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Sample records for ankle foot orthosis

  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. 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

  3. A portable powered ankle-foot orthosis for rehabilitation.

    Science.gov (United States)

    Shorter, K Alex; Kogler, Géza F; Loth, Eric; Durfee, William K; Hsiao-Wecksler, Elizabeth T

    2011-01-01

    Innovative technological advancements in the field of orthotics, such as portable powered orthotic systems, could create new treatment modalities to improve the functional out come of rehabilitation. In this article, we present a novel portable powered ankle-foot orthosis (PPAFO) to provide untethered assistance during gait. The PPAFO provides both plantar flexor and dorsiflexor torque assistance by way of a bidirectional pneumatic rotary actuator. The system uses a portable pneumatic power source (compressed carbon dioxide bottle) and embedded electronics to control the actuation of the foot. We collected pilot experimental data from one impaired and three nondisabled subjects to demonstrate design functionality. The impaired subject had bilateral impairment of the lower legs due to cauda equina syndrome. We found that data from nondisabled walkers demonstrated the PPAFO's capability to provide correctly timed plantar flexor and dorsiflexor assistance during gait. Reduced activation of the tibialis anterior during stance and swing was also seen during assisted nondisabled walking trials. An increase in the vertical ground reaction force during the second half of stance was present during assisted trials for the impaired subject. Data from nondisabled walkers demonstrated functionality, and data from an impaired walker demonstrated the ability to provide functional plantar flexor assistance. PMID:21674394

  4. A portable powered ankle-foot orthosis for rehabilitation

    Directory of Open Access Journals (Sweden)

    K. Alex Shorter, PhD

    2011-05-01

    Full Text Available Innovative technological advancements in the field of orthotics, such as portable powered orthotic systems, could create new treatment modalities to improve the functional outcome of rehabilitation. In this article, we present a novel portablepowered ankle-foot orthosis (PPAFO to provide untethered assistance during gait. The PPAFO provides both plantar flexor and dorsiflexor torque assistance by way of a bidirectional pneumatic rotary actuator. The system uses a portable pneumatic power source (compressed carbon dioxide bottle and embedded electronics to control the actuation of the foot. We collected pilot experimental data from one impaired and three nondisabled subjects to demonstrate design functionality. The impaired subject had bilateral impairment of the lower legs due to cauda equina syndrome. We found that data from nondisabledwalkers demonstrated the PPAFO’s capability to provide correctlytimed plantar flexor and dorsiflexor assistance during gait. Reduced activation of the tibialis anterior during stance and swing was also seen during assisted nondisabled walking trials. An increase in the vertical ground reaction force during the second half of stance was present during assisted trials for the impaired subject. Data from nondisabled walkers demonstrated functionality, and data from an impaired walker demonstrated the ability to provide functional plantar flexor assistance.

  5. 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...

  6. Comparison of three ankle-foot orthosis configurations for children with spastic hemiplegia.

    Science.gov (United States)

    Buckon, C E; Thomas, S S; Jakobson-Huston, S; Sussman, M; Aiona, M

    2001-06-01

    The purpose of this study was to examine the effectiveness of the hinged ankle-foot orthosis (HAFO), posterior leaf spring (PLS), and solid ankle-foot orthosis (SAFO), in preventing contracture, improving efficiency of gait, and enhancing performance of functional motor skills in 30 children (21 male, 9 female; mean age 9 years 4 months; age range 4 to 18 years,) with spastic hemiplegia. Following a 3-month baseline period of no ankle-foot orthosis (AFO) use, each AFO was worn for 3 months after which ankle range of motion, gait analysis, energy consumption, and functional motor skills were assessed. The HAFO and PLS increased passive ankle dorsiflexion and normalization of ankle rocker function during gait. Normalization of knee motion in stance was dependent upon the knee abnormality present and AFO configuration. The HAFO was the most effective in controlling knee hyperextension in stance, while PLS was the most effective in promoting knee extension in children with >10 degree knee flexion in stance. Energy efficiency was improved in 21 of the children, with 13 of these children demonstrating the greatest improvement in HAFO and PLS. Improvements in functional mobility were greatest in the HAFO and PLS. PMID:11409825

  7. Experimental evaluation of a portable powered ankle-foot orthosis.

    Science.gov (United States)

    Shorter, Kenneth A; Li, Yifan; Morris, Emily A; Kogler, Géza F; Hsiao-Wecksler, Elizabeth T

    2011-01-01

    Ankle-foot orthoses (AFOs) ameliorate the impact of impairments to the lower limb neuromuscular motor system that affect gait. Emerging technologies provide a vision for fully powered, untethered AFOs. The portable powered AFO (PPAFO) provides both plantarflexor and dorsiflexor torque assistance via a bi-directional pneumatic rotary actuator. The system uses a portable pneumatic power source (bottle of compressed CO(2)) and embedded electronics to control foot motion during level walking. Experimental data were collected to demonstrate functionality from two subjects with bilateral impairments to the lower legs. These data demonstrated the PPAFO's ability to provide functional assistance during gait. The stringent design requirements of light weight, small size, high efficiency and low noise make the creation of daily wear assist devices challenging; but once such devices appear, they will present new opportunities for clinical treatment of gait abnormalities. PMID:22254386

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

    Directory of Open Access Journals (Sweden)

    Dequan Zou, DSc

    2015-03-01

    Full Text Available 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, two made of CF composite material and one made of thermoplastic material, were fabricated and then mechanically tested to produce force-displacement data. The FEA models were validated by comparing model predictions with mechanical testing data performed under the same loading and boundary conditions. The actual mechanical testing demonstrated that CF performs better than thermoplastic. The simulation results showed that FEA models produced accurate predictions for both types of orthoses. The relative error of the energy return ratio predicted by the CF AFO FEA model developed in this study is less than 3%. We conclude that highly accurate FEA models will allow orthotists to improve CF AFO fabrication without wasting resources (time and money on trial and error fabrications that are expensive and do not consistently improve AFO and user performance.

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

    Science.gov (United States)

    Zou, Dequan; He, Tao; Dailey, Michael; Smith, Kirk E; Silva, Matthew J; Sinacore, David R; Mueller, Michael J; Hastings, Mary K

    2014-01-01

    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, two made of CF composite material and one made of thermoplastic material, were fabricated and then mechanically tested to produce force-displacement data. The FEA models were validated by comparing model predictions with mechanical testing data performed under the same loading and boundary conditions. The actual mechanical testing demonstrated that CF performs better than thermoplastic. The simulation results showed that FEA models produced accurate predictions for both types of orthoses. The relative error of the energy return ratio predicted by the CF AFO FEA model developed in this study is less than 3%. We conclude that highly accurate FEA models will allow orthotists to improve CF AFO fabrication without wasting resources (time and money) on trial and error fabrications that are expensive and do not consistently improve AFO and user performance. PMID:25856154

  10. Gait mode recognition and control for a portable-powered ankle-foot orthosis.

    Science.gov (United States)

    David Li, Yifan; Hsiao-Wecksler, Elizabeth T

    2013-06-01

    Ankle foot orthoses (AFOs) are widely used as assistive/rehabilitation devices to correct the gait of people with lower leg neuromuscular dysfunction and muscle weakness. We have developed a portable powered ankle-foot orthosis (PPAFO), which uses a pneumatic bi-directional rotary actuator powered by compressed CO2 to provide untethered dorsiflexor and plantarflexor assistance at the ankle joint. Since portability is a key to the success of the PPAFO as an assist device, it is critical to recognize and control for gait modes (i.e. level walking, stair ascent/descent). While manual mode switching is implemented in most powered orthotic/prosthetic device control algorithms, we propose an automatic gait mode recognition scheme by tracking the 3D position of the PPAFO from an inertial measurement unit (IMU). The control scheme was designed to match the torque profile of physiological gait data during different gait modes. Experimental results indicate that, with an optimized threshold, the controller was able to identify the position, orientation and gait mode in real time, and properly control the actuation. It was also illustrated that during stair descent, a mode-specific actuation control scheme could better restore gait kinematic and kinetic patterns, compared to using the level ground controller. PMID:24187192

  11. Experimental Implementation of Underactuated Potential Energy Shaping on a Powered Ankle-Foot Orthosis

    Science.gov (United States)

    Lv, Ge; Zhu, Hanqi; Elery, Toby; Li, Luwei; Gregg, Robert D.

    2016-01-01

    Traditional control methodologies of rehabilitation orthoses/exoskeletons aim at replicating normal kinematics and thus fall into the category of kinematic control. This control paradigm depends on pre-defined reference trajectories, which can be difficult to adjust between different locomotor tasks and human subjects. An alternative control category, kinetic control, enforces kinetic goals (e.g., torques or energy) instead of kinematic trajectories, which could provide a flexible learning environment for the user while freeing up therapists to make corrections. We propose that the theory of underactuated potential energy shaping, which falls into the category of kinetic control, could be used to generate virtual body-weight support for stroke gait rehabilitation. After deriving the nonlinear control law and simulating it on a human-like biped model, we implemented this controller on a powered ankle-foot orthosis that was designed specifically for testing torque control strategies. Experimental results with an able-bodied human subject demonstrate the feasibility of the control approach for both positive and negative virtual body-weight augmentation.

  12. Therapeutic Experience on Stance Control Knee-Ankle-Foot Orthosis With Electromagnetically Controlled Knee Joint System in Poliomyelitis

    Science.gov (United States)

    Kim, Jung-Hwan; Ji, Sang-Goo; Jung, Kang-Jae

    2016-01-01

    A 54-year-old man with poliomyelitis had been using a conventional, passive knee-ankle-foot orthosis (KAFO) with a drop ring lock knee joint for about 40 years. A stance control KAFO (SCKAFO) with an electromagnetically controlled (E-MAG) knee joint system was prescribed. To correct his gait pattern, he also underwent rehabilitation therapy, which included muscle re-education, neuromuscular electrical stimulation, strengthening exercises for the lower extremities, and balance training twice a week for about 4 months. Both before and after rehabilitation, we conducted a gait analysis and assessed the physiological cost index in energy expended during walking in a locked-knee state and while he wore a SCKAFO with E-MAG. When compared with the pre-rehabilitation data, the velocity, step length, stride length, and knee kinematic data were improved after rehabilitation. Although the SCKAFO with E-MAG system facilitated the control of knee motion during ambulation, appropriate rehabilitative therapy was also needed to achieve a normal gait pattern. PMID:27152288

  13. Therapeutic Experience on Stance Control Knee-Ankle-Foot Orthosis With Electromagnetically Controlled Knee Joint System in Poliomyelitis.

    Science.gov (United States)

    Kim, Jung-Hwan; Ji, Sang-Goo; Jung, Kang-Jae; Kim, Jae-Hyung

    2016-04-01

    A 54-year-old man with poliomyelitis had been using a conventional, passive knee-ankle-foot orthosis (KAFO) with a drop ring lock knee joint for about 40 years. A stance control KAFO (SCKAFO) with an electromagnetically controlled (E-MAG) knee joint system was prescribed. To correct his gait pattern, he also underwent rehabilitation therapy, which included muscle re-education, neuromuscular electrical stimulation, strengthening exercises for the lower extremities, and balance training twice a week for about 4 months. Both before and after rehabilitation, we conducted a gait analysis and assessed the physiological cost index in energy expended during walking in a locked-knee state and while he wore a SCKAFO with E-MAG. When compared with the pre-rehabilitation data, the velocity, step length, stride length, and knee kinematic data were improved after rehabilitation. Although the SCKAFO with E-MAG system facilitated the control of knee motion during ambulation, appropriate rehabilitative therapy was also needed to achieve a normal gait pattern. PMID:27152288

  14. A quasi-passive compliant stance control Knee-Ankle-Foot Orthosis.

    Science.gov (United States)

    Shamaei, Kamran; Napolitano, Paul C; Dollar, Aaron M

    2013-06-01

    In this paper, we present the design of a novel quasi-passive stance-control orthosis that implements a natural amount of knee compliance during the weight acceptance phase and potentially the entire stance phase of the gait, and allows for free motion during the rest of the gait. We explain that the unaffected knee behaves close to a linear torsional spring in stance and hypothesize that an assistive device that places a linear spring of appropriate stiffness in parallel with the knee can help restore the natural behavior of the joint in stance. We present the design of a friction-based latching mechanism and a control algorithm that engages the spring in parallel with the knee in stance and disengages it during the swing phase of gait, and explain how this module is implemented into a brace in order to create a novel class of compliant stance control orthosis. The device is quasi-passive in that a small actuator serves to lock and unlock the spring module, but the device otherwise requires no actuation and very little power, computation, and control to operate. PMID:24187288

  15. How can push-off be preserved during use of an ankle foot orthosis in children with hemiplegia? A prospective controlled study.

