. The diagnostic accuracy of ankle ligament imaging at 3T MRI was analyzed using arthroscopy as a reference standard. On MRI, deltoid ligament injury was identified in 18 (36%) patients as follows: superficial ligament alone, 9 (50%); deep ligament alone 2 (11%); and both ligaments 7 (39%). Syndesmosis abnormality was found in 21 (42%) patients as follows: anterior inferior tibiofibular ligament (AITFL) alone, 19 (90%); and AITFL and interosseous ligament, 2 (10%). There was no correlation between LCLC injury complexity and the prevalence of an accompanying deltoid or syndesmosis injury on both MRI and arthroscopic findings. MRI sensitivity and specificity for detection of deltoid ligament injury were 84% and 93.5%, and those for detection of syndesmosis injury were 91% and 100%, respectively. Deltoid ligament or syndesmosis injuries were common in patients undergoing surgery for CLAI, regardless of the LCLC injury complexity. 3T MRI is helpful for the detection of all types of ankle ligament injury. Therefore, careful interpretation of pre-operative MRI is essential.

  18. Isolated posterior high ankle sprain: a report of three cases.

    Science.gov (United States)

    Botchu, Rajesh; Allen, Patricia; Rennie, Winston J

    2013-12-01

    High ankle sprains are difficult to diagnose and account for 10% of all ankle sprains. A high index of suspicion is essential for diagnosis. High ankle sprains are managed symptomatically, with prolonged rehabilitation. The posterior inferior tibiofibular ligament is the strongest syndesmotic ligament; isolated injury of it is rare. We present 3 cases of isolated posterior high ankle sprain and discuss the relevant anatomy, mechanism of injury, and management. PMID:24366808

  19. The Effects of Kinesio™ Taping on Proprioception at the Ankle

    OpenAIRE

    Mark DeBeliso; Ross Vaughn; Jeff Lien; McChesney, John W.; Travis Halseth

    2004-01-01

    An experiment was designed to determine if KinesioTM taping the anterior and lateral portion of the ankle would enhance ankle proprioception compared to the untaped ankle. 30 subjects, 15 men, 15 women, ages 18-30 participated in this study. Exclusion criteria: Ankle injury < 6 months prior to testing, significant ligament laxity as determined through clinical evaluation by an ATC, or any severe foot abnormality. Experiment utilized a single group, pretest and posttest. Plantar flexion and in...

  20. Development and Reliability of the Ankle Instability Instrument

    OpenAIRE

    Docherty, Carrie L; Gansneder, Bruce M; Arnold, Brent L; Hurwitz, Shepard R.

    2006-01-01

    Context: Functional ankle instability has been defined in a variety of ways. Factors that are frequently used in this definition include a history of a severe ankle sprain, a history of multiple ankle sprains, and a recurrent feeling of instability or “giving way.” With all the variations in defining functional ankle instability, it becomes increasingly important to develop a more consistent framework for assessing this instability.

  1. Anterolateralni utesnitveni sindrom gležnja: Ankle impingement syndrome:

    OpenAIRE

    Frangež, Igor; Senekovič, Vladimir; Žnidaršič, Marta

    2011-01-01

    lnversion injuries of the ankle are common and most are managed adequately by functional treatment. A significant number will, however, remain symptomatic. Ankle impingement syndrome is clinicaly evident as pain, which is elicited by full range of motion in ankle joint because of the mechanical impidgement in the joint. Ankle impingement can result from trauma, infection, inflammation or from degenerative process. The impingement syndrome can be anterolateral, anteromedial, posterior, made of...

  2. Validation of the Ottawa ankle rules in children.

    OpenAIRE

    Libetta, C; Burke, D; Brennan, P; Yassa, J

    1999-01-01

    OBJECTIVE: To assess whether the Ottawa ankle rules can be used to accurately predict which children with ankle and midfoot injuries need radiography. METHODS: Prospective study with historical control group of all children aged 1-15 years presenting to Sheffield Children's Hospital accident and emergency department with blunt ankle and/or midfoot injuries during two five month periods before and after implementation of the Ottawa ankle rules. RESULTS: In the study group 432 out of 761 (56.76...

  3. RMI study and clinical correlations of ankle retinacula damage and outcomes of ankle sprain.

    Science.gov (United States)

    Stecco, Antonio; Stecco, Carla; Macchi, Veronica; Porzionato, Andrea; Ferraro, Claudio; Masiero, Stefano; De Caro, Raffaele

    2011-12-01

    Recent studies reveal the role of the ankle retinacula in proprioception and functional stability of the ankle, but there is no clear evidence of their role in the outcomes of ankle sprain. 25 patients with outcomes of ankle sprain were evaluated by MRI to analyze possible damage to the ankle retinacula. Patients with damage were subdivided into two groups: group A comprised cases with ankle retinacula damage only, and group B those also with anterior talofibular ligament rupture or bone marrow edema. Both groups were examined by VAS, CRTA and static posturography and underwent three treatments of deep connective tissue massage (Fascial Manipulation technique). All evaluations were repeated after the end of treatment and at 1, 3 and 6 months. At MRI, alteration of at least one of the ankle retinacula was evident in 21 subjects, and a further lesion was also identified in 7 subjects. After treatment, VAS and CRTA evaluations showed a statistically significant decrease in values with respect to those before treatment (p stabilometric platform results. No significant difference was found between groups A and B. The initial benefit was generally maintained at follow-up. The alteration of retinacula at MRI clearly corresponds to the proprioceptive damage revealed by static posturography and clinical examination. Treatment focused on the retinacula may improve clinical outcomes and stabilometric data. PMID:21305286

  4. Search the Foot and Ankle: Interactive Foot Diagram

    Science.gov (United States)

    ... of the Fifth Metatarsal » Ganglion Cyst » Lisfranc Injuries » Posterior Tibial Tendon Dysfunction (PTTD) » Tarsal Coalition » Ankle Fractures » Ankle Sprain » Chronic Ankle Instability » Equinus » Gout » Posterior Tibial Tendon Dysfunction (PTTD) » Talar Dome Lesion » Bunions (Hallux ...

  5. Arthroscopic isolated posterior labral repair in rugby players

    Directory of Open Access Journals (Sweden)

    Badge Ravi

    2009-01-01

    Full Text Available Background: The shoulder is the second most frequently injured joint after the knee in rugby players and labral tears appear to be common. There is limited data available in the literature regarding the mechanisms of posterior labral injury in rugby players and the management of these injuries. Objective: The aim of this study is to report the clinical presentation, arthroscopic findings, surgical technique for repair, and the functional outcome in elite English rugby players with isolated posterior labral injuries. Study Design: Case series (level IV evidence Materials and m0 ethods: Over a 5-year period we surgically treated 142 elite rugby players, of whom 11 (7.8% had isolated posterior labral injuries.All these 11 patients had significant contact injury. Only three (24% patients had a true posterior shoulder dislocation. Pre- and postoperative assessment included Constant score, Oxford shoulder score, and Oxford instability score. We also assessed the time taken to return to preinjury level of fitness and the complications of surgery. Results: Average follow-up was for 32 months (range 17-54 months. The mean Constant score improved from 66 to 99. The Oxford score indicated improvement, decreasing from 33 to 18; similarly, the Oxford instability score also decreased from 52.2 to 12.3. Return to playing rugby at peak level was at a mean of 4.3 months after arthroscopic repair. Conclusion: Successful clinical results and rapid return to play can be achieved by appropriate early arthroscopic repair and supervised accelerated rehabilitation for posterior labral tears in elite rugby players.

  6. Functional outcomes after arthroscopic treatment of lateral epicondylitis

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate surgical outcomes of arthroscopic debridement for lateral epicondylitis using a validated, patient-assessed scoring system as well as conventional outcome measures. We also wanted to identify potential predictive factors that may be associated with the outcomes. A total of 20 elbows in 18 patients with chronic lateral epicondylitis who underwent arthroscopic surgery were included. There were nine men and nine women with a mean age of 54 years (range 42-71 years). Operative treatment consisted of debridement of the extensor carpi radialis brevis (ECRB) origin and resection of the radiocapitellar synovial plica interposed in the joint. Outcomes were assessed using a patient rating, visual analogue scale (VAS) pain score, the Japanese Orthopaedic Association (JOA) elbow score, and the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire. The average length of follow-up was 28 months (range 24-40 months). After surgery, according to the patients' reports, 14 of 20 elbows were much better, and 6 elbows were better. A mean preoperative VAS pain score at rest of 3.9 points improved to 0.3 points (P<0.0001), and that during activity improved from 7.8 points to 0.9 points (P<0.0001). The mean preoperative JOA elbow score of 29 points was improved to 90 points (P<0.0001). The mean postoperative DASH score was 10.6 (range 0-50). Absent of T2-weighted high signal focus of the ECRB origin on preoperative magnetic resonance imaging (MRI) (P=0.02) and receiving public assistance (P=0.01) were significantly associated with worse DASH scores. Arthroscopic release was a satisfactory procedure for chronic lateral epicondylitis. Preoperative MRI of the ECRB origin and socioeconomic factors were significantly associated with postoperative residual symptoms evaluated with the DASH score. (author)

  7. The thrower's elbow: arthroscopic treatment of valgus extension overload syndrome.

    Science.gov (United States)

    O'Holleran, James D; Altchek, David W

    2006-02-01

    Injury to the medial collateral ligament of the elbow (MCL) can be a career-threatening injury for an overhead athlete without appropriate diagnosis and treatment. It has been considered separately from other athletic injuries due to the unique constellation of pathology that results from repetitive overhead throwing. The past decade has witnessed tremendous gains in understanding of the complex interplay between the dynamic and static stabilizers of the athlete's elbow. Likewise, the necessity to treat these problems in a minimally invasive manner has driven the development of sophisticated techniques and instrumentation for elbow arthroscopy. MCL injuries, ulnar neuritis, valgus extension overload with osteophyte formation and posteromedial impingement, flexor pronator strain, medial epicondyle pathology, and osteochondritis dissecans (OCD) of the capitellum have all been described as sequelae of the overhead throwing motion. In addition, loose body formation, bony spur formation, and capsular contracture can all be present in conjunction with these problems or as isolated entities. Not all pathology in the thrower's elbow is amenable to arthroscopic treatment; however, the clinician must be familiar with all of these problems in order to form a comprehensive differential diagnosis for an athlete presenting with elbow pain, and he or she must be comfortable with the variety of open and arthroscopic treatments available to best serve the patient. An understanding of the anatomy and biomechanics of the thrower's elbow is critical to the care of this population. The preoperative evaluation should focus on a thorough history and physical examination, as well as on specific diagnostic imaging modalities. Arthroscopic setup, including anesthesia, patient positioning, and portal choices will be discussed. Operative techniques in the anterior and posterior compartments will be reviewed, as well as postoperative rehabilitation and surgical results. Lastly, complications

  8. Joint sparing treatments in early ankle osteoarthritis: current procedures and future perspectives.

    Science.gov (United States)

    Castagnini, Francesco; Pellegrini, Camilla; Perazzo, Luca; Vannini, Francesca; Buda, Roberto

    2016-12-01

    Ankle osteoarthritis (AOA) is a severe pathology, mostly affecting a post-traumatic young population. Arthroscopic debridement, arthrodiastasis, osteotomy are the current joint sparing procedures, but, in the available studies, controversial results were achieved, with better outcomes in case of limited degeneration. Only osteotomy in case of malalignment is universally accepted as a joint sparing procedure in case of partial AOA. Recently, the biological mechanism of osteoarthritis has been intensively studied: it is a whole joint pathology, affecting cartilage, bone and synovial membrane. In particular, the first stage is characterized by a reversible catabolic activity with a state of chondropenia. Thus, biological procedures for early AOA were proposed in order to delay or to avoid end stage procedures. Mesenchymal stem cells (MSCs) may be a good solution to prevent or reverse degeneration, due to their immunomodulatory features (able to control the catabolic joint environment) and their regenerative osteochondral capabilities (able to treat the chondral defects). In fact, MSCs may regulate the cytokine cascade and the metalloproteinases release, restoring the osteochondral tissue as well. After interesting reports of mesenchymal stem cells seeded on scaffold and applied to cartilage defects in non-degenerated joints, bone marrow derived cells transplantation appears to be a promising technique in order to control the degenerative pathway and restore the osteochondral defects. PMID:26915003

  9. Midterm clinical outcomes following arthroscopic transosseous rotator cuff repair

    Directory of Open Access Journals (Sweden)

    Brody A Flanagin

    2016-01-01

    Full Text Available Purpose: Arthroscopic transosseous (TO rotator cuff repair has recently emerged as a new option for surgical treatment of symptomatic rotator cuff tears. Limited data is available regarding outcomes using this technique. This study evaluated midterm clinical outcomes following a novel arthroscopic TO (anchorless rotator cuff repair technique. Materials and Methods: A consecutive series of 107 patients and 109 shoulders underwent arthroscopic TO (anchorless rotator cuff repair for a symptomatic full-thickness tear. Pre and postoperative range of motion (ROM was compared at an average of 11.8 months. Postoperative outcome scores were obtained at an average of 38.0 months. Statistical analysis was performed to compare pre and postoperative ROM data. Univariate analysis was performed using Student′s t-test to compare the effect of other clinical characteristics on final outcome. Results: Statistically significant improvements were noted in forward flexion, external rotation and internal rotation (P < 0.0001. Average postoperative subjective shoulder value was 93.7, simple shoulder test 11.6, and American Shoulder and Elbow Surgeons (ASES score 94.6. According to ASES scores, results for the 109 shoulders available for final follow-up were excellent in 95 (87.1%, good in 8 (7.3%, fair in 3 (2.8%, and poor in 3 (2.8%. There was no difference in ROM or outcome scores in patients who underwent a concomitant biceps procedure (tenodesis or tenotomy compared with those who did not. Furthermore, there was no significant difference in outcome between patients who underwent either biceps tenodesis or tenotomy. Age, history of "injury" preceding the onset of pain, tear size, number of TO tunnels required to perform the repair, and presence of fatty infiltration did not correlate with postoperative ROM or subjective outcome measures at final follow-up. Two complications and four failures were noted. Conclusions: Arthroscopic TO rotator cuff repair technique

  10. Arthroscopic findings in patients with painful wrist ganglia.

    Science.gov (United States)

    Povlsen, B; Peckett, W R

    2001-09-01

    The aetiology of painful dorsal wrist ganglia remains obscure. In a prospective study we investigated the link between a painful dorsal wrist ganglion and wrist joint abnormality with wrist arthroscopy before excision of the ganglion. Of 16 wrists arthroscoped 12 were abnormal, 10 had an abnormal scapholunate joint, and two had abnormal lunatetriquetral joints. We think that painful dorsal wrist ganglia, like popliteal cysts in the knee, are markers of underlying joint abnormalities. Surgeons who treat painful ganglia should be aware of a possible underlying cause so that they can target treatment more accurately, particularly in recurrent cases and those patients with persistent wrist pain after excision of the ganglion. PMID:11680404

  11. A surgical ankle sprain pain model in the rat: Effects of morphine and indomethacin

    OpenAIRE

    Young Kim, Hee; Wang, Jigong; Chung, Kyungsoon; Mo Chung, Jin

    2008-01-01

    Ankle sprain is a frequent injury in humans that results in pain, swelling and difficulty in walking on the affected ankle. Currently a suitable animal model resembling human ankle sprain is lacking. Here, we describe an animal ankle sprain model induced by ankle ligament injury (ALI) in rats. Cutting combinations of the lateral ankle ligament complex produced pain, edema and difficulty of weight bearing, thereby mimicking severe (grade III) ankle sprain in humans. Analgesic compounds, morphi...

  12. Short-term ankle motor performance with ankle robotics training in chronic hemiparetic stroke

    Directory of Open Access Journals (Sweden)

    Anindo Roy, PhD

    2011-05-01

    Full Text Available Cerebrovascular accident (stroke often results in impaired motor control and persistent weakness that may lead to chronic disability, including deficits in gait and balance function. Finding ways to restore motor control may help reduce these deficits; however, little is known regarding the capacity or temporal profile of short-term motor adaptations and learning at the hemiparetic ankle. Our objective was to determine the short-term effects of a single session of impedance-controlled ankle robot (“anklebot” training on paretic ankle motor control in chronic stroke. This was a double-arm pilot study on a convenience sample of participants with chronic stroke (n = 7 who had residual hemiparetic deficits and an equal number of age- and sex-matched nondisabled control subjects. Training consisted of participants in each group playing a target-based video game with the anklebot for an hour, for a total of 560 movement repetitions in dorsiflexion/plantar flexion ranges followed by retest 48 hours later. Task difficulty was adjusted to ankle range of motion, with robotic assistance decreased incrementally across training. Assessments included robotic measures of ankle motor control on unassisted trials before and after training and at 48 hours after training. Following exposure to the task, subjects with stroke improved paretic ankle motor control across a single training session as indexed by increased targeting accuracy (21.6 +/– 8.0 to 31.4 +/– 4.8, p = 0.05, higher angular speeds (mean: 4.7 +/– 1.5 degrees/s to 6.5 +/– 2.6 degrees/s, p 0.05 at 48 hours in both groups. Robust maintenance of motor adaptation in the robot-trained paretic ankle over 48 hours may be indicative of short-term motor learning. Our initial results suggest that the anklebot may be a flexible motor learning platform with the potential to detect rapid changes in ankle motor performance poststroke.

  13. Invariant ankle moment patterns when walking with and without a robotic ankle exoskeleton

    OpenAIRE

    Kao, Pei-Chun; Lewis, Cara L.; Ferris, Daniel P.

    2009-01-01

    To guide development of robotic lower limb exoskeletons, it is necessary to understand how humans adapt to powered assistance. The purposes of this study were to quantify joint moments while healthy subjects adapted to a robotic ankle exoskeleton and to determine if the period of motor adaptation is dependent on the magnitude of robotic assistance. The pneumatically-powered ankle exoskeleton provided plantar flexor torque controlled by the wearer’s soleus electromyography (EMG). Eleven naïve ...

  14. [Ankle sprain during a volleyball game].

    Science.gov (United States)

    Boersma, Anton R; Munzebrock, Arvid V E

    2015-01-01

    A 27-year old woman was admitted to the emergency room after her left ankle rolled inward during a volleyball game. On physical examination a bony prominence on the lateral side of the left foot was noticeable, without neurovascular injury. An X-ray (anterior-posterior view) showed a subtalar dislocation without associated fractures. PMID:26420145

  15. Injury of the ankle joint ligaments

    International Nuclear Information System (INIS)

    The diagnosis of lateral collateral ankle ligament trauma is based on patient history, clinical examination and clinical stress tests. If the clinical stress test is positive, stress radiography can be performed. There is, however, no consensus about the usefulness of stress radiography in acute ankle sprain, and in particular about the cut-off talar tilt angle beyond which a two-ligament rupture would be certain, ranging from 5 to 30 . Today, magnetic resonance imaging (MRI) is not used in this area, although it does allow controlled positioning of the foot and defined section visualization of injured lateral collateral ankle ligaments. In acute and chronic sinus tarsi injuries, MRI forms the established basis for diagnostic imaging, and can provide a definitive answer in most cases. MRI is also the method of choice for chronic posttraumatic pain with anterolateral impingement after rupture of the anterior talofibular ligament. Generally, for the evaluation of acute ankle injuries, MRI has developed to be the most important second-step procedure when projection radiology is non-diagnostic. (orig.)

  16. Arthroscopic Trans-osseous Suture of Peripheral Triangular Fibrocartilage Complex Tear.

    Science.gov (United States)

    Jegal, Midum; Heo, Kang; Kim, Jong Pil

    2016-10-01

    The importance of foveal repair of the triangular fibrocartilage complex (TFCC) on stability of the distal radioulnar joint (DRUJ) has been emphasized with increasing knowledge of the anatomy and biomechanics of the TFCC and DRUJ. Although both open and arthroscopic techniques have been described for improving DRUJ stability, there has been a marked evolution of arthroscopic TFCC repair technique with successful clinical outcome. Recently, an arthroscopic trans-osseous technique has been described to repair foveal tears of the TFCC. The advantage of the technique is that it allows for anatomical repair of both the superficial and deep layers. This article describes the details of this novel technique. PMID:27595945

  17. Arthroscopic Bony Bankart Repair Using Double-Threaded Headless Screw: A Case Report

    Directory of Open Access Journals (Sweden)

    Takeshi Kokubu

    2012-01-01

    Full Text Available We present a case of arthroscopic fixation for bony Bankart lesion using a double-threaded cannulated screw. A 39-year-old man sustained a left shoulder injury from a motorcycle accident. Radiographs showed bony Bankart lesion and CT revealed 40% defect of glenoid articular surface. Arthroscopic fixation was performed using double-threaded cannulated screw after the bony fragment was reduced by suturing the labrum at the edge with a suture anchor. Arthroscopic bony Bankart repair using double-threaded cannulated screw fixation is effective because compression force could be applied between bony fragments and the screw head is not exposed in the glenohumeral joint.

  18. Arthroscopic partial meniscectomy in middle-aged patients with mild or no knee osteoarthritis

    DEFF Research Database (Denmark)

    Hare, Kristoffer B; Lohmander, Stefan; Christensen, Robin;

    2013-01-01

    Arthroscopic partial meniscectomy has been shown to be of no benefit to patients with concomitant knee osteoarthritis, but the optimal treatment of a degenerative meniscus tear in patients with mild or no knee osteoarthritis is unknown. This article describes the rationale and methodology of a...... randomized sham-controlled trial to assess the benefit of arthroscopic partial meniscectomy of a medial meniscus tear in patients with mild or no knee osteoarthritis. The objective of the study is to test whether the benefit from arthroscopic partial meniscectomy in patients with knee pain, medial meniscus...

  19. Local Anaesthetic Infusion with Elastomeric Pump After Arthroscopic Subacromial Decompression

    Science.gov (United States)

    Little, Kevin; Pillai, Anand; Fazzi, Umberto; Storey, Neil

    2007-01-01

    INTRODUCTION The use of extended local anaesthesia for postoperative pain has previously been reported, and has several advantages over other methods, including ease of placement, safety, reliability, lower cost and effective analgesia. We present our experience with a portable elastomeric infusion device in patients undergoing arthroscopic subacromial decompression, and make a case for its potential to allow same-day discharge. PATIENTS AND METHODS Forty patients undergoing arthroscopic subacromial decompression were followed-up. At the end of the procedure, an epidural catheter connected to a portable elastomeric local anaesthetic infusion system was inserted into the subacromial space. All patients were electively admitted for overnight stay postoperatively and assessed using a visual analogue scale (VAS) to evaluate their level of pain. RESULTS No patient reported severe pain at any stage. None of the patients required any parenteral opiate analgesia with the pump in situ. CONCLUSIONS These findings suggest that the use of this elastomeric infusion device following shoulder surgery allows safe and early discharge of patients with decreased need for parenteral opiate analgesia. PMID:17535622

  20. Does arthroscopic subacromial decompression improve quality of life

    Science.gov (United States)

    Whiteman, A; Wilson, J; Paul, E; Roy, B

    2015-01-01

    Introduction There has been a significant rise in the volume of subacromial decompression surgery performed in the UK. This study aimed to determine whether arthroscopic subacromial decompression improves health related quality of life in a cost effective manner. Methods Patients undergoing arthroscopic subacromial decompression surgery for impingement were enrolled between 2012 and 2014. The Oxford shoulder score and the EQ-5D™ instruments were completed prior to and following surgery. A cost–utility analysis was performed. Results Eighty-three patients were eligible for the study with a mean follow-up duration of 15 months (range: 4–27 months). The mean Oxford shoulder score improved by 13 points (95% confidence interval [CI]: 11–15 points). The mean health utility gain extrapolated from the EQ-5D™ questionnaire improved by 0.23 (95% CI: 0.16–0.30), translating to a minimum cost per QALY of £5,683. Conclusions Subacromial decompression leads to significant improvement in function and quality of life in a cost effective manner. This provides justification for its ongoing practice by appropriately trained shoulder surgeons in correctly selected patients. PMID:26263808

  1. Evaluation of pain after arthroscopically assisted anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Brown, D W; Curry, C M; Ruterbories, L M; Avery, F L; Anson, P S

    1997-01-01

    Pain after arthroscopically assisted anterior cruciate reconstruction was examined during the first 5 postoperative days to evaluate its intensity and duration. One hundred consecutive patients who underwent arthroscopically assisted anterior cruciate ligament reconstruction using a bone-patellar tendon-bone autograft were examined. During surgery, ketorolac (60 mg) was given intravenously and 0.25% bupivicaine (1 ml/kg total) was injected into the joint space and the graft donor site. After surgery, all patients received scheduled doses of oral acetaminophen (650 mg) and ketorolac (10 mg) four times a day, and they were allowed to take oral oxycodone (5 to 10 mg) every 2 hours as needed. Pain scores at rest and with activity reached a maximum on the 2nd postoperative morning. Oxycodone consumption also peaked on the 2nd postoperative day. Eighty-nine (89%) patients reported overall pain as mild or moderate, and 95 patients (95%) reported either excellent or good overall relief of pain. The 5-day cumulative mean of visual analog scale pain scores for attempting straight leg raises was significantly higher for patients unable to successfully perform that activity than for patients who were able to perform it. The association between elevated pain scores and diminished ability to perform straight leg raises suggests that pain may inhibit function and therefore early rehabilitation. PMID:9079170

  2. The successful arthroscopic treatment of suprascapular intraneural ganglion cysts.

    Science.gov (United States)

    Prasad, Nikhil K; Spinner, Robert J; Smith, Jay; Howe, Benjamin M; Amrami, Kimberly K; Iannotti, Joseph P; Dahm, Diane L

    2015-09-01

    OBJECT High-resolution magnetic resonance imaging (MRI) can distinguish between intraneural ganglion cysts and paralabral (extraneural) cysts at the glenohumeral joint. Suprascapular intraneural ganglion cysts share the same pathomechanism as their paralabral counterparts, emanating from a tear in the glenoid labrum. The authors present 2 cases to demonstrate that the identification and arthroscopic repair of labral tears form the cornerstone of treatment for intraneural ganglion cysts of the suprascapular nerve. METHODS Two patients with suprascapular intraneural ganglion cysts were identified: 1 was recognized and treated prospectively, and the other, previously reported as a paralabral cyst, was identified retrospectively through the reinter-pretation of high-resolution MR images. RESULTS Both patients achieved full functional recovery and had complete radiological involution of the intraneural ganglion cysts at the 3-month and 12-month follow-ups, respectively. CONCLUSIONS Previous reports of suprascapular intraneural ganglion cysts described treatment by an open approach to decompress the cysts and resect the articular nerve branch to the glenohumeral joint. The 2 cases in this report demonstrate that intraneural ganglion cysts, similar to paralabral cysts, can be treated with arthroscopic repair of the glenoid labrum without resection of the articular branch. This approach minimizes surgical morbidity and directly addresses the primary etiology of intraneural and extraneural ganglion cysts. PMID:26323813

  3. Prospective outcomes of arthroscopic treatment of dorsal wrist ganglia.

    Science.gov (United States)

    Aslani, Hamidreza; Najafi, Arvin; Zaaferani, Zohre

    2012-03-01

    The purpose of this study was to assess the results of arthroscopic resection of dorsal wrist ganglia. Between November 2002 and September 2007, all patients with dorsal wrist ganglia underwent arthroscopic resection in our institution. Average follow-up was 39.2 months (range, 24-71 months). Fifty-two patients (40 women and 12 men; mean age, 29.8 years) were treated with our operative technique. Symptoms at presentation were unpleasant appearance in 15 patients (28.8 %), pain in 30 (57.6%), and unpleasant appearance and pain in 7 (13.5%). The ganglion cyst site was in front of the midcarpal joint in 41 patients (78.8%), in front of the radiocarpal joint in 6 patients (11.5%), and in front of the radiocarpal and midcarpal joints in 5 patients (9.6%). Our surgical technique resulted in a significant improvement in flexion, extension, and grip strength (P≤.005). In patients with painful ganglia, treatment also had a significant effect. Nine (17.3%) recurrences were observed. Mean time off work was 14 days, but 19 patients returned to work immediately. According to the results of this study, we recommend the use of arthroscopy as the primary treatment method for dorsal wrist ganglion excision. PMID:22385448

  4. A multimodal approach to ankle instability: Interrelations between subjective and objective assessments of ankle status in athletes.

    Science.gov (United States)

    Golditz, Tobias; Welsch, Goetz H; Pachowsky, Milena; Hennig, Friedrich F; Pfeifer, Klaus; Steib, Simon

    2016-03-01

    The aim of this retrospective cohort study is to investigate the association between different subjective and objective assessments of ankle function in a population of athletes with or without functional ankle instability (FAI). 29 athletes with a history of ankle spraining were divided into two groups according to their ankle status: 16 with FAI (initial ankle sprain with residual functional instability) (age 24.6 ± 3.1 years), and 13 COPERS (initial ankle sprain without residual instability) (age 25.3 ± 4.4 years). The assessment of each individual's ankle function was based on three approaches: The "functional-ankle-ability-measure" (FAAM) assessing subjective ankle functionality, measures of sensorimotor control as objective functional measurements and MRI-based T2-mapping as a quantitative marker of compositional joint status. Pearson's product-moment-correlation coefficient, student's t-test and analysis-of-variance were used for statistical analysis. Significant group differences existed for subjective ankle function (FAAM, p = 0.04) and MRI-data mainly in the medial compartment of the ankle joint (p ≤ 0.05). We found unique associations between T2-mapping results and sensorimotor scores in the COPER (r = -0.756-0.849), and "FAI"-group (r = 0.630-0.657). The location and magnitude differed between groups. No correlations existed between these measures and the FAAM. This exploratory study provides preliminary evidence for potential interrelations between various diagnostic measures of ankle function and structure in individuals with and without FAI. We found associations between MRI-results and selected measures of sensorimotor control, indicating a potential link between loss of ankle function and early joint degeneration. Despite these interrelations, each of the different assessment options appears to contain unique information on ankle functionality important in a clinical assessment. PMID:26309042

  5. Arthroscopic Superior Capsule Reconstruction for Irreparable Rotator Cuff Tears

    Science.gov (United States)

    Mihata, Teruhisa; Lee, Thay Q.; Itami, Yasuo; HASEGAWA, Akihiko; Ohue, Mutsumi; Neo, Masashi

    2016-01-01

    Objectives: An arthroscopic superior capsule reconstruction, in which the fascia lata autograft attached medially to the superior glenoid and laterally to the greater tuberosity, restores shoulder stability and muscle balance in patients with irreparable rotator cuff tears; consequently, it improves shoulder function specifically deltoid muscle function and relieves pain. We assessed the clinical outcome of arthroscopic superior capsule reconstruction (Figure 1) in 100 consecutive patients with irreparable rotator cuff tears. Specifically, we focused on the rates of return to sport and work. Methods: From 2007 to 2014, we performed arthroscopic superior capsule reconstruction on 107 consecutive patients (mean 66.7 years; range, 43 to 82) with irreparable rotator cuff tears that had failed conservative treatment. Seven patients were lost to follow-up because of other medical problems or reasons. In the remaining 100 patients there were 56 supraspinatus and infraspinatus tears; 39 supraspinatus, infraspinatus, and subscapularis tears; 3 supraspinatus, infraspinatus, teres minor, and subscapularis tears; and 2 supraspinatus, infraspinatus, and teres minor tears. Physical examination, radiography, and MRI were performed before surgery; at 3, 6, and 12 months after surgery; and yearly thereafter. Rates of return to sport and work were also investigated in those patients who had been employed (34 patients: 21 manual workers, 10 farmers, 1 butcher, 1 cook, and 1 athletic trainer) or played sport (26 patients: 6 golf, 4 table tennis, 4 swimming, 3 martial arts, 2 baseball, 2 yoga, 1 tennis, 1 badminton, 1 skiing, 1 mountain-climbing, and 1 ground golf) before injury. Results: The average preoperative American Shoulder and Elbow Surgeons (ASES) score was 31.6 points (range, 3.3 to 63.3 points) and the average Japanese Orthopaedic Association (JOA) score was 51.6 points (26.5 to 68.5 points). Average postoperative clinical outcome scores all improved significantly at final

  6. A Systematic Review on the Treatment of Acute Ankle Sprain Brace versus Other Functional Treatment Types

    NARCIS (Netherlands)

    E. Kemler; I. van de Port; F. Backx; C.N. van Dijk

    2011-01-01

    Ankle injuries, especially ankle sprains, are a common problem in sports and medical care. Ankle sprains result in pain and absenteeism from work and/or sports participation, and can lead to physical restrictions such as ankle instability. Nowadays, treatment of ankle injury basically consists of ta

  7. Design of a simple, lightweight, passive-elastic ankle exoskeleton supporting ankle joint stiffness

    Science.gov (United States)

    Kim, Seyoung; Son, Youngsu; Choi, Sangkyu; Ham, Sangyong; Park, Cheolhoon

    2015-09-01

    In this study, a passive-elastic ankle exoskeleton (PEAX) with a one-way clutch mechanism was developed and then pilot-tested with vertical jumping to determine whether the PEAX is sufficiently lightweight and comfortable to be used in further biomechanical studies. The PEAX was designed to supplement the function of the Achilles tendon and ligaments as they passively support the ankle torque with their inherent stiffness. The main frame of the PEAX consists of upper and lower parts connected to each other by tension springs (N = 3) and lubricated hinge joints. The upper part has an offset angle of 5° with respect to the vertical line when the springs are in their resting state. Each spring has a slack length of 8 cm and connects the upper part to the tailrod of the lower part in the neutral position. The tailrod freely rotates with low friction but has a limited range of motion due to the stop pin working as a one-way clutch. Because of the one-way clutch system, the tension springs store the elastic energy only due to an ankle dorsiflexion when triggered by the stop pin. This clutch mechanism also has the advantage of preventing any inconvenience during ankle plantarflexion because it does not limit the ankle joint motion during the plantarflexion phase. In pilot jumping tests, all of the subjects reported that the PEAX was comfortable for jumping due to its lightweight (approximately 1 kg) and compact (firmly integrated with shoes) design, and subjects were able to nearly reach their maximum vertical jump heights while wearing the PEAX. During the countermovement jump, elastic energy was stored during dorsiflexion by spring extension and released during plantarflexion by spring restoration, indicating that the passive spring torque (i.e., supportive torque) generated by the ankle exoskeleton partially supported the ankle joint torque throughout the process.