    Science.gov (United States)

    Desloovere, Kaat; Molenaers, Guy; Van Gestel, Leen; Huenaerts, Catherine; Van Campenhout, Anja; Callewaert, Barbara; Van de Walle, Patricia; Seyler, J

    2006-10-01

    Several studies indicated that walking with an ankle foot orthosis (AFO) impaired third rocker. The purpose of this study was to evaluate the effects of two types of orthoses, with similar goal settings, on gait, in a homogeneous group of children, using both barefoot and shoe walking as control conditions. Fifteen children with hemiplegia, aged between 4 and 10 years, received two types of individually tuned AFOs: common posterior leaf-spring (PLS) and Dual Carbon Fiber Spring AFO (CFO) (with carbon fibre at the dorsal part of the orthosis). Both orthoses were expected to prevent plantar flexion, thus improving first rocker, allowing dorsiflexion to improve second rocker, absorbing energy during second rocker, and returning it during the third rocker. The effect of the AFOs was studied using objective gait analysis, including 3D kinematics, and kinetics in four conditions: barefoot, shoes without AFO, and PLS and CFO combined with shoes. Several gait parameters significantly changed in shoe walking compared to barefoot walking (cadence, ankle ROM and velocity, knee shock absorption, and knee angle in swing). The CFO produced a significantly larger ankle ROM and ankle velocity during push-off, and an increased plantar flexion moment and power generation at pre-swing compared to the PLS (rocker, sagittal knee and hip ROM). However, compared to shoes, not all improvements were statistically significant. PMID:16934470

  16. AN ANALYSIS OF THE MANUFACTURING POSSIBILITY OF SPECIAL ANKLE FOOT ORTHOSIS COMPONENTS BY OMPARISON BETWEEN THE REQUIRED PRECISION AND THE VAILABLE PRECISION ON A VERTICAL MACHINING CENTER PROGRAMED WITH TOPSOLID

    Directory of Open Access Journals (Sweden)

    Alexandru STANIMIR

    2010-06-01

    Full Text Available Validation of different solutions adopted to achieve new ankle foot orthosis involves among others their prototyping. In these paper we developed a representative part for two axis machining that requires the use of the main features of TopSolid Cad and Cam modules, and that assumes the use of the main manufacturing processes that usually may be met on a vertical machining center. Also, in order to determine the dimensional and geometrical deviations of the part this was done on the YMC 1050 machining center. After comparing the measured deviations with the requirements of various components of orthesis, we concluded that the available precision meets the requirements and that the machining center with TopSolid software that we have will enable us to realize special ankle foot orthosis of quality, for experimental research .

  17. Numerical and experimental investigation of the structural behavior of a carbon fiber reinforced ankle-foot orthosis.

    Science.gov (United States)

    Stier, Bertram; Simon, Jaan-Willem; Reese, Stefanie

    2015-05-01

    Ankle-foot orthoses (AFOs) are designed to enhance the gait function of individuals with motor impairments. Recent AFOs are often made of laminated composites due to their high stiffness and low density. Since the performance of AFO is primarily influenced by their structural stiffness, the investigation of the mechanical response is very important for the design. The aim of this paper is to present a three dimensional multi-scale structural analysis methodology to speed up the design process of AFO. The multi-scale modeling procedure was applied such that the intrinsic micro-structure of the fiber reinforced laminates could be taken into account. In particular, representative volume elements were used on the micro-scale, where fiber and matrix were treated separately, and on the textile scale of the woven structure. For the validation of this methodology, experimental data were generated using digital image correlation (DIC) measurements. Finally, the structural behavior of the whole AFO was predicted numerically for a specific loading scenario and compared with experimental results. It was shown that the proposed numerical multi-scale scheme is well suited for the prediction of the structural behavior of AFOs, validated by the comparison of local strain fields as well as the global force-displacement curves. PMID:25765189

  18. AN ANALYSIS OF THE MANUFACTURING POSSIBILITY OF SPECIAL ANKLE FOOT ORTHOSIS COMPONENTS BY OMPARISON BETWEEN THE REQUIRED PRECISION AND THE VAILABLE PRECISION ON A VERTICAL MACHINING CENTER PROGRAMED WITH TOPSOLID

    OpenAIRE

    Alexandru STANIMIR; Rusu, Florin; Cosmin BERCEANU; Dumitru FILIP

    2010-01-01

    Validation of different solutions adopted to achieve new ankle foot orthosis involves among others their prototyping. In these paper we developed a representative part for two axis machining that requires the use of the main features of TopSolid Cad and Cam modules, and that assumes the use of the main manufacturing processes that usually may be met on a vertical machining center. Also, in order to determine the dimensional and geometrical deviations of the part this was done on the YMC 1050 ...

  19. 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

  20. 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 ...

  1. 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? ...

  2. 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 ...

  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. Biomechanics Changes at Lower Limb Joints between Different Types of Ankle Foot Orthosis in Children with Cerebral Palsy%痉挛型脑瘫儿童佩戴不同类型踝足矫形器后下肢生物力学的变化

    Institute of Scientific and Technical Information of China (English)

    张旻; 冯美兰; 瞿佩玉

    2011-01-01

    Objective: To understand the kinematics and kinetics variables at lower limb joints between rigid ankle foot orthosis (RAFO) and dynamic ankle foot orthosis (DAFO) in children with spastic cerebral palsy (CP) in order to find a better design for the ankle foot orthosis (AFO) in future. Methods: Sixteen spastic cerebral palsy children (10 boys, 6 girls, aged from 4 to 8 years, average age=6.25± 1.18 years) were recruited from the Rehabilitation Department of Shanghai 6th People's Hospital (China). Kinematics parameters were measured by using Vicon threedimensional gait analysis system and the kinetics changes were examined by two Kislter force platforms at the same time under three conditions.. (1) RAFO, (2) DAFO and (3) Bare foot only. Results: Both RAFO and DAFO showed significantly larger stride length than the bare foot only (RAFO increased 0. 05 m and DAFO increased 0.07 m, P<0.05), and significantly higher dorsiflexion degrees were found in initial contact (RAFO increased 9°and DAFO increased 11.3°, P<0.05) and stance phase (RAFO increased 10° and DAFO increased 11°, P<0.05)under both two AFO conditions at same time. RAFO showed significantly smaller range of motion at ankle joint during walking that the dynamic ankle foot orthosis and bare foot only (7° decreased when compared to the DAFO and 8° decreased when compared to the bare foot condition, P<0. 05). Besides, DAFO showed significantly higher ankle plantarflexion degrees when compared to the RAFO (5. 5° increased, P<0. 05). Both two AFO conditions showed an obviously higher ankle plantar moment than bare foot condition (0. 33 Nm/kg increased in RAFO and 0.37 Nm/kg increased in DAFO, P<0. 05), and no other kinetic or kinematic differences were found in hip and knee joint under three conditions. Conclusion: Both two different AFO can help to improve the walking ability of CP children and offer a better foot position during walking. The DAFO showed a bigger range of motion and better

  5. Changes in joint kinematics in children with cerebral palsy while walking with and without a floor reaction ankle-foot orthosis Mudanças na cinemática articular em crianças com paralisia cerebral durante o andar com e sem órteses de reação ao solo

    Directory of Open Access Journals (Sweden)

    Paulo Roberto Garcia Lucareli

    2007-02-01

    Full Text Available INTRODUCTION: The floor reaction ankle-foot orthosis is commonly prescribed in the attempt to decrease knee flexion during the stance phase in the cerebral palsy (CP gait. Reported information about this type of orthosis is insufficient. PURPOSE: The purpose of this study was to determine the effect of clinically prescribed floor reaction ankle-foot orthosis on kinematic parameters of the hip, knee and ankle in the stance phase of the gait cycle, compared to barefoot walking on children with cerebral palsy. METHODS: A retrospective chart review of 2200 patients revealed that 71 patients (142 limbs had a diagnosis of diplegia, with no contractures in hip, knee or ankle flexion. Their average age was 12.2 ± 3.9. All of them were wearing clinically prescribed hinged floor reaction ankle-foot orthosis undergoing a three dimensional gait analysis. We divided the patients in three groups: Group I, with limited extension (maximum knee extension less than 15º; Group II, with moderate limited extension (maximum knee extension between 15º and 30º and Group III Crouch (maximum knee extension in stance more than 30º. RESULTS: Results indicate the parameters maximum knee extension and ankle dorsiflexion were significant in Group II e III; no change was observed in Group I. The maximum hip extension was not significant in all three groups. Conclusion: when indicated to improve the extension of the knees and ankle in the stance of the CP patients floor reaction ankle-foot orthosis was effective.INTRODUÇÃO: A órtese de reação ao solo é freqüentemente prescrita com o objetivo de reduzir a flexão do joelho durante a fase de apoio na marcha de pacientes com paralisia cerebral. Não há informações suficientes relatadas na literature sobre este tipo de órteses. OBJETIVOS: O objetivo deste estudo foi determinar o efeito que a órtese de reação ao solo tem na cinamática angular das articulações do quadril, joelho e tornozelo durante a fase de

  6. 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 ...

  7. Use of a static progressive stretch orthosis to treat post-traumatic ankle stiffness

    OpenAIRE

    Costa Christopher R; McElroy Mark J; Johnson Aaron J; Lamm Bradley M; Mont Michael A

    2012-01-01

    Abstract Background Chronic ankle stiffness can develop for numerous reasons after traumatic injury, and may adversely affect patient gait, mobility, and function. Although standard physical therapeutic techniques typically resolve this stiffness, some cases may be recalcitrant to these measures, making it difficult to restore range-of-motion. The purpose of this study was to evaluate a static progressive stretch orthosis for the treatment of chronic ankle stiffness. Methods Twenty-six patien...

  8. 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 ...

  9. Use of a static progressive stretch orthosis to treat post-traumatic ankle stiffness

    Directory of Open Access Journals (Sweden)

    Costa Christopher R

    2012-07-01

    Full Text Available Abstract Background Chronic ankle stiffness can develop for numerous reasons after traumatic injury, and may adversely affect patient gait, mobility, and function. Although standard physical therapeutic techniques typically resolve this stiffness, some cases may be recalcitrant to these measures, making it difficult to restore range-of-motion. The purpose of this study was to evaluate a static progressive stretch orthosis for the treatment of chronic ankle stiffness. Methods Twenty-six patients (26 ankles who had chronic post-traumatic ankle stiffness were studied. The patients began treatment at a mean of 47 weeks (range, 6 to 272 weeks following their initial injury using a static progressive stretch orthosis. A patient-directed protocol was used for 30 minutes per day, 1 to 3 times per day, until the range-of-motion was considered to have plateaued. Mean treatment time was 10 weeks (range, 3 to 19 weeks. Treatment duration, range-of-motion, and complications with the device were assessed. Results The overall mean improvement in motion (combined dorsiflexion and plantar flexion was 17 degrees (range, 2 to 44 degrees. There was a mean improvement in dorsiflexion of 9 degrees (range, -2 to 20 degrees, and a mean improvement of 8 degrees of plantar flexion (range, -10 to 35 degrees. There were no reports of numbness or skin problems. Conclusions The outcomes of this study suggest that a patient-directed treatment protocol using a static progressive stretch orthosis was an effective ancillary method for the treatment of chronic post-traumatic ankle stiffness that was refractory to standard physical therapy techniques.

  10. 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 ...

  11. 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.

  12. 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

  13. Effectiveness of adjustable dorsiflexion night splint in combination with accommodative foot orthosis on plantar fasciitis

    Directory of Open Access Journals (Sweden)

    Winson C. C. Lee, PhD

    2013-01-01

    Full Text Available Foot orthoses and night splints have been used separately to treat patients with plantar fasciitis, but were not always successful. Combined use of both orthoses might give better outcomes. This study evaluated the effectiveness of a soft and self-adjustable dorsiflexion night splint in combination with an accommodative foot orthosis for patients with plantar fasciitis. Twenty-eight patients were assigned to group A (foot orthosis only and group B (combination of foot orthosis and dorsiflexion night splints. A Foot Function Index (FFI questionnaire was used to evaluate the pain and functions of feet just before, 2 weeks after, and 8 weeks after the treatments. Results showed that subjects in group B had significantly reduced pain scores at week 2 (p < 0.001 and week 8 (p < 0.001. In group A, no statistical differences were noted in the pain (p = 0.15, disability (p = 0.56, activity limitation (p = 0.75, and total FFI (p = 0.35 scores for the three time periods. The application of foot orthoses with adjustable dorsiflexion night splints was found to be more effective than the application of foot orthoses alone in relieving foot pain in patients with plantar fasciitis.

  14. 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.

  15. A powered lower limb orthosis for gait assistance in incomplete spinal cord injured subjects

    OpenAIRE

    Font Llagunes, Josep Maria; Arroyo, Guillermo; Serrancolí, Gil; Romero, Francisco

    2011-01-01

    The paper deals with the mechanical design of a new active stance-control knee-ankle-foot orthosis (SCKAFO). The orthosis is intended to provide gait assistance for incomplete spinal cord injured patients that present functional hip muscles, but partially denervated knee and ankle muscles. It consists of a passive compliant joint that constrains ankle plantar flexion, along with a powered knee unit that prevents knee flexion during stance and controls flexion-extension du...

  16. Effect of antipronation foot orthosis geometry on compression of heel and arch soft tissues

    Directory of Open Access Journals (Sweden)

    Declan Sweeney, BSc (Hon

    2016-09-01

    Full Text Available This study aimed to understand how systematic changes in arch height and two designs of heel wedging affect soft tissues under the foot. Soft tissue thickness under the heel and navicular was measured using ultrasound. Heel pad thickness was measured while subjects were standing on a flat surface and also while they were standing on an orthosis with 4 and 8 degree extrinsic wedges and 4 and 8 mm intrinsic wedges (n = 27. Arch soft tissue thickness was measured when subjects were standing and when standing on an orthosis with –6 mm, standard, and +6 mm increments in arch height (n = 25. Extrinsic and intrinsic heel wedges significantly increased soft tissue thickness under the heel compared with no orthosis. The 4 and 8 degree extrinsic wedges increased tissue thickness by 28.3% and 27.6%, respectively, while the 4 and 8 mm intrinsic wedges increased thickness by 23.0% and 14.6%, respectively. Orthotic arch height significantly affected arch soft tissue thickness. Compared with the no orthosis condition, the –6 mm, standard, and +6 mm arch heights decreased arch tissue thickness by 9.1%, 10.2%, and 11.8%, respectively. This study demonstrates that change in orthotic geometry creates different plantar soft tissue responses that we expect to affect transmission of force to underlying foot bones.

  17. 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 ...

  18. A Powered Lower Limb Orthosis for Providing Legged Mobility in Paraplegic Individuals

    OpenAIRE

    Quintero, Hugo A.; Farris, Ryan J.; Hartigan, Clare; Clesson, Ismari; Goldfarb, Michael

    2011-01-01

    This paper presents preliminary results on the development of a powered lower limb orthosis intended to provide legged mobility (with the use of a stability aid, such as forearm crutches) to paraplegic individuals. The orthosis contains electric motors at both hip and both knee joints, which in conjunction with ankle-foot orthoses, provides appropriate joint kinematics for legged locomotion. The paper describes the orthosis and the nature of the controller that enables the SCI patient to comm...

  19. 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.

  20. 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

  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. 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.)

  3. 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.)

  4. 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.

  5. 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.

  6. Visualisation to enhance biomechanical tuning of ankle-foot orthoses (AFOs in stroke: study protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Carse Bruce

    2011-12-01

    Full Text Available Abstract Background There are a number of gaps in the evidence base for the use of ankle-foot orthoses for stroke patients. Three dimensional motion analysis offers an ideal method for objectively obtaining biomechanical gait data from stroke patients, however there are a number of major barriers to its use in routine clinical practice. One significant problem is the way in which the biomechanical data generated by these systems is presented. Through the careful design of bespoke biomechanical visualisation software it may be possible to present such data in novel ways to improve clinical decision making, track progress and increase patient understanding in the context of ankle-foot orthosis tuning. Methods A single-blind randomised controlled trial will be used to compare the use of biomechanical visualisation software in ankle-foot orthosis tuning against standard care (tuning using observation alone. Participants (n = 70 will have experienced a recent hemiplegia (1-12 months and will be identified by their care team as being suitable candidates for a rigid ankle-foot orthosis. The primary outcome measure will be walking velocity. Secondary outcome measures include; lower limb joint kinematics (thigh and shank global orientations & kinetics (knee and hip flexion/extension moments, ground reaction force FZ2 peak magnitude, step length, symmetry ratio based on step length, Modified Ashworth Scale, Modified Rivermead Mobility Index and EuroQol (EQ-5D. Additional qualitative measures will also be taken from participants (patients and clinicians at the beginning and end of their participation in the study. The main aim of the study is to determine whether or not the visualisation of biomechanical data can be used to improve the outcomes of tuning ankle-foot orthoses for stroke patients. Discussion In addition to answering the primary research question the broad range of measures that will be taken during this study are likely to contribute to a

  7. 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

  8. 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...

  9. 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

  10. 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

  11. 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

  12. 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 ...

  13. 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.

  14. 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.

  15. Imaging of Soft Tissue Lesions of the Foot and Ankle

    OpenAIRE

    Seyed Hassan Mostafavi

    2010-01-01

    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 intensit...

  16. 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

  17. The forgotten foot - an assessment of foot and ankle radiograph pathology in final year medical students.

    LENUS (Irish Health Repository)

    Groarke, P J

    2014-04-27

    It has been shown that doctors in Emergency Departments (EDs) have inconsistent knowledge of musculoskeletal anatomy. This is most likely due to a deficiency in focused musculoskeletal modules at undergraduate level in medical school. The aims of this study were to evaluate the knowledge of final year medical students on foot anatomy and common foot and ankle pathology as seen on radiographs.

  18. 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

  19. The Impacts of Hinged and Solid Ankle-Foot Orthoses on Standing and Walking in Children with Spastic Diplegia

    Directory of Open Access Journals (Sweden)

    Hamid DALVAND

    2013-11-01

    orthoses on walking efficiency and gait in children with cerebral palsy. J Rehabil Med 2008;40(7:529-34.Abel MF, Juhl GA,Vaughan CL, Damiano DL. Gait assessment of fixed ankle-foot orthoses in children with spastic diplegia. Arch Phys Med Rehabil 1998;79(2:126-33.Balaban B, Yasar E, Dal U, Yazicioglu K, Mohur H, Kalyon TA. The effect of hinged ankle-foot orthosis on gait and energy expenditure in spastic hemiplegic cerebral palsy. Disabil Rehabil 2007;29(2:139-44.Wilson H, Haideri N, Song K, Telford D. Ankle-foot orthoses for preambulatory children with spastic diplegia. J Pediat Orthoped 1997;17(3:370-6.Romkes J, Hell AK, Brunner R. Changes in muscle activity in children with hemiplegic cerebral palsy while walking with and without ankle-foot orthoses. Gait Posture 2006;24(4:467-74.Radtka SA, Skinner SR, Dixon DM, Johanson ME. A comparison of gait with solid, dynamic, and no ankle-foot orthoses in children with spastic cerebral palsy. Phys Ther 1997;77(4:395-409.Radtka SA, Skinner SR, Johanson ME. A comparison of gait with solid and hinged ankle-foot orthoses in children with spastic diplegic cerebral palsy. Gait Posture 2005;21:303-10.Hayek S, Hemo Y, Chamis S, Bat R, Segev E, Wientroub S, et al. The effect of community prescribed ankle–foot orthoses on gait parameters in children with spastic cerebral palsy. J Children’s Orthoped 2007;1(6:325-32.Burtenr PA, Woollactt MM, Qualls C. Stance balance control with orthoses in a group of children with spastic cerebral palsy. Dev Med Child Neurol 1999;41(11:748-57.Bjornson KF, Schmale GA, Adamczyk-Foster A, McLaughlin J. The effect of dynamic ankle foot orthoses on function in children with cerebral palsy. J Pediat Orthoped 2006;26(6:773-6.Hassani S, Ferdjallah M, Reiners K, Johnson C, Smith P, Harris G. Motor performance comparison of the hinged and dynamic ankle-foot orthotics. Dev Med Child Neurol 2002;44(91:4.Smith PA, Hassani S, Graf A, Flanagan A, Reiners K. Brace evaluation in children with diplegic cerebral palsy

  20. Restoration of ankle movements with the ActiGait implantable drop foot stimulator: a safe and reliable treatment option for permanent central leg palsy.

    Science.gov (United States)

    Martin, Klaus Daniel; Polanski, Witold Henryk; Schulz, Anne-Kathrin; Jöbges, Michael; Hoff, Hansjoerg; Schackert, Gabriele; Pinzer, Thomas; Sobottka, Stephan B

    2016-01-01

    OBJECT The ActiGait drop foot stimulator is a promising technique for restoration of lost ankle function by an implantable hybrid stimulation system. It allows ankle dorsiflexion by active peroneal nerve stimulation during the swing phase of gait. In this paper the authors report the outcome of the first prospective study on a large number of patients with stroke-related drop foot. METHODS Twenty-seven patients who experienced a stroke and with persisting spastic leg paresis received an implantable ActiGait drop foot stimulator for restoration of ankle movement after successful surface test stimulation. After 3 to 5 weeks, the stimulator was activated, and gait speed, gait endurance, and activation time of the system were evaluated and compared with preoperative gait tests. In addition, patient satisfaction was assessed using a questionnaire. RESULTS Postoperative gait speed significantly improved from 33.9 seconds per 20 meters to 17.9 seconds per 20 meters (p mobility, social participation, and quality of life was confirmed by 89% to 96% of patients. CONCLUSIONS The ActiGait implantable drop foot stimulator improves gait speed, endurance, and quality of life in patients with stroke-related drop foot. Regarding gait speed, the ActiGait system appears to be advantageous compared with foot orthosis or surface stimulation devices. Randomized trials with more patients and longer observation periods are needed to prove the long-term benefit of this device. PMID:26207599

  1. Clinical anatomy of the ankle and foot.

    Science.gov (United States)

    Hernández-Díaz, Cristina; Saavedra, Miguel Ángel; Navarro-Zarza, José Eduardo; Canoso, Juan J; Villaseñor-Ovies, Pablo; Vargas, Angélica; Kalish, Robert A

    This paper emphasizes the anatomical substrate of several foot conditions that are seldom discussed in this context. These include the insertional and non-insertional Achilles tendinopathies, plantar fasciopathy, inferior and posterior heel spurs, foot compartment syndromes, intermetatarsal bursitis and Morton's neuroma. It is a rather superficial anatomical review of an organ that remains largely neglected by rheumatologists. It is our hope that the cases discussed and the cross examination by instructors and participants will stimulate study of the foot and the attention it deserves. PMID:23228530

  2. Smoking cessation: the role of the foot and ankle surgeon.

    Science.gov (United States)

    Greenhagen, Robert M; Johnson, Adam R; Bevilacqua, Nicholas J

    2010-02-01

    Tobacco cigarette smoking causes many negative effects on the body, and it is the leading preventable cause of death in the United States. These negative effects are a concern for the foot and ankle surgeon, as smoking can increase the risk of diabetes and peripheral artery disease and delay healing of surgical incisions and ulcerations of the lower extremities. Tobacco cigarette smoking can also increase the risk of avascular necrosis and delayed union and nonunions of fractures and osteotomies. Smoking cessation is an important component in the overall treatment of conditions affecting the foot and ankle. Smoking cessation can be a difficult goal to achieve, but proper education and support can help patients reach this goal. PMID:20400436

  3. Journal of Foot and Ankle Research, one year on

    Directory of Open Access Journals (Sweden)

    Borthwick Alan M

    2009-11-01

    Full Text Available Abstract Journal of Foot and Ankle Research was launched one year ago, and a number of its key achievements are highlighted in this editorial. Although the journal is underpinned by professional bodies associated with the podiatry professions in the UK and Australasia, its content is aimed at the wider foot and ankle research community. Nevertheless, the journal's achievements over the past year reflect the development of research in the profession of podiatry. From this perspective, the journal may be viewed as contributing to the overall attainment of some of the profession's key goals and strategic aims over the last decade, across the UK and Australasia. The journal has also witnessed policy changes in the last year, and these are discussed - notably, the decision not to accept case reports for publication. We also report on a few of the key metrics, providing readers with a summary of the journal's performance over the last year.

  4. Foot and Ankle Deformity in Young Acrobatic and Artistic Gymnasts

    Directory of Open Access Journals (Sweden)

    Sobera Anna

    2015-09-01

    Full Text Available Purpose. The aim of the paper was to determine the occurrence of feet and ankle deformities in trampoline and artistic gymnasts. Methods. Ten acrobatic gymnasts (trampolinists and 10 artistic gymnasts aged 6-14 years were recruited. The calcaneal-tibial (rearfoot angle was determined as the angle of the upper calcaneal tendon and the longitudinal heel axis while Clarke angles were determined by podoscopy. Results. The trampolinists showed significantly greater medial angulation (calcaneal valgus than the group of gymnasts. Right and left foot Clark’s angles in both the trampoline and artistic gymnasts were above 55°. Conclusions. Trampolinists exhibit significantly more pronounced calcaneal valgus than artistic gymnasts. The prevalence of foot and ankle deformities in both populations should be addressed by coaches in the gymnastics training of young children.