  8. Acute and chronic lateral ankle instability in the athlete.

    Science.gov (United States)

    Chan, Keith W; Ding, Bryan C; Mroczek, Kenneth J

    2011-01-01

    Ankle sprain injuries are the most common injury sustained during sporting activities. Three-quarters of ankle injuries involve the lateral ligamentous complex, comprised of the anterior talofibular ligament (ATFL), the calcaneofibular ligament (CFL), and the posterior talofibular ligament (PTFL). The most common mechanism of injury in lateral ankle sprains occurs with forced plantar flexion and inversion of the ankle as the body's center of gravity rolls over the ankle. The ATFL followed by the CFL are the most commonly injured ligaments. Eighty percent of acute ankle sprains make a full recovery with conservative management, while 20% of acute ankle sprains develop mechanical or functional instability, resulting in chronic ankle instability. Treatment of acute ankle sprains generally can be successfully managed with a short period of immobilization that is followed by functional rehabilitation. Patients with chronic ankle instability who fail functional rehabilitation are best treated with a Brostrom-Gould anatomic repair or, in those patients with poor tissue quality or undergoing revision surgery, an anatomic reconstruction. PMID:21332435

  9. Predicting functional recovery after acute ankle sprain.

    Directory of Open Access Journals (Sweden)

    Sean R O'Connor

    Full Text Available INTRODUCTION: Ankle sprains are among the most common acute musculoskeletal conditions presenting to primary care. Their clinical course is variable but there are limited recommendations on prognostic factors. Our primary aim was to identify clinical predictors of short and medium term functional recovery after ankle sprain. METHODS: A secondary analysis of data from adult participants (N = 85 with an acute ankle sprain, enrolled in a randomized controlled trial was undertaken. The predictive value of variables (age, BMI, gender, injury mechanism, previous injury, weight-bearing status, medial joint line pain, pain during weight-bearing dorsiflexion and lateral hop test recorded at baseline and at 4 weeks post injury were investigated for their prognostic ability. Recovery was determined from measures of subjective ankle function at short (4 weeks and medium term (4 months follow ups. Multivariate stepwise linear regression analyses were undertaken to evaluate the association between the aforementioned variables and functional recovery. RESULTS: Greater age, greater injury grade and weight-bearing status at baseline were associated with lower function at 4 weeks post injury (p<0.01; adjusted R square=0.34. Greater age, weight-bearing status at baseline and non-inversion injury mechanisms were associated with lower function at 4 months (p<0.01; adjusted R square=0.20. Pain on medial palpation and pain on dorsiflexion at 4 weeks were the most valuable prognostic indicators of function at 4 months (p< 0.01; adjusted R square=0.49. CONCLUSION: The results of the present study provide further evidence that ankle sprains have a variable clinical course. Age, injury grade, mechanism and weight-bearing status at baseline provide some prognostic information for short and medium term recovery. Clinical assessment variables at 4 weeks were the strongest predictors of recovery, explaining 50% of the variance in ankle function at 4 months. Further

  10. Result from arthroscopic surgical treatment of renewed tearing of the rotator cuff of the shoulder

    Directory of Open Access Journals (Sweden)

    Glaydson Gomes Godinho

    2015-02-01

    Full Text Available OBJECTIVES: To evaluate function among patients with postoperative recurrence of rotator cuff injuries that was treated arthroscopically (case series and compare this with function in patients without recurrence (control group; and to compare function among patients with recurrence of rotator cuff injuries that were greater than and smaller than 3 cm.METHODS: This was a retrospective evaluation of patients who underwent arthroscopic revision of rotator cuff injuries using the ASES, Constant & Murley and UCLA scores and a visual analog pain scale, in comparison with patients in a control group who underwent primary rotator cuff repair.RESULTS: The size of the rotator cuff injury recurrence had a statistically significant influence on the result from the arthroscopic surgical treatment. The functional scores showed worse results than those from the first procedure.CONCLUSION: Arthroscopic surgical treatment of renewed tearing of rotator cuff injuries showed worse functional scores than those from primary repair of the injury.

  11. Enhanced balance associated with coordination training with stochastic resonance stimulation in subjects with functional ankle instability: an experimental trial

    Directory of Open Access Journals (Sweden)

    Brown Cathleen N

    2007-12-01

    Full Text Available Abstract Background Ankle sprains are common injuries that often lead to functional ankle instability (FAI, which is a pathology defined by sensations of instability at the ankle and recurrent ankle sprain injury. Poor postural stability has been associated with FAI, and sports medicine clinicians rehabilitate balance deficits to prevent ankle sprains. Subsensory electrical noise known as stochastic resonance (SR stimulation has been used in conjunction with coordination training to improve dynamic postural instabilities associated with FAI. However, unlike static postural deficits, dynamic impairments have not been indicative of ankle sprain injury. Therefore, the purpose of this study was to examine the effects of coordination training with or without SR stimulation on static postural stability. Improving postural instabilities associated with FAI has implications for increasing ankle joint stability and decreasing recurrent ankle sprains. Methods This study was conducted in a research laboratory. Thirty subjects with FAI were randomly assigned to either a: 1 conventional coordination training group (CCT; 2 SR stimulation coordination training group (SCT; or 3 control group. Training groups performed coordination exercises for six weeks. The SCT group received SR stimulation during training, while the CCT group only performed coordination training. Single leg postural stability was measured after the completion of balance training. Static postural stability was quantified on a force plate using anterior/posterior (A/P and medial/lateral (M/L center-of-pressure velocity (COPvel, M/L COP standard deviation (COPsd, M/L COP maximum excursion (COPmax, and COP area (COParea. Results Treatment effects comparing posttest to pretest COP measures were highest for the SCT group. At posttest, the SCT group had reduced A/P COPvel (2.3 ± 0.4 cm/s vs. 2.7 ± 0.6 cm/s, M/L COPvel (2.6 ± 0.5 cm/s vs. 2.9 ± 0.5 cm/s, M/L COPsd (0.63 ± 0.12 cm vs. 0.73 ± 0

  12. Effects of Nintendo Wii Fit Plus training on ankle strength with functional ankle instability.

    Science.gov (United States)

    Kim, Ki-Jong; Jun, Hyun-Ju; Heo, Myoung

    2015-11-01

    [Purpose] The objective of this study was to examine the effects of a training program using the Nintendo Wii Fit Plus on the ankle muscle strengths of subjects with functional ankle instability. [Subjects and Methods] This study was conducted using subjects in their 20s who had functional ankle instability. They were randomized to a strengthening training group and a balance training group with 10 subjects in each, and they performed an exercise using Nintendo Wii Fit Plus for 20 minutes. In addition, every participant completed preparation and finishing exercises for 5 minutes, respectively. [Results] The muscle strengths after conducting plantar flexion and dorsiflexion significantly increased at the angular velocities of 60° and 120° in the strengthening training group. Furthermore, the muscle strengths after conducting plantar flexion, dorsiflexion, eversion, and inversion significantly increased at the angular velocities of 60° and 120° in the balance training group. [Conclusion] The balance training group using Nintendo Wii Fit Plus showed better results than the strengthening training group. Consequently, it is recommended to add the balance training program of the Nintendo Wii Fit Plus to conventional exercise programs to improve ankle muscle strength in functional ankle instability at a low cost. PMID:26696703

  13. Modulation of ankle stiffness during postural sway.

    Science.gov (United States)

    Lang, Christopher B; Kearney, Robert E

    2014-01-01

    Ankle stiffness is a nonlinear, time-varying system which contributes to the control of human upright stance. This study sought to examine the nature of the contribution of stiffness to postural control by determining how intrinsic and reflex stiffnesses varied with sway. Subjects were instructed to stand quietly on a bilateral electro-hydraulic actuator while perturbations were applied about the ankle. Subjects performed three types of trials: normal stance, forward lean, and backward lean. Position, torque, and EMGs from the tibialis anterior and triceps surae were recorded. Background torque, intrinsic stiffness and reflex stiffness were calculated for each perturbation. Intrinsic and reflex stiffnesses were heavily modulated by postural sway. Moreover, they were modulated in a complimentary manner; intrinsic stiffness was lowest when reflex gain was highest, and vice versa. These findings suggest that intrinsic stiffness is modulated simultaneously with reflex stiffness to optimize the control of balance. PMID:25570884

  14. MR arthrography of the ankle joint

    International Nuclear Information System (INIS)

    Due to its superior soft tissue contrast conventional MRI is the imaging method of choice in the evaluation of ankle joint disorders. Conventional MR imaging can accurately demonstrate normal or acutely injured ligaments; however, in subacute and chronic injury joint fluid necessary for delineation of injured ligaments is absent and MR arthrography should be performed. MR arthrography uses the intraarticular injection of contrast material to distend the joint, yielding improved discrimination of intraarticular structures. This joint distension with MR arthrography is also helpful in the staging of osteochondritis dissecans, since in cases of unstable lesions tracking of contrast material into the interface can be more easily demonstrated. Finally, high contrast and joint distension by MR arthrography improves the detection of intraarticular loose bodies, which often require surgery. MR artrography, although invasive, may provide additional information in various ankle joint disorders. (orig.)

  15. The Effects of Spinal, Inhalation, and Total Intravenous Anesthetic Techniques on Ischemia-Reperfusion Injury in Arthroscopic Knee Surgery

    Directory of Open Access Journals (Sweden)

    Müge Koşucu

    2014-01-01

    Full Text Available Purpose. To compare the effects of different anesthesia techniques on tourniquet-related ischemia-reperfusion by measuring the levels of malondialdehyde (MDA, ischemia-modified albumin (IMA and neuromuscular side effects. Methods. Sixty ASAI-II patients undergoing arthroscopic knee surgery were randomised to three groups. In Group S, intrathecal anesthesia was administered using levobupivacaine. Anesthesia was induced and maintained with sevoflurane in Group I and TIVA with propofol in Group T. Blood samples were obtained before the induction of anesthesia (t1, 30 min after tourniquet inflation (t2, immediately before (t3, and 5 min (t4, 15 min (t5, 30 min (t6, 1 h (t7, 2 h (t8, and 6 h (t9 after tourniquet release. Results. MDA and IMA levels increased significantly compared with baseline values in Group S at t2–t9 and t2–t7. MDA levels in Group T and Group I were significantly lower than those in Group S at t2–t8 and t2–t9. IMA levels in Group T were significantly lower than those in Group S at t2–t7. Postoperatively, a temporary 1/5 loss of strength in dorsiflexion of the ankle was observed in 3 patients in Group S and 1 in Group I. Conclusions. TIVA with propofol can make a positive contribution in tourniquet-related ischemia-reperfusion.

  16. [Advances on biomechanics and kinematics of sprain of ankle joint].

    Science.gov (United States)

    Zhao, Yong; Wang, Gang

    2015-04-01

    Ankle sprains are orthopedic clinical common disease, accounting for joint ligament sprain of the first place. If treatment is not timely or appropriate, the joint pain and instability maybe develop, and even bone arthritis maybe develop. The mechanism of injury of ankle joint, anatomical basis has been fully study at present, and the diagnostic problem is very clear. Along with the development of science and technology, biological modeling and three-dimensional finite element, three-dimensional motion capture system,digital technology study, electromyographic signal study were used for the basic research of sprain of ankle. Biomechanical and kinematic study of ankle sprain has received adequate attention, combined with the mechanism research of ankle sprain,and to explore the the biomechanics and kinematics research progress of the sprain of ankle joint. PMID:26072625

  17. Diagnosis of ligament injuries in the superior ankle joint

    International Nuclear Information System (INIS)

    Nearly 40 years after ankle arthrography was first introduced, the anterior and inversion stress views of the ankle are still widely preferred as a noninvasive method of evaluating ligament injuries in the upper ankle. We consider the stress test, bilaterally performed using a standardized stress apparatus, as a basic examination by which to differentiate between slight and severe sprain. Intensive muscel splinting due to painful swelling can sometimes be treated by injection of local anesthetic. Like many authors, we perform ankle arthrography in cases where there is a significant difference between the clinical findings and the stress test. The technique of ankle arthrography can be readily learned and is extremely accurate in delineating the extent of ligamentous injury produced by moderate or severe ankle sprains. It can be performed in any X-ray department. (orig.)

  18. A new method of arthroscopic reconstruction of the dislocated acromio-clavicular joint.

    OpenAIRE

    Trikha, S. P.; Acton, D.; Wilson, A. J.; Curtis, M. J.

    2004-01-01

    BACKGROUND: Symptomatic total acromio-clavicular joint dislocation (Rockwood et al. types III-VI) may be treated by surgical reconstruction. AIM: To describe an arthroscopically assisted technique to reconstruct anatomically the coraco-clavicular ligaments in acute or chronic (> 6 weeks) acromio-clavicular joint dislocation. METHODS: This new technique involves arthroscopic exposure of the coracoid process. Prior to introducing this technique, cadaveric studies were undertaken. RESULTS: Five ...

  19. Arthroscopic lysis and lavage in patients with temporomandibular anterior disc displacement without reduction

    Czech Academy of Sciences Publication Activity Database

    Machoň, V.; Šedý, Jiří; Klíma, K.; Hirjak, D.; Foltán, R.

    2012-01-01

    Roč. 41, č. 1 (2012), s. 109-113. ISSN 0901-5027 R&D Projects: GA MŠk(CZ) LC554; GA ČR GAP304/10/0320 Grant ostatní: GA MŠk(CZ) 1M0538 Institutional research plan: CEZ:AV0Z50390703 Keywords : temporomandibular joint * arthroscopic lysis * arthroscopic lavage Subject RIV: FJ - Surgery incl. Transplants Impact factor: 1.521, year: 2012

  20. Lipoma arborescens of the knee: report of a case managed by arthroscopic synovectomy.

    Science.gov (United States)

    Franco, Michel; Puch, J M; Carayon, M J; Bortolotti, D; Albano, Laetitia; Lallemand, A

    2004-01-01

    We report a case of lipoma arborescens treated with an arthroscopic procedure. Lipoma arborescens is an uncommon pseudo-tumoral synovial lesion usually located in the suprapatellar pouch of the knee. This diagnosis should be considered, particularly in patients with chronic joint effusion. Magnetic resonance imaging confirms the lipomatous nature of the synovial proliferation. When limited to the anterior compartment of the knee, lipoma arborescens can be treated by arthroscopic synovectomy. PMID:14769527

  1. Arthroscopic excision of heterotopic calcification in a chronic rectus femoris origin injury: a case report

    OpenAIRE

    El-Husseiny, M; Sukeik, M.; Haddad, FS

    2012-01-01

    Rectus femoris origin injuries in adult athletes are uncommon. In the acute phase, conservative treatment seems to have a favourable outcome, with surgical repair reserved for unsuccessful cases only. However, a group of patients may develop chronic pain and disability after recovery from the acute phase due to heterotopic calcification occurring at the site of injury. Open and arthroscopic excision of such calcifications has been described in the literature although arthroscopic excision of ...

  2. Arthroscopic Subacromial Decompression for Small and Medium Size Tears of Rotator Cuff without Tendon Repair

    OpenAIRE

    Suhail Karkabi; Nahum Rosenberg

    2014-01-01

    According to our previous clinical impression, we hypothesized that patients who had symptomatic rotator cuff tendon tear in a diamemter below 3 cm would benefit from arthroscopic subacromial decompression only, without the need for the repair of the thorn tendon. From 1998 to 2003, 160 patients (168 shoulders) had arthroscopic subacromial decompression for impingement syndrome with a torn rotator cuff without repairing the tear of the cuffs (120 males and 40 females). The average patient age...

  3. Clinical Effect of Steroid Administration in Patients with Chronic Impingement Syndrome on Postoperative Arthroscopic Subacromial Decompression

    OpenAIRE

    YILDIZ, Vahit; Aydin, Ali; KALALI, Fatih; Ömer Selim YILDIRIM; Topal, Murat; AYDIN, Pelin

    2012-01-01

    Objective: We aimed in our study to investigate the effect of intraarticular corticosteroid injection applied to patients with the chronic impingement syndrome after arthroscopic subacromial decompression on the clinical result. Materials and Methods: We employed in our study a total of 44 (24 males, 20 females) patients with chronic impingement syndrome to whom intraarticular corticosteroid injection was applied before arthroscopic subacromial decompression between 1-7 times. We measured c...

  4. Prediction of post-operative pain following arthroscopic subacromial decompression surgery: an observational study

    OpenAIRE

    Anthony Davis; Chinn, David J; Sunil Sharma

    2013-01-01

    Background: Arthroscopic shoulder surgery is increasingly performed as a day case procedure. Optimal post-operative pain relief remains a challenge due to considerable variations in the level of pain experienced between individuals. Our aim was to examine whether the preoperative electrical pain threshold was a strong predictor of elevated postoperative pain levels following arthroscopic subacromial decompression (ASD) surgery. Methods: Forty consenting patients with American Society of Anest...

  5. Arthroscopic Resection of The Distal Clavicle With Concomitant Subacromial Decompression: A Case Series

    OpenAIRE

    Chan, HZ; Ooi, CL; Lim, MY; Ong, EKS; Zulkiflee, O

    2014-01-01

    Abstract Shoulder impingement syndrome and acromioclavicular joint osteoarthritis often occur simultaneously and easily missed. Kay et al. reported excellent results with combined arthroscopic subacromial decompression and resection of the distal end of the clavicle in patients with both disorders1. Arthroscopic treatment of these disorders produces more favourable results than open procedures. We report two patients who were not responding to conservative management and were treated with dir...

  6. Arthroscopic treatment of chronically painful calcific tendinitis of the rectus femoris

    OpenAIRE

    Peng, Xu; Feng, Yong; Chen, Guangxing; Yang, Liu

    2013-01-01

    Background Relatively large calcific tendinitis with persistent symptoms after extended periods of conservative treatment is an indication for operative therapy. Arthroscopy, as a treatment for calcific tendinitis of the hip abductors and calcinosis circumscripta, has been described previously; however, to our knowledge, the clinical and radiological response to arthroscopic removal of calcific tendinitis of the rectus femoris tendon has not. Methods We present arthroscopic treatment of unusu...

  7. “Subcritical” Glenoid Bone Loss Increases Redislocation Rates in Primary Arthroscopic Bankart Repair

    OpenAIRE

    Shaha, James S.; Cook, Jay B.; Song, Daniel J.; Rowles, Douglas J.; Bottoni, Craig R.; Shaha, Steven H.; Tokish, John M.

    2014-01-01

    Objectives: While bone loss is increasingly recognized as a risk factor for failure after arthroscopic stabilization, the precise definition of critical bone loss has not been defined. Additionally, there is no clarity on the amount of bone loss routinely present in patients presenting for primary arthroscopic stabilization of anterior glenohumeral instability. The purpose of this study is to report on the average bone loss measured in primary isolated Bankart reconstructions of the shoulder ...

  8. Long term results of arthroscopic bankart repair for traumatic anterior shoulder instability

    OpenAIRE

    Ee, Gerard WW; Mohamed, Sedeek; Tan, Andrew HC

    2011-01-01

    Background The arthroscopic method offers a less invasive technique of Bankart repair for traumatic anterior shoulder instability. We would like to report the 2 year clinical outcomes of bio-absorbable suture anchors used in traumatic anterior dislocations of the shoulder. Methods Data from 79 shoulders in 74 patients were collected over 4 years (2004 - 2008). Each patient was followed-up over a period of 2 years. The patients underwent arthroscopic Bankart repair using bio-absorbable suture ...

  9. Analysis of the functional results of arthroscopic Bankart repair in posttraumatic recurrent anterior dislocations of shoulder

    OpenAIRE

    Amit Mishra; Pulak Sharma; Deepak Chaudhary

    2012-01-01

    Background: The Bankart lesion represents the most common form of labro-ligamentous injury in patients with traumatic dislocations of the shoulder leading to shoulder instability. We report the clinical outcome of arthroscopic repair of Bankart lesion in 50 patients. Materials and Methods: Sixty five patients with posttraumatic anterior dislocation of shoulder were treated by arthroscopic repair from Jan 2005 to Nov 2008. Fifty patients, with an average age of 26.83 years (range 18-45 yea...

  10. Arthroscopic Treatment of Septic Arthritis of the Elbow in a 4-Year-Old Girl

    Directory of Open Access Journals (Sweden)

    Masashi Koide

    2015-01-01

    Full Text Available Pediatric septic arthritis is uncommon and has been traditionally treated by joint aspiration or open arthrotomy. There are some reports about arthroscopic surgery in pediatric septic arthritis of the knee, hip, and shoulder. However, there is no report for the case of elbow. We report a case of pediatric septic arthritis of elbow treated with arthroscopically with good clinical condition at 3-year follow-up. This paper is based on a report first published in Japanese (Tojo (2012.

  11. Clinical and Radiological Evaluation after Arthroscopic Rotator Cuff Repair Using Suture Bridge Technique

    OpenAIRE

    Lee, Kwang Won; Seo, Dong Wook; Bae, Kyoung Wan; Choy, Won Sik

    2013-01-01

    Background We retrospectively assessed the clinical outcomes and investigated risk factors influencing retear after arthroscopic suture bridge repair technique for rotator cuff tear through clinical assessment and magnetic resonance arthrography (MRA). Methods Between January 2008 and April 2011, sixty-two cases of full-thickness rotator cuff tear were treated with arthroscopic suture bridge repair technique and follow-up MRA were performed. The mean age was 56.1 years, and mean follow-up per...

  12. Diagnostic dilemmas in foot and ankle injuries

    Energy Technology Data Exchange (ETDEWEB)

    Keene, J.S.; Lange, R.H.

    1986-07-11

    Differential diagnosis of foot and ankle injuries should include (1) stress fractures of the great toe sesamoids, the shaft of the fifth metatarsal, and the tarsal navicular bone; (2) transchondral talar-dome fractures; (3) fractures of the os trigonum; and (4) dislocating peroneal tendons. Diagnosis of these injuries is challenging because the initial roentgenograms often are normal, and special clinical tests and ancillary studies are required.

  13. Osteoarthritis after osteosynthesis of ankle injuries

    International Nuclear Information System (INIS)

    98 patients were clinically and radiographically examined 2 to 9 years following the osteosynthesis of ankle fractures. The rate of secondary osteoarthritis was 70% including 40% of minor, 17% of medium and 13% of serious changes. Depending on the injured structures the frequency of posttraumatic osteoarthritis varies. Medium and serious radiology changes cause obvious dysfunction in 56% and 62% respectively. Joints free of Osteoarthritis one year after the injury will not develop secondary osteoarthritis later. (orig.)

  14. Diagnostic dilemmas in foot and ankle injuries

    International Nuclear Information System (INIS)

    Differential diagnosis of foot and ankle injuries should include (1) stress fractures of the great toe sesamoids, the shaft of the fifth metatarsal, and the tarsal navicular bone; (2) transchondral talar-dome fractures; (3) fractures of the os trigonum; and (4) dislocating peroneal tendons. Diagnosis of these injuries is challenging because the initial roentgenograms often are normal, and special clinical tests and ancillary studies are required

  15. Optimal management of ankle syndesmosis injuries

    OpenAIRE

    Porter DA; Jaggers RR; Barnes AF; Rund AM

    2014-01-01

    David A Porter, Ryan R Jaggers, Adam Fitzgerald Barnes, Angela M Rund Methodist Sports Medicine/The Orthopedic Specialists, Indianapolis, IN, USA Abstract: Syndesmosis injuries occur when there is a disruption of the distal attachment of the tibia and fibula. These injuries occur commonly (up to 18% of ankle sprains), and the incidence increases in the setting of athletic activity. Recognition of these injuries is key to preventing long-term morbidity. Diagnosis and treatment of these injuri...

  16. The management of soft tissue ankle injuries.

    OpenAIRE

    Crean, D.

    1981-01-01

    The anatomy of the ankle, and the types of sporting injuries that occur in this joint, are described. Traditional treatment of soft tissue injuries involves immobilisation, and the value of this is questioned. An alternative treatment strategy is described, and involves immobilisation and compression for twenty-four hours, followed by rapid mobilisation using a balance board. This alternative strategy can bring about full functional mobility in 94% of patients within 14 days.

  17. MR imaging of the ankle: Normal variants

    International Nuclear Information System (INIS)

    Thirty asymptomatic ankles were studied with high-resolution surface coil MR imaging. The thirty ankles were reviewed for identification or normal structures. The MR appearance of the deltoid and posterior to talo-fibular ligaments, peroneous brevis and longus tendons, and posterior aspect of the tibial-talar joint demonstrated several normal variants not previously described. These should not be misinterpreted as pathologic processes. The specific findings included (1) cortical irregularity of the posterior tibial-talar joint in 27 of 30 cases which should not be mistaken for osteonecrois; (2) normal posterior talo-fibular ligament with irregular and frayed inhomogeneity, which represents a normal variant in seven of ten cases; and (3) fluid in the shared peroneal tendons sheath which may be confused for a longitudinal tendon tear in three of 30 cases. Ankle imaging with the use of MR is still a relatively new procedure. Further investigation is needed to better define normal anatomy as well as normal variants. The authors described several structures that normally present with variable MR imaging appearances. This is clinically significant in order to maintain a high sensitivity and specificity in MR imaging interpretation

  18. Forces predicted at the ankle during running.

    Science.gov (United States)

    Burdett, R G

    1982-01-01

    A biomechanical model of the ankle joint was developed and was used to predict the forces at the ankle during the stance phase of running. Measurements from five cadavers were averaged to obtain insertion points and directions of pull of equivalent tendons with respect to the assumed center of the ankle joint. A minimum joint force solution was obtained by assuming that only two equivalent muscle groups could exert force at one time. Three subjects ran at 4.47 m/s across a force platform that recorded the external forces and moments acting on the foot. Cinematography was used to measure the foot and leg positions during stance. Peak resultant joint forces ranging from 9.0 to 13.3 times body weight and peak Achilles tendon forces ranging from 5.3 to 10.0 times body weight were predicted. Small variations in some cases resulted in large differences in predicted forces. The highest tendon forces predicted exceeded those reported to cause damage to cadaver tendons in other studies. PMID:7132650

  19. Kinesthesia Is Not Affected by Functional Ankle Instability Status.

    Science.gov (United States)

    Hubbard, Tricia J; Kaminski, Thomas W

    2002-12-01

    OBJECTIVE: To determine whether subjects with functional ankle instability suffered kinesthetic deficits in the injured ankle compared with the healthy ankle and to examine the effect of prophylactic ankle bracing on kinesthesia in uninjured and functionally unstable ankles. DESIGN AND SETTING: We tested subjects over 4 consecutive days in a climate-controlled athletic training/sports medicine laboratory setting. A single-group time-series design enabled all subjects to serve as their own controls. A different bracing condition was tested on each of those occasions. SUBJECTS: Sixteen subjects (8 men, 8 women; age = 21.6 +/- 1.7 years; mass = 73.5 +/- 15.0 kg; height = 172.9 +/- 8.8 cm) with unilateral functional ankle instability participated in this study. MEASUREMENTS: Kinesthetic threshold-to-detection of passive motion (TTDPM) measurements were obtained during passive inversion and eversion movements (0.5 degrees.s(-1)) under 4 different bracing or taping conditions (unbraced, Swede-O Ankle Lok, Aircast Air-Stirrup, and tape). RESULTS: We analyzed the data using a 3-factor analysis of variance with repeated measures on the ankle and motion factors. Threshold-to-detection of passive motion scores in the unbraced condition were significantly better than the TTDPM scores in any of the other 3 test conditions. No significant differences were seen in TTDPM scores between the 2 ankles under any of the 4 conditions. CONCLUSIONS: Threshold-to-detection of passive motion scores did not differ in uninjured ankles and those with functional instability; however, bracing with either the Ankle Lok or Air-Stirrup decreased the ability to detect passive motion when compared with the no-tape (unbraced) condition. Further research is needed to determine the exact contributions of taping and bracing on ankle joint kinesthesia. PMID:12937571

  20. Kinematics and kinetics of an accidental lateral ankle sprain

    OpenAIRE

    Kristianslund, Eirik; Bahr, Roald; Krosshaug, Tron

    2011-01-01

    Ankle sprains are common during sporting activities and can have serious consequences. Understanding of injury mechanisms is essential to prevent injuries, but only two previous studies have provided detailed descriptions of the kinematics of lateral ankle sprains and measures of kinetics are missing. In the present study a female handball player accidentally sprained her ankle during sidestep cutting in a motion analysis laboratory. Kinematics and kinetics were calculated from 240 Hz recordi...

  1. Alteration in global motor strategy following lateral ankle sprain

    OpenAIRE

    Bastien, Maude; Moffet, Hélène; Bouyer, Laurent J; Perron, Marc; Hébert, Luc J; Leblond, Jean

    2014-01-01

    Background Lateral ankle sprain (LAS) has often been considered an injury leading to localized joint impairments affecting the musculoskeletal system. Persistent chronic ankle instability and bilateral alterations in motor control after a first ankle sprain episode suggest that the origin of relapses might be a maladaptive reorganization of central motor commands. The objectives of this study were (1) to compare the quality of motor control through motor strategy variables of two groups (with...

  2. Experimental and computational analysis of composite ankle-foot orthosis

    OpenAIRE

    Dequan Zou, DSc; Tao He, MS; Michael Dailey, MBA, CO; Kirk E. Smith, BS; Matthew J. Silva, PhD; David R. Sinacore, PhD, PT; Michael J. Mueller, PhD, PT; Mary K. Hastings, DPT, MSCI

    2015-01-01

    Carbon fiber (CF) ankle-foot orthoses (AFOs) can improve gait by increasing ankle plantar-flexor power and improving plantar-flexor ankle joint moment and energy efficiency compared with posterior leaf spring AFOs made of thermoplastic. However, fabricating a CF AFO to optimize the performance of the individual user may require multiple AFOs and expensive fabrication costs. Finite element analysis (FEA) models were developed to predict the mechanical behavior of AFOs in this study. Three AFOs...

  3. Neuropathic midfoot deformity: associations with ankle and subtalar joint motion

    OpenAIRE

    Sinacore, David R; Gutekunst, David J; Hastings, Mary K.; Strube, Michael J; Bohnert, Kathryn L.; Prior, Fred W.; Johnson, Jeffrey E

    2013-01-01

    Background Neuropathic deformities impair foot and ankle joint mobility, often leading to abnormal stresses and impact forces. The purpose of our study was to determine differences in radiographic measures of hind foot alignment and ankle joint and subtalar joint motion in participants with and without neuropathic midfoot deformities and to determine the relationships between radiographic measures of hind foot alignment to ankle and subtalar joint motion in participants with and without neuro...

  4. Review of common and unusual causes of lateral ankle pain

    International Nuclear Information System (INIS)

    Lateral ankle pain is a common clinical presentation having several important causes, including lateral ligament injury, peroneal tendon injury, sinus tarsi syndrome, and nerve entrapments. However, other causes should be kept in mind in patients with unusual patterns of pain or intractable symptoms. We present a review of common and some unusual causes of lateral ankle pain including a review of post-operative imaging findings following surgery for lateral ankle ligament and peroneal tendon injuries. (orig.)

  5. Influence on ankle taping on dynamic balance performance

    OpenAIRE

    Kenny, Ian; Wu, Can; McEvoy, Johnson

    2011-01-01

    peer-reviewed This research aimed to investigate the effect of ankle taping on dynamic balance performance. Eighteen recreational athletes without any previous ankle sprain history performed six star excursion balance tests on each leg; randomly three trials with taped ankles and three trials without. A three-layer modified closed-basket inelastic taping technique was used. Normalised (by leg length) reaching distance was measured. It was found 1.Movement direction significantl...

  6. Review of ankle inversion sprain simulators in the biomechanics laboratory

    OpenAIRE

    Sophia Chui-Wai Ha; Daniel Tik-Pui Fong; Kai-Ming Chan

    2015-01-01

    Ankle inversion ligamentous sprain is one of the most common sports injuries. The most direct way is to investigate real injury incidents, but it is unethical and impossible to replicate on test participants. Simulators including tilt platforms, trapdoors, and fulcrum devices were designed to mimic ankle inversion movements in laboratories. Inversion angle was the only element considered in early designs; however, an ankle sprain is composed of inversion and plantarflexion in clinical observa...

  7. Understanding acute ankle ligamentous sprain injury in sports

    OpenAIRE

    Fong Daniel TP; Chan Yue-Yan; Mok Kam-Ming; Yung Patrick SH; Chan Kai-Ming

    2009-01-01

    Abstract This paper summarizes the current understanding on acute ankle sprain injury, which is the most common acute sport trauma, accounting for about 14% of all sport-related injuries. Among, 80% are ligamentous sprains caused by explosive inversion or supination. The injury motion often happens at the subtalar joint and tears the anterior talofibular ligament (ATFL) which possesses the lowest ultimate load among the lateral ligaments at the ankle. For extrinsic risk factors to ankle sprai...

  8. Systematic review of chronic ankle instability in children

    OpenAIRE

    Mandarakas, Melissa; Pourkazemi, Fereshteh; Sman, Amy; Burns, Joshua; Hiller, Claire E

    2014-01-01

    Background Chronic ankle instability (CAI) is a disabling condition often encountered after ankle injury. Three main components of CAI exist; perceived instability; mechanical instability (increased ankle ligament laxity); and recurrent sprain. Literature evaluating CAI has been heavily focused on adults, with little attention to CAI in children. Hence, the objective of this study was to systematically review the prevalence of CAI in children. Methods Studies were retrieved from major databas...

  9. The Anatomic Pattern of Injuries in Acute Inversion Ankle Sprains

    OpenAIRE

    Khor, Yuet Peng; Tan, Ken Jin

    2013-01-01

    Background: There are little data on the incidence and patterns of injuries seen on magnetic resonance imaging (MRI) in acute inversion ankle sprains. This study may help in the understanding of the pathomechanics, natural history, and outcomes of this common injury. Study Design: Case series; Level of evidence, 4. Methods: From June 2011 to June 2013, a total of 64 consecutive patients had MRI of the ankle performed for acute inversion injury to the ankle. All injuries/pathologies reported w...

  10. Neuromuscular control and rehabilitation of the unstable ankle

    OpenAIRE

    Hung, You-jou

    2015-01-01

    Lateral ankle sprain is a common orthopedic injury with a very high recurrence rate in athletes. After decades of research, it is still unclear what contributes to the high recurrence rate of ankle sprain, and what is the most effective intervention to reduce the incident of initial and recurrent injuries. In addition, clinicians often implement balance training as part of the rehabilitation protocol in hopes of enhancing the neuromuscular control and proprioception of the ankle joint. Howeve...

  11. Review of common and unusual causes of lateral ankle pain

    Energy Technology Data Exchange (ETDEWEB)

    Choudhary, Surabhi [Nuffield Orthopaedic Centre NHS Trust, Musculoskeletal Radiology, Oxford (United Kingdom); McNally, Eugene [Nuffield Orthopaedic Centre NHS Trust, Musculoskeletal Radiology, Oxford (United Kingdom); Nuffield Orthopaedic Centre and University of Oxford, Musculoskeletal Radiology, Oxford (United Kingdom)

    2011-11-15

    Lateral ankle pain is a common clinical presentation having several important causes, including lateral ligament injury, peroneal tendon injury, sinus tarsi syndrome, and nerve entrapments. However, other causes should be kept in mind in patients with unusual patterns of pain or intractable symptoms. We present a review of common and some unusual causes of lateral ankle pain including a review of post-operative imaging findings following surgery for lateral ankle ligament and peroneal tendon injuries. (orig.)

  12. Limiting the use of routine radiography for acute ankle injuries.

    OpenAIRE

    Cockshott, W P; Jenkin, J. K.; Pui, M.

    1983-01-01

    In the diagnosis of ankle injuries routine radiography is often productive. An international survey of the average number of radiographs made of injured ankles suggested that two projections are adequate to detect fractures. This was confirmed in a prospective study of 242 patients coming to a hospital emergency department with recent ankle injuries. All the fractures could be identified on an anteroposterior or a lateral projection, although some were more obvious on an oblique view. As well...

  13. Rehabilitation of Ankle and Foot Injuries in Athletes

    OpenAIRE

    Chinn, Lisa; Hertel, Jay

    2010-01-01

    Foot and ankle injuries are extremely common among athletes and other physically active individuals. Rehabilitation programs that emphasize the use of therapeutic exercise to restore joint range of motion, muscle strength, neuromuscular coordination, and gait mechanics have been shown to have clinical success for patients suffering various foot and ankle pathologies. Rehabilitation programs are discussed for ankle sprains, plantar fasciitis, Achilles tendonitis, and turf toe.

  14. Differences in Men's and Women's Mean Ankle Ligamentous Laxity

    OpenAIRE

    Wilkerson, Ricky D; Mason, Melanie A

    2000-01-01

    The incidence of ligamentous ankle injuries is known to be one of the most common athletic injuries that exists. Recently, there has been a great deal of interest regarding the increased risk of female ligamentous injury, such as the anterior cruciate ligament, lateral ankle sprains and others. The purpose of this study is to evaluate whether or not normal lateral ankle ligamentous laxity is similar in male and female athletes. This study selects 22 male and 27 female college athletes who hav...

  15. MRI in acute ligamentous injuries of the ankle.

    Science.gov (United States)

    Martella, Ilenia; Azzali, Emanuele; Milanese, Gianluca; Praticò, Francesco Emanuele; Ruggirello, Margherita; Trunfio, Vincenzo; Parziale, Raffaele; Corrado, Michele; Della Casa, Giovanni; Capasso, Raffaella; De Filippo, Massimo

    2016-01-01

    Ankle sprains are the most common lower limb injuries and affect more frequently young athletes; imaging is needed for an accurate diagnosis of such traumatic injuries. The purpose of this review is to analyse the magnetic resonance (MR) findings of both normal and pathological ankle's ligaments; indeed, MRI is the gold standard for the diagnosis of acute traumatic injuries and is useful for differentiation of the causes of ankle instability as well as for pre-operative planning. PMID:27467862

  16. Syndesmotic Malreduction after Ankle ORIF; Is Radiography Sufficient?

    OpenAIRE

    Alireza Manafi Rasi; Gholamhossein Kazemian; Mohamad M Omidian; Ali Nemati

    2013-01-01

      Background: Ankle fractures, especially those resulting from external rotation mechanisms are associated with injury to the distal tibiofibular syndesmosis. Some authors have recommended performing CT scanning after open ankle surgery to evaluate the reduction of syndesmosis. In this current study, we aimed to investigate the sensitivity of plain radiography in diagnosing syndesmosis malreduction after open reduction and internal fixation (ORIF) in patients with ankle fractures.   Methods: ...

  17. Benign and malignant tumors of the foot and ankle

    Energy Technology Data Exchange (ETDEWEB)

    Singer, Adam D.; Datir, Abhijit; Langley, Travis [Emory University Hospital, Department of Radiology, Section of Musculoskeletal Imaging, Atlanta, GA (United States); Tresley, Jonathan [University of Wisconsin, Department of Radiology, Madison, WI (United States); Clifford, Paul D.; Jose, Jean; Subhawong, Ty K. [University of Miami, Department of Radiology, Miami, FL (United States)

    2016-03-15

    Pain and focal masses in the foot and ankle are frequently encountered and often initiate a workup including imaging. It is important to differentiate benign lesions from aggressive benign or malignant lesions. In this review, multiple examples of osseous and soft tissue tumors of the foot and ankle will be presented. Additionally, the compartmental anatomy of the foot and ankle will be discussed in terms of its relevance for percutaneous biopsy planning and eventual surgery. Finally, a general overview of the surgical management of benign, benign aggressive and malignant tumors of the foot and ankle will be discussed. (orig.)

  18. [Measurement ofthe ankle-brachial pressure index (ABPI)].

    Science.gov (United States)

    Kulisić, Sandra Marinović

    2012-10-01

    Measurement of the ankle-brachial pressure index, also known as ankle-brachial index or ankle-arm index is a ratio of the ankle blood pressure and brachial blood pressure. It is easy to perform and allows for diagnosis and further definition of the severity of peripheral arterial disease with sensitivity 90% and specificity 98%. The test is not appropriate for mild arterial changes as in case of comorbidity. Its further objectives are to identify patients at an higher risk of cardiovascular events. PMID:23193828

  19. Benign and malignant tumors of the foot and ankle

    International Nuclear Information System (INIS)

    Pain and focal masses in the foot and ankle are frequently encountered and often initiate a workup including imaging. It is important to differentiate benign lesions from aggressive benign or malignant lesions. In this review, multiple examples of osseous and soft tissue tumors of the foot and ankle will be presented. Additionally, the compartmental anatomy of the foot and ankle will be discussed in terms of its relevance for percutaneous biopsy planning and eventual surgery. Finally, a general overview of the surgical management of benign, benign aggressive and malignant tumors of the foot and ankle will be discussed. (orig.)

  20. [Arthroscopic distal ulna resection after post traumatic ulno carpal abutment].

    Science.gov (United States)

    Mathoulin, C; Pagnotta, A

    2006-11-01

    Ulno carpal abutments secondary to the sequels of a fracture of the radius are often due to the inversion of the distal radio ulnar index by shortening relative to the radius. This positive ulnar variance eventually leads to an abutment between the head of the ulnar and the proximal articular face of the lunate with alteration of the cartilaginous carpal surfaces. The wrist arthroscopy makes diagnosis and treatment possible in a less invasive way. The patients are operated on as outpatients under local regional anaesthetic using a pneumatic tourniquet. The arthroscope is positioned using the 3-4 radio carpal opening permitting exploration of the joint. The surgical treatment is performed by arthroscopy using a burr and going in through the 6R radio carpal opening. In this way we use the technique of partial resection of the distal ulna. We have a series of 62 patients who have benefited from the technique of partial resection of the ulnar head by arthroscopy. There were 30 men and 32 women. The average age was 66 years old (between 45 and 82). Our average follow-up is 32 months (between 12 and 60 months). Recovery of mobility was immediate in all cases with persistent pain in the radio ulnar joint in 8 cases. Arthroscopic treatment of ulno carpal abutment has proved itself effective and innocuous. It should nevertheless be reserved for operations on small sized inversions of the distal radio ulnar index (less than 5 mm). In the event of larger ulnar variances we prefer ulnar shortening osteotomy. The other techniques will be restricted to cases where the distal radio ulnar joint has been impaired. PMID:17361890

  1. Is End-Stage Ankle Arthrosis Best Managed with Total Ankle Replacement or Arthrodesis? A Systematic Review

    OpenAIRE

    Jordan, Robert W.; Chahal, Gurdip S.; Anna Chapman

    2014-01-01

    Introduction. End-stage ankle osteoarthritis is a debilitating condition. Traditionally, ankle arthrodesis (AA) has been the surgical intervention of choice but the emergence of total ankle replacement (TAR) has challenged this concept. This systematic review aims to address whether TAR or AA is optimal in terms of functional outcomes. Methods. We conducted a systematic review according to PRISMA checklist using the online databases Medline and EMBASE after January 1, 2005. Participants must ...

  2. Noise-enhanced dynamic single leg balance in subjects with functional ankle instability

    Institute of Scientific and Technical Information of China (English)

    Scott; Ross; Brent; Arnold

    2012-01-01

    <正>Background:Stochastic resonance stimulation(SRS) transmits subsensory electrical Gaussian white noise into the body to enhance sensorimotor function.This therapy has improved static single leg balance in subjects with functional ankle instability.However,the effect of this stimulation on dynamic single leg balance is not known.Improvements in dynamic single leg balance with SRS may have implications For enhancing functional rehabilitation for ankle instability.Thus,the purpose of this study was to determine the effects of SRS on dynamic single leg balance in subjects with functional ankle instability. Methods:This study was an experimental research design and data were collected in a sports medicine research laboratory.Twelve subjects with functional ankle instability(69±15 kg;173±10 cm;21±2 years) reported a history of ankle sprains and instability at the ankle with physical activity.A single leg jump-landing test was used to assess dynamic balance.Subjects were required to jump between 50% and 55% of the maximal vertical jump height,land on a single leg atop a force plate,and stabilize as quickly as possible.Jump-landing tests were performed with and without SRS.Three trials were performed for each treatment condition(SRS and control).A randomized block design was used to determine test order.Anterior/posterior and medial/lateral time-to-stabilization were computed to assess dynamic balance.Lesser time indicated better stability.One-tailed paired samples t tests were used for analysis(α≤0.05). Results:SRS improved anterior/posterior time-to-stabilization(stochastic resonance = 1.32±0.31 s,control = 1.74±0.80 s,p = 0.03),but did not enhance medial/lateral time-to-stabilization(stochastic resonance = 1.95±0.40 s,control = 1.92±0.48 s,p = 0.07). Conclusion:Clinicians might use SRS to facilitate balance improvements with sagittal plane dynamic single leg balance exercises that patients may not be able to perform otherwise.

  3. Kinematics of ankle taping after a training session.

    Science.gov (United States)

    Meana, M; Alegre, L M; Elvira, J L L; Aguado, X

    2008-01-01

    This study aimed to test the effectiveness of ankle taping on the limitation of forced supination during a change of direction, as well as the losses of effectiveness after a 30-minute training session. Fifteen young men with no ankle injury volunteered for the study. The static and dynamic ranges of movement (ROM) were measured before and after a training session. The dynamic measurements were recorded using high-speed 3D photogrammetry. The differences between static and dynamic measures of ankle supination and plantar flexion were significant. The losses of effectiveness during supination and ankle plantar flexion restriction were 42.3 % and 47.6 %, respectively. Ankle taping was effective in restricting the maximal static ROMs before a training session, but the effectiveness decreased after 30 min of training. The present study shows the necessity of performing dynamic ROM analysis of sports techniques involved in the ankle sprain mechanism in order to determine the degree of tape restriction after a training session, because there were differences between static and dynamic ankle ROMs. The lack of effects on the restriction of the dynamic plantar flexion would bring into question the necessity of ankle taping in subjects without previous injuries. PMID:17614032

  4. Relationship between stress ankle radiographs and injured ligaments on MRI

    International Nuclear Information System (INIS)

    This study was performed to investigate the relationship between the injured lateral ankle ligaments on MRI and stress ankle radiographs. Two hundred and twenty-nine consecutive patients (mean age 35.5 years, SD 14.6 years; 136 males and 93 females) that underwent ankle stress radiographs and MRI for lateral ankle instability were included. Tibiotalar tilt angle and anterior translation of talus were measured on stress ankle radiographs. Degree of lateral ligaments (anterior talofibular, calcaneofibular, and posterior talofibular) and deltoid ligament injuries were evaluated and scored as intact (0), partial injury (1), and complete injury (2) on MR images. Effusion of ankle joint was also recorded. The effects of gender, age, injuries of ligaments, and ankle joint effusion on stress radiographs were statistically analyzed. Gender (p = 0.010), age (p = 0.020), and anterior talofibular ligament (ATFL) injury (p < 0.001) were the factors significantly affecting tibiotalar tilt angle. Posterior talofibular ligament (PTFL) injury (p = 0.014) was found to be the only significant factor affecting the anterior translation on the anterior drawer radiographs. ATFL injury and PTFL injury on MRI significantly affected tibiotalar tilt angle and anterior drawer on stress radiographs. Other factors, such as age and gender, need to be considered in evaluating radiographic lateral ankle instability. (orig.)

  5. Rehabilitation of the Ankle After Acute Sprain or Chronic Instability

    OpenAIRE

    Mattacola, Carl G.; Dwyer, Maureen K.

    2002-01-01

    Objective: To outline rehabilitation concepts that are applicable to acute and chronic injury of the ankle, to provide evidence for current techniques used in the rehabilitation of the ankle, and to describe a functional rehabilitation program that progresses from basic to advanced, while taking into consideration empirical data from the literature and clinical practice.

  6. THE EFFECTS OF KINESIO TAPING ON PROPRIOCEPTION AT THE ANKLE

    Directory of Open Access Journals (Sweden)

    Mark DeBeliso

    2004-03-01

    Full Text Available An experiment was designed to determine if KinesioTM taping the anterior and lateral portion of the ankle would enhance ankle proprioception compared to the untaped ankle. 30 subjects, 15 men, 15 women, ages 18-30 participated in this study. Exclusion criteria: Ankle injury < 6 months prior to testing, significant ligament laxity as determined through clinical evaluation by an ATC, or any severe foot abnormality. Experiment utilized a single group, pretest and posttest. Plantar flexion and inversion with 20° of plantar flexion reproduction of joint position sense (RJPS was determined using an ankle RJPS apparatus. Subjects were barefooted, blindfolded, and equipped with headphones playing white noise to eliminate auditory cues. Subjects had five trials in both plantar flexion and inversion with 20° plantar flexion before and after application of the KinesioTM tape to the anterior/lateral portion of the ankle. Constant error and absolute error were determined from the difference between the target angle and the trial angle produced by the subject. The treatment group (KinesioTM taped subjects showed no change in constant and absolute error for ankle RJPS in plantar flexion and 20º of plantar flexion with inversion when compared to the untaped results using the same motions. The application of KinesioTM tape does not appear to enhance proprioception (in terms of RJPS in healthy individuals as determined by our measures of RJPS at the ankle in the motions of plantar flexion and 20º of plantar flexion with inversion.

  7. Relationship between stress ankle radiographs and injured ligaments on MRI

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kyoung Min; Chung, Chin Youb; Chung, Myung Ki; Won, Sung Hun; Lee, Seung Yeol; Park, Moon Seok [Seoul National University Bundang Hospital, Department of Orthopaedic Surgery, Kyungki (Korea, Republic of); Kwon, Soon-Sun [Seoul National University Bundang Hospital, Biomedical Research Institute, Kyungki (Korea, Republic of)

    2013-11-15

    This study was performed to investigate the relationship between the injured lateral ankle ligaments on MRI and stress ankle radiographs. Two hundred and twenty-nine consecutive patients (mean age 35.5 years, SD 14.6 years; 136 males and 93 females) that underwent ankle stress radiographs and MRI for lateral ankle instability were included. Tibiotalar tilt angle and anterior translation of talus were measured on stress ankle radiographs. Degree of lateral ligaments (anterior talofibular, calcaneofibular, and posterior talofibular) and deltoid ligament injuries were evaluated and scored as intact (0), partial injury (1), and complete injury (2) on MR images. Effusion of ankle joint was also recorded. The effects of gender, age, injuries of ligaments, and ankle joint effusion on stress radiographs were statistically analyzed. Gender (p = 0.010), age (p = 0.020), and anterior talofibular ligament (ATFL) injury (p < 0.001) were the factors significantly affecting tibiotalar tilt angle. Posterior talofibular ligament (PTFL) injury (p = 0.014) was found to be the only significant factor affecting the anterior translation on the anterior drawer radiographs. ATFL injury and PTFL injury on MRI significantly affected tibiotalar tilt angle and anterior drawer on stress radiographs. Other factors, such as age and gender, need to be considered in evaluating radiographic lateral ankle instability. (orig.)

  8. Foot and ankle injuries in child and adolescent athletes

    OpenAIRE

    Yildirim, Yakup; Esemenli, Tanil

    2004-01-01

    Foot and ankle injuries are most commonly encountered in athletes. Of these, pediatric and adolescent injuries have unique characteristics because of the distinct growth potentials and their consequences specific to this age group. In this article, foot and ankle injuries in child and adolescent athletes are reviewed in the light of the literature.

  9. Rehabilitation of the Ankle after Acute Sprain or Chronic Instability.

    Science.gov (United States)

    Mattacola, Carl G.; Dwyer, Maureen K.

    2002-01-01

    Outlines rehabilitation concepts applicable to acute and chronic ankle injury, providing evidence for current techniques used in ankle rehabilitation and describing a functional rehabilitation program that progresses from basic to advanced, while taking into account empirical data from the literature and clinical practice. The article notes that…

  10. Triplane ankle fracture with deltoid ligament tear and syndesmotic disruption

    OpenAIRE

    Cummings, Robert Jay

    2008-01-01

    In patients with immature skeletons, ligamentous injuries rarely accompany ankle fractures. In this article, we report about deltoid ligament tears and syndesmotic disruptions accompanying triplane ankle fractures in two children, and make recommendations as to the evaluation and treatment of children with such injuries.

  11. Acute lateral ankle sprains: from functional treatment to prevention

    NARCIS (Netherlands)

    Kemler, H.J.

    2015-01-01

    Ankle sprains are common in daily life and often considered to be minor injuries. The objective in this thesis was to provide more evidence on the burden and optimal management of ankle sprains in terms of the magnitude of the problem, the prognostic consequences and ways to improve treatment and p

  12. Understanding acute ankle ligamentous sprain injury in sports

    Directory of Open Access Journals (Sweden)

    Fong Daniel TP

    2009-07-01

    Full Text Available Abstract This paper summarizes the current understanding on acute ankle sprain injury, which is the most common acute sport trauma, accounting for about 14% of all sport-related injuries. Among, 80% are ligamentous sprains caused by explosive inversion or supination. The injury motion often happens at the subtalar joint and tears the anterior talofibular ligament (ATFL which possesses the lowest ultimate load among the lateral ligaments at the ankle. For extrinsic risk factors to ankle sprain injury, prescribing orthosis decreases the risk while increased exercise intensity in soccer raises the risk. For intrinsic factors, a foot size with increased width, an increased ankle eversion to inversion strength, plantarflexion strength and ratio between dorsiflexion and plantarflexion strength, and limb dominance could increase the ankle sprain injury risk. Players with a previous sprain history, players wearing shoes with air cells, players who do not stretch before exercising, players with inferior single leg balance, and overweight players are 4.9, 4.3, 2.6, 2.4 and 3.9 times more likely to sustain an ankle sprain injury. The aetiology of most ankle sprain injuries is incorrect foot positioning at landing – a medially-deviated vertical ground reaction force causes an explosive supination or inversion moment at the subtalar joint in a short time (about 50 ms. Another aetiology is the delayed reaction time of the peroneal muscles at the lateral aspect of the ankle (60–90 ms. The failure supination or inversion torque is about 41–45 Nm to cause ligamentous rupture in simulated spraining tests on cadaver. A previous case report revealed that the ankle joint reached 48 degrees inversion and 10 degrees internal rotation during an accidental grade I ankle ligamentous sprain injury during a dynamic cutting trial in laboratory. Diagnosis techniques and grading systems vary, but the management of ankle ligamentous sprain injury is mainly conservative

  13. Clinical experiences with three different designs of ankle prostheses.

    Science.gov (United States)

    Rippstein, Pascal F

    2002-12-01

    Until 1995, fusion was in our institution the only rational surgical option for a severe ankle arthrosis. Consistent reports about good mid- and long-term results with ankle replacement allowed us to change our minds. Ankle replacement became the gold standard and fusion was then almost totally banished. Because ankle arthrosis can be morphologically different from one patient to another, we soon believed that one single type of ankle prosthesis would not be the universal optimal solution for all patients. We therefore divided the ankle arthrosis into three groups. Each group shows the best solution from each of the ankle prostheses with which we had gained experience (Agility, STAR, and BP). The Agility prosthesis, which was indicated for ankles with extremely damaged geometry, did not restore sufficiently the ankle motion. Preoperatively stiff ankles remained stiff postoperatively. Additionally, significant residual pain was more likely to occur in those patients. These cases did not show significant advantages compared with ankle fusion, especially from a functional point of view. Fusion for these stiff ankles is therefore today our first treatment of choice. In our experience, the malleolar joints do not have to be replaced. Even a severe arthrosis at this level does not produce significant pain, provided that osteophytes have been removed and joint height has been restored by the implanted prosthesis. It is our strong belief that these malleolar joints are also less sensitive to pain, similar to the femoropatellar joint. For these reasons, a replacement of the malleolar joints and the resurfacing of the talar sides is not necessary. Leaving the talar sides untouched requires less bone resection and makes the implantation of the talar component easier. Although we obtained good results with the STAR prosthesis, we progressively abandoned it because of these reasons, and we preferred the BP prosthesis. The BP prosthesis works on the same biomechanic principle as

  14. Robotic Ankle for Omnidirectional Rock Anchors

    Science.gov (United States)

    Parness, Aaron; Frost, Matthew; Thatte, Nitish

    2013-01-01

    Future robotic exploration of near-Earth asteroids and the vertical and inverted rock walls of lava caves and cliff faces on Mars and other planetary bodies would require a method of gripping their rocky surfaces to allow mobility without gravitational assistance. In order to successfully navigate this terrain and drill for samples, the grippers must be able to produce anchoring forces in excess of 100 N. Additionally, the grippers must be able to support the inertial forces of a moving robot, as well gravitational forces for demonstrations on Earth. One possible solution would be to use microspine arrays to anchor to rock surfaces and provide the necessary load-bearing abilities for robotic exploration of asteroids. Microspine arrays comprise dozens of small steel hooks supported on individual suspensions. When these arrays are dragged along a rock surface, the steel hooks engage with asperities and holes on the surface. The suspensions allow for individual hooks to engage with asperities while the remaining hooks continue to drag along the surface. This ensures that the maximum possible number of hooks engage with the surface, thereby increasing the load-bearing abilities of the gripper. Using the microspine array grippers described above as the end-effectors of a robot would allow it to traverse terrain previously unreachable by traditional wheeled robots. Furthermore, microspine-gripping robots that can perch on cliffs or rocky walls could enable a new class of persistent surveillance devices for military applications. In order to interface these microspine grippers with a legged robot, an ankle is needed that can robotically actuate the gripper, as well as allow it to conform to the large-scale irregularities in the rock. The anchor serves three main purposes: deploy and release the anchor, conform to roughness or misalignment with the surface, and cancel out any moments about the anchor that could cause unintentional detachment. The ankle design contains a

  15. Clinical assessment and management of ankle sprains.

    Science.gov (United States)

    Myrick, Karen M

    2014-01-01

    Ankle sprains are a common occurrence and are frequently either undertreated or overtreated. With the incidence estimated at more than 3 million a year and at a rate of 2.15/1,000 in the United States alone, this is an orthopaedic injury that providers should be acutely aware of and successfully able to evaluate and treat. This clinical feature will provide a thorough review of the mechanism of injury, the history and physical examination, and the classification and management of these injuries. Clinical red flags are discussed. PMID:25233201

  16. MRI of injuries of the lateral ankle ligaments

    International Nuclear Information System (INIS)

    The most frequent sport injury of the ankle is located in the lateral ankle ligaments. The diagnosis of lateral collateral ankle ligament trauma is based on patient history, clinical examination, and stress radiography, allowing a fair diagnosis for the daily routine. For the direct visualization and precise diagnosis of the lateral ankle ligaments MRI provides the best answer. MRI is used with controlled positioning of the foot, correct angulation of sequenzes, and distinct analysis of MR findings. Sinus tarsi ligaments and ligaments of the distal syndesmosis should be included to the report. In selected patients MRI allows the best evaluation of the extent of the lateral ankle ligaments. MRI is the method of choice for combined osteochondral injuries and soft tissue lesions too. (orig.)

  17. Syndesmosis and lateral ankle sprains in the National Football League.

    Science.gov (United States)

    Osbahr, Daryl C; Drakos, Mark C; O'Loughlin, Padhraig F; Lyman, Stephen; Barnes, Ronnie P; Kennedy, John G; Warren, Russell F

    2013-11-01

    Syndesmosis sprains in the National Football League (NFL) can be a persistent source of disability, especially compared with lateral ankle injuries. This study evaluated syndesmosis and lateral ankle sprains in NFL players to allow for better identification and management of these injuries. Syndesmosis and lateral ankle sprains from a single NFL team database were reviewed over a 15-year period, and 32 NFL team physicians completed a questionnaire detailing their management approach. A comparative analysis was performed analyzing several variables, including diagnosis, treatment methods, and time lost from sports participation. Thirty-six syndesmosis and 53 lateral ankle sprains occurred in the cohort of NFL players. The injury mechanism typically resulted from direct impact in the syndesmosis and torsion in the lateral ankle sprain group (P=.034). All players were managed nonoperatively. The mean time lost from participation was 15.4 days in the syndesmosis and 6.5 days in the lateral ankle sprain groups (P⩽.001). National Football League team physicians varied treatment for syndesmosis sprains depending on the category of diastasis but recommended nonoperative management for lateral ankle sprains. Syndesmosis sprains in the NFL can be a source of significant disability compared with lateral ankle sprains. Successful return to play with nonoperative management is frequently achieved for syndesmosis and lateral ankle sprains depending on injury severity. With modern treatment algorithms for syndesmosis sprains, more aggressive nonoperative treatment is advocated. Although the current study shows that syndesmosis injuries require longer rehabilitation periods when compared with lateral ankle sprains, the time lost from participation may not be as prolonged as previously reported. PMID:24200441

  18. Comparing Arc-shaped Feet and Rigid Ankles with Flat Feet and Compliant Ankles for a Dynamic Walker

    DEFF Research Database (Denmark)

    Kuhlemann, Ilyas; Matthias Braun, Jan; Wörgötter, Florentin;

    2014-01-01

    In this paper we show that exchanging curved feet and rigid ankles by at feet and compliant ankles improves the range of gait parameters for a bipedal dynamic walker. The new lower legs were designed such that they t to the old set-up, allowing for a direct and quantitative comparison. The dynami...

  19. Arthroscopic Shoulder Surgery in Female Professional Tennis Players

    Science.gov (United States)

    Young, Simon W.; Safran, Marc R.; Dakic, Jodie; Nguyen, Michael L.; Stroia, Kathleen

    2013-01-01

    Objectives: Recent publications have highlighted the relatively poor outcome of other overhead athletes, particularly baseball players, with regard to return to sports at the same or higher level after shoulder surgery. However, true assessment of their ability when returning to sport is not as clear. Further, ability to return to other overhead sports has not been reported. Our objective was to assess outcome and time to return to previous level of function following shoulder surgery in professional tennis players. Methods: The records of all female tennis players on the Women’s Tennis Association (WTA) professional circuit between January 2008 and June 2010 were reviewed to identify players who underwent shoulder surgery on their dominant (serving) shoulder. Details of the surgery including date, procedures performed, and complications were recorded. The primary outcomes were ability and time to return to professional play, and if they were able to return to their previous level of function, as determined by singles ranking. Pre and post-operative singles rankings were used to determine rate and completeness of return to preoperative function. Their highest ranking pre-injury, post operatively, and the time to return to pre-injury ranking were evaluated. Results: During the study period eight professional women tennis players from the WTA underwent shoulder surgery on their dominant arm. All surgery was performed arthroscopically, 7 out of 8 players had more than one procedure performed during the surgery. In total, 3 players underwent debridement of a partial rotator cuff tear and 2 players underwent repair of a complete supraspinatus tear. Three players had an anterior labral repair or reconstruction for anterior instability, and one player underwent repair of a SLAP lesion. Two players underwent neurolysis of a suprascapular nerve, and three players in total underwent a subacromial decompression. All players (100%) returned to professional play. The mean

  20. Fracture line index of fibular stalk and the ankle joint bone in the classification of the ankle joint trauma

    International Nuclear Information System (INIS)

    Objective: To evaluate the fracture line index of fibular stalk and the ankle joint bone in the classification of the ankle joint trauma. Methods: Measure fracture line index of fibular stalk and the ankle joint in 217 adult cases of fracture and dislocation of ankle joint. And the cases were classified by the results of the measurement. Results: Measurement was unavailable in 9 cases of tearing fracture. In 31 cases, the lesions could not be particularly classified. And in the rest 176 cases the trauma were precisely classified. The over all successful rate was 81.6%. Conclusion: Fracture line index of fibular stalk and the ankle joint bone are valuable in classification of the trauma of the angle joint. While the specificity of this method is low in differentiating the adducting and abducting fracture of the medial angle, in which a combined investigation is recommended

  1. The foot and ankle of Australopithecus sediba.

    Science.gov (United States)

    Zipfel, Bernhard; DeSilva, Jeremy M; Kidd, Robert S; Carlson, Kristian J; Churchill, Steven E; Berger, Lee R

    2011-09-01

    A well-preserved and articulated partial foot and ankle of Australopithecus sediba, including an associated complete adult distal tibia, talus, and calcaneus, have been discovered at the Malapa site, South Africa, and reported in direct association with the female paratype Malapa Hominin 2. These fossils reveal a mosaic of primitive and derived features that are distinct from those seen in other hominins. The ankle (talocrural) joint is mostly humanlike in form and inferred function, and there is some evidence for a humanlike arch and Achilles tendon. However, Au. sediba is apelike in possessing a more gracile calcaneal body and a more robust medial malleolus than expected. These observations suggest, if present models of foot function are correct, that Au. sediba may have practiced a unique form of bipedalism and some degree of arboreality. Given the combination of features in the Au. sediba foot, as well as comparisons between Au. sediba and older hominins, homoplasy is implied in the acquisition of bipedal adaptations in the hominin foot. PMID:21903807

  2. The Burden of Craft in Arthroscopic Rotator Cuff Repair: Where Have We Been and Where We Are Going.

    Science.gov (United States)

    Burkhart, Stephen S

    2015-08-01

    The rather turbulent history of arthroscopic rotator cuff repair went through stages of innovation, conflict, disruption, assimilation, and transformation that might be anticipated when a new and advanced technology (arthroscopic cuff repair) displaces an entrenched but outdated discipline (open cuff repair). The transition from open to arthroscopic rotator cuff repair has been a major paradigm shift that has greatly benefited patients. However, this technical evolution/revolution has also imposed a higher "burden of craft" on the practitioners of arthroscopic rotator cuff repair. Technological advancements in surgery demand that surgeons accept this burden of craft and master the advanced technology for the benefit of their patients. This article outlines the author's involvement in the development of arthroscopic rotator cuff repair, and it also explores the surgeon's obligation to accept the burden of craft that is imposed by this discipline. PMID:26251931

  3. Arthroscopic assisted fixation for the distal radius fractures

    International Nuclear Information System (INIS)

    Anatomic reduction of the articular surface of the distal radius is still the main goal when treating fractures in the young population. Appropriate assessment of intra-articular reduction is difficult when performing open reduction and internal fixation without having to open the joint capsule. This preliminary report focuses on the description of the surgical technique, philosophy, indications and advantages of using wrist arthroscopy to assist fixation of distal radius fractures. Twenty-seven patients (16 males and 11 females) underwent arthroscopic assisted fixation for intra-articular distal radius fractures between March of 1999 and august of 2002. According to the AO classification there were 9 C1, 12 C2, 2 C3, 3 B1 and 1 B2. Average age was 41 years old (range: 18-48). Average follow up was 6 months. Patients were evaluated at final follow-up for wrist motion, pain and grip strength. Radiographic studies were also obtained to evaluate final position of the distal radius

  4. Postoperative pain control after arthroscopic rotator cuff repair.

    Science.gov (United States)

    Uquillas, Carlos A; Capogna, Brian M; Rossy, William H; Mahure, Siddharth A; Rokito, Andrew S

    2016-07-01

    Arthroscopic rotator cuff repair (ARCR) can provide excellent clinical results for patients who fail to respond to conservative management of symptomatic rotator cuff tears. ARCR, however, can be associated with severe postoperative pain and discomfort that requires adequate analgesia. As ARCR continues to shift toward being performed as an outpatient procedure, it is incumbent on physicians and ambulatory surgical centers to provide appropriate pain relief with minimal side effects to ensure rapid recovery and safe discharge. Although intravenous and oral opioids are the cornerstone of pain management after orthopedic procedures, they are associated with drowsiness, nausea, vomiting, and increased length of hospital stay. As health care reimbursements continue to become more intimately focused on quality, patient satisfaction, and minimizing of complications, the need for adequate pain control with minimal complications will continue to be a principal focus for providers and institutions alike. We present a review of alternative modalities for pain relief after ARCR, including cryotherapy, intralesional anesthesia, nerve blockade, indwelling continuous nerve block catheters, and multimodal anesthesia. In choosing among these modalities, physicians should consider patient- and system-based factors to allow the efficient delivery of analgesia that optimizes recovery and improves patient satisfaction. PMID:27079219

  5. Imaging evaluation of traumatic ligamentous injuries of the ankle and foot.

    Science.gov (United States)

    Nazarenko, Anna; Beltran, Luis S; Bencardino, Jenny T

    2013-05-01

    Sports ankle injuries are very common worldwide. In the United States, it is estimated that 2 million acute ankle sprains occur each year, averaging to $318 to $914 per sprain. Magnetic resonance imaging is excellent for depicting normal ankle anatomy and can elegantly demonstrate ligamentous injuries of the ankle and associated conditions after ankle sprain. This article encompasses epidemiology, biomechanics, normal anatomy, and pathologic conditions of the ankle and foot ligaments. The specific ligaments discussed include the syndesmotic ligaments, lateral ligament complex of the ankle, deltoid ligament, spring ligament, ligaments of the sinus tarsi, and the Lisfranc ligament. PMID:23622094

  6. Arthroscopic Treatment of a Case with Concomitant Subacromial and Subdeltoid Synovial Chondromatosis and Labrum Tear

    Directory of Open Access Journals (Sweden)

    Nevres Hurriyet Aydogan

    2013-01-01

    Full Text Available Synovial chondromatosis is a disease that seldomly seen in shoulder joint and is related to benign synovial proliferation and synchronous chondral tissue formation within the joint cavity. Patients suffer from progressive restriction of range of motion and shoulder pain. Extra-articular involvement is an extremely rare condition. Degenerative osteoarthritis, joint subluxation, and bursitis are common complications in untreated patients. Open or arthroscopic surgery is suitable while there is no consensus related to superiority of different approaches. We presented an arthroscopic treatment of a male patient, 48 years old with labrum tear and synovial chondromatosis localized in subacromial and subdeltoid region. Advantages of arthroscopic surgery in the presence of intra- and extra-articular combined pathologies are also discussed.