  5. Foot and ankle fractures at the supination line

    OpenAIRE

    Schepers, Tim; Schie- van der Weert, E.M.; De Vries, Mark; Van der Elst, M.

    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 supination line injuries visible at the initial radiographs at the Emergency Department and to determine the type and percentage of misdiagnosed injuries. Method: Retrospective study of consecutive pa...

  6. Entrapment neuropathy about the foot and ankle: an update.

    Science.gov (United States)

    Pomeroy, Gregory; Wilton, James; Anthony, Steven

    2015-01-01

    Occurrences of entrapment neuropathies of the lower extremity are relatively infrequent; therefore, these conditions may be underappreciated and difficult to diagnose. Understanding the anatomy of the peripheral nerves and their potential entrapment sites is essential. A detailed physical examination and judicious use of imaging modalities are also vital when establishing a diagnosis. Once an accurate diagnosis is obtained, treatment is aimed at reducing external pressure, minimizing inflammation, correcting any causative foot and ankle deformities, and ultimately releasing any constrictive tissues. PMID:25538131

  7. Foot and ankle injuries during the Athens 2004 Olympic Games

    OpenAIRE

    Mirones Steven; Romansky Nick; Forgrave Mike; Siapkara Angeliki; Galanakos Spyros P; Vergados Nikolaos; Papadakis Stamatios A; Badekas Thanos; Trnka Hans-Jeorg; Delmi Marino

    2009-01-01

    Abstract Background Major, rare and complex incidents can occur at any mass-gathering sporting event and team medical staff should be appropriately prepared for these. One such event, the Athens Olympic Games in 2004, presented a significant sporting and medical challenge. This study concerns an epidemiological analysis of foot and ankle injuries during the Games. Methods An observational, epidemiological survey was used to analyse injuries in all sport tournaments (men's and women's) over th...

  8. Radiology of the ankle and foot

    International Nuclear Information System (INIS)

    The purpose of this paper is to provide a systematic approach to the diagnosis of common foot conditions, including traumatic conditions, arthritis, and tumors. The differential diagnosis of monarticular arthritis and pain in the big toe is discussed. The characteristic features of rheumatoid arthritis are compared with those of degenerative and metabolic deposition disease. Trauma, including common athletic injuries, is reviewed. Selected tumors that frequently cause confusion, such as synovial chondromatosis, PVNS, and tendon sheath xanthoma, are shown

  9. An evaluation of the posterior leaf spring orthosis using joint kinematics and kinetics.

    Science.gov (United States)

    Ounpuu, S; Bell, K J; Davis, R B; DeLuca, P A

    1996-01-01

    The primary function of the posterior leaf spring orthosis (PLS) is to prevent excessive equinus or drop foot in swing. The name of the orthosis, posterior leaf "spring," suggests that it also mechanically augments push-off in stance. The purpose of this study was to determine the effect of the PLS on ankle function by using computerized gait-analysis techniques. Multiple barefoot versus brace walks were compared in 31 children with cerebral palsy. Results indicate that the PLS reduces excessive equinus in swing and is sufficiently flexible to allow ankle dorsiflexion in midstance. In terminal stance, the peak power-generating capabilities of the ankle were reduced when the child was wearing the PLS. Energy results indicate that more mechanical energy was absorbed during midstance and less produced during terminal stance with the PLS. Therefore, the PLS improved ankle function but did not augment ankle function through storage and return of mechanical, or spring, energy. PMID:8728642

  10. 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...

  11. 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

  12. MDCT classification of osseous ankle and foot injuries

    International Nuclear Information System (INIS)

    Conventional radiography plays an essential role in the primary evaluation of acute ankle and foot trauma. In the case of complex injuries, however, subsequent computed tomography (CT) is nowadays recommended. In this connection, multidetector computed tomography (MDCT) allows better temporal, spatial, and contrast resolution compared with the conventional single-slice spiral CT. Multiplanar reformation and three-dimensional reconstruction of the acquired data sets are also helpful tools for critical assessment of therapeutic intervention. This report reviews the potential of the MDCT technique for accurate fracture classification, precise illustration of displaced components, and postoperative control of arrangement of typical lesions. (orig.)

  13. Management strategies of sarcomas of the ankle and foot

    International Nuclear Information System (INIS)

    Purpose: To evaluate the management and outcomes of 40 patients treated at the Massachusetts General Hospital between 1974 and September 1996 for soft tissue sarcomas of the foot or ankle. Materials and Methods: Seventy seven percent of patients had AJCC stage II or III disease. Primary disease was treated in 28 patients while recurrent disease was addressed in 12. The mean tumor size was 4.6 cm with a median tumor size of 4.0 cm, (range 1 to 15 cm). Seventeen patients were treated with surgery followed by radiation therapy for primary or recurrent disease. Preoperative radiation therapy was employed in 15 patients, 5 of whom received additional postoperative radiation therapy for close or positive margins. Six patients received radiation treatment alone. Amputations were performed in 5 patients. Two amputations were performed due to inadequate surgical margins obtained at the time of resection. Three amputations were performed due to local failure. The median preoperative radiation dose was 48 Gy. The median total dose was 59 Gy (range 22 Gy to 70 Gy). Chemotherapy was incorporated in the therapy of 6 patients. Results: After a mean follow-up of 4.9 years, 28 (70%) patients remain without evidence of disease. Four patients have died of disease. Five patients have died of intercurrent disease or another cancer. Three patients remain alive with disease. There were 5 isolated local failures, 4 distant failures and 1 combined local and distant failure. Of the 5 patients with isolated local failures, 3 were treated with radiation alone. The most common site of distant failure was the lung. Actuarial local control rates are 80% at 5 and 10 years in this population. Actuarial overall survival at 5 and 10 years are 83% and 69% respectively. Wound healing difficulties occurred in 13 patients. Seven patients suffered a wound dehiscence. Five patients required therapy for wound dehiscence and infection and one patient was treated for wound infection only. In six patients

  14. Effects of Ankle Arthrodesis on Biomechanical Performance of the Entire Foot.

    Directory of Open Access Journals (Sweden)

    Yan Wang

    Full Text Available Ankle arthrodesis is one popular surgical treatment for ankle arthritis, chronic instability, and degenerative deformity. However, complications such as foot pain, joint arthritis, and bone fracture may cause patients to suffer other problems. Understanding the internal biomechanics of the foot is critical for assessing the effectiveness of ankle arthrodesis and provides a baseline for the surgical plan. This study aimed to understand the biomechanical effects of ankle arthrodesis on the entire foot and ankle using finite element analyses. A three-dimensional finite element model of the foot and ankle, involving 28 bones, 103 ligaments, the plantar fascia, major muscle groups, and encapsulated soft tissue, was developed and validated. The biomechanical performances of a normal foot and a foot with ankle arthrodesis were compared at three gait instants, first-peak, mid-stance, and second-peak.Changes in plantar pressure distribution, joint contact pressure and forces, von Mises stress on bone and foot deformation were predicted. Compared with those in the normal foot, the peak plantar pressure was increased and the center of pressure moved anteriorly in the foot with ankle arthrodesis. The talonavicular joint and joints of the first to third rays in the hind- and mid-foot bore the majority of the loading and sustained substantially increased loading after ankle arthrodesis. An average contact pressure of 2.14 MPa was predicted at the talonavicular joint after surgery and the maximum variation was shown to be 80% in joints of the first ray. The contact force and pressure of the subtalar joint decreased after surgery, indicating that arthritis at this joint was not necessarily a consequence of ankle arthrodesis but rather a progression of pre-existing degenerative changes. Von Mises stress in the second and third metatarsal bones at the second-peak instant increased to 52 MPa and 34 MPa, respectively, after surgery. These variations can provide

  15. Epidemiology of ankle and foot overuse injuries in sports : A systematic review

    NARCIS (Netherlands)

    Sobhani, S.; Dekker, R.; Postema, K.; Dijkstra, P. U.

    2013-01-01

    Studies regarding ankle and foot overuse injuries are quite diverse in research methodology, data reporting, and outcomes. The aims of this systematic review were to analyze the methodology of published studies regarding ankle and foot overuse injuries in different sports disciplines and to summariz

  16. 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

  17. Reliability and validity of the Dutch version of the foot and ankle outcome score (FAOS)

    OpenAIRE

    van den Akker-Scheek, Inge; Seldentuis, Arnoud; Reininga, Inge HF; Stevens, Martin

    2013-01-01

    Background The Foot and Ankle Outcome Score (FAOS) is a patient-reported questionnaire measuring symptoms and functional limitations of the foot and ankle. Aim is to translate and culturally adapt the Dutch version of the FAOS and to investigate internal consistency, validity, repeatability and responsiveness. Methods According to the Cross Cultural Adaptation of Self-Report Measures guideline, the FAOS was translated into Dutch. Eighty-nine patients who had undergone an ankle arthroscopy, an...

  18. Foot and ankle surgery in Australia: a descriptive analysis of the Medicare Benefits Schedule database, 1997–2006

    OpenAIRE

    Menz Hylton B; Gilheany Mark F; Landorf Karl B

    2008-01-01

    Abstract Background Foot and ankle problems are highly prevalent in the general community and a substantial proportion of people seek surgical treatment to alleviate foot pain and deformity. However, the epidemiology of foot and ankle surgery has not been examined in detail. Therefore, the aim of this study was to examine patterns and costs of private sector foot surgery provision in Australia. Methods Data pertaining to all foot and ankle surgical procedures for the calendar years 1997–2006 ...

  19. The Effect of an Inclined Ankle on the Activation of the Abductor Hallucis Muscle during Short Foot Exercise

    OpenAIRE

    Heo, Hyo-Jin; An, Duk-hyun

    2014-01-01

    [Purpose] The purpose of this study was to identify the effects of an inclined ankle on the activation of the abductor hallucis muscle during short foot exercises. [Subjects] We recruited 14 healthy volunteers who were free of pain, and did not suffer from arthritis or osteomuscular problems related to the foot or ankle. [Methods] The subjects performed short foot exercises and short inclined foot exercises with 30° passive ankle dorsiflexion. [Results] The exercise with an inclined foot show...

  20. The relationship of foot and ankle mobility to the frontal plane projection angle in asymptomatic adults

    OpenAIRE

    Wyndow, Narelle; De Jong, Amy; Rial, Krystal; Tucker, Kylie; Collins, Natalie; Vicenzino, Bill; Russell, Trevor; Crossley, Kay

    2016-01-01

    Background The frontal plane projection angle (FPPA) is frequently used as a measure of dynamic knee valgus during functional tasks, such as the single leg squat. Increased dynamic knee valgus is observed in people with knee pathologies including patellofemoral pain and anterior cruciate injury. As the foot is the primary interface with the support surface, foot and ankle mobility may affect the FPPA. This study investigated the relationship between foot and ankle mobility and the FPPA in asy...

  1. Biomechanical consequences of gait impairment at the ankle and foot : Injury, malalignment, and co-contraction

    OpenAIRE

    Wang, Ruoli

    2012-01-01

    The human foot contributes significantly to the function of the whole lower extremity during standing and locomotion. Nevertheless, the foot and ankle often suffer injuries and are affected by many musculoskeletal and neurological pathologies. The overall aim of this thesis was to evaluate gait parameters and muscle function change due to foot and ankle injury, malalignment and co-contraction. Using 3D gait analysis, analytical analyses and computational simulations, biomechanical consequence...

  2. Performance of spinal cord injury individuals while standing with the Mohammad Taghi Karimi reciprocal gait orthosis (MTK-RGO)

    International Nuclear Information System (INIS)

    Most patients with spinal cord injury use a wheelchair to transfer from place to place, however they need to stand and walk with orthosis to improve their health status. Although many orthoses have been designed for paraplegic patients, they have experienced various problems while in use. A new type of reciprocal gait orthosis was designed in the Bioengineering Unit of Strathclyde University to solve the problems of the available orthoses. Since there was no research undertaken regarding testing of the new orthosis on paraplegic subjects, this study was aimed to evaluate the new orthosis during standing of paraplegic subjects. Five paraplegic patients with lesion level between T12 and L1 and aged matched normal subjects were recruited into this study. The stability of subjects was evaluated during quiet standing and while undertaking hand tasks during standing with the new orthosis and the knee ankle foot orthosis (KAFO). The difference between the performances of paraplegic subjects while standing with both orthoses, and between the function of normal and paraplegic subjects were compared using the paired t test and independent sample t test, respectively. The stability of paraplegic subjects in standing with the new orthosis was better than that of the KAFO orthosis (p < 0.05). Moreover, the force applied on the crutch differed between the orthoses. The functional performance of paraplegic subjects was better with the new orthosis compared with normal subjects. The performance of paraplegic subjects while standing with the new orthosis was better than the KAFO. Therefore, the new orthosis may be useful to improve standing and walking in patients with paraplegia.