  7. MR findings of chondromalacia Patella : correlation of the grade and associated lesions with arthroscopic findings

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Yon Su; Kwon, Soon Tae; Lee, Hwan Do; Kang, Yong Soo; Byun, Ki Yong; Rhee, Kwang Jin [Chungnam National Univ., Taejon (Korea, Republic of). Coll. of Medicine

    1998-02-01

    To assess the MR findings of chondromalacia patella and correlate the grade and associated lesions with the arthroscopic findings. Twenty-five patients with pain in the anterior part of the knee underwent fat-suppressed axial and coronal T2-weighted and T2-weighted imaging, using a 10-cm field of view, and a 5-inch general purpose coil. We retrospectively assessed these findings, and the locations, grades and associated lesions, and correlated these with arthroscopic findings. We evaluated the exact location and grade of chondromalacia patella and associated lesions, as seen on MR images. These and the arthroscopic findings showed close correlation, and in cases involving this condition, MRI is thus a useful indicator of an appropriate surgical method and plan. (author). 18 refs., 5 figs.

  8. ARTHROSCOPIC TREATMENT FOR DISCOID LATERAL MENISCUS INJURY OF THE KNEE IN CHILDREN

    Institute of Scientific and Technical Information of China (English)

    蒋垚; 赵金忠; 翟伟韬; 曾炳芳

    2001-01-01

    Objective To study the arthroscopic treatment results.for discoid lateral meniscus injury of the knee in children. Methods 74 children patients, including 98 knees underwent arthroscopic treatment due to discoid lateral meniscus injury were followed up. By Watanabe classification, incomplete discoid meniscus was seen in 34 knees, complete in 42 and Wrisberg type in 22. The methods of treatment were partial, subtotal or total meniscectomy. The follow-up time ranged from 3 to 24 months, averaged 8 months. The results were analyzed according to Lysholm knee evaluation method. Results By Lysholm evaluation the results were excellent in 68 knees (69.4 % ) and good in 30 (30.6%). Conclusion Arthroscopic treatment is a reliable way for discoid lateral meniscus injury in children.

  9. [Arthroscopic management of intra-articular fractures of the distal radius].

    Science.gov (United States)

    Cognet, J-M; Martinache, X; Mathoulin, C

    2008-09-01

    The use of arthroscopy in the management of intra-articular fractures of the distal radius has become established over the last ten years, but the operative technique is not yet standardised. We report our experience with this technique and give a stage by stage description of the operative procedure. The arthroscopic part of the procedure consists firstly of an evaluation of the bony, cartilaginous and ligamentous injuries and secondly direct visual control of the reduction. The choice of bone fixation depends on the individual preferences of the surgeon but may be influenced by the configuration of the fracture. A literature review reiterates the advantages of arthroscopic assistance in managing these fractures without revealing any disadvantages. However, mastery of the arthroscopic techniques is vital before the full advantages of this type of management can be realised. PMID:18774328

  10. Early intra-articular complement activation in ankle fractures

    DEFF Research Database (Denmark)

    Schmal, Hagen; Salzmann, Gian M; Niemeyer, Philipp;

    2014-01-01

    Cytokine regulation possibly influences long term outcome following ankle fractures, but little is known about synovial fracture biochemistry. Eight patients with an ankle dislocation fracture were included in a prospective case series and matched with patients suffering from grade 2 osteochondri......Cytokine regulation possibly influences long term outcome following ankle fractures, but little is known about synovial fracture biochemistry. Eight patients with an ankle dislocation fracture were included in a prospective case series and matched with patients suffering from grade 2...... osteochondritis dissecans (OCD) of the ankle. All fractures needed external fixation during which joint effusions were collected. Fluid analysis was done by ELISA measuring aggrecan, bFGF, IL-1 β, IGF-1, and the complement components C3a, C5a, and C5b-9. The time periods between occurrence of fracture and...... and OCD patients, bFGF, IGF-1, and all complement components were significantly higher concentrated in ankle joints with fractures (P < 0.01). Complement activation and inflammatory cell infiltration characterize the joint biology following acute ankle fractures....

  11. Managing ankle ligament sprains and tears: current opinion.

    Science.gov (United States)

    McGovern, Ryan P; Martin, RobRoy L

    2016-01-01

    The purpose of this paper is to present a current review of pathoanatomical features, differential diagnosis, objective assessment, intervention, and clinical course associated with managing lateral ankle ligament sprains. Proper diagnosis and identification of affected structures should be obtained through history and objective assessment. From this information, an individualized evidence-based intervention plan can be developed to enable recovery while decreasing the risk of reinjury. An appropriate evaluation is needed not only to determine the correct diagnosis but also to allow for grading and determining the prognosis of the injury in those with an acute lateral ankle sprain. Examination should include an assessment of impairments as well as a measure of activity and participation. Evidence-based interventions for those with an acute lateral ankle sprain should include weight bearing with bracing, manual therapy, progressive therapeutic exercises, and cryotherapy. For those with chronic ankle instability (CAI), interventions should include manual therapy and a comprehensive rehabilitation program. It is essential to understand the normal clinical course for athletes who sustain a lateral ankle sprain as well as risk factors for an acute injury and CAI. Risk factors for both an acute lateral ankle sprain and CAI include not using an external support and not participating in an appropriate exercise program. Incorporating the latest evidence-based rehabilitation techniques provides the best course of treatment for athletes with an acute ankle sprain or CAI. PMID:27042147

  12. How Successful are Current Ankle Replacements?: A Systematic Review of the Literature

    OpenAIRE

    Gougoulias, Nikolaos; Khanna, Anil; Maffulli, Nicola

    2009-01-01

    Total ankle arthroplasty provides an alternative to arthrodesis for management of ankle arthritis. What is the outcome of total ankle arthroplasty implants currently in use? We conducted a systematic literature search of studies reporting on the outcome of total ankle arthroplasty. We included peer-reviewed studies reporting on at least 20 total ankle arthroplasties with currently used implants, with a minimum followup of 2 years. The Coleman Methodology Score was used to evaluate the quality...

  13. Isokinetic testing of evertor and invertor muscles in patients with chronic ankle instability.

    OpenAIRE

    David, Pascal; Halimi, Mohamad; Mora, Isabelle; Doutrellot, Pierre-Louis; Petitjean, Michel

    2013-01-01

    Ankle sprains are among the most common sport-related injuries and can lead to chronic ankle instability. Impaired sensorimotor function of the ankle musculature is often suggested as a cause. The current study sought to assess and compare the isokinetic performance and electromyographic patterns of evertor and invertor muscles in patients with chronic ankle instability and in a control group. Twelve patients with chronic ankle instability and twelve healthy subjects were included. Isokinetic...

  14. Biochemical T2* MR quantification of ankle arthrosis in pes cavovarus

    OpenAIRE

    Krause, F G; Klammer, G; Benneker, L M; Werlen, S; Mamisch, T.C.; Weber, M.

    2010-01-01

    Pes cavovarus affects the ankle biomechanics and may lead to ankle arthrosis. Quantitative T2 STAR (T2*) magnetic resonance (MR) mapping allows high resolution of thin cartilage layers and quantitative grading of cartilage degeneration. Detection of ankle arthrosis using T2* mapping in cavovarus feet was evaluated. Eleven cavovarus patients with symptomatic ankle arthrosis (13 feet, mean age 55.6 years, group 1), 10 cavovarus patients with no or asymptomatic, mild ankle arthrosis (12 feet, me...

  15. Biomechanics of supination ankle sprain : a case report of an accidental injury event in the laboratory

    OpenAIRE

    Fong, Daniel Tik-Pui; Hong, Youlian; Shima, Yosuke; Krosshaug, Tron; Young, Patrick Shu-Hang; Chan, Kai-Ming

    2009-01-01

    Ankle sprain is the most common injury in sports,5 but the mechanism of injury is not clear. Injury mechanisms can be studied through many different approaches.9 Over the years, ankle kinematics has been studied during simulated subinjury or close-to-injury situations, that is, sudden simulated ankle spraining motion on inversion platforms.11 Because these tests did not induce real injury, they could only somewhat suggest the ankle kinematics during an ankle sprain injury. The most direct way...

  16. Effect of a 6-week dynamic neuromuscular training programme on ankle joint function: A Case report

    OpenAIRE

    O'Driscoll Jeremiah; Kerin Fearghal; Delahunt Eamonn

    2011-01-01

    Abstract Background Ankle joint sprain and the subsequent development of chronic ankle instability (CAI) are commonly encountered by clinicians involved in the treatment and rehabilitation of musculoskeletal injuries. It has recently been advocated that ankle joint post-sprain rehabilitation protocols should incorporate dynamic neuromuscular training to enhance ankle joint sensorimotor capabilities. To date no studies have reported on the effects of dynamic neuromuscular training on ankle joi...

  17. Electroacupuncture reduces the evoked responses of the spinal dorsal horn neurons in ankle-sprained rats

    OpenAIRE

    Kim, Jae Hyo; Kim, Hee Young; Chung, Kyungsoon; Chung, Jin Mo

    2011-01-01

    Acupuncture is shown to be effective in producing analgesia in ankle sprain pain in humans and animals. To examine the underlying mechanisms of the acupuncture-induced analgesia, the effects of electroacupuncture (EA) on weight-bearing forces (WBR) of the affected foot and dorsal horn neuron activities were examined in a rat model of ankle sprain. Ankle sprain was induced manually by overextending ligaments of the left ankle in the rat. Dorsal horn neuron responses to ankle movements or compr...

  18. Clinician Recommendations and Perceptions of Factors Associated With Ankle Brace Use

    OpenAIRE

    Denton, Jason M.; Waldhelm, Andrew; Hacke, Jonathon D.; Gross, Michael T.

    2015-01-01

    Background: Little information is available regarding the ankle braces orthopaedic sports medicine clinicians recommend or clinicians’ concerns that may influence their decisions to recommend use of an ankle brace. Hypotheses: (1) Clinicians most frequently recommend lace-up braces with straps. (2) Clinicians who are concerned about potential adverse side effects from ankle brace use are less likely to recommend an ankle brace to prevent ankle sprain injuries. Study Design: Descriptive survey...

  19. Responses of spinal dorsal horn neurons to foot movements in rats with a sprained ankle

    OpenAIRE

    Kim, Jae Hyo; Kim, Hee Young; Chung, Kyungsoon; Chung, Jin Mo

    2011-01-01

    Acute ankle injuries are common problems and often lead to persistent pain. To investigate the underlying mechanism of ankle sprain pain, the response properties of spinal dorsal horn neurons were examined after ankle sprain. Acute ankle sprain was induced manually by overextending the ankle of a rat hindlimb in a direction of plantarflexion and inversion. The weight-bearing ratio (WBR) of the affected foot was used as an indicator of pain. Single unit activities of dorsal horn neurons in res...

  20. Ultrasound-guided interventions of the foot and ankle.

    Science.gov (United States)

    Yablon, Corrie M

    2013-02-01

    Ultrasound (US) provides excellent delineation of tendons and ligaments in the foot and ankle and provides real-time visualization of a needle during interventions, yielding greater accuracy and efficacy than the traditional blind approach using anatomical landmarks. For this reason, US is rapidly gaining acceptance as the preferred modality for guiding interventions in the foot and ankle where the anatomy is complex, neurovascular structures should be identified, and precise technique is demanded. In the foot and ankle, US is especially useful to guide tendon sheath, bursal, and Achilles paratenon injections, Morton neuroma injections, plantar fascial injections, and joint aspirations and injections. PMID:23487336

  1. Ankle-foot orthosis function in low-level myelomeningocele.

    Science.gov (United States)

    Hullin, M G; Robb, J E; Loudon, I R

    1992-01-01

    Six children with low-level myelomeningocele underwent gait analysis. All showed excessive ankle dorsiflexion and knee flexion when walking barefoot. A rigid thermoplastic ankle-foot orthosis (AFO) improved gait by preventing ankle dorsiflexion and reducing knee flexion. Biomechanically, the AFO caused a reduction in external knee moment by aligning the knee with the ground reaction force. Small changes in the foot-shank angle of the orthosis had profound effects on knee mechanics. Knee hyperextension could be controlled by a rocker sole. Kinetic gait analysis permits understanding of the biomechanical effects of orthoses. PMID:1613099

  2. Proprioceptive exercises for ankle ligament injury: a CAT

    Directory of Open Access Journals (Sweden)

    Raúl Aguilera Eguía

    2013-06-01

    Full Text Available This CAT (Critically Appraised Topic answered the question: In recreational athletes suffering from chronic ankle sprain, can proprioceptive exercises reduce its recurrence?The clinical question was analyzed in three parts: patient, intervention and outcome. The purpose was to test the validity, results and effectiveness of proprioceptive exercises in recreational athletes suffering from chronic ankle sprain to reduce its recurrence from the article "Effectiveness of proprioceptive exercises for ankle ligament injury in adults: A systematic literature and meta-analisys "Postle”1 (2012.

  3. Review of ankle inversion sprain simulators in the biomechanics laboratory

    Directory of Open Access Journals (Sweden)

    Sophia Chui-Wai Ha

    2015-10-01

    Full Text Available Ankle inversion ligamentous sprain is one of the most common sports injuries. The most direct way is to investigate real injury incidents, but it is unethical and impossible to replicate on test participants. Simulators including tilt platforms, trapdoors, and fulcrum devices were designed to mimic ankle inversion movements in laboratories. Inversion angle was the only element considered in early designs; however, an ankle sprain is composed of inversion and plantarflexion in clinical observations. Inversion velocity is another parameter that increased the reality of simulation. This review summarised the simulators, and aimed to compare and contrast their features and settings.

  4. Return to Play Following Ankle Sprain and Lateral Ligament Reconstruction.

    Science.gov (United States)

    Shawen, Scott B; Dworak, Theodora; Anderson, Robert B

    2016-10-01

    Ankle sprains are the most common musculoskeletal injury occurring during athletics. Proper initial treatment with supportive pain control, limited immobilization, early return to weight bearing and range of motion, and directed physical therapy are essential for preventing recurrent injury. Reconstruction of the lateral ligaments is indicated for patients with continued instability and dysfunction despite physical therapy. Return to athletic activity should be reserved for athletes who have regained strength, proprioception, and range of motion of the injured ankle. Athletes with a history of an ankle sprain should be prophylactically braced or tapped to reduce risk of recurrent injury. PMID:27543408

  5. Multicenter follow-up study of ankle fracture surgery

    Institute of Scientific and Technical Information of China (English)

    XU Hai-lin; WANG Gang; WANG Guang-lin; WU Xin-bao; LIU Li-min; LI Xuan; ZHANG Dian-ying; FU Zhong-guo; WANG Tian-bing; ZHANG Pei-xun; JIANG Bao-guo; SHEN Hui-liang

    2012-01-01

    Background Few data on ankle fractures in China from large multicenter epidemiological and clinical studies are available.The aim of this research was to evaluate the epidemiological features and surgical outcomes of ankle fractures by reviewing 235 patients who underwent ankle fracture surgery at five hospitals in China.Methods This study included patients who underwent ankle fracture surgery at five Chinese hospitals from January 2000 to July 2009.Age,gender,mechanism of injury,Arbeitsgemeinschaft für Osteosynthesefragen (AO) fracture type,fracture pattern,length of hospital stay and treatment outcome were recorded.Statistical analyses were conducted using SPSS software.The American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale,visual analogue scale (VAS),and arthritis scale were used to evaluate outcome.Results Of 235 patients with ankle fractures,105 were male with an average age of 37.8 years and 130 were female with an average age of 47.3 years.The average follow-up period was 55.7 months.There were significant differences in the ratios of patients in different age groups between males and females,and in mechanisms of injury among different age groups.There were also significant differences in the length of hospital stay among different fracture types and mechanisms of injury.In healed fractures,the average AOFAS ankle-hindfoot score was 95.5,with an excellence rate of 99.6%,the average VAS score was 0.17,and the average arthritis score was 0.18.Movement of the injured ankle was significantly different to that of the uninjured ankle.There were no significant differences between AO fracture types,fracture patterns or follow-up periods and AOFAS score,but there were some significant differences between these parameters and ankle joint movements,pain VAS score and arthritis score.Conclusions Ankle fractures occur most commonly in middle-aged and young males aged 20-39 years and in elderly females aged 50-69 years.The most common mechanisms of

  6. EFFECTIVENESS OF ULTRASONOGRAPHY IN DIAGNOSING CHRONIC LATERAL ANKLE INSTABILITY:A SYSTEMATIC REVIEW

    Science.gov (United States)

    Bakowski, Jordan; Dew, Stephanie; Greenwald, Bridget; Hyde, Eryn; Webber, Nicole

    2016-01-01

    Background Chronic ankle instability (CAI) is a condition that often develops after repeated ankle sprains, increasing the suceptability of the ankle to move into excessive inversion when walking on unstable surfaces. Treatment for CAI costs approximately three billion health care dollars annually. Currently, common diagnostic tools used to identify ankle instability are arthroscopy, imaging, manual laxity testing, and self-reported questionnaires. Purpose The purpose of this systematic review was to investigate the effectiveness of ultrasonography in diagnosing CAI, in comparison with other diagnostic tools. Methods Search limits: articles published between the years 2000-2015, and articles that were peer reviewed and published in the English language. Databases searched: CINAHL, PubMed, Medline, Medline Plus, Science Direct, OVID, Cochrane, and EBSCO. Titles and abstracts of the 1,420 articles were screened for the inclusion criteria by two independent raters, with discrepancies solved by a third rater. The modified 14-point Quality Assessment of Diagnostic Accuracy Studies (QUADAS) scale was used to assess methodological quality of included articles. Results Six high quality articles were included in this systematic review, as indicated by high scores on the QUADAS scale, ranging from 10 to 13. Sensitivity of US ranged from: 84.6 % -100%, specificity of US ranged from: 90.9% − 100% and accuracy ranged from: 87% − 90.9%. Discussion The results of the included studies suggest that US is able to accurately differentiate between the grades of ankle sprains and between a lax ligament, torn ligament, thick ligament, absorbed ligament and a non-union avulsion fracture. These findings indicate that US is a reliable method for diagnosing CAI, and that US is able to classify the degree of instability. Conclusion Researchers found that US is effective, reliable, and accurate in the diagnosis of CAI. Clinical Implications US would allow for earlier diagnosis, which

  7. Use of a Bone Graft Drill Harvester to Create the Fenestration During Arthroscopic Ulnohumeral Arthroplasty.

    Science.gov (United States)

    Wijeratna, Malin D; Ek, Eugene T; Hoy, Gregory A; Chehata, Ash

    2015-10-01

    The Outerbridge-Kashiwagi procedure, or ulnohumeral arthroplasty, was described in 1978 as a method of treating elbow arthritis by creating a fenestration in the olecranon fossa. This fenestration diminishes the likelihood of recurrent spurs in the olecranon fossa and coronoid fossa, without loss of structural bony strength. Arthroscopic techniques have now been developed to perform this procedure. We describe an efficient method of creating the fenestration between the olecranon fossa and coronoid fossa during an arthroscopic ulnohumeral arthroplasty, or Outerbridge-Kashiwagi procedure, that also reduces the amount of residual bone debris produced during the resection. PMID:26697312

  8. Technique of synovial biopsy of metacarpophalangeal joints using the needle arthroscope.

    Science.gov (United States)

    Gáspár, Levente; Szekanecz, Zoltán; Dezso, Balázs; Szegedi, Gyula; Csernátony, Zoltán; Szepesi, Kálmán

    2003-01-01

    We demonstrate the technique, advantages, and disadvantages of metacarpophalangeal joint examination with needle arthroscope. We evaluated our experience from biopsies of 10 metacarpophalangeal joints of eight rheumatoid women aged 41-45 years. The procedures were performed using a 1-mm needle arthroscope. The synovium biopsy was taken with a microforceps. The procedure was performed under local anesthesia. The tight tension of the joint and traction of the finger is necessary for good visualization, but despite this visibility can be difficult. Needle biopsy is a useful method for the early diagnosis of rheumatoid arthritis. PMID:12548452

  9. [Ankle fractures in the elderly patient].

    Science.gov (United States)

    Crevoisier, Xavier; Baalbaki, Rayan; Dos Santos, Tiago; Assal, Mathieu

    2014-12-17

    Ankle fractures in adults are usually managed by open reduction internal fixation. In elderly patients the surgical dilemma relates to bone quality. Osteoporosis is the enemy of internal fixation, and secure purchase of screws in osteopenic bone may be difficult to achieve. Insufficient screw purchase may lead to loss of reduction, wound breakdown, and infection. Postoperative management after osteosynthesis usually requires an extended period of restricted weight bearing. However, this is not feasible in older patients as a result of their lack of strength in the upper extremities and frequent comorbidities. Therefore, augmen- ted methods of internal fixation and specific surgical techniques have been developed using metal and bone cement. This permits this fragile population to begin early full weight bearing in a removable brace. PMID:25752013

  10. Ankle-brachial index in HIV infection

    Directory of Open Access Journals (Sweden)

    Martos Francisco

    2009-04-01

    Full Text Available Abstract Prognosis for patients with the human immunodeficiency virus (HIV has improved with the introduction of highly active antiretroviral therapy (HAART. Evidence over recent years suggests that the incidence of cardiovascular disease is increasing in HIV patients. The ankle-brachial index (ABI is a cheap and easy test that has been validated in the general population. Abnormal ABI values are associated with increased cardiovascular mortality. To date, six series of ABI values in persons with HIV have been published, but none was a prospective study. No agreement exists concerning the risk factors for an abnormal ABI, though its prevalence is clearly higher in these patients than in the general population. Whether this higher prevalence of an abnormal ABI is associated with a higher incidence of vascular events remains to be determined.

  11. Optimal management of ankle syndesmosis injuries

    Directory of Open Access Journals (Sweden)

    Porter DA

    2014-08-01

    Full Text Available David A Porter, Ryan R Jaggers, Adam Fitzgerald Barnes, Angela M Rund Methodist Sports Medicine/The Orthopedic Specialists, Indianapolis, IN, USA Abstract: Syndesmosis injuries occur when there is a disruption of the distal attachment of the tibia and fibula. These injuries occur commonly (up to 18% of ankle sprains, and the incidence increases in the setting of athletic activity. Recognition of these injuries is key to preventing long-term morbidity. Diagnosis and treatment of these injuries requires a thorough understanding of the normal anatomy and the role it plays in the stability of the ankle. A complete history and physical examination is of paramount importance. Patients usually experience an external rotation mechanism of injury. Key physical exam features include detailed documentation about areas of focal tenderness (syndesmosis and deltoid and provocative maneuvers such as the external rotation stress test. Imaging workup in all cases should consist of radiographs with the physiologic stress of weight bearing. If these images are inconclusive, then further imaging with external rotation stress testing or magnetic resonance imaging are warranted. Nonoperative treatment is appropriate for stable injuries. Unstable injuries should be treated operatively. This consists of stabilizing the syndesmosis with either trans-syndesmotic screw or tightrope fixation. In the setting of a concomitant Weber B or C fracture, the fibula is anatomically reduced and stabilized with a standard plate and screw construct. Proximal fibular fractures, as seen in the Maisonneuve fracture pattern, are not repaired operatively. Recent interest is moving toward repair of the deltoid ligament, which may provide increased stability, especially in rehabilitation protocols that involve early weight bearing. Rehabilitation is focused on allowing patients to return to their pre-injury activities as quickly and safely as possible. Protocols initially focus on

  12. Medline Plus

    Full Text Available ... and Muscles Ankle Injuries and Disorders Arthroscopic Ankle Fusion on 72 Year-Old with Severe Arthritis Pain ( ... Gables, FL, 11/27/2012) Arthritis Arthroscopic Ankle Fusion on 72 Year-Old with Severe Arthritis Pain ( ...

  13. Hallux Valgus, Ankle Osteoarthrosis, and Adult Acquired Flatfoot Deformity : A Review of Three Common Foot&Ankle Pathologies and Their Treatments

    OpenAIRE

    Crevoisier X.; Assal M.; Stankova K.

    2016-01-01

    The pathogenesis of hallux valgus deformity is multifactorial. Conservative treatment can alleviate pain but is unable to correct the deformity. Surgical treatment must be adapted to the type and severity of the deformity. Success of surgical treatment ranges from 80% to 95%, and complication rates range from 10% to 30%. Ankle osteoarthrosis most commonly occurs as a consequence of trauma. Ankle arthrodesis and total ankle replacement are the most common surgical treatments of end stage ankle...

  14. FUNCTIONAL OUTCOME OF ARTHROSCOPIC RECONSTRUCTION OF ANTERIOR CRUCIATE LIGAMENT TEARS

    Directory of Open Access Journals (Sweden)

    Ashok Kumar

    2016-02-01

    Full Text Available BACKGROUND Anterior Cruciate Ligament (ACL tear is the most common serious ligamentous injury to the knee joint. Anterior Cruciate Ligament (ACL injury is quite common among young active population, athletes and contact sports. The exact incidence of anterior cruciate ligament tears is not known as the cases are being under reported. The ACL is the primary stabilizer against anterior translation of the tibia on the femur and is important in counteracting rotation and valgus stress. MATERIALS AND METHODS Between November 2012 to October 2014, 34 consecutive patients who underwent arthroscopic assisted ACL reconstructions in the Department of Orthopedics and Traumatology, King George Hospital, Visakhapatnam were the material in our study. Age groups between 18 to 45 years considered. We utilised both BPTB and Quadrupled hamstring graft depending on the patient’s age, outcome testing in all cases was performed at the latest follow-up (at least 6 months. Post-operative physiotherapy rehabilitation protocol followed for 06 months. RESULTS Standard protocol of Lysholm and IKDC knee scoring system were used for evaluation of the results of the surgery during followup. Patients were evaluated periodically at preop, 3 months, 6 months, 12 months, 18 months and 24 months. CONCLUSION Patients with isolated ACL injury had better outcome compared to patients who underwent associated meniscectomy. Most common mechanism of injury was activity of sports in 20 patients. Postoperatively at 3 months, anterior drawer’s was 1+ in 6, 29 (85.2% patients had normal range of motion; 29 (85.29% patients had 5/5 quadriceps power (MRC grading 94% of them had 5/5 power at latest followup. No significant difference between outcomes of BPTB and Hamstrings graft. Functional outcome of our study were similar to the previously published studies.

  15. Differential contributions of ankle plantarflexors during submaximal isometric muscle action

    DEFF Research Database (Denmark)

    Masood, Tahir; Bojsen-Møller, Jens; Kalliokoski, Kari K;

    2014-01-01

    The objective of this study was to investigate the relative contributions of superficial and deep ankle plantarflexors during repetitive submaximal isometric contractions using surface electromyography (SEMG) and positron emission tomography (PET). Myoelectric signals were obtained from twelve...

  16. Design of a portable hydraulic ankle-foot orthosis.

    Science.gov (United States)

    Neubauer, Brett C; Nath, Jonathan; Durfee, William K

    2014-01-01

    Small-scale hydraulics is ideal for powered human assistive devices including powered ankle foot orthoses because a large torque can be generated with an actuator that is small and light. A portable hydraulic ankle foot orthosis has been designed and is undergoing preliminary prototyping and engineering bench test evaluation. The device provides 90 Nm of ankle torque and has an operating pressure of 138 bar (2,000 psi). The battery-operated hydraulic power supply weighs about 3 kg and is worn at the waist. The ankle component weighs about 1.2 Kg and connects to the power supply with two hoses. Performance simulation and preliminary bench testing suggests that the device could be useful in certain rehabilitation applications. PMID:25570175

  17. Management of Syndesmotic Ankle Injuries in Children and Adolescents.

    Science.gov (United States)

    Shore, Benjamin J; Kramer, Dennis E

    2016-06-01

    Pediatric ankle injuries are common, especially in athletes; however, the incidence of syndesmosis injuries in children has been scarcely reported. Injuries to the ankle syndesmosis, termed "high ankle sprains," can affect high-level and recreational athletes and have been related to delayed return to play, persistent pain, and adult injuries have been associated with long-term disability. Syndesmotic injuries do occur in children, especially those who participate in sports that involve cutting and pivoting (football, soccer) or sports with rigid immobilization of the ankle (skiing, hockey). Unstable pediatric syndesmosis injuries requiring surgical fixation are often associated with concomitant fibular fracture in skeletally mature children. Physician vigilance and careful clinical examination coupled with appropriate radiographs can determine the extent of the injury in the majority of circumstances. PMID:27100034

  18. Ankle Injuries and Disorders - Multiple Languages: MedlinePlus

    Science.gov (United States)

    ... Supplements Videos & Tools You Are Here: Home → Multiple Languages → All Health Topics → Ankle Injuries and Disorders URL of this page: https://medlineplus.gov/languages/ankleinjuriesanddisorders.html Other topics A-Z A B ...

  19. Clinical anatomy and biomechanics of the ankle in dance.

    Science.gov (United States)

    Russell, Jeffrey A; McEwan, Islay M; Koutedakis, Yiannis; Wyon, Matthew A

    2008-01-01

    The ankle is an important joint to understand in the context of dance because it is the connection between the leg and the foot that establishes lower extremity stability. Its function coordinates with the leg and foot and, thus, it is crucial to the dancer's ability to perform. Furthermore, the ankle is one of the most commonly injured body regions in dance. An understanding of ankle anatomy and biomechanics is not only important for healthcare providers working with dancers, but for dance scientists, dance instructors, and dancers themselves. The bony architecture, the soft tissue restraints, and the locomotive structures all integrate to allow the athletic artistry of dance. Yet, there is still much research to be carried out in order to more completely understand the ankle of the dancer. PMID:19618582

  20. Stress Fractures of the Foot and Ankle in Athletes

    OpenAIRE

    Mayer, Stephanie W.; Joyner, Patrick W.; Almekinders, Louis C.; Parekh, Selene G.

    2014-01-01

    Context: Stress fractures of the foot and ankle are a common problem encountered by athletes of all levels and ages. These injuries can be difficult to diagnose and may be initially evaluated by all levels of medical personnel. Clinical suspicion should be raised with certain history and physical examination findings. Evidence Acquisition: Scientific and review articles were searched through PubMed (1930-2012) with search terms including stress fractures and 1 of the following: foot ankle, me...

  1. Accessory Navicular Bone Mimicking Navicular Fracture after Ankle Sprain

    OpenAIRE

    Muharrem Çidem; Murat Uludağ; Kerem Gün; Ülkü Akarırmak

    2011-01-01

    An accessory navicular bone (ANB) is present in 10-30% of normal feet. A morphological classification of ANB on the basis of the radiographic appearance distinguishes three types. Most symptomatic ANBs are of type 2. Although the diagnosis and treatment of sprained ankle are generally straightforward, together with an ANB, it might be misdiagnosed as a fracture. We present a 20-year-old male with type 2 ANB who was misdiagnosed as navicular fracture following sprained ankle. Turk J Phys Med...

  2. Hyaluronic acid as a treatment for ankle osteoarthritis

    OpenAIRE

    Sun, Shu-Fen; Chou, Yi-Jiun; Hsu, Chien-Wei; Chen, Wen-ling

    2009-01-01

    Viscosupplementation refers to the concept of synovial fluid replacement with intra-articular injections of hyaluronic acid (HA) for the relief of pain associated with osteoarthritis (OA). Intra-articular viscosupplementation was approved by the Food and Drug Administration (FDA) in 1997. It is currently indicated only for the treatment of pain associated with knee OA. However, OA can occur in several of the weight-bearing joints of the foot and ankle. Ankle OA produces chronic disability tha...

  3. Inadvertent Screw Stripping During Ankle Fracture Fixation in Elderly Bone

    OpenAIRE

    Dinah, A. Feroz; Mears, Simon C.; Knight, Trevor A.; Soin, Sandeep P.; Campbell, John T.; Belkoff, Stephen M.

    2011-01-01

    Poor screw purchase because of osteoporosis presents difficulties in ankle fracture fixation. The aim of our study was to determine if cortical thickness, unicortical versus bicortical purchase, and bone mineral density are predictors of inadvertent screw stripping and overtightening. Ten paired cadaver ankles (average donor age, 81.7 years; range, 50-97 years) were used for the study. Computed tomography scanning with phantoms of known density was used to determine the bone density along the...

  4. TOTAL ANKLE ARTHROPLASTY: BRAZILIAN EXPERIENCE WITH THE HINTEGRA PROSTHESIS

    OpenAIRE

    Nery, Caio; Fernandes, Túlio Diniz; Réssio, Cibele; Fuchs, Mauro Luiz; Godoy Santos, Alexandre Leme de; Ortiz, Rafael Trevisan

    2015-01-01

    Ankle arthrosis is becoming more and more common. The search for solutions that preserve joint function has led to a new generation of prosthesis with three components and more degrees of freedom. This paper presents the results achieved for ten patients treated with the HINTEGRA Prosthesis (Integra, New Deal), through collaborative action between the Foot and Ankle Groups of the Orthopedics and Traumatology divisions of Escola Paulista de Medicina, Unifesp, and the School of Medicine of the ...

  5. Muscle fatigue degrades force sense at the ankle joint.

    OpenAIRE

    Vuillerme, Nicolas; Boisgontier, Matthieu

    2008-01-01

    To investigate the effects of muscle fatigue on force sense at the ankle joint, 10 young healthy adults were asked to perform an isometric contra-lateral force ankle-matching task in two experimental conditions of: (1) no-fatigue and (2) fatigue of the plantar-flexor muscles. Measures of the overall accuracy and the variability of the force matching performances were determined using the absolute error and the variable error, respectively. Results showed less accurate and less consistent forc...

  6. MR imaging of the lateral collateral ligaments after ankle sprain

    International Nuclear Information System (INIS)

    35 patients with ankle sprain were examined by MRI and stress radiographs. 13 were operated afterwards, 22 patients underwent a functional conservative therapy and were examined by MRI and stress radiographs and second time after three months. MRI reports were correct in 12 of 13 operated cases. After conservative therapy we did not find any disrupted ankle ligament. MRI showed intact ligaments thickened by scar. (orig./MG)

  7. EFFECTS OF ANKLE JOINT COOLING ON PERONEAL SHORT LATENCY RESPONSE

    OpenAIRE

    J. Ty Hopkins; Iain Hunter; Todd McLoda

    2006-01-01

    While cryotherapy has direct physiological effects on contractile tissues, the extent to which joint cooling affects the neuromuscular system is not well understood. The purpose of the study was to detect changes in ankle dynamic restraint (peroneal short latency response and muscle activity amplitude) during inversion perturbation following ankle joint cryotherapy. A 2x3 factorial design was used to compare reaction time and EMG amplitude data of treatment conditions (cryotherapy and control...

  8. Developing A mobile App for the Rehabilitation of Ankle Sprains

    OpenAIRE

    Suzanne McDonough; Christopher Bleakley; Christopher Nugent; Joseph Rafferty; Jonathan Synnott; Adele Boyd; Katie Hunter

    2015-01-01

    Background: Musculoskeletal injuries are common and costly. Ankle sprains are one of the most common such injuries, carrying significant risk of persistent disabling symptoms. Rehabilitation has been shown to be more effective than standard conservative approaches for musculoskeletal injuries. The use of a mobile app to present rehabilitation guidance may offer a more accessible, engaging and effective solution to ankle sprain rehabilitation. Several existing apps target the prevention and re...

  9. Comparison of Ankle Proprioception Between Pregnant and Non Pregnant Women

    OpenAIRE

    Preetha R; John Solomon M

    2011-01-01

    Pregnant women report falls especially during their third trimester. Physiological changes along with ligament laxity can affect the joint proprioception in this population. This study was conducted to compare the ankle proprioception between pregnant and non pregnant women. Thirty pregnant and 30 non pregnant women were included in the study and the position of ankles were recorded by a digital camera placed 60 cms away from the feet of the subject. UTHSCSA Image tool software version 3.0. w...

  10. Proprioceptive exercises for ankle ligament injury: a CAT

    OpenAIRE

    Raúl Aguilera Eguía; Alexis Espinoza Salinas; Edson Zafra Santos; Tamara Aguilera Eguía

    2013-01-01

    This CAT (Critically Appraised Topic) answered the question: In recreational athletes suffering from chronic ankle sprain, can proprioceptive exercises reduce its recurrence?The clinical question was analyzed in three parts: patient, intervention and outcome. The purpose was to test the validity, results and effectiveness of proprioceptive exercises in recreational athletes suffering from chronic ankle sprain to reduce its recurrence from the article "Effectiveness of proprioceptive exercises...

  11. The ANKLE TRIAL (ANKLE treatment after injuries of the ankle ligaments: what is the benefit of external support devices in the functional treatment of acute ankle sprain? : a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Witjes Suzanne

    2012-02-01

    Full Text Available Abstract Background Acute lateral ankle ligament injuries are very common problems in present health care. Still there is no hard evidence about which treatment strategy is superior. Current evidence supports the view that a functional treatment strategy is preferable, but insufficient data are present to prove the benefit of external support devices in these types of treatment. The hypothesis of our study is that external ankle support devices will not result in better outcome in the treatment of acute ankle sprains, compared to a purely functional treatment strategy. Overall objective is to compare the results of three different strategies of functional treatment for acute ankle sprain, especially to determine the advantages of external support devices in addition to functional treatment strategy, based on balance and coordination exercises. Methods/design This study is designed as a randomised controlled multi-centre trial with one-year follow-up. Adult and healthy patients (N = 180 with acute, single sided and first inversion trauma of the lateral ankle ligaments will be included. They will all follow the same schedule of balancing exercises and will be divided into 3 treatment groups, 1. pressure bandage and tape, 2. pressure bandage and brace and 3. no external support. Primary outcome measure is the Karlsson scoring scale; secondary outcomes are FAOS (subscales, number of recurrent ankle injuries, Visual Analogue Scales of pain and satisfaction and adverse events. They will be measured after one week, 6 weeks, 6 months and 1 year. Discussion The ANKLE TRIAL is a randomized controlled trial in which a purely functional treated control group, without any external support is investigated. Results of this study could lead to other opinions about usefulness of external support devices in the treatment of acute ankle sprain. Trial registration Netherlands Trial Register (NTR: NTR2151

  12. Managing ankle ligament sprains and tears: current opinion

    Directory of Open Access Journals (Sweden)

    McGovern RP

    2016-03-01

    Full Text Available Ryan P McGovern,1 RobRoy L Martin,1,2 1Department of Physical Therapy, Rangos School of Health Sciences, Duquesne University, 2Centers for Sports Medicine – University of Pittsburgh, Pittsburgh, PA, USA Abstract: The purpose of this paper is to present a current review of pathoanatomical features, differential diagnosis, objective assessment, intervention, and clinical course associated with managing lateral ankle ligament sprains. Proper diagnosis and identification of affected structures should be obtained through history and objective assessment. From this information, an individualized evidence-based intervention plan can be developed to enable recovery while decreasing the risk of reinjury. An appropriate evaluation is needed not only to determine the correct diagnosis but also to allow for grading and determining the prognosis of the injury in those with an acute lateral ankle sprain. Examination should include an assessment of impairments as well as a measure of activity and participation. Evidence-based interventions for those with an acute lateral ankle sprain should include weight bearing with bracing, manual therapy, progressive therapeutic exercises, and cryotherapy. For those with chronic ankle instability (CAI, interventions should include manual therapy and a comprehensive rehabilitation program. It is essential to understand the normal clinical course for athletes who sustain a lateral ankle sprain as well as risk factors for an acute injury and CAI. Risk factors for both an acute lateral ankle sprain and CAI include not using an external support and not participating in an appropriate exercise program. Incorporating the latest evidence-based rehabilitation techniques provides the best course of treatment for athletes with an acute ankle sprain or CAI. Keywords: reinjury, chronic ankle instability, rehabilitation techniques, diagnosis, intervention, athlete

  13. Ultrasound-guided intervention in the ankle and foot.

    Science.gov (United States)

    Drakonaki, Eleni E; Allen, Gina M; Watura, Roland

    2016-01-01

    In this comprehensive review, we discuss the main interventions performed in the foot and ankle for Achilles tendinopathy, Morton's neuromas and Plantar fasciitis as well as techniques for intra-articular and peritendinous injections. We present the different imaging techniques and injectable agents that can be used in clinical practice, trying to help the reader decide the most appropriate way of managing the patient with a problem in the ankle and foot. PMID:26537692

  14. Fractures and Soft Tissue Injuries of the Feet and Ankle

    OpenAIRE

    English, Edward

    1985-01-01

    An accurate clinical diagnosis of foot and ankle pain can be made by a history, physical examination and routine X-rays of the affected part. Each problem has a specific treatment; however, fractures and dislocations around the foot and ankle can be thought of in an organized fashion by proper physical examination and then the appropriate treatment. Fractures and soft tissue injuries can be treated rationally by understanding the mechanism of injury and the possibility of subsequent deformity...

  15. The ANKLE TRIAL (ANKLE treatment after injuries of the ankle ligaments): what is the benefit of external support devices in the functional treatment of acute ankle sprain? : a randomised controlled trial

    OpenAIRE

    Witjes Suzanne; Gresnigt Femke; van den Bekerom Michel PJ; Olsman Jan G; van Dijk Niek C

    2012-01-01

    Abstract Background Acute lateral ankle ligament injuries are very common problems in present health care. Still there is no hard evidence about which treatment strategy is superior. Current evidence supports the view that a functional treatment strategy is preferable, but insufficient data are present to prove the benefit of external support devices in these types of treatment. The hypothesis of our study is that external ankle support devices will not result in better outcome in the treatme...

  16. Treatment of acute ankle ligament injuries: a systematic review

    OpenAIRE

    Petersen, Wolf; Rembitzki, Ingo Volker; Koppenburg, Andreas Gösele; Ellermann, Andre; Liebau, Christian; Brüggemann, Gerd Peter; Best, Raymond

    2013-01-01

    Background Lateral ankle sprains are common musculoskeletal injuries. Objectives The objective of this study was to perform a systematic literature review of the last 10 years regarding evidence for the treatment and prevention of lateral ankle sprains. Data source Pubmed central, Google scholar. Study eligibility criteria Meta-analysis, prospective randomized trials, English language articles. Interventions Surgical and non-surgical treatment, immobilization versus functional treatment, diff...

  17. Ankle injuries of elite male Iranian gymnasts and anthropometric characteristics

    OpenAIRE

    GHASEMPOUR, Hadi; Rajabi, Reza; Alizadeh, Mohammad Hossein; TAVANAI, Ali

    2014-01-01

    In men's gymnastics, the ankle is the most frequently injured part of the body. However, very few studies have been conducted to determine the roles of various risk factors so that the rate of these injuries can be reduced. The aim of this study was to determine the relationship between anthropometric factors (intrinsic risk factors) and the ankle injuries incurred by elite male gymnasts in the Iranian Premier League and Division One. This research was cross sectional correlation study in its...

  18. Syndesmotic Malreduction after Ankle ORIF; Is Radiography Sufficient?

    Directory of Open Access Journals (Sweden)

    Alireza Manafi Rasi

    2013-12-01

    Full Text Available   Background: Ankle fractures, especially those resulting from external rotation mechanisms are associated with injury to the distal tibiofibular syndesmosis. Some authors have recommended performing CT scanning after open ankle surgery to evaluate the reduction of syndesmosis. In this current study, we aimed to investigate the sensitivity of plain radiography in diagnosing syndesmosis malreduction after open reduction and internal fixation (ORIF in patients with ankle fractures.   Methods: Thirty patients with ankle fractures participated in this prospective study. ORIFs were performed with respect to all of the technical guidelines shown in orthopedic literature for exact syndesmosis reduction, such as fibular length and proper settings. In the operating room, plain radiography was performed in anteroposterior, mortise and lateral views to assess whether syndesmosis was malreduced. If malreduction was detected, the patient was revised. As the gold standard, patients underwent postoperative bilateral CT scanning to investigate the syndesmosis reduction which was then compared to the healthy side. Finally, the sensitivity of plain radiography in the diagnosis of syndesmosis malreduction was determined by comparing this method to CT scanning. Results: In both of the methods we did not find any patient with syndesmosis malreduction. Hence, the sensitivity of plain radiography was determined 100%. Conclusion: Based on our findings, there is no need to perform CT scanning to evaluate syndesmosis reduction after ankle ORIF in patients with ankle fractures. Plain radiography is sufficient and has satisfactory sensitivity in these patients.

  19. Impingement syndrome of the shoulder following double row suture anchor technique for arthroscopic rotator cuff repair: a case report

    Directory of Open Access Journals (Sweden)

    Rambani Rohit

    2009-06-01

    Full Text Available Abstract Introduction Arthroscopic repair of the rotator cuff is a demanding surgery. Accurate placement of anchors is key to success. Case presentation A 38-year-old woman received arthroscopic repair of her rotator cuff using a double row suture anchor technique. Postoperatively, she developed impingement syndrome which resulted from vertical displacement of a suture anchor once the shoulder was mobilised. The anchor was removed eight weeks following initial surgery and the patient had an uneventful recovery. Conclusion Impingement syndrome following arthroscopic repair of the rotator cuffs using double row suture anchor has not been widely reported. This is the first such case where anchoring has resulted in impingement syndrome.

  20. Application of optical coherence tomography enhances reproducibility of arthroscopic evaluation of equine joints

    NARCIS (Netherlands)

    Niemelä, Tytti; Virén, Tuomas; Liukkonen, Jukka; te Moller, Nikae; Puhakka, Pia H.; Jurvelin, Jukka S.; Tulamo, R.M.; Töyräs, Juha

    2014-01-01

    Background: Arthroscopy is widely used in various equine joints for diagnostic and surgical purposes. However, accuracy of defining the extent of cartilage lesions and reproducibility in grading of lesions are not optimal. Therefore, there is a need for new, more quantitative arthroscopic methods. A

  1. Arthroscopically assisted osteosynthesis of tibial plateau fractures in patients older than 55 years

    NARCIS (Netherlands)

    Roerdink, WH; Oskam, J; Vierhout, PAM

    2001-01-01

    Purpose: To evaluate the end results of arthroscopically assisted osteosynthesis of tibial plateau fractures in patients older than 55 years of age. Type of Study: Case series. Methods: Over a 5-year period, 201 consecutive patients presented with tibial plateau fracture; 131 of these patients were

  2. Treatment of intra-articular fractures of the distal radius: fluoroscopic or arthroscopic reduction?

    Science.gov (United States)

    Varitimidis, S E; Basdekis, G K; Dailiana, Z H; Hantes, M E; Bargiotas, K; Malizos, K

    2008-06-01

    In a randomised prospective study, 20 patients with intra-articular fractures of the distal radius underwent arthroscopically- and fluoroscopically-assisted reduction and external fixation plus percutaneous pinning. Another group of 20 patients with the same fracture characteristics underwent fluoroscopically-assisted reduction alone and external fixation plus percutaneous pinning. The patients were evaluated clinically and radiologically at follow-up of 24 months. The Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire and modified Mayo wrist score were used at 3, 9, 12 and 24 months postoperatively. In the arthroscopically- and fluoroscopically-assisted group, triangular fibrocartilage complex tears were found in 12 patients (60%), complete or incomplete scapholunate ligament tears in nine (45%), and lunotriquetral ligament tears in four (20%). They were treated either arthroscopically or by open operation. Patients who underwent arthroscopically- and fluoroscopically-assisted treatment had significantly better supination, extension and flexion at all time points than those who had fluoroscopically-assisted surgery. The mean DASH scores were similar for both groups at 24 months, whereas the difference in the mean modified Mayo wrist scores remained statistically significant. Although the groups are small, it is clear that the addition of arthroscopy to the fluoroscopically-assisted treatment of intra-articular distal radius fractures improves the outcome. Better treatment of associated intra-articular injuries might also have been a reason for the improved outcome. PMID:18539672

  3. Analgesic efficacy of intra-articular morphine after arthroscopic knee surgery in sport injury patients

    Directory of Open Access Journals (Sweden)

    Mitra Yari

    2013-07-01

    Full Text Available BACKGROUND: Anterior Cruciate Ligament (ACL tearing is a common injury among football players. The present study aims to determine the best single-dose of intra-articular morphine for pain relief after arthroscopic knee surgery that, in addition to adequate and long-term analgesia, leads to fewer systemic side effects. METHODS: This clinical trial was conducted on 40 ASA-I athletes. After surgery, all participants received an injection of 20cc of 0.5% intra-articular bupivacaine. In addition, the first control group received a saline injection and 5, 10 and 15 mg of morphine were respectively injected into the joints of the second, third and fourth groups by use of Arthroscopic equipment before the Arthroscopic removal. The amount of pain based on VAS at 1, 2, 4, 6 and 24 hours after surgery, duration of analgesia and the consumption of narcotic drugs were recorded. RESULTS: The VAS scores in the fourth, sixth and twenty-fourth hours after surgery showed a significant difference between the study groups. The average time to the first analgesic request from the bupivacaine plus 15 mg morphine group was significantly longer than other groups and total analgesic requests were significantly lower than other groups. No drowsiness complications were observed in any of the groups in the first 24 hours after injection. CONCLUSION: Application of 15 mg intra-articular morphine after Arthroscopic knee surgery increases the analgesia level as well as its duration (IRCT138902172946N3 .

  4. Editorial Commentary: Arthroscopic Hip Preservation Is Critical for Preserving Health and Function in Adolescents and Adults.

    Science.gov (United States)

    Martin, Hal David

    2016-09-01

    Hip health is a critical factor in preserving daily life activities and wellbeing for both adults and adolescents. There are several potential economic influences in developing arthroscopic hip techniques for the evaluation and treatment of hip pathology in patients of all ages. PMID:27594331

  5. Evaluating fracture risk in acute ankle sprains: Any news since the Ottawa Ankle Rules? A systematic review.

    Science.gov (United States)

    Jonckheer, Pascale; Willems, Tine; De Ridder, Roel; Paulus, Dominique; Holdt Henningsen, Kirsten; San Miguel, Lorena; De Sutter, An; Roosen, Philip

    2016-03-01

    Background Ankle sprain is frequently encountered, both in primary care and in emergency departments. Since 1992, the Ottawa ankle rules (OAR) can assist clinicians in determining whether an X-ray should be performed to exclude a fracture. Several guidelines recommend the use of OAR based on a systematic review from 2003. Ten years later, one can wonder if this recommendation should be changed. Objective To review systematically the current evidence on the most accurate method to assess the fracture risk after an ankle sprain in adults. Methods A methodical search for systematic reviews, meta-analyses and primary studies was carried out in Medline, Cochrane Database of systematic reviews, Embase, Pedro, CINAHL, Medion and specific guideline search engines. At least two independent researchers performed selection, quality appraisal (with validated checklists) and data extraction. Results One systematic review and 21 primary studies were selected. Sensitivity and specificity of the OAR range from 92-100% and from 16-51%, respectively. To improve the OAR specificity, other tools are proposed such as the Bernese ankle rules. Vibrating tuning fork test and ultrasound could be useful in patient with OAR positive to decrease the need for radiographs. No evidence was found in favour of the use of magnetic resonance imaging (MRI) or computed tomography (CT) in the acute phase of ankle sprain. Conclusion The findings confirm the value of the OAR at ruling out fractures after an ankle sprain and propose other or additional tools to decrease the need for X-rays. PMID:26691309

  6. Single-row vs. double-row arthroscopic rotator cuff repair: clinical and 3 Tesla MR arthrography results

    Directory of Open Access Journals (Sweden)

    Tudisco Cosimo

    2013-01-01

    Full Text Available Abstract Background Arthroscopic rotator cuff repair has become popular in the last few years because it avoids large skin incisions and deltoid detachment and dysfunction. Earlier arthroscopic single-row (SR repair methods achieved only partial restoration of the original footprint of the tendons of the rotator cuff, while double-row (DR repair methods presented many biomechanical advantages and higher rates of tendon-to-bone healing. However, DR repair failed to demonstrate better clinical results than SR repair in clinical trials. MR imaging at 3 Tesla, especially with intra-articular contrast medium (MRA, showed a better diagnostic performance than 1.5 Tesla in the musculoskeletal setting. The objective of this study was to retrospectively evaluate the clinical and 3 Tesla MRA results in two groups of patients operated on for a medium-sized full-thickness rotator cuff tear with two different techniques. Methods The first group consisted of 20 patients operated on with the SR technique; the second group consisted of 20 patients operated on with the DR technique. All patients were evaluated at a minimum of 3 years after surgery. The primary end point was the re-tear rate at 3 Tesla MRA. The secondary end points were the Constant-Murley Scale (CMS, the Simple Shoulder Test (SST scores, surgical time and implant expense. Results The mean follow-up was 40 months in the SR group and 38.9 months in the DR group. The mean postoperative CMS was 70 in the SR group and 68 in the DR group. The mean SST score was 9.4 in the SR group and 10.1 in the DR group. The re-tear rate was 60% in the SR group and 25% in the DR group. Leakage of the contrast medium was observed in all patients. Conclusions To the best of our knowledge, this is the first report on 3 Tesla MRA in the evaluation of two different techniques of rotator cuff repair. DR repair resulted in a statistically significant lower re-tear rate, with longer surgical time and higher implant

  7. Radiology of chronic diseases of the ankle joint

    International Nuclear Information System (INIS)

    The etiology of chronic diseases of the ankle joint comprises a wide spectrum including chronic inflammatory processes and chronic degenerative, tumorous and neuropathic processes, as well as some specific syndromes based on chronic changes of the ankle joint. Of the inflammatory processes, chronic juvenile arthritis (JVC) is the most common disease. However, also Reiter disease, psoriasis or chronic monoarthritid diseases such as gout, as well as granulomatous diseases (tuberculosis, sarcoidosis) and fungal infections, may affect the ankle joint in a chronic course. Chronic degenerative changes are usually secondary due to abnormal positioning of the joint constituents or repetitive trauma. Neuropathic changes, as frequently seen in the course of diabetes, present with massive osseous destruction and malposition of the articular constituents. Chronic osseous as well as cartilaginous and synovial changes are seen in hemoplici patients. Chronic traumatic changes are represented by pigmented villonodular synovitis (PVNS), and chondromatosis, both with a predilection for the ankle joint. Due to the possibilities of magnetic resonance imaging (MRI), diagnosis of chronic ankle changes includes chronic ligamentous, tendinous and soft tissue changes. With the use MRI, specific syndromes can be defined which particularly affect the ankle joint in a chronic way, such as the os trigonum syndrome, the anterolateral impingement syndrome and the sinus tarsi syndrome. Nevertheless, plain film radiographs are still the basic element of any investigation. MRI, however, can be potentially used as a second investigation, saving an unnecessary cascade of investigations with ultrasound and CT. The latter investigations are used only with very specific indications, for instance CT for subtle bone structures and sonography for a limited investigation of tendons or evaluation of fluid. Particularly due to the possibilities of MRI and the development of special gradient-echo imaging or

  8. Prophylactic Ankle Taping and Bracing: A Numbers-Needed-to-Treat and Cost-Benefit Analysis.

    Science.gov (United States)

    Olmsted, Lauren C.; Vela, Luzita I.; Denegar, Craig R.; Hertel, Jay

    2004-03-01

    OBJECTIVE: Taping and bracing are thought to decrease the incidence of ankle sprains; however, few investigators have addressed the effect of preventive measures on the rate of ankle sprains. Our purpose was to examine the effectiveness of ankle taping and bracing in reducing ankle sprains by applying a numbers-needed-to-treat (NNT) analysis to previously published studies. DATA SOURCES: We searched PubMed, CINAHL, SPORT Discus, and PEDro for original research from 1966 to 2002 with key words ankle taping, ankle sprains, injury incidence, prevention, ankle bracing, ankle prophylaxis, andnumbers needed to treat. We eliminated articles that did not address the effects of ankle taping or bracing on ankle injury rates using an experimental design. DATA SYNTHESIS: The search produced 8 articles, of which 3 permitted calculation of NNT, which addresses the clinical usefulness of an intervention by providing estimates of the number of treatments needed to prevent 1 injury occurrence. In a study of collegiate intramural basketball players, the prevention of 1 ankle sprain required the taping of 26 athletes with a history of ankle sprain and 143 without a prior history. In a military academy intramural basketball program, prevention of 1 sprain required bracing of 18 athletes with a history of ankle sprain and 39 athletes with no history. A study of ankle bracing in competitive soccer players produced an NNT of 5 athletes with a history of previous sprain and 57 without a prior injury. A cost- benefit analysis of ankle taping versus bracing revealed taping to be approximately 3 times more expensive than bracing. CONCLUSIONS/RECOMMENDATIONS: Greater benefit is achieved in applying prophylactic ankle taping or bracing to athletes with a history of ankle sprain, compared with those without previous sprains. The generalizability of these results to other physically active populations is unknown. PMID:15085217

  9. Responses of spinal dorsal horn neurons to foot movements in rats with a sprained ankle.

    Science.gov (United States)

    Kim, Jae Hyo; Kim, Hee Young; Chung, Kyungsoon; Chung, Jin Mo

    2011-05-01

    Acute ankle injuries are common problems and often lead to persistent pain. To investigate the underlying mechanism of ankle sprain pain, the response properties of spinal dorsal horn neurons were examined after ankle sprain. Acute ankle sprain was induced manually by overextending the ankle of a rat hindlimb in a direction of plantarflexion and inversion. The weight-bearing ratio (WBR) of the affected foot was used as an indicator of pain. Single unit activities of dorsal horn neurons in response to plantarflexion and inversion of the foot or ankle compression were recorded from the medial part of the deep dorsal horn, laminae IV-VI, in normal and ankle-sprained rats. One day after ankle sprain, rats showed significantly reduced WBRs on the affected foot, and this reduction was partially restored by systemic morphine. The majority of deep dorsal horn neurons responded to a single ankle stimulus modality. After ankle sprain, the mean evoked response rates were significantly increased, and afterdischarges were developed in recorded dorsal horn neurons. The ankle sprain-induced enhanced evoked responses were significantly reduced by morphine, which was reversed by naltrexone. The data indicate that movement-specific dorsal horn neuron responses were enhanced after ankle sprain in a morphine-dependent manner, thus suggesting that hyperactivity of dorsal horn neurons is an underlying mechanism of pain after ankle sprain. PMID:21389306

  10. Range of Motion of the Ankle According to Pushing Force, Gender and Knee Position

    Science.gov (United States)

    Cho, Kang Hee; Lee, Hyunkeun

    2016-01-01

    Objective To investigate the difference of range of motion (ROM) of ankle according to pushing force, gender and knee position. Methods One hundred and twenty-eight healthy adults (55 men, 73 women) between the ages of 20 and 51, were included in the study. One examiner measured the passive range of motion (PROM) of ankle by Dualer IQ Inclinometers and Commander Muscle Testing. ROM of ankle dorsiflexion (DF) and plantarflexion (PF) according to change of pushing force and knee position were measured at prone position. Results There was significant correlation between ROM and pushing force, the more pushing force leads the more ROM at ankle DF and ankle PF. Knee flexion of 90° position showed low PF angle and high ankle DF angle, as compared to the at neutral position of knee joint. ROM of ankle DF for female was greater than for male, with no significant difference. ROM of ankle PF for female was greater than male regardless of the pushing force. Conclusion To our knowledge, this is the first study to assess the relationship between pushing force and ROM of ankle joint. There was significant correlation between ROM of ankle and pushing force. ROM of ankle PF for female estimated greater than male regardless of the pushing force and the number of measurement. The ROM of the ankle is measured differently according to the knee joint position. Pushing force, gender and knee joint position are required to be considered when measuring the ROM of ankle joint. PMID:27152277

  11. Comparison of the operation of arthroscopic tibial inlay and traditional tibial inlay for posterior cruciate ligament reconstruction

    OpenAIRE

    Lu, Daifeng; Xiao, Mochao; Lian, Yongyun; Zhou, Yong; Liu, Xuefeng

    2014-01-01

    Objective: To perform dual-bundle reconstruction of posterior cruciate ligament using full arthroscopic tibial inlay technology with self-designed tibia tunnel drilling system and to compare the effect of arthroscopic tibial inlay versus traditional technique for posterior cruciate ligament reconstruction. Material and methods: 32 patients were randomly divided into experiment group (improved tibial inlay, n = 17) and control group (traditional tibial inlay, n = 15). Self-designed tibia tunne...

  12. COMPREHENSIVE POST‐ARTHROSCOPIC MANAGEMENT OF A MIDDLE‐AGED ADULT WITH GLENOHUMERAL OSTEOARTHRITIS: A CASE REPORT

    OpenAIRE

    Hagen, Nicholas D.; Olson, Thomas; Millett, Peter

    2013-01-01

    Comprehensive Arthroscopic Management (CAM) is a new glenohumeral debridement procedure developed as a joint preserving alternative to total shoulder arthroplasty (TSA). The procedure consists of several arthroscopic components including: A. scar tissue and chondral debridement, B. synovectomy, C. inferior humeral osteoplasty, D. capsular release, E. axillary nerve decompression, and F. tenodesis of the long head of the biceps. In this case, an active, middle age patient who failed physical t...

  13. Arthroscopic verification of objectivity of the orthopaedic examination and magnetic resonance imaging in intra-articular knee injury. Retrospective study

    OpenAIRE

    Dutka, Julian; Skowronek, Michał; Skowronek, Paweł; Dutka, Łukasz

    2011-01-01

    Introduction Arthroscopy of the knee joint is regarded as the most objective diagnostic method in intra-articular knee joint lesions. Aim The purpose of this study was to assess the objectivity and diagnostic value of orthopaedic examination (OE) and magnetic resonance imaging (MRI) in reference to the arthroscopic result. Material and methods In a group of 113 patients treated by arthroscopic surgery for post-traumatic knee pathology between 2008 and 2010 in our department, accuracy of clini...

  14. Early Clinical Results of Arthroscopic Remplissage in Patients with Anterior Shoulder Instability with Engaging Hill-Sachs Lesion in Iran

    OpenAIRE

    Hamid Reza Aslani; Zohreh Zafarani; Adel Ebrahimpour; Shahin Salehi; Ali Moradi; Soheil Sabzevari

    2014-01-01

    Background:   To assess the outcome of the remplissage arthroscopic surgical method in patients with anterior shoulder dislocation associated with Hill-Sachs lesion.     Methods:   Ten patients with anterior shoulder dislocations and Hill-Sachs lesions were entered into this study and were operated on by the remplissage arthroscopic surgical method. They were followed up 22 months after surgery in   order to evaluate the outcome of the treatment, including recurrence of dislocation and motion...

  15. Arthroscopic pubic symphysis debridement and adductor enthesis repair in athletes with athletic pubalgia: technical note and video illustration.

    Science.gov (United States)

    Hopp, Sascha; Tumin, Masjudin; Wilhelm, Peter; Pohlemann, Tim; Kelm, Jens

    2014-11-01

    We elaborately describe our novel arthroscopic technique of the symphysis pubis in athletes with osteitis pubis and concomitant adductor enthesopathy who fail to conservative treatment modalities. The symphysis pubis is debrided arthroscopically and the degenerated origin of adductor tendon (enthesis) is excised and reattached. With our surgical procedure the stability of the symphysis pubis is successfully preserved and the adductor longus enthesopathy simultaneously addressed in the same setting. PMID:25055756

  16. Effects of interscalene brachial plexus block to intra-operative hemodynamics and postoperative pain for arthroscopic shoulder surgery

    OpenAIRE

    Lee, Hyun-Young; Kim, Sang Hun; So, Keum Yung; Kim, Dong Jun

    2012-01-01

    Background Although arthroscopic shoulder surgery is less invasive and painful than open shoulder surgery, it can often cause intra-operative hemodynamic instability and severe post-operative pain. This study was conducted to investigate the efficacy of the interscalene brachial plexus block (IBPB) on intra-operative hemodynamic changes and post-operative pain during arthroscopic shoulder surgery. Methods After institutional review board approval, 50 consecutive patients that had undergone ar...

  17. No evidence of long-term benefits of arthroscopic acromioplasty in the treatment of shoulder impingement syndrome

    OpenAIRE

    Ketola, S.; Lehtinen, J.; Rousi, T.; Nissinen, M.; Huhtala, H.; Konttinen, Y T; Arnala, I.

    2013-01-01

    Objectives To report the five-year results of a randomised controlled trial examining the effectiveness of arthroscopic acromioplasty in the treatment of stage II shoulder impingement syndrome. Methods A total of 140 patients were randomly divided into two groups: 1) supervised exercise programme (n = 70, exercise group); and 2) arthroscopic acromioplasty followed by a similar exercise programme (n = 70, combined treatment group). Results The main outcome measure was self-reported pain as mea...

  18. Pulsed electromagnetic fields after arthroscopic treatment for osteochondral defects of the talus: double-blind randomized controlled multicenter trial

    OpenAIRE

    Krips Rover; d'Hooghe Pieter RN; Meuffels Duncan E; Sierevelt Inger N; de Haan Rob J; Blankevoort Leendert; van Bergen Christiaan JA; van Damme Geert; van Dijk C Niek

    2009-01-01

    Abstract Background Osteochondral talar defects usually affect athletic patients. The primary surgical treatment consists of arthroscopic debridement and microfracturing. Although this is mostly successful, early sport resumption is difficult to achieve, and it can take up to one year to obtain clinical improvement. Pulsed electromagnetic fields (PEMFs) may be effective for talar defects after arthroscopic treatment by promoting tissue healing, suppressing inflammation, and relieving pain. We...

  19. [Ankle sprains: from diagnosis to management. the physiatric view].

    Science.gov (United States)

    Moreira, Vítor; Antunes, Filipe

    2008-01-01

    Ankle injuries are the most frequently encountered injuries in clinical practice. They are often managed by general practicians, and not only by orthopaedic or physiatric physicians. This injury is usually non-complicated, but some care should be taken to assure an adequate management and to exclude severe lesions. The stability of the ankle is necessary for functional activity of lower extremity, allowing walking and participation in other high demanding activities like running or jumping. There is a constant concern in adopting the best diagnostic and treatment procedures to enhance the recovery and to prevent the chronic joint instability. According to this, there should be proposed comprehensive strategies focusing the rehabilitation view. The ankle is a complex articular structure with contributions from the talocrural, subtalar, and inferior tibiofibular joints. The full understanding of the functional anatomy and biomechanics is the first step for the evaluation of the etiologic factors. The recognition of the mechanism of injury, and the risk factors, should be carefully addressed to make an accurate diagnosis, proper management and to implement prophylactic measures, knowing that the lateral ligamentous complex is the most commonly injured. As always, diagnosis can be made taking an adequate history, performing a thorough physical examination, and when necessary, requesting complementary studies. The priority in initial assessment it's to clear out some severe complications, like fractures, that can mimic or that can be associated with ankle sprains. Although the conventional radiology is suitable for most cases, that has been greatly improved through the institution of the Ottawa Rules, in selected patients the severity of the damage is best evaluated with other imaging resources. Treatment of acute ankle sprains depends on the severity of the injury. Most acute lateral ligament injuries are best treated nonsurgically and will regain satisfactory ankle

  20. The Effects of Kinesiotape Applied to the Lateral Aspect of the Ankle: Relevance to Ankle Sprains – A Systematic Review

    Science.gov (United States)

    Wilson, Brendan; Bialocerkowski, Andrea

    2015-01-01

    Objective To identify, evaluate and synthesise evidence on the effect of kinesiotape applied to the lateral aspect of the ankle, through a systematic review of quantitative studies. Data Sources A search for quantitative studies was undertaken using key terms of “kinesiotape” and “ankle” in seven electronic databases, using the maximum date ranges. Databases included: the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Medline, Physiotherapy Evidence Database, Scopus, SPORTDiscus and Web of Science. Study Selection Database hits were evaluated against explicit inclusion criteria. From 107 database hits, 8 quantitative studies were included. Data Extraction Two independent reviewers appraised the methodological rigour of the studies using the McMaster Critical Review Form for Quantitative Studies. Data were extracted on participant characteristics, kinesiotape parameters, comparison interventions, outcome measures and findings. Data Syntheses Most studies (n=7) had good to very good methodological rigour. Meta-analysis was not possible due to heterogeneity in participants, interventions and outcome measures. No adverse events were reported. Kinesiotape may produce different effects in healthy and injured ankles. In healthy ankles, kinesiotape may increase postural control, whereas in injured ankles it may improve proprioception, plantarflexor endurance and the performance of activities. These trends were identified from a small body of evidence including 276 participants. Conclusions It is recommended that kinesiotape may be used in clinical practice to prevent lateral ankle injuries (through its effects on postural control) and manage lateral ankle injuries due to its positive effects on proprioception, muscle endurance and activity performance. It appears that kinesiotape may not provide sufficient mechanical support to improve postural control in unstable ankles. Adverse events associated with kinseiotape are unlikely. PMID

  1. Early Intra-Articular Complement Activation in Ankle Fractures

    Directory of Open Access Journals (Sweden)

    Hagen Schmal

    2014-01-01

    Full Text Available Cytokine regulation possibly influences long term outcome following ankle fractures, but little is known about synovial fracture biochemistry. Eight patients with an ankle dislocation fracture were included in a prospective case series and matched with patients suffering from grade 2 osteochondritis dissecans (OCD of the ankle. All fractures needed external fixation during which joint effusions were collected. Fluid analysis was done by ELISA measuring aggrecan, bFGF, IL-1β, IGF-1, and the complement components C3a, C5a, and C5b-9. The time periods between occurrence of fracture and collection of effusion were only significantly associated with synovial aggrecan and C5b-9 levels (P<0.001. Furthermore, synovial expressions of both proteins correlated with each other (P<0.001. Although IL-1β expression was relatively low, intra-articular levels correlated with C5a (P<0.01 and serological C-reactive protein concentrations 2 days after surgery (P<0.05. Joint effusions were initially dominated by neutrophils, but the portion of monocytes constantly increased reaching 50% at day 6 after fracture (P<0.02. Whereas aggrecan and IL-1β concentrations were not different in fracture and OCD patients, bFGF, IGF-1, and all complement components were significantly higher concentrated in ankle joints with fractures (P<0.01. Complement activation and inflammatory cell infiltration characterize the joint biology following acute ankle fractures.