  3. Finite Element Analysis of Foot and Ankle Impact Injury: Risk Evaluation of Calcaneus and Talus Fracture

    OpenAIRE

    Duo Wai-Chi Wong; Wenxin Niu; Yan Wang; Ming Zhang

    2016-01-01

    Introduction Foot and ankle impact injury is common in geriatric trauma and often leads to fracture of rearfoot, including calcaneus and talus. The objective of this study was to assess the influence of foot impact on the risk of calcaneus and talus fracture via finite element analysis. Methods A three-dimensional finite element model of foot and ankle was constructed based on magnetic resonance images of a female aged 28. The foot sustained a 7-kg passive impact through a foot plate. The sim...

  4. Management of diabetic neuropathic foot and ankle malunions and nonunions

    Directory of Open Access Journals (Sweden)

    John J. Stapleton

    2011-05-01

    Full Text Available The management of diabetic neuropathic foot and ankle malunions and/or nonunions is often complicated by the presence of broken or loosened hardware, Charcot joints, infection, osteomyelitis, avascular bone necrosis, unstable deformities, bone loss, disuse and pathologic osteopenia, and ulcerations. The author discusses a rational approach to functional limb salvage with various surgical techniques that are aimed at achieving anatomic alignment, long-term osseous stability, and adequate soft tissue coverage. Emphasis is placed on techniques to overcome the inherent challenges that are encountered when surgically managing a diabetic nonunion and/or malunion. Particular attention is directed to the management of deep infection and Charcot neuroarthropathy in the majority of the cases presented.

  5. Foot and ankle tuberculosis: case series and literature review.

    Science.gov (United States)

    Korim, Muhammad; Patel, Rizwan; Allen, Patricia; Mangwani, Jitendra

    2014-12-01

    Foot and ankle tuberculosis (TB) is a rare presentation of skeletal TB. The uncommon site along with low index of clinical suspicion in the western world leads to delays in the diagnosis and treatment. This can make joint sparing procedures less successful, especially in the midfoot where the joints can often be interconnected. Plain radiographs have low sensitivity and specificity and cross sectional imaging in the form of MRI or CT is more reliable. Treatment involves the use of multiple anti-tuberculous drugs in the first instance, followed by surgery to address any symptomatic deformity and/or secondary degenerative changes. We present our experience on the management of this rare problem and review the literature on the clinical presentation, diagnosis, imaging modalities and treatment. PMID:25178156

  6. Seronegative inflammations of the ankle and foot: diagnostic challenges

    International Nuclear Information System (INIS)

    Seronegative inflammatory disease was diagnosed in seven patients who had pain, swelling, and redness of the foot and/or ankle. Since the clinical findings mimicked infection, tendinitis, fasciitis, or chronic strain, the initial diagnosis was erroneous and treatment ineffective. In addition to the test for the HLA-B27 antigen, technetium-99m-diphosphonate scintigraphy and magnification roentgenograms have proved valuable tools. Increased isotope uptake was found in all involved extremities, and magnification roentgenograms helped to detect early and subtle lesions of bone. The lesions comprised cortical erosion, increased intracortical absorption of bone, periosteal reactions, and osteoporosis. The response to anti-inflammatory drugs was good in all seven patients. Limited and preliminary follow-up data, including repeat bone scans, suggest that the inflammation may be of a transient nature

  7. Seronegative inflammations of the ankle and foot: diagnostic challenges

    Energy Technology Data Exchange (ETDEWEB)

    Capen, D.; Scheck, M.

    Seronegative inflammatory disease was diagnosed in seven patients who had pain, swelling, and redness of the foot and/or ankle. Since the clinical findings mimicked infection, tendinitis, fasciitis, or chronic strain, the initial diagnosis was erroneous and treatment ineffective. In addition to the test for the HLA-B27 antigen, technetium-99m-diphosphonate scintigraphy and magnification roentgenograms have proved valuable tools. Increased isotope uptake was found in all involved extremities, and magnification roentgenograms helped to detect early and subtle lesions of bone. The lesions comprised cortical erosion, increased intracortical absorption of bone, periosteal reactions, and osteoporosis. The response to anti-inflammatory drugs was good in all seven patients. Limited and preliminary follow-up data, including repeat bone scans, suggest that the inflammation may be of a transient nature.

  8. Clinical Efficacy and Safety of a New Method for Pressure Off-load for Patients with Diabetic Foot Syndrome: Ankle-foot Pneumoorthosis with TM Orlett

    Directory of Open Access Journals (Sweden)

    Galina Yurevna Strakhova

    2014-09-01

    Full Text Available AimThe purpose of this study was to assess the clinical efficacy, safety and consumer properties of ankle-foot pneumoorthosis with a HAS-337 TM Orlett compared with non-removable total contact cast (TCC immobilization.Materials and methodsOur study included 40 patients with diabetes mellitus type 1 (DM1 and type 2 (DM2 with neuropathic diabetic foot syndrome and chronic uninfected wounds of the plantar surface of the forefoot, with wound duration of at least 3 weeks, wound areas not less than 1 cm2 and wound depths not more than stage II based on Wagner’s classification. We excluded patients with infected wounds, osteomyelitis, Charcot osteoarthropathy or peripheral vascular disease. Our test group included 20 patients who received pressure off-load using ankle-foot pneumoorthosis with a HAS-337 TM Orlett. For a control group (n = 20, pressure off-load was achieved using TCC immobilization. Both groups were comparable with regard to age, gender, duration and degree of diabetes compensation and by original wound defect sizes (p >0.05. The study duration was 6 months. Plantar pressure was measured inside the orthosis or TCC and was compared with test shoe measurements. Our major criteria for pressure relief were reduced pressures in the wound area and the whole foot and the rate of wound healing.ResultsAt the end of the 6-month period, complete healing of all ulcers was achieved. The average healing time was 46.1±19.0 days for the test group and was 48.3±20.5 days for the control group (p >0.05. Two patients who wore pneumoorthosis with HAS-337 were discontinued upon patient request.With pneumoorthosis, the maximum peak pressure on the foot and wound defect areas was reduced by 26% and 57%, respectively. The pressure/time integral decreased on average by 41% (p >0.05. Furthermore, in the midfoot area with pneumoorthosis, the maximum pressure increased by 48% and the pressure/time integral increased by 47%.ConclusionsUsing pneumoorthosis with

  9. Powered ankle-foot prosthesis for the improvement of amputee ambulation.

    Science.gov (United States)

    Au, Samuel K; Herr, Hugh; Weber, Jeff; Martinez-Villalpando, Ernesto C

    2007-01-01

    This paper presents the mechanical design, control scheme, and clinical evaluation of a novel, motorized ankle-foot prosthesis, called MIT Powered Ankle-Foot Prosthesis. Unlike a conventional passive-elastic ankle-foot prosthesis, this prosthesis can provide active mechanical power during the stance period of walking. The basic architecture of the prosthesis is a unidirectional spring, configured in parallel with a force-controllable actuator with series elasticity. With this architecture, the anklefoot prosthesis matches the size and weight of the human ankle, and is also capable of delivering high mechanical power and torque observed in normal human walking. We also propose a biomimetic control scheme that allows the prosthesis to mimic the normal human ankle behavior during walking. To evaluate the performance of the prosthesis, we measured the rate of oxygen consumption of three unilateral transtibial amputees walking at self-selected speeds to estimate the metabolic walking economy. We find that the powered prosthesis improves amputee metabolic economy from 7% to 20% compared to the conventional passive-elastic prostheses (Flex-Foot Ceterus and Freedom Innovations Sierra), even though the powered system is twofold heavier than the conventional devices. This result highlights the benefit of performing net positive work at the ankle joint to amputee ambulation and also suggests a new direction for further advancement of an ankle-foot prosthesis. PMID:18002631

  10. MR imaging of the foot and ankle: patterns of bone marrow signal abnormalities

    International Nuclear Information System (INIS)

    Diagnosis of marrow disorders of the foot and ankle is among the more challenging aspects of MR interpretation. Evaluation of normal and abnormal bone marrow with regard to pattern, distribution, and signal characteristics on different sequences often allows a specific diagnosis. This pictorial review illustrates MR imaging findings of normal variants of bone marrow of the foot and ankle, and the varied responses of bone marrow to trauma, stress, or disease. (orig.)

  11. Reconstruction of Soft-Tissue Defects at the Foot and Ankle after Oncological Resection

    OpenAIRE

    Ring, Andrej; Kirchhoff, Pascal; Goertz, Ole; Behr, Bjorn; Daigeler, Adrien; Lehnhardt, Marcus; HARATI, KAMRAN

    2016-01-01

    Introduction Solid malignancies at the foot and ankle region are rare and include mainly soft-tissue sarcomas, bone sarcomas, and skin malignancies. Complete surgical resection with clear margins still remains the mainstay of therapy in these malignancies. However, attainment of negative surgical margins in patients with locally advanced tumors of the foot and ankle region may require extensive surgery and could result in loss of extremity function. In these circumstances, plastic surgical...

  12. Reconstruction of Soft-Tissue Defects at the Foot and Ankle after Oncological Resection

    OpenAIRE

    Ring, Andrej; Kirchhoff, Pascal; Goertz, Ole; Behr, Bjorn; Daigeler, Adrien; Lehnhardt, Marcus; HARATI, KAMRAN

    2016-01-01

    Introduction Solid malignancies at the foot and ankle region are rare and include mainly soft-tissue sarcomas, bone sarcomas, and skin malignancies. Complete surgical resection with clear margins still remains the mainstay of therapy in these malignancies. However, attainment of negative surgical margins in patients with locally advanced tumors of the foot and ankle region may require extensive surgery and could result in loss of extremity function. In these circumstances, plastic surgical te...

  13. Foot and Ankle Injuries in Professional Soccer Players: Diagnosis, Treatment, and Expectations.

    Science.gov (United States)

    Nery, Caio; Raduan, Fernando; Baumfeld, Daniel

    2016-06-01

    Soccer is one of the most popular sports in the world. It has undergone many changes in recent years, mainly because of increased physical demands, and this has led to an increased injury risk. Direct contact accounts for half of all injuries in both indoor and outdoor soccer and ankle sprains are the most common foot and ankle injury. There is a spectrum of foot and ankle injuries and their treatment should be individualized in these high-demand patients. An injury prevention program is also important and should the players, the trainer, responsible physician, and physical therapists. PMID:27261812

  14. Pathology-designed custom molded foot orthoses.

    Science.gov (United States)

    Rosenbloom, Kevin B

    2011-01-01

    Treating patients with custom foot orthoses for common pathologies is a rewarding experience when the proper steps are taken during foot casting and custom-orthosis prescription writing. This article describes successful methods for orthoses casting and prescription writing for custom-molded orthoses for Achilles tendonitis, pes planus, hallux limitus, plantar fasciitis/heel spurs, lateral ankle instability, metatarsalgia, and pes cavus. In addition, a summary of orthotic laboratory instructions for each pathology-designed custom orthosis is provided, which should be considered by orthotic laboratories. PMID:21276525

  15. The Split Second Effect: The Mechanism of How Equinus Can Damage the Human Foot and Ankle.

    Science.gov (United States)

    Amis, James

    2016-01-01

    We are currently in the process of discovering that many, if not the majority, of the non-traumatic acquired adult foot and ankle problems are caused by a singular etiology: non-neuromuscular equinus or the isolated gastrocnemius contracture. There is no question that this biomechanical association exists and in time much more will be uncovered. There are three basic questions that must be answered: why would our calves tighten as we normally age, how does a tight calf, or equinus, actually cause problems remotely in the foot and ankle, and how do the forces produced by equinus cause so many seemingly unrelated pathologies in the foot and ankle? The purpose of this paper is to address the second question: how does a tight calf mechanically cause problems remotely in the foot and ankle? There has been little evidence in the literature addressing the biomechanical mechanisms by which equinus creates damaging forces upon the foot and ankle, and as a result, a precise, convincing mechanism is still lacking. Thus, the mere concept that equinus has anything to do with foot pathology is generally unknown or disregarded. The split second effect, described here, defines exactly how the silent equinus contracture creates incremental and significant damage and injury to the human foot and ankle resulting in a wide variety of pathological conditions. The split second effect is a dissenting theory based on 30 years of clinical and academic orthopedic foot and ankle experience, keen clinical observation along the way, and review of the developing literature, culminating in examination of many hours of slow motion video of normal and abnormal human gait. To my knowledge, no one has ever described the mechanism in detail this precise. PMID:27512692

  16. Towards a better understanding of foot and ankle kinematics in rheumatoid arthritis : the effects of walking speed and structural impairments

    OpenAIRE

    Dubbeldam, Rosemary

    2012-01-01

    From an early stage of the disease 40% to 60% of the Rheumatoid arthritis (RA) patients suffer from walking impairments such as pain, diminished mobility and problems with daily activities. With the recent development of optical recording technologies and detailed foot and ankle computer models, typical RA foot and ankle kinematic measures have been assessed and reported. However, the relationships between kinematics and walking impairments or pathological changes of foot and ankle structures...