  2. Magnetic resonance imaging of ankle ligaments and tendon injuries

    International Nuclear Information System (INIS)

    Today MRI allows evaluation of the integrity of injured ankle ligaments. The major difficulty in MRI is inconsistency in visualization by inadequate appreciation of the three-dimensional orientation of each ankle ligament. Using this technique, 52 patients with sprained ankles underwent MRI. The integrity of rupture of the collateral lateral ligaments was obtained in all 52 ankles. Full-lenght visualization is essential for evaluation of the ankle ligaments with MRI. In these 52 patients the angle of tilt on the stress X-ray was compared with the rate of MRI findings showing an injury affecting two ligaments. We found that none of the patients in whom the angle of lateral tilt was less than 5 had rupture of two laterial ligaments, while 32% of patients with angles of tilt of 6-14 and 42% of those with angles of tilt over 15 on stress X-ray had two ruptured lateral ligaments. The advantages of MRI are that it offers the best visualization of the extent of the tendon lesion. MRI, however, seems to be superior to US in detecting and quantifying lesions of the Achilles tendon. Therefore, MRI may be indicated in particularly difficult cases of tendons injuries in the foot. (orig.)

  3. Reflex ankle stiffness is inversely correlated with natural body sway.

    Science.gov (United States)

    Julien, Brianna L; Bendrups, Andrew P

    2016-02-01

    We aimed to determine whether effective ankle stiffness (EAS), measured during slow unperceived perturbations of stance, is related to natural anterior-posterior body sway. Because the perturbations are not perceived, any neural component of the response to perturbation is assumed to be "reflex", in the broad sense of an involuntary response to a stimulus. Subjects stood on a force platform for three 10-min trials. EAS was obtained from the average slope (Δτ/Δα) of the relation between ankle torque (τ) and ankle angle (α), recorded during repeated perturbations delivered at the waist by a weak spring. EAS was normalised using the subject's "load stiffness" (LS), calculated from mass (m) and height (h) above the ankle joint (m·g·h). Sway was obtained from fluctuations in ankle angle prior to perturbation. Variation in EAS and sway between subjects provided spread of data for correlation. There were no significant changes in EAS or sway across trials. All subjects had higher EAS than LS and mean EAS (1124Nm/rad) was significantly greater (pinverted pendulum with a stiffness of about twice LS and that EAS is largely generated by neural modulation of postural muscles. The inverse correlation between EAS and body sway suggests that the reflex mechanisms responding to perturbation also influence the extent of natural sway. PMID:27004645

  4. Total ankle arthroplasty with severe preoperative varus deformity.

    Science.gov (United States)

    Hanselman, Andrew E; Powell, Brian D; Santrock, Robert D

    2015-04-01

    Advancements in total ankle arthroplasty (TAA) over the past several decades have led to improved patient outcomes and implant survivorship. Despite these innovations, many implant manufacturers still consider a preoperative coronal plane deformity greater than 10° a relative contraindication to TAA. Without proper intraoperative alignment, these implants may experience abnormal wear and hardware failure. Correcting these deformities, often through the use of soft tissue procedures and/or osteotomies, not only increases the difficulty of a case, but also the intraoperative time and radiation exposure. The authors report a case in which a 54-year-old man with a severe right ankle varus deformity of 29° underwent successful TAA using the INBONE II Prophecy total ankle system (Wright Medical Technology, Inc, Memphis, Tennessee) and additional soft tissue reconstruction. Intraoperatively, the patient's coronal deformity was corrected to 1.8°. At 8 months postoperatively, the patient ambulated without restriction and had substantial improvement in validated patient outcome scores, specifically the Academy of Orthopaedic Surgeons Foot and Ankle Module and the Short Form Health Survey-12 This unique report documents the first time that this particular implant, with an exclusive preoperative computed tomography-derived patient-specific guide, has been used effectively for a severe preoperative varus deformity greater than 20° without the need for an osteotomy. Future studies should be directed toward the prospective evaluation of different total ankle implant systems and their outcomes with severe coronal plane deformity, specifically computed tomography-derived patient-specific guided implants. PMID:25901630

  5. [PARTICULAR QUALITIES OF DIAGNOSTIC ACUTE LATERAL ANKLE LIGAMENT INJURIES].

    Science.gov (United States)

    Krasnoperov, S N; Shishka, I V; Golovaha, M L

    2015-01-01

    Delayed diagnosis of acute lateral ankle ligaments injury and subsequent inadequate treatment leads to the development of chronic instability and rapid progression of degenerative processes in the joint. The aim of our work was to improve treatment results by developing an diagnostic algorithm and treatment strategy of acute lateral ankle ligament injuries. The study included 48 patients with history of acute inversion ankle injury mechanism. Diagnostic protocol included clinical and radiological examination during 48 hours and after 7-10 days after injury. According to the high rate of inaccurate clinical diagnosis in the first 48 hours of the injury a short course of conservative treatment for 7-10 days is needed with follow-up and controlling clinical and radiographic instability tests. Clinical symptoms of ankle inversion injury showed that the combination of local tenderness in the projection of damaged ligaments, the presence of severe periarticular hematoma in the lateral department and positive anterior drawer and talar tilt tests in 7-10 days after the injury in 87% of cases shows the presence of ligament rupture. An algorithm for diagnosis of acute lateral ankle ligament injury was developed, which allowed us to determine differential indications for surgical repair of the ligaments and conservative treatment of these patients. PMID:27089717

  6. Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults

    Science.gov (United States)

    ... Force Recommendations Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults The ... Recommendation | 1 Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults Potential ...

  7. 78 FR 34708 - Proposed Information Collection (Ankle Conditions Disability Benefits Questionnaire) Activity...

    Science.gov (United States)

    2013-06-10

    ... AFFAIRS Proposed Information Collection (Ankle Conditions Disability Benefits Questionnaire) Activity... Control No. 2900--NEW (Ankle Conditions Disability Benefits Questionnaire)'' in any correspondence. During... Conditions Disability Benefits Questionnaire, VA Form 21-0960M-2. OMB Control Number: 2900--NEW...

  8. 78 FR 68908 - Agency Information Collection (Ankle Conditions Disability Benefits Questionnaire) Under OMB Review

    Science.gov (United States)

    2013-11-15

    ... AFFAIRS Agency Information Collection (Ankle Conditions Disability Benefits Questionnaire) Under OMB... Questionnaire)'' in any correspondence. FOR FURTHER INFORMATION CONTACT: Crystal Rennie, Enterprise Records... Disability Benefits Questionnaire)''. SUPPLEMENTARY INFORMATION: Title: Ankle Conditions Disability...

  9. Ankle Injuries Among United States High School Sports Athletes, 2005–2006

    OpenAIRE

    Nelson, Alex J.; Collins, Christy L; Yard, Ellen E.; Fields, Sarah K; Comstock, R. Dawn

    2007-01-01

    Context: Ankle injuries are the most common sport-related injuries. To date, no studies have been published that use national data to present a cross-sport, cross-sex analysis of ankle injuries among US high school athletes.

  10. Assessment of AK (Above Knee) Prosthesis with Different Ankle Assembly Using GRF Pattern in Stance Phase

    Science.gov (United States)

    Kim, Sung-Min; Kim, Sung-Jae; Bae, Ha-Suk

    In this study, ground reaction force (GRF), absolute symmetry index (ASI) and coefficient of variation (CV) of fixed, single-axis and multi-axis prosthetic ankle assemblies were investigated by biomechanical evaluation of above knee amputees. In the experiments, 37 normal male volunteers, two male and two female Above Knee (AK) amputees GRF data were tested with fixed, single-axis and multi-axis prosthetic ankle assembly. A gait analysis was carried out to derive the ratio of GRF to weight as the percentage of total stance phase for ten points. The results showed that fixed-axis ankle assembly was superior to other two ankle assemblies for forwarding and braking forces. Multi-axis ankle was relatively superior to other two ankle assemblies for gait balancing and movement of the mass center. Single-axis ankle was relatively superior to the other two ankle assemblies for CV and ASI of GRF.

  11. Effects of conservative therapy applied before arthroscopic subacromial decompression on the clinical outcome in patients with stage 2 shoulder impingement syndrome

    OpenAIRE

    Aydin, Ali; YILDIZ, Vahit; Topal, Murat; TUNCER, Kutsi; KÖSE, Mehmet; Şenocak, Eyüp

    2014-01-01

    To investigate the effects of conservative therapy applied before arthroscopic subacromial decompression on the clinical outcome in patients with stage 2 shoulder impingement syndrome. Materials and methods: Sixty-eight patients having stage 2 shoulder impingement syndrome and treated with arthroscopic subacromial decompression were included in the study. We divided these patients into 2 groups, whereby 32 (47%) patients received conservative therapy before arthroscopic subacromial decompres...

  12. Functional performance of a total ankle replacement: thorough assessment by combining gait and fluoroscopic analyses

    OpenAIRE

    Cenni, Francesco; Leardini, Alberto; Pieri, Maddalena; Berti, Lisa; Belvedere, Claudio; Romagnoli, Matteo; Giannini, Sandro

    2013-01-01

    BACKGROUND: A thorough assessment of patients after total ankle replacement during activity of daily living can provide complete evidence of restored function in the overall lower limbs and replaced ankle. This study analyzes how far a possible restoration of physiological mobility in the replaced ankle can also improve the function of the whole locomotor apparatus. METHODS: Twenty patients implanted with an original three-part ankle prosthesis were analyzed 12 months after surgery d...

  13. Ankle sprain : Subjective and objective measures of functional impairment and treatment

    OpenAIRE

    Leanderson, Johan

    1996-01-01

    This thesis is based upon a series of studies were performed in order to provide more informationabout the etiology of late symptoms after ankle sprain, most often referred to as functional instabilityof the ankle joint. In a retrospective study of basketball players, the incidence of ankle sprains and theprevalence of late symptoms after such an injury were investigated. The injury incidence was cal-culated to 5.5 ankle injuries /1000 activity hours, which is three to four times higher than ...

  14. Effects of Kinesio taping on joint position sense of the ankle

    OpenAIRE

    Seo, Hyun-Do; Kim, Min-Young; Choi, Jung-Eun; Lim, Ga-Hee; Jung, Seong-In; Park, So-Hyun; Cheon, Song-Hee; Lee, Hae-Yong

    2016-01-01

    [Purpose] The purpose of this study was to examine the effect of Kinesio taping on the joint position sense of the ankle. [Subjects and Methods] The subjects of this study were 26 nomal adults who had experienced ankle sprain. Kinesio taping was applied over the ankle medial ligament and ankle lateral ligament with eight pattern reinforcement taping. Joint position sense was measured using isokinetic equipment (Biodex System 4 pro dynamometer, Biodex Medical systems Inc., USA) during dorsifle...

  15. Ankle manual therapy for individuals with post-acute ankle sprains: description of a randomized, placebo-controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Fisher Beth E

    2010-10-01

    Full Text Available Abstract Background Ankle sprains are common within the general population and can result in prolonged disablement. Limited talocrural dorsiflexion range of motion (DF ROM is a common consequence of ankle sprain. Limited talocrural DF ROM may contribute to persistent symptoms, disability, and an elevated risk for re-injury. As a result, many health care practitioners use hands-on passive procedures with the intention of improving talocrural joint DF ROM in individuals following ankle sprains. Dosage of passive hands-on procedures involves a continuum of treatment speeds. Recent evidence suggests both slow- and fast-speed treatments may be effective to address disablement following ankle sprains. However, these interventions have yet to be longitudinally compared against a placebo study condition. Methods/Design We developed a randomized, placebo-controlled clinical trial designed to test the hypotheses that hands-on treatment procedures administered to individuals following ankle sprains during the post-acute injury period can improve short-, intermediate-, and long-term disablement, as well as reduce the risk for re-injury. Discussion This study is designed to measure the clinical effects of hands-on passive stretching treatment procedures directed to the talocrural joint that vary in treatment speed during the post-acute injury period, compared to hands-on placebo control intervention. Trial Registration http://www.clinicaltrials.gov identifier NCT00888498.

  16. Arthroscopic Bioabsorbable Screw Fixation of Unstable Osteochondritis Dissecans in Adolescents: Clinical Results, Magnetic Resonance Imaging, and Second-Look Arthroscopic Findings

    Science.gov (United States)

    Chun, Keun Churl; Kim, Kwang Mee; Jeong, Ki Joon; Lee, Yong Chan; Kim, Jeong Woo

    2016-01-01

    Background This study aimed to evaluate the clinical and radiological outcomes of arthroscopic bioabsorbable screw fixation in osteochondritis dissecans (OCD) in adolescent patients with unstable lesions causing pain. Methods The study included 11 patients (10 males and 1 female) with OCD who underwent arthroscopic bioabsorbable screw fixation between July 2007 and February 2014 and were available for follow-up for more than 12 months. The mean age at diagnosis was 16.3 years (range, 11 to 19 years), and the average follow-up period was 51 months (range, 12 to 91 months). Clinical results were evaluated using the Knee Injury and Osteoarthritis Outcome Score (KOOS), Lysholm knee score, and International Knee Documentation Committee (IKDC) score measured before surgery and at follow-up. Functional evaluation was made using the Tegner activity scale. Magnetic resonance imaging (MRI) and second-look arthroscopy were performed at the 12-month follow-up. Results Between the preoperative assessment and follow-up, improvements were seen in the KOOS (range, 44.9 to 88.1), Lysholm knee score (range, 32.6 to 82.8), and IKDC score (range, 40.8 to 85.6). The Tegner activity scale also improved from 2.8 to 6.1. Based on postoperative MRI, there were eight Dipaola grade I cases and three grade II cases. No complications due to fixation failure developed in any case. Second-look arthroscopy at 12 months postoperatively revealed that the lesion was covered with cartilage in all cases. Conclusions For unstable OCD lesions causing pain in adolescents, arthroscopic bioabsorbable screw fixation provided favorable outcomes with reduced pain and restoration of movement. Therefore, it should be considered as an effective treatment for OCD. PMID:26929800

  17. Exercise and ankle sprain injuries: a comprehensive review.

    Science.gov (United States)

    Calatayud, Joaquin; Borreani, Sebastien; Colado, Juan Carlos; Flandez, Jorge; Page, Phil; Andersen, Lars L

    2014-02-01

    Ankle sprains are common in team sports and sports played on courts, and often result in structural and functional alterations that lead to a greater reinjury risk. Specific exercises are often used to promote neuromuscular improvements in the prevention and rehabilitation of ankle injuries. This literature review summarizes the neuromuscular characteristics of common ankle sprains and the effectiveness of exercise as an intervention for improving neuromuscular function and preventing reinjury. Our review found that appropriate exercise prescription can increase static and dynamic balance and decrease injury recurrence. In particular, the addition of dynamic activities in the exercise program can be beneficial because of the anticipatory postural adjustments identified as a key factor in the injury mechanism. PMID:24565825

  18. Peroneal muscle weakness in female basketballers following chronic ankle sprain.

    Science.gov (United States)

    Rottigni, S A; Hopper, D

    1991-01-01

    Female A-grade basketballers were examined for invertor and evertor muscle strength. Two test groups participated. The injured group were players who had persisting disability following ankle sprains. The control group were players who had never sustained an ankle sprain. Test apparatus was the Orthotron isokinetic dynamometer at contraction speed of 180° per second. Trends towards higher invertor and evertor strength in uninjured group when compared with the injured group found in the present study have been supported by one other report. Invertors were found to be significantly stronger than evertors in both injured and uninjured groups, with the exception of the dominant leg of the uninjured group. A significant weakness in non-dominant evertors of the uninjured group was detected. Dominance did not significantly alter strength differences in the invertor or evertor muscle groups within the uninjured population. The clinical importance of strengthening the peroneal muscles in ankle sprain rehabilitation is discussed, and further research considerations provided. PMID:25025187

  19. Arthrography of the ankle joint in chronic instability

    International Nuclear Information System (INIS)

    Papers on arthrography of injuries of the lateral ligaments of the ankle relate mainly to recent distortion of the joint. Arthrography performed at a later stage after injury generally is considered useless. In fact, changes in chronic instability are observed; they are subtle and consist either of small recesses adjacent to the lateral malleolus or communication of the joint with the peroneal tendon sheaths. Arthrography was assessed in 61 cases of recurrent lateral sprains of the ankle more than 2 weeks after acute injury; 38 were considered as positive. Twenty-five patients had operative evaluation, with four false negative and one false positive results. Small recesses adjacent to the lateral malleolus or opacification of the peroneal tendon sheaths are sequelae of an acute sprain with tear of the anterior talofibular and/or the calcaneofibular ligaments. Although false negative results occur, arthrography is useful in the preoperative assessment of chronic ankle instability. (orig.)

  20. Injured lateral ankle ligaments: technique and assessment of MRI

    International Nuclear Information System (INIS)

    56 patients with the clinical diagnosis of sprained ankles were investigated. Evaluation of the anterior (AFTL) and posterior fibulotalar ligament (PFTL) was performed with the foot in dorsiflexion (20 ) and of the fibulo calcanear ligament (FCL) in plantarflexion (45 ). Axial T1w-SE and T2w-TSE images were obtained. Full-length visualisation of ligmaments in one slice and the extent of injury were evaluated. 12 ankle injuries were confirmed by operation. With MRI full-length visualisation of lateral ankle ligaments was possible in 86%. A partial/complete rupture of the AFTL was noticed in 33/64% and of the FCI in 29/39%, and of the PFTL in 27/5%. Sensitivity/specificity of MRI when compared to surgery was 100/100% for injuries of the AFTL, 64/100% for the FCL, and 33/78% for the PFTL. (orig./MG)

  1. Examination of the sprained ankle: Anterior drawer test or arthrography?

    International Nuclear Information System (INIS)

    The accuracy of the anterior drawer test for the diagnosis of recent lateral ligament tears in the ankle was evaluated in a series of 192 patients using surgical or arthrographic findings for reference. Considerable overlapping of results was obtained in ankles with and without ligament tear. Twenty-eight per cent of the anterior talofibular ligament tears, and 38% of the combined anterior talofibular and calcaneofibular tears were not detected, and single and combined tears could not be differentiated. It is concluded that the anterior drawer test is too unreliable as a basis for any decision regarding surgical treatment of a recent sprain. Therefore, arthrography is recommended as the method of choice in such cases of recent ankle sprain, where the need of surgery has to be supported by X-ray analysis. (orig.)

  2. Arthrography of the ankle joint in chronic instability

    Energy Technology Data Exchange (ETDEWEB)

    Dory, M.A.

    1986-05-01

    Papers on arthrography of injuries of the lateral ligaments of the ankle relate mainly to recent distortion of the joint. Arthrography performed at a later stage after injury generally is considered useless. In fact, changes in chronic instability are observed; they are subtle and consist either of small recesses adjacent to the lateral malleolus or communication of the joint with the peroneal tendon sheaths. Arthrography was assessed in 61 cases of recurrent lateral sprains of the ankle more than 2 weeks after acute injury; 38 were considered as positive. Twenty-five patients had operative evaluation, with four false negative and one false positive results. Small recesses adjacent to the lateral malleolus or opacification of the peroneal tendon sheaths are sequelae of an acute sprain with tear of the anterior talofibular and/or the calcaneofibular ligaments. Although false negative results occur, arthrography is useful in the preoperative assessment of chronic ankle instability.

  3. Examination of the sprained ankle: Anterior drawer test or arthrography

    Energy Technology Data Exchange (ETDEWEB)

    Laehde, S.; Putkonen, M.; Puranen, J.; Raatikainen, T.

    1988-11-01

    The accuracy of the anterior drawer test for the diagnosis of recent lateral ligament tears in the ankle was evaluated in a series of 192 patients using surgical or arthrographic findings for reference. Considerable overlapping of results was obtained in ankles with and without ligament tear. Twenty-eight per cent of the anterior talofibular ligament tears, and 38% of the combined anterior talofibular and calcaneofibular tears were not detected, and single and combined tears could not be differentiated. It is concluded that the anterior drawer test is too unreliable as a basis for any decision regarding surgical treatment of a recent sprain. Therefore, arthrography is recommended as the method of choice in such cases of recent ankle sprain, where the need of surgery has to be supported by X-ray analysis.

  4. Assessment of a portable device for the quantitative measurement of ankle joint stiffness in spastic individuals

    DEFF Research Database (Denmark)

    Lorentzen, Jakob; Grey, Michael J; Geertsen, Svend Sparre;

    2012-01-01

    Neurokinetics RA1 Ridgidity Analyzer to measure stiffness of the ankle joint in 46 controls, 14 spinal cord injured (SCI) and 23 multiple sclerosis (MS) participants. METHODS: Ankle stiffness measures were made twice by two raters, at speeds above and below the expected stretch reflex threshold. Ankle torque...

  5. Diagnosis, treatment and prevention of ankle sprains : an evidence-based clinical guideline

    NARCIS (Netherlands)

    Kerkhoffs, Gino M.; van den Bekerom, Michel; Elders, Leon A. M.; van Beek, Peter A.; Hullegie, Wim A. M.; Bloemers, Guus M. F. M.; de Heus, Elly M.; Loogman, Masja C. M.; Rosenbrand, Kitty C. J. G. M.; Kuipers, Ton; Hoogstraten, J. W. A. P.; Dekker, Rienk; ten Duis, Henk-Jan; van Dijk, C. Niek; van Tulder, Maurits W.; van der Wees, Philip J.; de Bie, Rob A.

    2012-01-01

    Ankle injuries are a huge medical and socioeconomic problem. Many people have a traumatic injury of the ankle, most of which are a result of sports. Total costs of treatment and work absenteeism due to ankle injuries are high. The prevention of recurrences can result in large savings on medical cost

  6. Diagnosis, treatment and prevention of ankle sprains: an evidence-based clinical guideline.

    NARCIS (Netherlands)

    Kerkhoffs, G.M.; Bekerom, M. van den; Elders, L.A.; Beek, P.A. van; Hullegie, W.A.; Bloemers, G.M.; Heus, E.M. de; Loogman, M.C.; Rosenbrand, K.C.; Kuipers, T.; Hoogstraten, J.W.; Dekker, R.; Duis, H.J. Ten; Dijk, C.N. van; Tulder, M.W. van; Wees, P.J. van der; Bie, R.A. de

    2012-01-01

    Ankle injuries are a huge medical and socioeconomic problem. Many people have a traumatic injury of the ankle, most of which are a result of sports. Total costs of treatment and work absenteeism due to ankle injuries are high. The prevention of recurrences can result in large savings on medical cost

  7. Deltoid ligament in acute ankle injury: MR imaging analysis

    International Nuclear Information System (INIS)

    To identify the pattern of deltoid ligament injury after acute ankle injury and the relationship between ankle fracture and deltoid ligament tear by magnetic resonance imaging (MRI). Thirty-six patients (32 male, and 4 female; mean age, 29.8 years) with acute deltoid ligament injury who had undergone MRI participated in this study. The deltoid ligament was classified as having 3 superficial and 2 deep components. An image analysis included the integrity and tear site of the deltoid ligament, and other associated injuries. Association between ankle fracture and deltoid ligament tear was assessed using Fisher's exact test (P < 0.05). Of the 36 patients, 21 (58.3 %) had tears in the superficial and deep deltoid ligaments, 6 (16.7 %) in the superficial ligaments only, and 4 (11.1 %) in the deep ligaments only. The most common tear site of the three components of the superficial deltoid and deep anterior tibiotalar ligaments was their proximal attachments (94 % and 91.7 % respectively), and that of the deep posterior tibiotalar ligament (pTTL) was its distal attachment (82.6 %). The common associated injuries were ankle fracture (63.9 %), syndesmosis tear (55.6 %), and lateral collateral ligament complex tear (44.4 %). All the components of the deltoid ligament were frequently torn in patients with ankle fractures (tibionavicular ligament, P = 0.009). The observed injury pattern of the deltoid ligament was complex and frequently associated with concomitant ankle pathology. The most common tear site of the superficial deltoid ligament was the medial malleolar attachment, whereas that of the deep pTTL was near its medial talar insertion. (orig.)

  8. Acute paediatric ankle trauma: MRI versus plain radiography

    International Nuclear Information System (INIS)

    Objective: To evaluate the diagnosis of acute physeal ankle fractures on plain radiographs using MRI as the gold standard. Methods: Sixty consecutive children, 29 with a clinical diagnosis of lateral ligament injury and 31 with physeal ankle fractures, were examined using both radiographs and MRI in the acute period. The imaging data were reviewed by three ''masked'' radiologists. The fracture diagnosis and Slater-Harris classification of radiographs were compared with findings on MRI. Results: Plain radiography produced five of 28 (18%) false negative and 12 of 92 (13%) false positive fracture diagnoses compared with MRI. Six of the 12 false positive fractures were due to a misclassification of lateral ligament disruption as SH1 fractures. Altogether a difference was found in 21% of cases in either the diagnosis or the classification of the fractures according to Salter- Harris. All bone bruises in the distal tibia and fibula and 64% of bone bruises in the talus were seen in association with lateral ligament injuries. Talar bone bruises in association with fractures occurred on the same side as the malleolar fracture; talar bone bruises in association with lateral ligament disruption were seen in different locations. The errors identified on radiographs by MRI did not affect the management of the injury. Conclusions: The incidence of false negative ankle fractures in plain radiographs was small and no complex ankle fractures were missed on radiographs. The total extent of complex fractures was, however, not always obvious on radiographs. In an unselected series of relatively mild ankle injuries, we were unable to show a single case where the treatment or prognosis based on plain radiography should have been significantly altered after having done a routine MRI examination. Plain radiography is still the diagnostic cornerstone of paediatric ankle injuries. (orig.)

  9. Deltoid ligament in acute ankle injury: MR imaging analysis

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Min Sun; Choi, Yun Sun; Kim, Yun Jung; Jung, Yoon Young [Eulji University, Department of Radiology, Eulji Hospital, Seoul (Korea, Republic of); Kim, Jin Su; Young, Ki Won [Eulji University, Department of Orthopedic Surgery, Eulji Hospital, Seoul (Korea, Republic of)

    2014-05-15

    To identify the pattern of deltoid ligament injury after acute ankle injury and the relationship between ankle fracture and deltoid ligament tear by magnetic resonance imaging (MRI). Thirty-six patients (32 male, and 4 female; mean age, 29.8 years) with acute deltoid ligament injury who had undergone MRI participated in this study. The deltoid ligament was classified as having 3 superficial and 2 deep components. An image analysis included the integrity and tear site of the deltoid ligament, and other associated injuries. Association between ankle fracture and deltoid ligament tear was assessed using Fisher's exact test (P < 0.05). Of the 36 patients, 21 (58.3 %) had tears in the superficial and deep deltoid ligaments, 6 (16.7 %) in the superficial ligaments only, and 4 (11.1 %) in the deep ligaments only. The most common tear site of the three components of the superficial deltoid and deep anterior tibiotalar ligaments was their proximal attachments (94 % and 91.7 % respectively), and that of the deep posterior tibiotalar ligament (pTTL) was its distal attachment (82.6 %). The common associated injuries were ankle fracture (63.9 %), syndesmosis tear (55.6 %), and lateral collateral ligament complex tear (44.4 %). All the components of the deltoid ligament were frequently torn in patients with ankle fractures (tibionavicular ligament, P = 0.009). The observed injury pattern of the deltoid ligament was complex and frequently associated with concomitant ankle pathology. The most common tear site of the superficial deltoid ligament was the medial malleolar attachment, whereas that of the deep pTTL was near its medial talar insertion. (orig.)

  10. Acute paediatric ankle trauma: MRI versus plain radiography

    Energy Technology Data Exchange (ETDEWEB)

    Lohman, M. [Helsinki Univ. Central Hospital (Finland). Dept. of Radiology; Radiological Dept., Helsinki University Central Hospital (Finland); Kivisaari, A.; Kivisaari, L. [Helsinki Univ. Central Hospital (Finland). Dept. of Radiology; Kallio, P.; Puntila, J. [Dept. of Paediatric Surgery, Hospital for Children and Adolescents, Helsinki Univ. Central Hospital, Helsinki (Finland); Vehmas, T. [Finnish Institute of Occupational Health, Helsinki (Finland)

    2001-09-01

    Objective: To evaluate the diagnosis of acute physeal ankle fractures on plain radiographs using MRI as the gold standard. Methods: Sixty consecutive children, 29 with a clinical diagnosis of lateral ligament injury and 31 with physeal ankle fractures, were examined using both radiographs and MRI in the acute period. The imaging data were reviewed by three ''masked'' radiologists. The fracture diagnosis and Slater-Harris classification of radiographs were compared with findings on MRI. Results: Plain radiography produced five of 28 (18%) false negative and 12 of 92 (13%) false positive fracture diagnoses compared with MRI. Six of the 12 false positive fractures were due to a misclassification of lateral ligament disruption as SH1 fractures. Altogether a difference was found in 21% of cases in either the diagnosis or the classification of the fractures according to Salter- Harris. All bone bruises in the distal tibia and fibula and 64% of bone bruises in the talus were seen in association with lateral ligament injuries. Talar bone bruises in association with fractures occurred on the same side as the malleolar fracture; talar bone bruises in association with lateral ligament disruption were seen in different locations. The errors identified on radiographs by MRI did not affect the management of the injury. Conclusions: The incidence of false negative ankle fractures in plain radiographs was small and no complex ankle fractures were missed on radiographs. The total extent of complex fractures was, however, not always obvious on radiographs. In an unselected series of relatively mild ankle injuries, we were unable to show a single case where the treatment or prognosis based on plain radiography should have been significantly altered after having done a routine MRI examination. Plain radiography is still the diagnostic cornerstone of paediatric ankle injuries. (orig.)

  11. ARTHROSCOPIC SUBACROMIAL DECOMPRESSION: ACROMIOPLASTY VERSUS BURSECTOMY ALONE-DOES IT REALLY MATTER? A SYSTEMATIC REVIEW

    Science.gov (United States)

    Donigan, Jonathan A; Wolf, Brian R

    2011-01-01

    Background Subacromial impingement is a common disorder mat in some cases results in surgical management. Arthroscopic subacromial bursectomy alone or in combination with acromioplasty are treatment options when non-operative measures fail. Methods A systematic review of all level-I and level-II studies regarding subacromial bursectomy and acromioplasty for impingement was performed. Medline publications were reviewed for appropriate studies. Results A total of six studies that met inclusion criteria were identified. However, only one randomized study was identified that directly compared the treatments in question. Additionally, only one prospective study of subacromial bursectomy was identified. A comparison of similar outcome measures revealed bursectomy alone provided similar results to bursectomy with acromioplasty. Discussion Limited high-level studies are available regarding arthroscopic treatment of subacromial impingement. Data available currently suggests that bursectomy alone provides similar outcomes to bursectomy with acromioplasty. PMID:22096430

  12. Arthroscopic knee surgery does not modify hyperalgesic responses to heat injury

    DEFF Research Database (Denmark)

    Werner, Mads U; Duun, Preben; Kraemer, Otto;

    2003-01-01

    BACKGROUND: Experimental studies suggest that surgical injury may up- or down-regulate nociceptive function. Therefore, the aim of this clinical study was to evaluate the effect of elective arthroscopically assisted knee surgery on nociceptive responses to a heat injury. METHODS: Seventeen patients...... thresholds (P > 0.08) in the burn area before surgery compared to after surgery. CONCLUSION: Arthroscopic knee surgery did not modify nociceptive responses to a contralaterally applied experimental burn injury....... scheduled to undergo repair of the anterior cruciate ligament and 16 healthy controls were studied. The first burn injury was induced 6 days before surgery, and the second burn was induced 1 day after surgery with a contact thermode (12.5 cm2, 47 degrees C for 7 min) placed on the medial aspect of the calf...