  17. Functional analysis of the foot and ankle myology of gibbons and bonobos

    OpenAIRE

    Vereecke, Evie; D'Aout, K; Payne, R; Aerts, P.

    2005-01-01

    This study investigates the foot and ankle myology of gibbons and bonobos, and compares it with the human foot. Gibbons and bonobos are both highly arboreal species, yet they have a different locomotor behaviour. Gibbon locomotion is almost exclusively arboreal and is characterized by speed and mobility, whereas bonobo locomotion entails some terrestrial knuckle-walking and both mobility and stability are important. We examine if these differences in locomotion are reflected in their foot myo...

  18. 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.

  19. The role of the reversed oblique radiograph in trauma of the foot and ankle

    Energy Technology Data Exchange (ETDEWEB)

    Geusens, E.; Geyskens, W.; Brys, P. [Dept. of Radiology, University Hospitals, Leuven (Belgium); Janzing, H. [Dept. of Traumatology, University Hospitals, Leuven (Belgium)

    2000-03-01

    The objective of this study was to demonstrate the statistical significance of a reversed oblique radiograph of the foot in patients with ankle or foot trauma. In 100 consecutive patients a reversed oblique radiograph of the foot was taken in addition to the conventional plain films. Ten of 29 fractures were not visualised on the conventional films of foot and ankle and could only be diagnosed on the reversed oblique film. In 7 of these 10 cases an avulsion fracture at the anterolateral aspect of the calcaneus was present. This additional reversed oblique film of the foot seems to be of considerable importance, especially when an anterolateral avulsion fracture of the calcaneus is clinically suspected. (orig.)

  20. Reproducibility of and sex differences in common orthopaedic ankle and foot tests in runners

    OpenAIRE

    Worp, M.P. van der; Wijer, A. de; Staal, J.B.; Nijhuis-Van der Sanden, M.W.

    2014-01-01

    BACKGROUND: For future etiologic cohort studies in runners it is important to identify whether (hyper)pronation of the foot, decreased ankle joint dorsiflexion (AJD) and the degree of the extension of the first Metatarsophalangeal joint (MTP1) are risk factors for running injuries and to determine possible sex differences.These parameters are frequently determined with the navicular drop test (NDT) Stance and Single Limb-Stance, the Ankle Joint Dorsiflexion-test, and the extension MTP1-test i...

  1. Health care consumption and costs due to foot and ankle injuries in the Netherlands, 1986-2010

    NARCIS (Netherlands)

    A.S. de Boer (Annette ); T. Schepers (Tim); M.J.M. Panneman (Martien); E.F. van Beeck (Ed); E.M.M. van Lieshout (Esther)

    2014-01-01

    textabstractBackground: Foot and ankle injuries account for a large proportion of Emergency Department attendance. The aim of this study was to assess population-based trends in attendances due to foot and ankle injuries in the Netherlands since 1986, and to provide a detailed analysis of health car

  2. Management of High-Energy Foot and Ankle Injuries in the Geriatric Population

    Science.gov (United States)

    Herscovici, Dolfi; Scaduto, Julia M.

    2012-01-01

    By the year 2035 almost 20% of the US population of 389 million people will be 65 years and older. What this group has, compared with aged populations in the past, is better health, more mobility, and more active lifestyles. From January 1989 through December 2010, a total of 494 elderly patients with 536 foot and ankle injuries were identified. Within this group, 237 (48%) patients with 294 injuries were sustained as a result of a high-energy mechanism. These mechanisms consisted of 170 motor vehicle accidents, 30 as a result of high (not ground level) energy falls, 2 from industrial accidents, and 35 classified as other, which included sports, blunt trauma, bicycle, airplane or boating accidents, crush injuries, and injuries resulting from a lawn mower. The injuries produced were 17 metatarsal fractures, 9 Lisfranc injuries, 10 midfoot (navicular, cuneiform, or cuboid) fractures, 23 talus fractures, 63 calcaneal fractures, 73 unimalleolar, bimalleolar, or trimalleolar ankle fractures, 45 pilon fractures, and 3 pure dislocations of the foot or ankle. Overall, 243 (83%) of these injuries underwent surgical fixation and data have shown that when surgery is used to manage high-energy injuries of the foot and ankle in the elderly individuals, the complications and outcomes are similar to those seen in younger patients. Therefore, the decision for surgical intervention for high-energy injuries of the foot and ankle should be based primarily on the injury pattern and not solely on the age of the patient. PMID:23569695

  3. MRI diagnosis of soft ganglion cyst in the foot and ankle

    International Nuclear Information System (INIS)

    Objective: To explore the clinical and MR imaging features of soft tissue ganglion cyst in the foot and ankle. Methods: Clinical and MR imaging data of 12 patients (male to female ratio 1:5, mean age 47 years) with soft tissue ganglion cysts in the feet and ankles were retrospectively analyzed. Results: The 12 ganglion cysts were located near the first metatarsophalangeal joint (2), in the medial dorsum of foot (4), in the ankle (5) and in the heel (1). Compared with muscle, all lesions showed homogeneous slight T1 hypointensity and T2 hyperintensity with thin mural enhancement following the injection of Gd-DTPA. Ten cases were multilocular, and 5 showed mild pericystic edema. Conclusion: Soft tissue ganglion cyst of the foot and ankle are more common in middle aged women. They are frequently located in the ankle and medial dorsum of foot. On MRI they usually appear as multilocular cysts with homogeneous slightly low signal intensity relative to muscle on T1WI, high signal intensity on T2WI and contrast enhancement of the thin wall. (authors)

  4. Negative pressure wound therapy for soft tissue injuries around the foot and ankle

    OpenAIRE

    Oh Jong-Keon; Shon Oog-Jin; Min Woo-Kie; Oh Chang-Wug; Kim Joon-Woo; Lee Hyun-Joo; Park Byung-Chul; Ihn Joo-Chul

    2009-01-01

    Abstract Background This study was performed to evaluate the results of negative pressure wound therapy (NPWT) in patients with open wounds in the foot and ankle region. Materials and methods Using a NPWT device, 16 patients were prospectively treated for soft tissue injuries around the foot and ankle. Mean patient age was 32.8 years (range, 3–67 years). All patients had suffered an acute trauma, due to a traffic accident, a fall, or a crush injury, and all had wounds with underlying tendon o...

  5. Eversion during external rotation of the human cadaver foot produces high ankle sprains.

    Science.gov (United States)

    Wei, Feng; Post, Joel M; Braman, Jerrod E; Meyer, Eric G; Powell, John W; Haut, Roger C

    2012-09-01

    While high ankle sprains are often clinically ascribed to excessive external foot rotation, no experimental study documents isolated anterior tibiofibular ligament (ATiFL) injury under this loading. We hypothesized that external rotation of a highly everted foot would generate ATiFL injury, in contrast to deltoid ligament injury from external rotation of a neutral foot. Twelve (six pairs) male cadaveric lower extremity limbs underwent external foot rotation until gross failure. All limbs were positioned in 20° of dorsiflexion and restrained with elastic athletic tape. Right limbs were in neutral while left limbs were everted 20°. Talus motion relative to the tibia was measured using motion capture. Rotation at failure for everted limbs (46.8 ± 6.1°) was significantly greater than for neutral limbs (37.7 ± 5.4°). Everted limbs showed ATiFL injury only, while neutral limbs mostly demonstrated deltoid ligament failure. This is the first biomechanical study to produce isolated ATiFL injury under external foot rotation. Eversion of the axially loaded foot predisposes the ATiFL to injury, forming a basis for high ankle sprain. The study helps clarify a mechanism of high ankle sprain and may heighten clinical awareness of isolated ATiFL injury in cases of foot eversion prior to external rotation. It may also provide guidance to investigate the effect of prophylactic measures for this injury. PMID:22328337

  6. Do clinical foot and ankle assessments improve the prediction of patient reported outcomes in knee arthroplasty?

    OpenAIRE

    Gates, Lucy

    2015-01-01

    Knee arthroplasty (KA) has been considered to be a successful and cost-effective intervention for individuals with severe end stage Osteoarthritis (OA). A number of clinically important predictors of outcomes following KA have been established, however there are still other factors to be identified to improve our ability to recognise patients at risk of poor KA outcomes. Although the relationship between foot, ankle and knee kinematics has become widely accepted, it is not known whether foot ...

  7. Patient specific ankle-foot orthoses using rapid prototyping

    Directory of Open Access Journals (Sweden)

    Sivak Seth

    2011-01-01

    Full Text Available Abstract Background Prefabricated orthotic devices are currently designed to fit a range of patients and therefore they do not provide individualized comfort and function. Custom-fit orthoses are superior to prefabricated orthotic devices from both of the above-mentioned standpoints. However, creating a custom-fit orthosis is a laborious and time-intensive manual process performed by skilled orthotists. Besides, adjustments made to both prefabricated and custom-fit orthoses are carried out in a qualitative manner. So both comfort and function can potentially suffer considerably. A computerized technique for fabricating patient-specific orthotic devices has the potential to provide excellent comfort and allow for changes in the standard design to meet the specific needs of each patient. Methods In this paper, 3D laser scanning is combined with rapid prototyping to create patient-specific orthoses. A novel process was engineered to utilize patient-specific surface data of the patient anatomy as a digital input, manipulate the surface data to an optimal form using Computer Aided Design (CAD software, and then download the digital output from the CAD software to a rapid prototyping machine for fabrication. Results Two AFOs were rapidly prototyped to demonstrate the proposed process. Gait analysis data of a subject wearing the AFOs indicated that the rapid prototyped AFOs performed comparably to the prefabricated polypropylene design. Conclusions The rapidly prototyped orthoses fabricated in this study provided good fit of the subject's anatomy compared to a prefabricated AFO while delivering comparable function (i.e. mechanical effect on the biomechanics of gait. The rapid fabrication capability is of interest because it has potential for decreasing fabrication time and cost especially when a replacement of the orthosis is required.

  8. Natural history of sensory nerve recovery after cutaneous nerve injury following foot and ankle surgery

    Science.gov (United States)

    Bai, Lu; Han, Yan-ni; Zhang, Wen-tao; Huang, Wei; Zhang, Hong-lei

    2015-01-01

    Cutaneous nerve injury is the most common complication following foot and ankle surgery. However, clinical studies including long-term follow-up data after cutaneous nerve injury of the foot and ankle are lacking. In the current retrospective study, we analyzed the clinical data of 279 patients who underwent foot and ankle surgery. Subjects who suffered from apparent paresthesia in the cutaneous sensory nerve area after surgery were included in the study. Patients received oral vitamin B12 and methylcobalamin. We examined final follow-up data of 17 patients, including seven with sural nerve injury, five with superficial peroneal nerve injury, and five with plantar medial cutaneous nerve injury. We assessed nerve sensory function using the Medical Research Council Scale. Follow-up immediately, at 6 weeks, 3, 6 and 9 months, and 1 year after surgery demonstrated that sensory function was gradually restored in most patients within 6 months. However, recovery was slow at 9 months. There was no significant difference in sensory function between 9 months and 1 year after surgery. Painful neuromas occurred in four patients at 9 months to 1 year. The results demonstrated that the recovery of sensory function in patients with various cutaneous nerve injuries after foot and ankle surgery required at least 6 months. PMID:25788928

  9. Natural history of sensory nerve recovery after cutaneous nerve injury following foot and ankle surgery

    Directory of Open Access Journals (Sweden)

    Lu Bai

    2015-01-01

    Full Text Available Cutaneous nerve injury is the most common complication following foot and ankle surgery. However, clinical studies including long-term follow-up data after cutaneous nerve injury of the foot and ankle are lacking. In the current retrospective study, we analyzed the clinical data of 279 patients who underwent foot and ankle surgery. Subjects who suffered from apparent paresthesia in the cutaneous sensory nerve area after surgery were included in the study. Patients received oral vitamin B 12 and methylcobalamin. We examined final follow-up data of 17 patients, including seven with sural nerve injury, five with superficial peroneal nerve injury, and five with plantar medial cutaneous nerve injury. We assessed nerve sensory function using the Medical Research Council Scale. Follow-up immediately, at 6 weeks, 3, 6 and 9 months, and 1 year after surgery demonstrated that sensory function was gradually restored in most patients within 6 months. However, recovery was slow at 9 months. There was no significant difference in sensory function between 9 months and 1 year after surgery. Painful neuromas occurred in four patients at 9 months to 1 year. The results demonstrated that the recovery of sensory function in patients with various cutaneous nerve injuries after foot and ankle surgery required at least 6 months

  10. Natural history of sensory nerve recovery after cutaneous nerve injury following foot and ankle surgery

    Institute of Scientific and Technical Information of China (English)

    Lu Bai; Yan-ni Han; Wen-tao Zhang; Wei Huang; Hong-lei Zhang

    2015-01-01

    Cutaneous nerve injury is the most common complication following foot and ankle surgery. However, clinical studies including long-term follow-up data after cutaneous nerve injury of the foot and ankle are lacking. In the current retrospective study, we analyzed the clinical data of 279 patients who underwent foot and ankle surgery. Subjects who suffered from apparent paresthesia in the cutaneous sensory nerve area after surgery were included in the study. Pa-tients received oral vitamin B12 and methylcobalamin. We examined ifnal follow-up data of 17 patients, including seven with sural nerve injury, ifve with superifcial peroneal nerve injury, and ifve with plantar medial cutaneous nerve injury. We assessed nerve sensory function using the Medical Research Council Scale. Follow-up immediately, at 6 weeks, 3, 6 and 9 months, and 1 year after surgery demonstrated that sensory function was gradually restored in most patients within 6 months. However, recovery was slow at 9 months. There was no signiifcant difference in sensory function between 9 months and 1 year after surgery. Painful neuromas occurred in four patients at 9 months to 1 year. The results demonstrated that the recovery of sensory func-tion in patients with various cutaneous nerve injuries after foot and ankle surgery required at least 6 months.