  13. Imaging of soft tissue lesions of the foot and ankle.

    Science.gov (United States)

    Bancroft, Laura W; Peterson, Jeffrey J; Kransdorf, Mark J

    2008-11-01

    Differential diagnosis of soft tissue lesions of the foot can be narrowed with imaging. The cystic nature of ganglia, synovial cysts, and bursitis can be confirmed with MR imaging or sonography. Location and signal characteristics of noncystic lesions can suggest Morton's neuroma, giant cell tumor of tendon sheath, and plantar fibromatosis. Synovial-based lesions of the foot and ankle can be differentiated based on presence or absence of mineralization, lesion density, signal intensity, and enhancement pattern. Knowledge of the incidence of specific neoplasms of the foot and ankle based on patient age aids in providing a limited differential diagnosis. PMID:19038615

  14. Ankle sprain and postural sway in basketball players.

    Science.gov (United States)

    Leanderson, J; Wykman, A; Eriksson, E

    1993-01-01

    The present study compares postural ankle stability between previously injured basketball players, uninjured players and a control/group. Postural sway was recorded and analysed by stabilometry using a specially designed computer-assisted forceplate. Recordings were obtained for 60 s on each foot. The stabilometric results in the players with no previous injuries did not differ from those in the controls. Players with a previously injured ankle differed significantly from the control group. These players had a larger mean postural sway and used a larger sway area. PMID:8536030

  15. Imaging of Soft Tissue Lesions of the Foot and Ankle

    Directory of Open Access Journals (Sweden)

    Seyed Hassan Mostafavi

    2010-05-01

    Full Text Available Differential diagnosis of soft tissue lesions of the foot may be narrowed with imaging. The cystic nature of ganglia, synovial cysts, and bursitis can be confirmed with MR imaging or sonography. Location and signal characteristics of noncystic lesions may suggest Morton's neuroma, giant cell tumor of the tendon sheath and plantar fibromatosis. Synovial-based lesions of the foot and ankle can be differentiated based on presence or absence of mineralization, lesion density, signal intensity, and the enhancement pattern. Knowledge of the incidence of specific neoplasms of the foot and ankle based on patient age aids in providing a limited differential diagnosis

  16. A historical perspective on ankle ligaments reconstructive surgery.

    Science.gov (United States)

    Di Matteo, Berardo; Tarabella, Vittorio; Filardo, Giuseppe; Tomba, Patrizia; Viganò, Anna; Marcacci, Maurilio; Zaffagnini, Stefano

    2016-04-01

    Ankle sprains are by far the most common injuries treated by sport medicine physicians. Treatment is mainly conservative, but in some cases surgical intervention is required. The aim of the present manuscript is to give an insight into the origins and developments of ankle ligaments reconstructive surgery, underlining the fundamental steps that marked the transition from a mere conservative approach to surgical treatment options. In this historical note, the most illustrious figures who contributed to this particular field of orthopaedic practice are also acknowledged. Level of evidence V. PMID:26718639

  17. Functional bandage for ankle sprains. Recommendations for nursing

    Directory of Open Access Journals (Sweden)

    Mª Isabel Arcos Cirauqui

    2011-11-01

    Full Text Available Three quarters of ankle injuries are diagnosed as sprains. For the most part sprains are caused by a forced inversion movement with involvement of the lateral collateral ligament (LCL. One of the recommended guidelines is immobilization by taping. The aim of this article is to unify the recommendations for nursing, on taping in the treatment of ankle sprains. The methodology used was a literature review, analyzing the information found in books and journals in hospital libraries and nursing databases on the Internet. The main results are a set of guidelines for the most accurate and therapeutic taping.

  18. Effect of continuous passive motion on functional recovery after senile arthroscope operation of knee joint%持续被动活动对老年膝关节镜术后功能恢复的作用

    Institute of Scientific and Technical Information of China (English)

    李泓

    2003-01-01

    @@ INTRODUCTION With popularit and development of arthroscope technique, it has been broadly ursed in treatment of disease of knee joint. Rehabilitation after arthroscope operation especially after senile arthxoscope operation of knee joint is very important.

  19. Supervised strengthening exercises versus home-based movement exercises after arthroscopic acromioplasty : A randomized clinical trial

    OpenAIRE

    Holmgren, Theresa; Öberg, Birgitta; Sjöberg, Irene; Johansson, Kajsa

    2012-01-01

    Objective: To evaluate and compare the efficacy of 2 rehabilitation strategies after arthroscopic acromioplasty: supervised physical therapy focusing on strengthening exercises of the rotator cuff and scapula stabilizers (PT-group) vs home-based movement exercises (H-group). Design: A randomized, single-blinded, clinically controlled study. Patients: Thirty-six patients entered the study. Thirteen in the PT-group and 16 in the H-group fulfilled all the assessments. Methods: For 12 weeks follo...

  20. All-arthroscopic treatment of tibial avulsion fractures of the posterior cruciate ligament

    OpenAIRE

    Gwinner, Clemens; Hoburg, Arnd; Wilde, Sophie; Schatka, Imke; Krapohl, Björn Dirk; Jung, Tobias M.

    2016-01-01

    Background: The posterior cruciate ligament (PCL) avulsion fracture from its tibial insertion is a rare condition. Despite the further technical advent in refixation of avulsion fractures, the reported failure rate of current approaches remains high and the optimal surgical technique has not been elucidated yet. The purpose of the current study is to present an all-inside arthroscopic reconstruction technique for bony tibial avulsion fractures of the PCL and initial clinical outcomes. Methods...

  1. Use of a Bone Graft Drill Harvester to Create the Fenestration During Arthroscopic Ulnohumeral Arthroplasty

    OpenAIRE

    Wijeratna, Malin D.; Ek, Eugene T.; Hoy, Gregory A.; Chehata, Ash

    2015-01-01

    The Outerbridge-Kashiwagi procedure, or ulnohumeral arthroplasty, was described in 1978 as a method of treating elbow arthritis by creating a fenestration in the olecranon fossa. This fenestration diminishes the likelihood of recurrent spurs in the olecranon fossa and coronoid fossa, without loss of structural bony strength. Arthroscopic techniques have now been developed to perform this procedure. We describe an efficient method of creating the fenestration between the olecranon fossa and co...

  2. The outcome study of arthroscopic repair with anchor suture for anterior shoulder instabilities

    Directory of Open Access Journals (Sweden)

    Guity MR

    2010-10-01

    Full Text Available "nBackground: Anterior glenohumeral instabilities can be corrected with open and arthroscopic surgery. The purpose of this study was to evaluate retrospectively the surgical outcomes of arthroscopic repair of anterior glenohumeral instabilities with use of suture anchors in a series of patients who were followed for twenty to fifty months."n "nMethods: The results of arthroscopic Bankart repair with use of suture anchors in 30 patients with traumatic recurrent anterior instability of the shoulder were evaluated. At the time of follow-up (mean of thirty-three months, the patients were assessed with two outcome measurement tools (the Rowe score, the Constant score. The recurrence rate, range of motion, and risk factors for postoperative recurrence were evaluated."n "nResults: According to the Rowe scale, 12 patients (40% had an excellent score; 13 (43%, a good score; 4 (13%, a fair score; and 1 (4%, a poor score. The mean ROWE score was 81.8 and the mean CONSTANT score was 85.5. Overall, the rate of postoperative recurrence of instability was 10% (two dislocations, one subluxation. The mean delay to recurrence was 20 months. Loss of external rotation in regard to uninvolved extremity was less than 10 degrees in 30% and more than 10 degrees in 10% of patients. The average number of anchors used was 3.2 which follow-up radiographs showed all of them in the osseous glenoid without pullout. In preoperative studies, shoulder 3D CT scan was not performed routinely. Radiographic signs of degenerative changes were noted in one shoulder."n "nConclusion: Arthroscopic capsulolabral repair with use of suture anchors can provide satisfactory outcomes in terms of recurrence rate, activity, and range of motion.

  3. ASSESSMENT OF THE RESULTS FROM ARTHROSCOPIC SURGICAL TREATMENT FOR TRAUMATIC ANTERIOR SHOULDER DISLOCATION: FIRST EPISODE

    OpenAIRE

    Miyazaki, Alberto Naoki; Fregoneze, Marcelo; Santos, Pedro Doneux; da Silva, Luciana Andrade; do Val Sella, Guilherme; Botelho, Vinicius; Duarte, Clodoaldo; Checchia, Sergio Luiz

    2015-01-01

    Objective: To assess the clinical results obtained of patients who underwent arthroscopic surgical treatment following a first episode of traumatic anterior shoulder dislocation. Methods: Between August 2000 and October 2008, 14 shoulders of 14 patients were treated by the Shoulder and Elbow Group of Santa Casa Hospital, São Paulo. Thirteen patients (93%) were male and one (7%) was female; their ages ranged from 17 to 41 years, with a mean of 28 years. All of the patients evaluated were regul...

  4. Patients with shoulder impingement remain satisfied 6 years after arthroscopic subacromial decompression

    OpenAIRE

    Lunsjö, Karl; Bengtsson, Marie; Nordqvist, Anders; Abu-Zidan, Fikri M

    2011-01-01

    Background Although arthroscopic subacromial decompression (ASD) is a common procedure for treatment of shoulder impingement, few long term results have been published. In this prospective study, we determined whether the high degree of patient satisfaction at 6 months postoperatively reported by us earlier remained at the 6-year follow-up. Patients and methods We originally reported high patient satisfaction 6 months after ASD for shoulder impingement in 50 prospectively studied patients usi...

  5. Time and cost savings in arthroscopic subacromial decompression: the use of bipolar versus monopolar radiofrequency

    OpenAIRE

    Diab, Mohammed A.; Fernandez, G N; Elsorafy, Kareem

    2008-01-01

    There is currently an increased interest in the use of electro surgery in arthroscopy. Since the introduction of the bipolar arthroscopic radiofrequency (RF) wand, it has started to replace the classic Bovie monopolar probe on the assumption that the new technology provides multifunctional devices, combining both tissue removal and haemostasis into one instrument. The more efficient tissue ablation and precise haemostasis achieved with these instruments should result in a significant reductio...

  6. ARTHROSCOPIC REPAIR OF BANKART’S LESION USING SUTURE ANCHORS IN RECURRENT ANTERIOR SHOULDER INSTABILITY

    OpenAIRE

    Santosh Kumar; Anant Kumar; Sanjay

    2015-01-01

    BACKGROUND : Shoulder instability and its treatment were described even in ancient times by the Greek and Egyptian physicians. Evidence of shoulder dislocation has been found in archaeological and paleopathological examinations of human shoulders several thousand years old. 1 Many techniques have been described in literature for treatment of recurrent shoulder dislocation. Arthroscopic repair of Bankart’s lesion using suture anchors is a noble technique. A sut...

  7. Analysis of the Arthroscopically Diagnosed Soft-Tissue Injuries Associated With the Distal Radius Fractures

    OpenAIRE

    Katerina Katerina Kasapinova; Viktor Kamiloski

    2014-01-01

    AIM: The aim of this study was to analyze the frequencies of these soft-tissue injuries and to describe the arthroscopic technique used for their diagnosis. METHODS: The prospective study included 85 patients with operatively treated distal radius fracture. Wrist arthroscopy was used to identify the associated lesions of triangular fibrocartilage complex (TFCC), scapholunate ligament (SL) and lunitriquetral ligament (LT), extrinsic ligaments, and chondral lesions. RESULTS: Wrist arthr...

  8. Direct “Cystoscopic” Approach for Arthroscopic Decompression of an Intraosseous Ganglion of the Lunate

    OpenAIRE

    Bhatia, Deepak N.

    2015-01-01

    Intraosseous ganglion cysts (IOGs) are uncommon lesions of the carpal bones and can present with persistent pain and stiffness of the wrist. Surgical decompression is recommended, and a variety of approaches to decompress symptomatic IOGs of the wrist have been described. We describe an arthroscopic approach that can be performed with only 2 portals and offers excellent access for visualization and instrumentation. The procedure involves creating a 3.2-mm tunnel into the lunate cyst; this is ...

  9. Effect of arthroscopic rotator cuff surgery in patients with preoperative restricted range of motion

    OpenAIRE

    Razmjou, Helen; Henry, Patrick; Costa, Giuseppe; Dwyer, Tim; Holtby, Richard

    2016-01-01

    Background The purpose of this study was to examine the impact of rotator cuff (RC) decompression and/or repair on post-operative ROM in patients with pre-operative restricted passive motion who had undergone arthroscopic subacromial debridement and/or rotator cuff repair. Potential predictors of ROM recovery such as age, sex, mechanism of injury, type of surgery, presence of an endocrine illness and having an active Worker Compensation claim related to the shoulder were explored. Methods A r...

  10. Arthroscopic management of recalcitrant stiffness following rotator cuff repair: A retrospective analysis

    OpenAIRE

    Sanjeev Bhatia; Mather, Richard C.; Hsu, Andrew R.; Ferry, Amon T; Romeo, Anthony A.; Nicholson, Gregory P.; Cole, Brian J.; Verma, Nikhil N.

    2013-01-01

    Background : Rotator cuff repair surgery is one of the most commonly performed procedures in the world but limited literature exists for guidance of optimal management of post-operative arthrofibrosis following cuff repair. The purpose of this study is to report the results of arthroscopic capsular release, lysis of adhesions, manipulation under anesthesia, and aggressive physical therapy in patients with recalcitrant postoperative stiffness after rotator cuff repair. Materials and Method...

  11. Systematic Review of Arthroscopic Versus Open Repair for Recurrent Anterior Shoulder Dislocations

    OpenAIRE

    Godin, Jonathan; Sekiya, Jon K.

    2011-01-01

    Context: It remains unknown if arthroscopic repair of recurrent anterior shoulder instability is as effective as open repair. Objective: The purpose of this study is to analyze the literature to provide clinical recommendations regarding the most appropriate therapeutic intervention for recurrent anterior shoulder instability. Study Design: Systematic review of level I and II studies. Data Sources: PubMed, EMBASE, the Cochrane Database of Systematic Reviews, and secondary references from 1967...

  12. Preoperative interscalene brachial plexus block aids in perioperative temperature management during arthroscopic shoulder surgery

    Science.gov (United States)

    Lim, Se Hun; Lee, Wonjin; Park, JaeGwan; Kim, Myoung-hun; Cho, Kwangrae; Lee, Jeong Han; Cheong, Soon Ho

    2016-01-01

    Background Hypothermia is common during arthroscopic shoulder surgery under general anesthesia, and anesthetic-impaired thermoregulation is thought to be the major cause of hypothermia. This prospective, randomized, double-blind study was designed to compare perioperative temperature during arthroscopic shoulder surgery with interscalene brachial plexus block (IBPB) followed by general anesthesia vs. general anesthesia alone. Methods Patients scheduled for arthroscopic shoulder surgery were randomly allocated to receive IBPB followed by general anesthesia (group GB, n = 20) or general anesthesia alone (group GO, n = 20), and intraoperative and postoperative body temperatures were measured. Results The initial body temperatures were 36.5 ± 0.3℃ vs. 36.4 ± 0.4℃ in group GB vs. GO, respectively (P = 0.215). The body temperature at 120 minutes after induction of anesthesia was significantly higher in group GB than in group GO (35.8 ± 0.3℃ vs. 34.9 ± 0.3℃; P < 0.001). The body temperatures at 60 minutes after admission to the post-anesthesia care unit were 35.8 ± 0.3℃ vs. 35.2 ± 0.2℃ in group GB vs. GO, respectively (P < 0.001). The concentrations of desflurane at 0, 15, and 120 minutes after induction of anesthesia were 6.0 vs. 6.0% (P = 0.330), 5.0 ± 0.8% vs. 5.8 ± 0.4% (P = 0.001), and 3.4 ± 0.4% vs. 7.1 ± 0.9% (P < 0.001) in group GB vs. GO, respectively. Conclusions The present study demonstrated that preoperative IBPB could reduce both the intraoperative concentration of desflurane and the reduction in body temperature during and after arthroscopic shoulder surgery.

  13. Functional Outcome Following Arthroscopic ACL Reconstruction with Rigid Fix: A Retrospective Observational Study

    Directory of Open Access Journals (Sweden)

    Satish Shervegar

    2015-09-01

    Full Text Available Background: No uniform consensus exists to decide type of fixation for arthroscopic anterior cruciate ligament reconstruction. Hypothsis: There is similar functional outcome after rigid fix compared to other methods of fixation which has been published. Study design: Retrospective observational study. Methods: A total of 50 patients underwent arthroscopic anterior cruciate ligament reconstruction with hamstring tendons using femoral Rigid fix cross-pin and interference screw tibial fixation. The evaluation methods were clinical examination, IKDC scores, Lysholm and pre injury and post reconstruction Tegner score. Patients were followed up from minimum of 6 months to 4 year seven months. Results: C In our study of sample size 50 we found that mean age of patients was 30.8 Years with male preponderance. Mean post operative IKDC and Lysholm score has been 75.6 and 84.4 respectively.Mean Tegner pre-injury score and post reconstruction score has been 5.4 and 4.26 .Box plot comparison of pre injury and post operativeTegner score reveals a statistically significant difference with respect to paired t test P Conclusions: Arthroscopic anterior cruciate ligament reconstruction with femoral rigid fix cross pins and tibial interference screws results in comparable short term to midterm functional results compared to other types of fixation

  14. Intraligamentous ganglion cysts of the anterior cruciate Ligament: MR findings with clinical and arthroscopic correlations

    Energy Technology Data Exchange (ETDEWEB)

    Do-Dai, D.D.; Youngberg, R.A.; Lanchbury, F.D.; Pitcher, J.D. Jr.; Garver, T.H. [Madigan Army Medical Center, Tacoma, WA (United States)

    1996-01-01

    Magnetic resonance findings with clinical and arthroscopic correlation of intraligamentous cysts of the anterior cruciate ligament (ACL) are presented. Three cases of intraligamentous cysts of the ACL were identified out of 681 knee MRI examinations over a 2-year period. Arthroscopy and postoperative MRI were performed in all three patients, each of whom experienced knee pain with extreme flexion and extension. In all three cases the intraligamentous cyst was homogeneously hypointense on T1-weighted imaging and hyperintense on T2-weighted imaging relative to the ACL. Two of the three ACL cysts required a 70{degrees} scope for adequate visualization and establishment of posteromedial and posterolateral portals for arthroscopic treatment. One cyst could not be visualized arthroscopically and probing of the ACL from the anterior portal resulted in drainage of the cyst. No patient had presence of ACL cyst on follow-up MRI or recurrence of symptoms at a mean of 24 months. Intraligamentous cyst of ACL is a rare cause of knee pain. It should be suspected in patients having chronic pain with extremes of motion. Magnetic resonance findings are diagnostic and help to guide arthroscopy. 14 refs., 3 figs.

  15. Arthroscopic resection of the distal clavicle in osteoarthritis of the acromioclavicular joint

    Science.gov (United States)

    Park, Tae-Soo; Lee, Kwang-Won

    2016-01-01

    Background: Symptomatic acromioclavicular joint (ACJ) lesions are a common cause of shoulder complaints that can be treated successfully with both conservative and surgical methods. There are several operative techniques, including both open and arthroscopic surgery, for excising the distal end of the clavicle. Here, we present a new modified arthroscopic technique for painful osteoarthritis of the ACJ and evaluate its clinical outcomes. Our hypothesis was that 4- to 7-mm resection of the distal clavicle in an en bloc fashion would have several advantages, including no bony remnants, maintenance of stability of the ACJ, and reduced prevalence of heterotopic ossification, in addition to elimination of the pathologic portion of the distal clavicle. Materials and Methods: 20 shoulders of 20 consecutive patients with painful and isolated osteoarthritis of the ACJ who were treated by arthroscopic en bloc resection of the distal clavicle were included in the study. There were 10 males and 10 females with an average age of 56 years (range 42–70 years). The mean duration of followup was 6 years and 2 months (range 4–8 years 10 months). The results were evaluated using the University of California Los Angeles (UCLA) shoulder rating score. Results: The overall UCLA score was 13.7 preoperatively, which improved to 33.4 postoperatively. All subscores were improved significantly (P painful osteoarthritis of the ACJ lesions in active patients engaged in overhead throwing sports and heavy labor. PMID:27512219

  16. Arthroscopic arthrodesis of the shoulder: Fourteen-year follow-up.

    Science.gov (United States)

    Jiménez-Martín, Antonio; Pérez-Hidalgo, Santiago

    2011-04-01

    Shoulder arthrodesis is indicated in infections, brachial paralysis, irreparable rotator cuff tears, osteoarthritis without indication of prosthesis, rescue after arthroplasty, or after surgery for cancer. Arthroscopic arthrodesis is exceptional. Our aim is presenting our result after 14 years of follow-up of one patient. We present a case report of a 17-year-old male patient. He suffered fracture of left scapula (type V, Ideberg), fracture of left clavicle (type I, Craig), and fracture of left distal ulna. We realized osteosynthesis of clavicle (plate and screws) with the aim of treating this floating shoulder. Electromyography showed partial axonotmesis of axilar nerve. After 7 months of follow-up, axonotmesis was still present. We realized arthroscopic shoulder arthrodesis (three cannulated screws). Fourteen years later, shoulder movement was as follows: Flexion, 0-90°; maximum abduction, 40° with shoulder atrophy; Constant, 47 points; and UCLA, 17 points, without pain. Arthrodesis with screws reaches a subjective benefit in 82% of patients. Percentage of pseudarthrosis is less than in patients treated with plates, although the risks of infections, fractures, and material removal are greater than in patients treated with plates. Shoulder arthroscopic arthrodesis is exceptional, but it allows minimal surgical aggression. PMID:21897586

  17. Arthroscopic arthrodesis of the shoulder: Fourteen-year follow-up

    Directory of Open Access Journals (Sweden)

    Antonio Jiménez-Martín

    2011-01-01

    Full Text Available Shoulder arthrodesis is indicated in infections, brachial paralysis, irreparable rotator cuff tears, osteoarthritis without indication of prosthesis, rescue after arthroplasty, or after surgery for cancer. Arthroscopic arthrodesis is exceptional. Our aim is presenting our result after 14 years of follow-up of one patient. We present a case report of a 17-year-old male patient. He suffered fracture of left scapula (type V, Ideberg, fracture of left clavicle (type I, Craig, and fracture of left distal ulna. We realized osteosynthesis of clavicle (plate and screws with the aim of treating this floating shoulder. Electromyography showed partial axonotmesis of axilar nerve. After 7 months of follow-up, axonotmesis was still present. We realized arthroscopic shoulder arthrodesis (three cannulated screws. Fourteen years later, shoulder movement was as follows: Flexion, 0-90°; maximum abduction, 40° with shoulder atrophy; Constant, 47 points; and UCLA, 17 points, without pain. Arthrodesis with screws reaches a subjective benefit in 82% of patients. Percentage of pseudarthrosis is less than in patients treated with plates, although the risks of infections, fractures, and material removal are greater than in patients treated with plates. Shoulder arthroscopic arthrodesis is exceptional, but it allows minimal surgical aggression.

  18. Time and cost savings in arthroscopic subacromial decompression: the use of bipolar versus monopolar radiofrequency

    Science.gov (United States)

    Fernandez, G. N.; Elsorafy, Kareem

    2008-01-01

    There is currently an increased interest in the use of electro surgery in arthroscopy. Since the introduction of the bipolar arthroscopic radiofrequency (RF) wand, it has started to replace the classic Bovie monopolar probe on the assumption that the new technology provides multifunctional devices, combining both tissue removal and haemostasis into one instrument. The more efficient tissue ablation and precise haemostasis achieved with these instruments should result in a significant reduction in the operative time and cost. We ran a prospective comparative randomised study to test this hypothesis. Forty patients underwent arthroscopic subacromial decompression, randomised into two groups. The group treated with bipolar RF was associated with an average operative time saving of 8 min (P < 0.0001) and an average cost saving of £83 (€111) per case (P < 0.003), compared to monopolar RF. Bipolar RF is the instrument of choice in arthroscopic shoulder surgery, as it saves time and money. PMID:18414860

  19. Concurrent arthroscopic bicruciate ligament reconstruction using Achilles tendon-bone allografts: experience with 15 cases

    Institute of Scientific and Technical Information of China (English)

    Shi De-hai; CAI Dao-zhang; WANG Kun; RONG Li-min; XU Yi-chun

    2008-01-01

    Objective: To evaluate the clinical outcome of arthroscopically assisted combined anterior and posterior cruciate ligament (ACL/PCL) reconstructions using Achil-les tendon-bone allografts. Methods: Associated meniscus injuries were treated according to established methods prior to ligament recon-structions during arthroscopic surgery. Thirty Achilles ten-don-bone allografts were used to reconstruct torn ACL and PCL in 15 knees. At postoperative follow-up, all knees were graded using the modified IKDC and the Lysholm scoring systems just as done preoperatively. Results were analyzed compared with the contralateral healthy knees. Results: Eleven men and 4 women with a minimum of 3-year follow-up (mean 38 months) were included in the study. Preoperatively, the group ratings by the modified IKDC standards were all severely abnormal. Twelve bicruciate reconstructions were performed in subacute or chronic stage (>3-8 weeks), 3 for acute ligamentous deficien-cies (≤ 3 weeks). The noticeable early complication was transitory local fever combined with joint effusion in one case. At postoperative follow-up, 9 knees were normal, 5 nearly normal and 1 abnormal. On Lysholm score the differ-ence was statistically significant (t- test, P<0.001) before and after operation. Conclusions: Achilles tendon-bone allograft offers an alternative for simultaneous arthroscopic ACL/PCL reconstructions. However, further investigation is needed to eradicate its potential immunogenicity for better use.

  20. Radial tunnel syndrome caused by ganglion cyst: treatment by arthroscopic cyst decompression.

    Science.gov (United States)

    Mileti, Joseph; Largacha, Mauricio; O'Driscoll, Shawn W

    2004-05-01

    Compressive neuropathies of the radial nerve at the elbow can lead to one of 2 clinical entities. Posterior interosseous syndrome is primarily a motor deficiency of the posterior interosseous nerve, and radial tunnel syndrome presents as pain along the radial tunnel and extensor muscle mass. The radial nerve can be compressed at a number of sites around the elbow. In addition, numerous mass lesions reported in the literature can cause compressive neuropathy of the radial nerve at the elbow. Standard surgical management for persistent radial tunnel syndrome that is refractory to nonsurgical treatment is open decompression of the radial nerve. Cysts occurring in other joints are commonly treated arthroscopically. Supraglenoid cysts of the shoulder, meniscal cysts in the knee, and dorsal wrist ganglia are routinely treated with arthroscopic decompression or excision with management of the underlying etiology of the cyst. We present a case of radial tunnel syndrome caused by a ganglion cyst of the proximal radioulnar joint that was treated using arthroscopic excision of the cyst and decompression of the radial nerve. PMID:15122155

  1. Analysis of the functional results of arthroscopic Bankart repair in posttraumatic recurrent anterior dislocations of shoulder

    Directory of Open Access Journals (Sweden)

    Amit Mishra

    2012-01-01

    Full Text Available Background: The Bankart lesion represents the most common form of labro-ligamentous injury in patients with traumatic dislocations of the shoulder leading to shoulder instability. We report the clinical outcome of arthroscopic repair of Bankart lesion in 50 patients. Materials and Methods: Sixty five patients with posttraumatic anterior dislocation of shoulder were treated by arthroscopic repair from Jan 2005 to Nov 2008. Fifty patients, with an average age of 26.83 years (range 18-45 years, were reviewed in the study. The average followup period was 27 months (range 24-36 months. University of California Los Angeles shoulder rating scale was used to determine the outcome after surgery. The recurrence rates, range of motion, as well as postoperative function and return to sporting activities were evaluated. Results : Thirty six patients (72.0% had excellent results, whereas seven patients (14.0% had good results. The mean pre- and postoperative range of external rotation was 80.38° and 75.18°, respectively. Eighty-six percent patients had stability compared with the normal sided shoulder and were able to return to sports. There were no cases of redislocation observed in this study; however, three cases had mild laxity of the joint. Conclusion: Arthroscopic Bankart repair with the use of suture anchors is a reliable treatment method, with good clinical outcomes, excellent postoperative shoulder motion and low recurrence rates.

  2. Long term results of arthroscopic bankart repair for traumatic anterior shoulder instability

    Directory of Open Access Journals (Sweden)

    Tan Andrew HC

    2011-06-01

    Full Text Available Abstract Background The arthroscopic method offers a less invasive technique of Bankart repair for traumatic anterior shoulder instability. We would like to report the 2 year clinical outcomes of bio-absorbable suture anchors used in traumatic anterior dislocations of the shoulder. Methods Data from 79 shoulders in 74 patients were collected over 4 years (2004 - 2008. Each patient was followed-up over a period of 2 years. The patients underwent arthroscopic Bankart repair using bio-absorbable suture anchors for their shoulder instability. These surgeries were performed at a single institution by a single surgeon over the time period. The patients were assessed with two different outcome measurement tools. The University of California at Los Angeles (UCLA shoulder rating scale and the Simple Shoulder Test (SST score. The scores were calculated before surgery and at the 2-year follow-up. The recurrence rates, range of motion as well post-operative function and return to sporting activities were evaluated. Results SST results from the 12 domains showed a significant improvement from a mean of 6.1 ± 3.1 to 11.1 ± 1.8 taken at the 2-year follow-up (p Conclusion Arthroscopic Bankart repair with the use of suture anchors is a reliable treatment method, with good clinical outcomes, excellent post-operative shoulder motion and low recurrence rates.

  3. Outcomes of arthroscopic "Remplissage": capsulotenodesis of the engaging large Hill-Sachs lesion

    Directory of Open Access Journals (Sweden)

    Mayo Lee

    2011-06-01

    Full Text Available Abstract Background A Hill-Sachs lesion of the humeral head after a shoulder dislocation is clinically insignificant in most cases. However, a sizable defect will engage with the anterior rim of the glenoid and cause instability even after anterior glenoid reconstruction. The purpose of this study was to evaluate the outcome of arthroscopic capsulotenodesis of the posterior capsule and infraspinatus tendon ("remplissage" to seal a large engaging Hill-Sachs lesion in an unstable shoulder. Methods This was a prospective follow-up study of patients who underwent arthroscopic surgery for recurrent shoulder instability with a large engaging Hill-Sachs lesion from 2007 to 2009. The clinical results were measured preoperatively and postoperatively with the Simple Shoulder test (SST and the Rowe score for instability. Results Eleven patients met the inclusion criteria of this study. The mean follow-up time was 30 months (range 24 to 35 months. At the last follow-up, significant improvement was observed in both scores with no recurrent dislocations. The mean SST improved from 6.6 to 11 (p Conclusions Arthroscopic remplissage for shoulder instability is an effective soft tissue technique to seal a large engaging Hill-Sachs lesion with respect to recurrence rate, range of motion and shoulder function.

  4. Minimum reporting standards for copers in chronic ankle instability research.

    Science.gov (United States)

    Wikstrom, Erik A; Brown, Cathleen N

    2014-02-01

    Lateral ankle sprains (LASs) are among the most common sports-related injuries and a high percentage of individuals who sprain their ankle go on to develop chronic ankle instability (CAI). The condition of CAI is often classified as having pain, loss of function, and a restriction of, or failure to, return to levels of previous activity. Historically, uninjured healthy controls are used as a comparison group to study the biomechanical and neuromuscular consequences of CAI. However, this model is not ideal to determine why a portion of the population experiencing an ankle sprain does not recover. A more appropriate comparison may be individuals who had an ankle sprain, and thus the exposure, but did not go on to develop CAI (i.e., copers). Thus, the purpose of this review was to determine the existing discrepancies and common standards in definitions of, terminology used for, and the inclusionary/exclusionary criteria used to describe copers within the CAI literature. Multiple databases were searched by keywords and specific authors. Potential studies were screened independently by both authors. Inclusion criteria consisted of an explicit definition of copers and explicit inclusionary/exclusionary criteria. A total of 21 studies were included in the current study and had four outcomes extracted: (1) the definition of copers; (2) the terminology used; (3) specific inclusionary/exclusionary criteria; and (4) injury characteristics of the copers. Based on the included operational definitions, it is recommend that future operational definitions of copers include three key components: (1) an initial LAS; (2) subsequent lack of CAI symptoms (i.e., no complaints of disability or giving way); and (3) a time since injury component. The term coper was overwhelming used within the existing literature (n = 15) and is thus recommended to be used in future studies when describing individuals who have suffered an LAS but failed to develop CAI. Minimal inclusionary criteria should

  5. The Effects of Ankle Sprain on Balance Tests in Adolescent Volleyball Players with Previous History of Ankle Sprain

    OpenAIRE

    Sarıal, Ceyda; Tayfur, Abdulhamıt; Kap, Beyza; Donder, Dılara; Ertuzun, Ozum Melıs; Tunay, Volga Bayrakcı

    2014-01-01

    Objectives: To investigate the impact of having previous history of inversion ankle sprain on balance tests in adolescent volleyball players. Methods: Fourty-five adolescent volleyball players with mean age of 15.26±1.03 participated in our study. Twenty-nine were uninjured (control group) and sixteen had previously experienced inversion injuries on right ankle. 9 players had the injury more than than one year ago and 7 players had it before six to twelf months. Balancing abilities were evalu...

  6. Brostrom-Gould procedure for the treatment of chronic lateral ankle instability

    OpenAIRE

    Asik, Mehmet; Sen, Cengiz; Dikici, Fatih; Taser, Omer F.

    2004-01-01

    Objectives: We evaluated the results in 10 patients who underwent surgery using the Brostrom-Gould method for chronic lateral ankle instability. Methods: Brostrom-Gould procedure was performed in 11 ankles of 10 patients (4 females, 6 males; age range 14-32 years) with chronic lateral ankle instability. Ankle injury was localized to the right (n=6) and left (n=3) ankles. One patient had bilateral instability. The average period between the time of injury and that of operation was 38 months...

  7. Potential savings of a program to prevent ankle sprain recurrence: Economic evaluation of a randomized controlled trial

    NARCIS (Netherlands)

    Hupperets, M.D.W.; Verhagen, E.A.L.M.; Heymans, M.W.; Bosmans, J.E.; Tulder, M.W. van; Mechelen, W. van

    2010-01-01

    Background: The most common ankle injury is the lateral ankle sprain. Dutch annual sports-related ankle sprain costs can roughly be estimated at 187,200,000. Research has shown that proprioceptive training accounts for an approximated overall 50% reduction in ankle sprain recurrence rate. Hypothesis

  8. Traumeel vs. diclofenac for reducing pain and improving ankle mobility after acute ankle sprain: A multicentre, randomised, blinded, controlled and non-inferiority trial

    OpenAIRE

    González de Vega, C; Speed, C; Wolfarth, B.; González, J.

    2013-01-01

    Background Acute ankle sprains are common and activity limiting injuries, and topical diclofenac gel has proven efficacy in alleviating pain and restoring function. This trial aimed to compare a topical natural agent, Traumeel with topical diclofenac gel (1%) in the management of acute ankle sprain. Methods This prospective, multicentre, randomised, blinded, active-control and non-inferiority study involved 449 physically active adults sustaining unilateral grade 1 or 2 ankle sprain within th...

  9. Accuracy of the ankle-brachial index using the SCVL®, an arm and ankle automated device with synchronized cuffs, in a population with increased cardiovascular risk

    OpenAIRE

    Rosenbaum, David; Rodriguez-Carranza, Sandra; Laroche, Patrick; Bruckert, Eric; Giral, Philippe; Girerd, Xavier

    2012-01-01

    Objective To evaluate the accuracy of the ankle brachial index (ABI) measured with the SCVL® (“screening cardiovascular lab”; GenNov, Paris, France), an automated device with synchronized arm and ankle cuffs with an automatic ABI calculation. Methods Patients were consecutively included in a cardiovascular prevention unit if they presented with at least two cardiovascular risk factors. ABI measurements were made using the SCVL, following a synchronized assessment of brachial and ankle systoli...