  11. 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

  12. Kinematics and kinetics with an adaptive ankle foot system during stair ambulation of transtibial amputees.

    Science.gov (United States)

    Alimusaj, Merkur; Fradet, Laetitia; Braatz, Frank; Gerner, Hans J; Wolf, Sebastian I

    2009-10-01

    Conventional prosthetic feet cannot adapt to specific conditions such as walking on stairs or ramps. Amputees are therefore forced to compensate their prosthetic deficits by modifying the kinematics and kinetics of their lower limbs. The Proprio-Foot (Ossur) intends to reduce these compensation mechanisms by automatically increasing dorsiflexion during stair ambulation thanks to an adaptive microprocessor-controlled ankle. The present investigation proposes to analyze the biomechanical effects of the dorsiflexion adaptation in transtibial (TT) amputees during stair ambulation. Sixteen TT amputees and sixteen healthy controls underwent conventional 3D gait analysis. Kinematics and kinetics of the lower limbs were compared during stair ascent and descent performed by patients with the prosthetic foot set to a neutral ankle angle and with an adapted dorsiflexion ankle angle of 4 degrees . Norm distance as well as minimum and maximal values of sagittal kinematics and kinetics were calculated for comparisons between patients and control subjects. For both stair ascent and descent, an improvement of the knee kinematics and kinetics could particularly be noticed on the involved side with an increase of the knee flexion and an increase of the knee moment during stance. Therefore, despite its additional weight compared to a conventional prosthetic ankle, the Proprio-Foot should be beneficial to active TT amputees whose knee musculature strength does not constitute a handicap. PMID:19616436

  13. Definition of coordinate system for three-dimensional data analysis in the foot and ankle.

    LENUS (Irish Health Repository)

    Green, Connor

    2012-02-01

    BACKGROUND: Three-dimensional data is required to have advanced knowledge of foot and ankle kinematics and morphology. However, studies have been difficult to compare due to a lack of a common coordinate system. Therefore, we present a means to define a coordinate frame in the foot and ankle and its clinical application. MATERIALS AND METHODS: We carried out ten CT scans in anatomically normal feet and segmented them in a general purpose segmentation program for grey value images. 3D binary formatted stereolithography files were then create and imported to a shape analysis program for biomechanics which was used to define a coordinate frame and carry out morphological analysis of the forefoot. RESULTS: The coordinate frame had axes standard deviations of 2.36 which are comparable to axes variability of other joint coordinate systems. We showed a strong correlation between the lengths of the metatarsals within and between the columns of the foot and also among the lesser metatarsal lengths. CONCLUSION: We present a reproducible method for construction of a coordinate system for the foot and ankle with low axes variability. CLINICAL RELEVANCE: To conduct meaningful comparison between multiple subjects the coordinate system must be constant. This system enables such comparison and therefore will aid morphological data collection and improve preoperative planning accuracy.

  14. Adipofascial sural artery flap for foot and ankle reconstruction in children: for better aesthetic outcome

    International Nuclear Information System (INIS)

    Wheel spoke injury of the ankle and foot is very common in children and its reconstruction is challenging. Reverse flow sural artery fasciocutaneous flap is versatile for this area but lead to significant donor site morbidity. Free tissue transfer is an option in children which needs a micro-vascular expertise, expensive equipment and long operating time. Method: Fifteen adipofascial flaps were done for foot and ankle coverage from June 2011 to June 2014 at CH and ICH Lahore. The efficacy of adipofascial sural artery flap for the coverage of these defects was evaluated. Results: Fifteen children presented with defects of foot and ankle, 11 (73%) were male and 4 (27%) were female. Their age ranged from 1 - 13 years. All patients had trauma to the foot due to wheel spoke injury. Flaps were used to cover tendoachilles and malleoli. In one patient there was flap tip necrosis with partial graft loss which healed with dressings. Donor site aesthetic outcome was satisfactory in all cases. Mean follow-up was I year. Conclusion: Adipofascial Sural artery flap is quick and safe with wide arc of rotation, minimal donor site morbidity and better aesthetic outcome and it does not sacrifice major extremity vessel. (author)

  15. An EMG-Controlled SMA Device for the Rehabilitation of the Ankle Joint in Post-Acute Stroke

    Science.gov (United States)

    Pittaccio, S.; Viscuso, S.

    2011-07-01

    The capacity of flexing one's ankle is an indispensible segment of gait re-learning, as imbalance, wrong compensatory use of other joints and risk of falling may depend on the so-called drop-foot. The rehabilitation of ankle dorsiflexion may be achieved through active exercising of the relevant musculature (especially tibialis anterior, TA). This can be troublesome for patients affected by weakness and flaccid paresis. Thus, as needs evolve during patient's improvements, a therapeutic device should be able to guide and sustain gradual recovery by providing commensurate aid. This includes exploiting even initial attempts at voluntary motion and turns those into effective workout. An active orthosis powered by two rotary actuators containing NiTi wire was designed to obtain ankle dorsiflexion. A computer routine that analyzes the electromyographic (sEMG) signal from TA muscle is used to control the orthosis and trigger its activation. The software also provides instructions and feed-back for the patient. Tests on the orthosis proved that it can produce strokes up to 36° against resisting torques exceeding 180 Ncm. Three healthy subjects were able to control the orthosis by modulating their TA sEMG activity. The movement produced in the preliminary tests is interesting for lower limb rehabilitation, and will be further improved by optimizing body-orthosis interface. It is hoped that this device will enhance early rehabilitation and recovery of ankle mobility in stroke patients.

  16. 3D musculo-skeletal finite element analysis of the foot kinematics under muscle activation with and without ankle arthrodesis

    OpenAIRE

    Perrier, Antoine; Bucki, Marek; Luboz, Vincent; Vuillerme, Nicolas; Payan, Yohan

    2015-01-01

    The choice between arthrodesis and arthroplasty in the context of advanced ankle arthrosis remains a highly disputed topic in the field of foot and ankle surgery. Arthrodesis, however, represents the most popular option. Biomechanical modeling has been widely used to investigate static loading of cadaveric feet as well as consequences of arthrodesis on bony structures. Although foot kinematics has been studied using motion analysis, this approach lacks accuracy in capturing internal joints mo...

  17. Progress in the clinical imaging research of bone diseases on ankle and foot sesamoid bones and accessory ossicles

    OpenAIRE

    Li, Xiaozhong; Shi, Lenian; Liu, Taiyun; Wang, Lin

    2012-01-01

    Sesamoid bones and accessory ossicles are research focuses of foot and ankle surgery. Pains of the foot and ankle are related to sesamoid bones and accessory ossicles. The specific anatomical and functional relationship of sesamoid bones and accessory ossicles can cause such bone diseases as the dislocation of sesamoid bones and accessory bones, infection, inflammation and necrosis of sesamoid bones, cartilage softening, tenosynovitis of sesamoid bones and the sesamoid bone syndrome. However,...

  18. Health care consumption and costs due to foot and ankle injuries in the Netherlands, 1986-2010

    OpenAIRE

    Boer, Annette; Schepers, Tim; Panneman, Martien; Van Beeck, Ed; Lieshout, Esther

    2014-01-01

    textabstractBackground: Foot and ankle injuries account for a large proportion of Emergency Department attendance. The aim of this study was to assess population-based trends in attendances due to foot and ankle injuries in the Netherlands since 1986, and to provide a detailed analysis of health care costs in these patients. Methods. Age- and gender-standardized emergency attendance rates and incidence rates for hospital admission were calculated for each year of the study. Injury cases and h...

  19. Use of the semitendinosus tendon for foot and ankle tendon reconstructions,

    Directory of Open Access Journals (Sweden)

    Frederico Lutti Guerra de Aguiar Zink

    2014-10-01

    Full Text Available Objective:To demonstrate the results obtained from foot and ankle tendon reconstructions using the tendon of the semitendinosus muscle. The clinical results, the patient's degree of satisfaction and complications in the graft donor and recipient areas were evaluated.Methods:This was a retrospective study in which the medical files of 38 patients who underwent this surgical procedure between 2006 and 2010 were surveyed. The functional results from this technique, the complications in the donor and recipient areas and the patients' degree of satisfaction were evaluated.Results:Three patients presented complications in the recipient area (skin necrosis; one patient showed complications in the donor area (pain and insensitivity; and all patients had satisfactory functional results, with complete range of motion.Conclusion:The semitendinosus muscle is a good option for treatments for foot and ankle tendon injuries.

  20. Utility of Fresh Frozen Section Analysis in Foot and Ankle Surgery: A Pilot Study.

    Science.gov (United States)

    Monaco, Spencer J; Manway, Jeffery M; Burns, Patrick R

    2016-01-01

    The use of intraoperative fresh frozen section (FFS) analysis to determine the presence of infection has been well reported in orthopedic studies. Specifically, the number of polymorphonuclear leukocytes per high-power field has been used to diagnose total joint arthroplasty-related infection. Less commonly, reconstructive surgeons have extended the use of FFS analysis for intraoperative evaluation when suspicion of deep infection with or without hardware is high. The purpose of the present study was to retrospectively review the data from 11 patients undergoing foot and ankle reconstruction in the setting of possible deep infection and determine the usefulness of FFS analysis. A retrospective review of the medical records of patients who had undergone reconstructive foot and ankle revision surgery with intraoperative FFS analysis and tissue/swab cultures available was performed. A positive FFS was defined as >5 polymorphonuclear leukocytes per high-power field. A positive frozen section was associated with a positive tissue culture 4 of 7 times (57%). The sensitivity and specificity of FFS analysis for infection was 80% and 50%, respectively. The positive and negative predictive value of the FFS result was 57.1% and 75%, respectively. In conclusion, FFS analysis and intraoperative cultures correlated only 57% of the time in the present series. This test had moderate sensitivity for detecting infection at 80%, but the specificity was poor (50%). More research is needed to further evaluate the role of FFS analysis in foot and ankle surgery. PMID:27068638

  1. Negative pressure wound therapy for soft tissue injuries around the foot and ankle

    Directory of Open Access Journals (Sweden)

    Oh Jong-Keon

    2009-05-01

    Full Text Available Abstract Background This study was performed to evaluate the results of negative pressure wound therapy (NPWT in patients with open wounds in the foot and ankle region. Materials and methods Using a NPWT device, 16 patients were prospectively treated for soft tissue injuries around the foot and ankle. Mean patient age was 32.8 years (range, 3–67 years. All patients had suffered an acute trauma, due to a traffic accident, a fall, or a crush injury, and all had wounds with underlying tendon or bone exposure. Necrotic tissues were debrided before applying NPWT. Dressings were changed every 3 or 4 days and treatment was continued for 18.4 days on average (range, 11–29 days. Results Exposed tendons and bone were successfully covered with healthy granulation tissue in all cases except one. The sizes of soft tissue defects reduced from 56.4 cm2 to 42.9 cm2 after NPWT (mean decrease of 24%. In 15 of the 16 cases, coverage with granulation tissue was achieved and followed by a skin graft. A free flap was needed to cover exposed bone and tendon in one case. No major complication occurred that was directly attributable to treatment. In terms of minor complications, two patients suffered scar contracture of grafted skin. Conclusion NPWT was found to facilitate the rapid formation of healthy granulation tissue on open wounds in the foot and ankle region, and thus, to shorten healing time and minimize secondary soft tissue defect coverage procedures.