  10. Evaluation of flexibility of the ankle in elementary students with mental retardation

    Directory of Open Access Journals (Sweden)

    Stavrou V.

    2011-01-01

    Full Text Available Aim: This study aims to measure and evaluate the flexibility of the legs, namely the ankle by measuring the maximum values in flexion and extension of both legs. Method: The study included twelve students with mental retardation. Measured and recorded values of ankle-bending extent of both legs and assign the average of each test. Calculated and measurement the temperature of space and time. The measurement flexion and extension of the ankle was a plastic protractor. Results: The flexion presents decrease at the right ankle relationship with the left ankle by 1.86. The extension presents decrease at the left ankle relationship with the right ankle by 11.43. Conclusions: The results found that the normal range of motion of joints has a significant role in improving efficiency and thus on quality of life of persons with mental retardation. The flexibility is a determinant of performance and therefore should be evaluated at regular intervals.

  11. A CLINICAL STUDY OF ARTHROSCOPIC MANAGEMENT OF ANTERIOR C RUCIATE LIGAMENT INJURIES OF KNEE JOINT

    Directory of Open Access Journals (Sweden)

    Paragjyoti

    2015-09-01

    Full Text Available BACKGROUND : Anterior C ruciate L igament (ACL tear is a common sports injury of the knee. There are a lot of controversies related to the management of this injury and more than 2000 papers have been published on the various aspects of the topic. Arthroscopic reconstruction of the ACL with autogenous graft material is widely used nowadays. The two most commonly used grafts are the central one - third of the patellar ligament (bone - tendon - bone, BTB and the hamstring tendon ( S emitendinosus - gracilis, STG construct but the former graft leads to increased donor site morbidity & hurdles in postoperative rehab & pain. The aim of the study is to study the Arthroscopic management of anterior cruciate ligament injury of knee joint using quadrupled hamstring graft. METHOD: The study was carried out on 30 cases of anterior cruciate ligament injury of knee joint attending the OPD and emergency of department of Orthopaedics, Silchar Medical College & Hospital who met the inclusion criteria. An informed consent was obtained from each patient prior to participation in the study. All the patients were examined in detail and worked up to obtain pre - anaesthetic clearance. X - rays and MRI were done routinely in all the cases. Clinical and radiological parameters were recorded. Arthroscopic anterior cruciate ligament reconstruction with quadrupled hamstring graft was done in all the patients. Concomitant meniscal inju ries were treated according to the merit of the injury. Patients were followed up at regular intervals and outcome variables were assessed and recorded. RESULTS: Results of our study clearly showed that arthroscopic ACL reconstruction using quadrupled hamstring graft is a safe, effective and reproducible procedure in restoring knee function with minimal donor site morbidity. At follow up evaluation, all patients had good outcomes in terms of clinical stability, range of motion and general symptoms. CONCLUSION: From the results in this study

  12. INTRAARTICULAR INJECTION OF HYALURONIC ACID AFTER ARTHROSCOPIC LAVAGE OF THE KNEE: LONG-TERM RESULTS

    Directory of Open Access Journals (Sweden)

    Lidia Vladimirovna Luchikhina

    2013-01-01

    Full Text Available Objective: to evaluate the efficiency of arthroscopic lavage in combination with subsequent injection of hyaluronic acid into the joint cavity at shortand long-term follow-ups. Subjects and methods. Eighty-two patients with knee osteoarthrosis (OA were examined in accordance with the American College of Rheumatology criteria. Group 1 consisted of 40 patients only after arthroscopic lavage; Group 2 comprised 42 patients who were administered hyaluronic acid after arthroscopic lavage. Clinical evaluation encompassed pain while walking, resting, and moving (by a visual analogue scale, limited ability in covering 100 m (by a 5-point scale, general clinical evaluation (by a 5-point ordinal scale, the presence or absence of pain after 100-m walking, as well as resting pain (its presence or absence. Results. The treatment effect evaluated using different indicators was comparably positive in both groups within 3 months. Following 3 months of therapy, its effect remained stable and even better in Group 2. The latter showed a particularly noticeable superiority a year later. Thus, there were excellent and good results in 88 and 47.5% in Groups 2 and 1, respectively. The clinical symptoms of the disease were absent in 58% in Group 2 and in only 15% in Group 1. Moreover, Group 1 showed worsening and 20% of the patients had no effect. This trend was also seen while evaluating the therapeutic effectiveness in different periods. Thus, after therapy, no substantial difference was found in both groups, but 3 months later this difference was as many as 0.8 scores and a year later Group 2 had many points in its favor (1.2 scores. Conclusion. Arthroscopic lavage followed by the administration of hyaluronic acid makes it possible to prevent the negative effect of a washing liquid on the metabolism and structure of the articular cartilage and to achieve a long-term effect against the major clinical symptoms (joint pain and function affecting the quality of life. The

  13. Gait Training and Ankle Dorsiflexors in Cerebral Palsy

    OpenAIRE

    J Gordon Millichap

    2015-01-01

    Investigators at University of Copenhagen, Denmark, evaluated whether 4 weeks of 30 min daily treadmill training with an incline may facilitate corticospinal transmission and improve control of the ankle joint in 16 children, aged 5-14 years, with cerebral palsy.

  14. Syndesmotic Stabilization in Pronation External Rotation Ankle Fractures

    NARCIS (Netherlands)

    M.P.J. van den Bekerom; D. Haverkamp; G.M.M.J. Kerkhoffs; C.N. van Dijk

    2010-01-01

    Boden et al. suggested syndesmosis fixation was not necessary in distal pronation external rotation (PER) ankle fractures if rigid bimalleolar fracture fixation is achieved and was not necessary with deltoid ligament injury if the fibular fracture is no higher than 4.5 cm of the tibiotalar joint. We

  15. Kinematics and kinetics of an accidental lateral ankle sprain.

    Science.gov (United States)

    Kristianslund, Eirik; Bahr, Roald; Krosshaug, Tron

    2011-09-23

    Ankle sprains are common during sporting activities and can have serious consequences. Understanding of injury mechanisms is essential to prevent injuries, but only two previous studies have provided detailed descriptions of the kinematics of lateral ankle sprains and measures of kinetics are missing. In the present study a female handball player accidentally sprained her ankle during sidestep cutting in a motion analysis laboratory. Kinematics and kinetics were calculated from 240 Hz recordings with a full-body marker setup. The injury trial was compared with two previous (non-injury) trials. The injury trial showed a sudden increase in inversion and internal rotation that peaked between 130 and 180 ms after initial contact. We observed an attempted unloading of the foot from 80 ms after initial contact. As the inversion and internal rotation progressed, the loads were likely to exceed injury threshold between 130 and 180 ms. There was a considerable amount of dorsiflexion in the injury trial compared to neutral flexion in the control trials, similar to the previously published kinematical descriptions of lateral ankle sprains. The present study also adds valuable kinetic information that improves understanding of the injury mechanism. PMID:21824618

  16. Tibiofemoral angle and its relation to ankle sprain occurrence.

    Science.gov (United States)

    Pefanis, Nikolaos; Karagounis, Panagiotis; Tsiganos, Georgios; Armenis, Elias; Baltopoulos, Panagiotis

    2009-12-01

    The lack of a normal joint orientation generates translational or shear forces across the joint. These forces can put abnormally high strain on the cartilage and the surrounding capsuloligamentous tissues. Ankle joint structure can affect or be affected by bony malformations of the surrounding areas, including the knee and hip. The aim of the current study is to examine the possible relationship between the tibiofemoral (TFA) angle and other factors (anthropometric characteristics, medical history, and age) on the occurrence of ankle sprains because its value provides useful information for the anatomical alignment of the lower extremity. The study sample consisted of 45 high-level athletes, evenly distributed among 3 sports (basketball, soccer, and volleyball). TFA measurements were made on radiographs. The study lasted 2 years. A logistic regression was used to determine the importance of each factor on the probability in question. A significance level of P = .1 was used. The factors contributing more to an ankle sprain were a previous injury of the same type followed by body mass index (BMI) and age. On the contrary, TFA was proven to be statistically nonsignificant. When the BMI variable was substituted with body inertia propensity, a derived variable, the TFA remained statistically nonsignificant. TFA magnitude does not seem to be a determinant factor that could increase the probability of spraining an ankle. PMID:20400424

  17. New ankle actuation mechanism for a humanoid robot

    NARCIS (Netherlands)

    Oort, van Gijs; Reinink, Roelof; Stramigioli, Stefano

    2011-01-01

    In this article we discuss the design of a new ankle actuation mechanism for the humanoid robot TUlip. The new mechanism consists of two coupled series-elastic systems. We discuss the choice of actuators according to calculations for maximum achievable walking speed. Some control issues, MIMO and no

  18. Reconstructive foot and ankle surgeries in diabetic patients

    Directory of Open Access Journals (Sweden)

    Ajit Kumar Varma

    2011-01-01

    Full Text Available Diabetic foot and ankle deformities are secondary to long-standing diabetes and neglected foot care. The concept of surgical correction for these deformities is quite recent. The primary objective of reconstructive foot and ankle surgery is the reduction of increased plantar pressures, reduction of pain and the restoration of function, stability and proper appearance. Foot and ankle deformities can result in significant disability, loss of life style, employment and even the loss of the lower limb. Therefore, restoration of normal, problem free foot function and activities will have a significant impact on peoples′ lives. Reconstructive surgical procedures are complex and during reconstruction, internal and external fixation devices, including pins, compression screws, staples, and wires, may be used for repair and stabilization. The surgeries performed depend on the type and severity of the condition. Surgery can involve any part of the foot and ankle, and may involve tendon, bone, joint, tissue or skin repair. Corrective surgeries can at times be performed on an outpatient basis with minimally invasive techniques. Recovery time depends on the type of condition being treated.

  19. Ankle Joint Fusion With an Anatomically Preshaped Anterior Locking Plate.

    Science.gov (United States)

    Wiewiorski, Martin; Barg, Alexej; Schlemmer, Thomas; Valderrabano, Victor

    2016-01-01

    We present a novel fixation plate for primary ankle joint fusion. A single anatomically preshaped angular stable plate was used with an anterior approach. An excellent result with good bone consolidation was present at the 1-year follow-up examination. PMID:25998475

  20. Wear prediction on total ankle replacement effect of design parameters

    CERN Document Server

    Saad, Amir Putra Bin Md; Harun, Muhamad Noor; Kadir, Mohammed Rafiq Abdul

    2016-01-01

    This book develops and analyses computational wear simulations of the total ankle replacement for the stance phase of gait cycle. The emphasis is put on the relevant design parameters. The book presents a model consisting of three components; tibial, bearing and talar representing their physiological functions.

  1. Ultrasound Findings of the Painful Ankle and Foot

    Directory of Open Access Journals (Sweden)

    Suheil Artul

    2014-01-01

    Full Text Available Objectives: To document the prevalence and spectrum of musculoskeletal ultrasound (MSKUS findings at different parts of the foot. Materials and Methods: All MSKUS studies conducted on the foot during a 2-year period (2012-2013 at the Department of Radiology were reviewed. Demographic parameters including age, gender, and MSKUS findings were documented. Results: Three hundred and sixty-four studies had been conducted in the 2-year period. Ninety-three MSKUS evaluations were done for the ankle, 30 studies for the heel, and 241 for the rest of the foot. The most common MSKUS finding at the ankle was tenosynovitis, mostly in female patients; at the heel it was Achilles tendonitis, also mostly in female patients; and for the rest of the foot it was fluid collection and presence of foreign body, mainly in male patients. The number of different MSKUS abnormalities that were reported was 9 at the ankle, 9 at the heel, and 21 on the rest of the foot. Conclusions: MSKUS has the potential for revealing a huge spectrum of abnormalities. The most common finding was collection/hematoma and foreign bodies at the foot, tenosynovitis at the ankle, and Achilles tendinitis at the heel.

  2. Flexor Digitorum Accessorius Longus: Importance of Posterior Ankle Endoscopy

    Directory of Open Access Journals (Sweden)

    Jorge Pablo Batista

    2015-01-01

    Full Text Available Endoscopy for the posterior region of the ankle through two portals is becoming more widespread for the treatment of a large number of conditions which used to be treated with open surgery years ago. The tendon of the flexor hallucis longus (FHL travels along an osteofibrous tunnel between the posterolateral and posteromedial tubercles of the talus. Chronic inflammation of this tendon may lead to painful stenosing tenosynovitis. The aim of this report is to describe two cases depicting an accessory tendon which is an anatomical variation of the flexor hallucis longus in patients with posterior friction syndrome due to posterior ankle impingement and associated with a posteromedial osteochondral lesion of the talus. The anatomical variation (FDAL described was a finding during an endoscopy of the posterior region of the ankle, and we have spared it by sectioning the superior flexor retinaculum only. The accessory flexor digitorum longus is an anatomical variation and should be taken into account when performing an arthroscopy of the posterior region of the ankle. We recommend this treatment on this type of injury although we admit this does not make a definite conclusion.

  3. Genetic determinants of the ankle-brachial index

    DEFF Research Database (Denmark)

    Wassel, Christina L; Lamina, Claudia; Nambi, Vijay;

    2012-01-01

    Candidate gene association studies for peripheral artery disease (PAD), including subclinical disease assessed with the ankle-brachial index (ABI), have been limited by the modest number of genes examined. We conducted a two stage meta-analysis of ∼50,000 SNPs across ∼2100 candidate genes to...

  4. Ankle sprain: pathophysiology, predisposing factors, and management strategies

    Directory of Open Access Journals (Sweden)

    Tricia J Hubbard

    2010-07-01

    Full Text Available Tricia J Hubbard, Erik A WikstromUNC Charlotte, Department of Kinesiology, CharlotteAbstract: With the high percentage (up to 75% of initial lateral ankle sprains (LAS leading to repetitive sprains and chronic symptoms, it is imperative to better understand how best to treat and rehabilitate LAS events. The purpose of this paper is to review LAS pathophysiology, predisposing factors, and the current evidence regarding therapeutic modalities and exercises used in the treatment of LAS. Functional rehabilitation, early mobilization with support, is the current standard of care for LAS. However, the high percentage of reinjury occurrence and development of chronic symptoms (up to 75% after a LAS, suggests the current standard of care may not be effective. Recent evidence has shown the need for more stringent immobilization to facilitate ligament healing and restoration of joint stability and function after a LAS. Additionally, the importance of adding adjunctive therapies, specifically joint mobilizations and balance training have been shown to improve function and decrease the incidence of reinjury after a LAS. Modifying current rehabilitation protocols to include protecting the ankle joint with stringent immobilization, and including joint mobilizations and balance training may be the first step to decreasing the incidence of short and long term ankle joint dysfunction.Keywords: rehabilitation, recurrent sprains, chronic ankle instability (CAI

  5. Has the assessment of isolated ankle injuries altered since 1993?

    OpenAIRE

    Locker, T; Tryfonidis, M.; Mason, S

    2005-01-01

    Background: Performance of emergency departments in England and Wales has declined in recent years. Data from the authors' department has shown that junior doctors now see fewer patients and spend longer over their assessment than was the case previously. This study aimed to determine how the assessment of patients with isolated ankle injuries changed over an 11 year period.

  6. Foot and ankle fractures at the supination line

    NARCIS (Netherlands)

    T. Schepers (Tim); E.M. van Schie- van der Weert; M.R. de Vries (Mark); M. van der Elst

    2011-01-01

    textabstractBackground: The supination line is a fictive line along the foot and ankle, on which over twenty fracture types and approximately ten different ligamentous sprain-injuries have been identified. Objective: The current study was conducted to evaluate the incidence of different types of sup

  7. Development and Validation of Cognitive Rehearsal as a Training Strategy for Arthroscopic Surgery

    Science.gov (United States)

    Kovacevic, David; Hodgins, Justin Lane; Lowe, Dylan T.; He, Janice; Popkin, Charles Aaron; Lynch, Thomas Sean; Ahmad, Christopher S.

    2016-01-01

    Objectives: Surgical performance is a highly intellectual activity that involves the processing of perceptual information from the five senses. Strategies to process, organize, and retain this perceptual information may benefit learning techniques. Once such strategy, cognitive rehearsal, is the activity where a skill is rehearsed in memory prior to the actual performance. This study aimed to develop and validate a cognitive rehearsal strategy for arthroscopic knee surgery in orthopaedic residents. We hypothesized that this training tool will lead to increased comfort and confidence with arthroscopic surgery performance. Methods: An expert surgeon was filmed performing an arthroscopic ACL reconstruction using patellar bone-tendon-bone autograft. An instructional training video was then created incorporating the extracorporeal and arthroscopic footage with voice over and subtitles. Following the surgery, cognitive recall of the procedure was conducted with the surgeon to identify key visual, cognitive, and kinesthetic cues to develop a mental imagery script to enhance rehearsal of arthroscopic surgery. Orthopaedic residents from two academic training programs were invited to participate. Demographic information including training level, previous musical experience, organized sports participation, and preferred learning style was collected. The training session consisted of a relaxation exercise, instructional video of an expert performing the procedure, learning the mental imagery script, and rehearsing the procedure out loud with a partner. The residents’ ability to rehearse the procedure was assessed before and after the training session with a modified version of a previously validated questionnaire, and a post-training session survey was administered to define which components of the rehearsal seemed most beneficial. Statistical analysis included a reliability analysis for internal consistency, and a nonparametric Wilcoxon test to compare the composite

  8. The Effect of Prosthetic Ankle Units on Roll-Over Shape Characteristics During Walking in Persons with Bilateral Transtibial Amputations

    OpenAIRE

    Gard, Steven A.; Su, Po-Fu; Lipschutz, Robert D.; Hansen, Andrew H.

    2011-01-01

    Some important functions of walking are adversely affected or eliminated in prosthesis users due to reduced or absent ankle motion. The purpose of this retrospective data analysis was to determine the effect of prosthetic ankle units on the characteristics of the ankle-foot roll-over shape in persons with bilateral transtibial amputations. Seventeen subjects were fitted with Endolite Multiflex Ankles to provide ankle plantar/dorsiflexion during the stance phase of gait. Two quantitative gait ...

  9. One strategy for arthroscopic suture fixation of tibial intercondylar eminence fractures using the Meniscal Viper Repair System

    Directory of Open Access Journals (Sweden)

    Ochiai Satoshi

    2011-08-01

    Full Text Available Abstract Background Principles for the treatment of tibial intercondylar eminence fracture are early reduction and stable fixation. Numerous ways to treatment of this fracture have been invented. We designed a simple, low-invasive, and arthroscopic surgical strategy for tibial intercondylar eminence fracture utilizing the Meniscal Viper Repair System used for arthroscopic meniscal suture. Methods We studied 5 patients, who underwent arthroscopic suture fixation that we modified. The present technique utilized the Meniscal Viper Repair System for arthroscopic suture of the meniscus. With one handling, a high-strength ultra-high molecular weight polyethylene(UHMWPE suture can be passed through the anterior cruciate ligament (ACL and the loops for suture retrieval placed at both sides of ACL. Surgical results were evaluated by the presence or absence of bone union on plain radiographs, postoperative range of motion of the knee joint, the side-to-side differences measured by Telos SE, and Lysholm scores. Results The reduced position achieved after surgery was maintained and good function was obtained in all cases. The mean distance of tibia anterior displacement and assessment by Lysholm score showed good surgical results. Conclusion This method simplified the conventional arthroscopic suture fixation and increased its precision, and was applicable to Type II fractures that could be reduced, as well as surgically indicated Types III and IV. The present series suggested that our surgical approach was a useful surgical intervention for tibial intercondylar eminence fracture.

  10. EFFECTS OF ANKLE JOINT COOLING ON PERONEAL SHORT LATENCY RESPONSE

    Directory of Open Access Journals (Sweden)

    J. Ty Hopkins

    2006-06-01

    Full Text Available While cryotherapy has direct physiological effects on contractile tissues, the extent to which joint cooling affects the neuromuscular system is not well understood. The purpose of the study was to detect changes in ankle dynamic restraint (peroneal short latency response and muscle activity amplitude during inversion perturbation following ankle joint cryotherapy. A 2x3 factorial design was used to compare reaction time and EMG amplitude data of treatment conditions (cryotherapy and control across time (pre-treatment, post-treatment, and 30 min post-treatment. Thirteen healthy volunteers (age 23 ± 4 yrs, ht 1.76 ± 0.09 m, mass 78.8 ± 16.6 kg, with no history of lower extremity joint injury participated in this study. Surface EMG was collected from the peroneus longus (PL of the dominant leg during an ankle inversion perturbation triggered while walking. Subjects walked the length of a 6.1 m runway 30 times. A trap door mechanism, inducing inversion perturbation, was released at heel contact during six randomly selected trials for each leg. Following baseline measurements, a 1.5 L bag of crushed ice was applied to the lateral ankle of subjects in the treatment group with an elastic wrap. A bag similar in weight and consistency was applied to the lateral ankle of subjects in the control group. A repeated measures ANOVA was used to compare treatment conditions across time (p 0.05 for PL reaction time. Average RMS EMG, normalized to an isometric reference position, increased in the cryotherapy group at the 30 min post-treatment interval relative to the control group (p < 0.05. Joint cooling does not result in deficiencies in reaction time or immediate muscle activation following inversion perturbation compared to a control

  11. Ankle muscle strength discriminates fallers from non-fallers

    Science.gov (United States)

    Cattagni, Thomas; Scaglioni, Gil; Laroche, Davy; Van Hoecke, Jacques; Gremeaux, Vincent; Martin, Alain

    2014-01-01

    It is well known that center of pressure (CoP) displacement correlates negatively with the maximal isometric torque (MIT) of ankle muscles. This relationship has never been investigated in elderly fallers (EF). The purpose of this study was thus to analyze the relationship between the MIT of ankle muscles and CoP displacement in upright stance in a sample aged between 18 and 90 years old that included EF. The aim was to identify a threshold of torque below which balance is compromised. The MIT of Plantar flexors (PFs) and dorsal flexors (DFs) and CoP were measured in 90 volunteers: 21 healthy young adults (YA) (age: 24.1 ± 5.0), 12 healthy middle-aged adults (MAA) (age: 50.2 ± 4.5), 27 healthy elderly non-fallers (ENF) (age: 75.5 ± 7.0) and 30 EF (age: 78.8 ± 6.7). The MIT of PF and DF were summed to obtain the overall maximal ankle muscle strength. Body weight and height were used to normalize MIT (nMIT) and CoP (nCoP), respectively. nCoP correlated negatively with nMIT. 90% of EF generated an nMIT 3.1 N·m·kg−1. The relationship between nMIT and nCoP implies that ankle muscle weakness contributes to increased postural instability and the risk of falling. We observed that below the threshold of 3.1 N·m·kg−1, postural stability was dramatically diminished and balance was compromised. Our results suggest that measuring ankle torque could be used in routine clinical practice to identify potential fallers. PMID:25566068

  12. Functional Treatment Comparing with Immobilization after Acute Ankle Sprain

    Directory of Open Access Journals (Sweden)

    Hamidreza Mohammadi

    2013-02-01

    Full Text Available Background: Ankle injuries are among the most prevalent injuries with which a physician may encounter. In this study, the efficiency of the functional treatment was compared with the immobilization treatment in healing the acute ankle sprain. Materials and Methods: This clinical trial study was carried out on 100 male patients whose ankle sprain had been diagnosed by Yasuj Shahid Beheshti Hospital. Using block allocation randomization method and regardless of damage degree, patients were divided into two groups, functional method (1st group or immobilization with plaster (2nd group, for treatment. Several variables such as range of motion, pain intensity, inflammation, joint tenderness and returning to work after 2, 6 and 12 weeks were examined. Results: After two weeks, the average pain intensity in the first group (33.2±3.2 has been decreased compared to the second group (55±1.2, which showed a significant difference between the two groups (p<0.05. The average ankle range of motion in the first and second groups was 29.08±1.2 degrees and 20.4±2.2 degrees, respectively which had been increased significantly in the first group compared to the second group (p<0.03. Similarly, a considerable difference was observed in decreased inflammation and tenderness in the first group compared to the second one. Conclusion: In acute ankle sprains, the functional treatment is better than the immobilization treatment in alleviating pain, inflammation and improving the range of joint motion.

  13. The Effects of Ankle Sprain on Balance Tests in Adolescent Volleyball Players with Previous History of Ankle Sprain

    Science.gov (United States)

    Sarıal, Ceyda; Tayfur, Abdulhamıt; Kap, Beyza; Donder, Dılara; Ertuzun, Ozum Melıs; Tunay, Volga Bayrakcı

    2014-01-01

    Objectives: To investigate the impact of having previous history of inversion ankle sprain on balance tests in adolescent volleyball players. Methods: Fourty-five adolescent volleyball players with mean age of 15.26±1.03 participated in our study. Twenty-nine were uninjured (control group) and sixteen had previously experienced inversion injuries on right ankle. 9 players had the injury more than than one year ago and 7 players had it before six to twelf months. Balancing abilities were evaluated by Star Excursion Balance Test (SEBT) and Single Limb Hurdle Test (SLHT). The fact that players with history of injury had the ankle sprain at right foot led us to perform the measurements in the control group also for the right foot. We compared the results of injured and uninjured players on both tests. Results: Uninjured players' reaching distance on right foot was found out to be significantly more than in players with ankle sprain at medial and posteromedial directions of SEBT(p.05). For comparing athletes' performances with SLHT, finishing time was found significantly better in uninjured players (pbalance tests compared to uninjured players. This demonstrates that they should be given a training including balance and stabilization programs.

  14. Foot and ankle kinematics in rheumatoid arthritis: influence of foot and ankle joint and leg tendon pathologies

    NARCIS (Netherlands)

    Dubbeldam, R.; Baan, H.; Nene, A.V.; Drossaers-Bakker, K.W.; Laar, van de M.A.F.J.; Hermens, H.J.; Buurke, J.H.

    2013-01-01

    Objective From early onset of the disease, patients with rheumatoid arthritis (RA) experience walking impairments. Pathologic effects of RA on foot and ankle structures have been studied clinically, but little is known as to how they relate to kinematic changes during gait. The aim of this study was

  15. Italian translation, cultural adaptation and validation of the "American Orthopaedic Foot and Ankle Society's (AOFAS) ankle-hindfoot scale".

    Science.gov (United States)

    Leigheb, Massimiliano; Janicka, Paulina; Andorno, Silvano; Marcuzzi, Augusto; Magnani, Corrado; Grassi, Federico

    2016-01-01

    Background and Aim of the workAnkle and hindfoot injuries are common and may lead to functional impairment, disability, exclusion from occupational and daily activities. It's necessary a standardized method for assessing treatment outcomes in people with same condition and disease.American-Orthopaedics-Foot-and-Ankle-Society's-Ankle-Hindfoot-Evaluation-Scale (AOFAS-AHES) is specific to estimate clinical problems of the ankle-hindfoot.Outcome evaluation scales should be translated and culturally adapted into the language of the investigated patient.Our purpose was to translate and culturally adapt into Italian AOFAS-AHES, and to check its reproducibility and validity.MethodsAn Italian translation of the AOFAS-scale was retranslated into English by a native English and compared to the original to define a second correct Italian-version, that was submitted to 50 randomized patients operated at their ankle or hindfoot with a minimum follow-up of 6 months for cultural adaptation, and to 10 healthcare professionals to check comprehension of the medical part.To check intra and inter-observer reproducibility each patient underwent 2 interviews by interviewer-A and 1 by B. ShortForm(SF)-36-questionnaire for quality of life and Visual-Analogue-Scale (VAS) for pain were also compared for validation. The Pearson's-Correlation-Coefficient and the Intra-Class-Correlation coefficient were calculated to check inter and intra-observer reproducibility for validation.ResultsCultural adaptation revealed to be good. We obtained a good correlation of the inter and intra-observer reproducibility. Further validation of the Italian-AOFAS-AHES was obtained comparing AOFAS results to SF-36.ConclusionsItalian translation, cultural adaptation and validation of the AOFAS-AHES has been performed successfully and could be useful to improve assistance quality in care practice. PMID:27163894

  16. Arthroscopic subacromial decompression results in normal shoulder function after two years in less than 50% of patients

    DEFF Research Database (Denmark)

    Konradsen, Lars Aage Glud; Jensen, Claus Hjorth

    2015-01-01

    INTRODUCTION: The aim of this study was to evaluate the outcome two years after arthroscopic subacromial decompression using the Western Ontario Rotator-Cuff (WORC) index and a diagram-based questionnaire to self-assess active shoulder range of motion (ROM). METHODS: Outcomes in 80 patients with...... impingement of the shoulder undergoing arthroscopic subacromial decompression were prospectively assessed preoperatively, at three months and at two years post-operatively using the WORC index. All patients had received non-operative treatment for at least six months before undergoing surgery. Active range of...... only 45% reported near normal or normal WORC scores, and 56% presented with a reduced active ROM at two years. CONCLUSION: Arthroscopic subacromial decompression -appears effective in alleviating symptoms in patients with subacromial impingement who are resistant to conservative treatment, but can only...

  17. Early Clinical Results of Arthroscopic Remplissages in Patients with Anterior Shoulder Instability with Engaging Hill-Sachs Lesion in Iran

    Directory of Open Access Journals (Sweden)

    Hamid Reza Aslani

    2014-03-01

    Full Text Available Background:   To assess the outcome of the remplissage arthroscopic surgical method in patients with anterior shoulder dislocation associated with Hill-Sachs lesion.     Methods:   Ten patients with anterior shoulder dislocations and Hill-Sachs lesions were entered into this study and were operated on by the remplissage arthroscopic surgical method. They were followed up 22 months after surgery in   order to evaluate the outcome of the treatment, including recurrence of dislocation and motion limitation.     Results:   During the internal follow up period no case of recurrence was found. Motion limitation during the follow up   period was not significant (internal rotation limitation=5°±1°, and external rotation limitation=4°±1° Conclusions:   Our findings suggest that the remplissage arthroscopic surgical method is an acceptable, safe and   reliable treatment for anterior shoulder dislocation with engaging Hill-Sachs lesion.

  18. Total Ankle Replacement for Treatment of End-Stage Osteoarthritis in Elderly Patients

    Directory of Open Access Journals (Sweden)

    Beat Hintermann

    2012-01-01

    Full Text Available End-stage osteoarthritis of the ankle is a disabling problem, particularly in elderly patients who experience an overall loss of mobility and functional impairment and who then need compensatory adaption. Ankle arthrodesis, which has been demonstrated to provide postoperative pain relief and hindfoot stability, leaves the patient with a stiff foot and gait changes. For elderly patient, these changes may be more critical than generally believed. Additionally, the long duration of healing and rehabilitation process needed for ankle arthrodesis may be problematic in the elderly. In contrast to ankle arthrodesis, total ankle replacement has significant advantages including a less strenuous postoperative rehabilitation and preservation of ankle motion which supports physiological gait. Recently, total ankle replacement has evolved as a safe surgical treatment in patients with end-stage ankle osteoarthritis with reliable mid- to long-term results. Total ankle replacement needs less immobilization than arthrodesis and does allow for early weight-bearing and should be considered as a treatment option of first choice in many elderly patients with end-stage osteoarthritis of the ankle, especially in elderly patients with lower expectations and physical demands.

  19. Gait Biomechanics in Participants, Six Months after First-time Lateral Ankle Sprain.

    Science.gov (United States)

    Doherty, C; Bleakley, C; Hertel, J; Caulfield, B; Ryan, J; Delahunt, E

    2016-06-01

    No research currently exists predicating a link between the injury-affiliated sensorimotor deficits of acute ankle sprain and those of chronic ankle instability during gait. This analysis evaluates participants with a 6-month history of ankle sprain injury to affirm this link. 69 participants with a 6-month history of acute first-time lateral ankle sprain were divided into subgroups ('chronic ankle instability' and 'coper') based on their self-reported disability and compared to 20 non-injured participants during a gait task. Lower extremity kinematic and kinetic data were collected from 200 ms pre- to 200 ms post-heel strike (period 1) and from 200 ms pre- to 200 ms post-toe off (period 2). The 'chronic ankle instability' subgroup (who reported greater disability) displayed increased knee flexion during period 1. During period 2, this subgroup exhibited greater total displacement at their ankle joint and greater extensor dominance at their knee. That many of these features are present, both in individuals with acute ankle sprain and those with chronic ankle instability may advocate a link between acute deficits and long-term outcome. Clinicians must be aware that the sensorimotor deficits of ankle sprain may persevere beyond the acute stage of injury and be cognizant of the capacity for impairments to pervade proximally. PMID:27136507

  20. Effect of a 6-week dynamic neuromuscular training programme on ankle joint function: A Case report

    Directory of Open Access Journals (Sweden)

    O'Driscoll Jeremiah

    2011-06-01

    Full Text Available Abstract Background Ankle joint sprain and the subsequent development of chronic ankle instability (CAI are commonly encountered by clinicians involved in the treatment and rehabilitation of musculoskeletal injuries. It has recently been advocated that ankle joint post-sprain rehabilitation protocols should incorporate dynamic neuromuscular training to enhance ankle joint sensorimotor capabilities. To date no studies have reported on the effects of dynamic neuromuscular training on ankle joint positioning during landing from a jump, which has been reported as one of the primary injury mechanisms for ankle joint sprain. This case report details the effects of a 6-week dynamic neuromuscular training programme on ankle joint function in an athlete with CAI. Methods The athlete took part in a progressive 6-week dynamic neuromuscular training programme which incorporated postural stability, strengthening, plyometric, and speed/agility drills. The outcome measures chosen to assess for interventional efficacy were: 1 Cumberland Ankle Instability Tool (CAIT scores, 2 Star Excursion Balance Test (SEBT reach distances, 3 ankle joint plantar flexion during drop landing and drop vertical jumping, and 4 ground reaction forces (GRFs during walking. Results CAIT and SEBT scores improved following participation in the programme. The angle of ankle joint plantar flexion decreased at the point of initial contact during the drop landing and drop vertical jumping tasks, indicating that the ankle joint was in a less vulnerable position upon landing following participation in the programme. Furthermore, GRFs were reduced whilst walking post-intervention. Conclusions The 6-week dynamic neuromuscular training programme improved parameters of ankle joint sensorimotor control in an athlete with CAI. Further research is now required in a larger cohort of subjects to determine the effects of neuromuscular training on ankle joint injury risk factors.