  2. Estimation of ground reaction force and zero moment point on a powered ankle-foot prosthesis.

    Science.gov (United States)

    Martinez-Villalpando, Ernesto C; Herr, Hugh; Farrell, Matthew

    2007-01-01

    The ground reaction force (GRF) and the zero moment point (ZMP) are important parameters for the advancement of biomimetic control of robotic lower-limb prosthetic devices. In this document a method to estimate GRF and ZMP on a motorized ankle-foot prosthesis (MIT Powered Ankle-Foot Prosthesis) is presented. The method proposed is based on the analysis of data collected from a sensory system embedded in the prosthetic device using a custom designed wearable computing unit. In order to evaluate the performance of the estimation methods described, standing and walking clinical studies were conducted on a transtibial amputee. The results were statistically compared to standard analysis methodologies employed in a gait laboratory. The average RMS error and correlation factor were calculated for all experimental sessions. By using a static analysis procedure, the estimation of the vertical component of GRF had an averaged correlation coefficient higher than 0.94. The estimated ZMP location had a distance error of less than 1 cm, equal to 4% of the anterior-posterior foot length or 12% of the medio-lateral foot width. PMID:18003052

  3. C.T. imaging of the foot and ankle

    International Nuclear Information System (INIS)

    Acute or chronic injuries to the tarsus are sometimes very difficult to diagnose on conventional X-ray examination, due to the nature of the injury sustained or the subtle changes that are sought. Patients with these injuries proceed to Nuclear Medicine bone scan examination to find if there is an injury, but this examination does not yield the detail or extent of damage that is required by orthopedic surgeons. Computerized tomography (C.T.) imaging produces exquisite bony detail in the axial and coronal planes that make diagnosis simple and treatment easily planned. C.T. is clearly superior to plain film examination in the search for fibrous tarsal coalition, and yields greater anatomical information in patients with known osseous foot disorders. C.T. may also demonstrate multiplicity of coalition. 9 figs

  4. Finite Element Analysis of Foot and Ankle Impact Injury: Risk Evaluation of Calcaneus and Talus Fracture.

    Directory of Open Access Journals (Sweden)

    Duo Wai-Chi Wong

    Full Text Available Foot and ankle impact injury is common in geriatric trauma and often leads to fracture of rearfoot, including calcaneus and talus. The objective of this study was to assess the influence of foot impact on the risk of calcaneus and talus fracture via finite element analysis.A three-dimensional finite element model of foot and ankle was constructed based on magnetic resonance images of a female aged 28. The foot sustained a 7-kg passive impact through a foot plate. The simulated impact velocities were from 2.0 to 7.0 m/s with 1.0 m/s interval.At 5.0 m/s impact velocity, the maximum von Mises stress of the trabecular calcaneus and talus were 3.21MPa and 2.41MPa respectively, while that of the Tresca stress were 3.46MPa and 2.55MPa. About 94% and 84% of the trabecular calcaneus and talus exceeded the shear yielding stress, while 21.7% and 18.3% yielded the compressive stress. The peak stresses were distributed around the talocalcaneal articulation and the calcaneal tuberosity inferiorly, which corresponded to the common fracture sites.The prediction in this study showed that axial compressive impact at 5.0 m/s could produce considerable yielding of trabecular bone in both calcaneus and talus, dominantly by shear and compounded with compression that predispose the rearfoot in the risk of fracture. This study suggested the injury pattern and fracture mode of high energy trauma that provides insights in injury prevention and fracture management.

  5. Mechanical energy profiles of the combined ankle-foot system in normal gait: insights for prosthetic designs.

    Science.gov (United States)

    Takahashi, Kota Z; Stanhope, Steven J

    2013-09-01

    Over the last half-century, the field of prosthetic engineering has continuously evolved with much attention being dedicated to restoring the mechanical energy properties of ankle joint musculatures during gait. However, the contributions of 'distal foot structures' (e.g., foot muscles, plantar soft tissue) have been overlooked. Therefore, the purpose of this study was to quantify the total mechanical energy profiles (e.g., power, work, and work-ratio) of the natural ankle-foot system (NAFS) by combining the contributions of the ankle joint and all distal foot structures during stance in level-ground steady state walking across various speeds (0.4, 0.6, 0.8 and 1.0 statures/s). The results from eleven healthy subjects walking barefoot indicated ankle joint and distal foot structures generally performed opposing roles: the ankle joint performed net positive work that systematically increased its energy generation with faster walking speeds, while the distal foot performed net negative work that systematically increased its energy absorption with faster walking speeds. Accounting for these simultaneous effects, the combined ankle-foot system exhibited increased work-ratios with faster walking. Most notably, the work-ratio was not significantly greater than 1.0 during the normal walking speed of 0.8 statures/s. Therefore, a prosthetic design that strategically exploits passive-dynamic properties (e.g., elastic energy storage and return) has the potential to replicate the mechanical energy profiles of the NAFS during level-ground steady-state walking. PMID:23628408

  6. MRI abnormalities of foot and ankle in asymptomatic, physically active individuals

    International Nuclear Information System (INIS)

    Objective. To assess MRI changes in the ankle and foot after physical exercise.Design and patients. Nineteen non-professional marathon runners and 19 age- and sex-matched controls volunteered for the study. All had ankle and foot MR images (1.5 T) taken in three perpendicular planes (STIR, T2F and T1FS sequences) within 3 h of running a full-length marathon (42.125 km). Three radiologists independently analysed the groups on a masked basis using a predefined form.Results. Severe bone marrow oedema was seen in one and slight bone marrow oedema in three marathon runners. Slight bone marrow oedema was found in three control subjects. Signal alteration within the soleus muscle, consistent with a grade 1 strain, was found in one marathon runner. Small punctate hyperintensities within the Achilles tendon were seen in 26% of the marathon runners and in 63% of controls (P=0.016). An increased amount of fluid in the retrocalcaneal bursa was found in one control and in none of the marathon runners. Small amounts of fluid in the retrocalcaneal bursa were seen in 68% of marathon runners and in 53% of controls. Grade 1 or 2 peritendinous joint fluid was found around 22% of tendons, among both marathon runners and controls, most often involving the tendon sheath of the flexor hallucis longus muscle. An increased amount of joint fluid was noted in 34% of the joints of the marathon runners, and in 18% of the controls.Conclusion. MRI shows several abnormalities in the ankle and foot both after marathon races and in asymptomatic physically active individuals without any preceding extraordinary strain. Recreational sports may lead to a number of positive MRI findings without correlation with clinical findings. (orig.)

  7. MRI abnormalities of foot and ankle in asymptomatic, physically active individuals

    Energy Technology Data Exchange (ETDEWEB)

    Lohman, M.; Kivisaari, A.; Kivisaari, L. [Helsinki Univ. Central Hospital (Finland). Dept. of Radiology; Vehmas, T.; Malmivaara, A. [Finnish Inst. of Occupational Health, Helsinki (Finland); Kallio, P. [Orthopaedic Div., Dept. of Paediatric Surgery, Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki (Finland)

    2001-02-01

    Objective. To assess MRI changes in the ankle and foot after physical exercise.Design and patients. Nineteen non-professional marathon runners and 19 age- and sex-matched controls volunteered for the study. All had ankle and foot MR images (1.5 T) taken in three perpendicular planes (STIR, T2F and T1FS sequences) within 3 h of running a full-length marathon (42.125 km). Three radiologists independently analysed the groups on a masked basis using a predefined form.Results. Severe bone marrow oedema was seen in one and slight bone marrow oedema in three marathon runners. Slight bone marrow oedema was found in three control subjects. Signal alteration within the soleus muscle, consistent with a grade 1 strain, was found in one marathon runner. Small punctate hyperintensities within the Achilles tendon were seen in 26% of the marathon runners and in 63% of controls (P=0.016). An increased amount of fluid in the retrocalcaneal bursa was found in one control and in none of the marathon runners. Small amounts of fluid in the retrocalcaneal bursa were seen in 68% of marathon runners and in 53% of controls. Grade 1 or 2 peritendinous joint fluid was found around 22% of tendons, among both marathon runners and controls, most often involving the tendon sheath of the flexor hallucis longus muscle. An increased amount of joint fluid was noted in 34% of the joints of the marathon runners, and in 18% of the controls.Conclusion. MRI shows several abnormalities in the ankle and foot both after marathon races and in asymptomatic physically active individuals without any preceding extraordinary strain. Recreational sports may lead to a number of positive MRI findings without correlation with clinical findings. (orig.)

  8. Management of High-Energy Foot and Ankle Injuries in the Geriatric Population

    OpenAIRE

    Herscovici, Dolfi; Scaduto, Julia M.

    2012-01-01

    By the year 2035 almost 20% of the US population of 389 million people will be 65 years and older. What this group has, compared with aged populations in the past, is better health, more mobility, and more active lifestyles. From January 1989 through December 2010, a total of 494 elderly patients with 536 foot and ankle injuries were identified. Within this group, 237 (48%) patients with 294 injuries were sustained as a result of a high-energy mechanism. These mechanisms consisted of 170 moto...

  9. Inter-assessor reliability of practice based biomechanical assessment of the foot and ankle

    Directory of Open Access Journals (Sweden)

    Jarvis Hannah L

    2012-06-01

    Full Text Available Abstract Background There is no consensus on which protocols should be used to assess foot and lower limb biomechanics in clinical practice. The reliability of many assessments has been questioned by previous research. The aim of this investigation was to (i identify (through consensus what biomechanical examinations are used in clinical practice and (ii evaluate the inter-assessor reliability of some of these examinations. Methods Part1: Using a modified Delphi technique 12 podiatrists derived consensus on the biomechanical examinations used in clinical practice. Part 2: Eleven podiatrists assessed 6 participants using a subset of the assessment protocol derived in Part 1. Examinations were compared between assessors. Results Clinicians choose to estimate rather than quantitatively measure foot position and motion. Poor inter-assessor reliability was recorded for all examinations. Intra-class correlation coefficient values (ICC for relaxed calcaneal stance position were less than 0.23 and were less than 0.14 for neutral calcaneal stance position. For the examination of ankle joint dorsiflexion, ICC values suggest moderate reliability (less than 0.61. The results of a random effects ANOVA highlight that participant (up to 5.7°, assessor (up to 5.8° and random (up to 5.7° error all contribute to the total error (up to 9.5° for relaxed calcaneal stance position, up to 10.7° for the examination of ankle joint dorsiflexion. Kappa Fleiss values for categorisation of first ray position and mobility were less than 0.05 and for limb length assessment less than 0.02, indicating slight agreement. Conclusion Static biomechanical assessment of the foot, leg and lower limb is an important protocol in clinical practice, but the key examinations used to make inferences about dynamic foot function and to determine orthotic prescription are unreliable.

  10. Accessory ossicles and sesamoid bones of the ankle and foot: imaging findings, clinical significance and differential diagnosis

    International Nuclear Information System (INIS)

    Accessory ossicles and sesamoid bones are frequent findings in routine radiographs of the ankle and foot. They are commonly considered fortuitous and unrelated to the patient's complaint; however, they may eventually cause painful syndromes or degenerative changes in response to overuse and trauma. They may also suffer or simulate fractures. Our aim was to review, illustrate and discuss the imaging findings of some of the more frequent accessory ossicles and sesamoid bones of the ankle and foot region, with particular emphasis on those that may be of clinical significance or simulate fractures. (orig.)

  11. Accessory ossicles and sesamoid bones of the ankle and foot: imaging findings, clinical significance and differential diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Mellado, J.M.; Ramos, A.; Salvado, E.; Camins, A.; Sauri, A. [Inst. de Diagnostic per la Imatge, Hospital Universitari de Tarragona Joan XXIII, Tarragona (Spain); Danus, M. [Dept. of Nuclear Medicine, Hospital Universitari de Tarragona Joan XXIII, Tarragona (Spain)

    2003-12-01

    Accessory ossicles and sesamoid bones are frequent findings in routine radiographs of the ankle and foot. They are commonly considered fortuitous and unrelated to the patient's complaint; however, they may eventually cause painful syndromes or degenerative changes in response to overuse and trauma. They may also suffer or simulate fractures. Our aim was to review, illustrate and discuss the imaging findings of some of the more frequent accessory ossicles and sesamoid bones of the ankle and foot region, with particular emphasis on those that may be of clinical significance or simulate fractures. (orig.)

  12. Image-Guided Intervention of the Postoperative Foot and Ankle After Ligament and Tendon Repair.

    Science.gov (United States)

    Khanna, Monica; Walker, Miny; Amiras, Dimitri; Rosenfeld, Peter

    2016-02-01

    This review article describes the potential range of image-guided interventional procedures performed following foot and ankle ligament and/or tendon repair. Diagnosis of the cause of recurrent or persistent pain/symptoms in this postoperative group is challenging and requires a coordinated clinical and radiologic assessment. This directs appropriate treatment including image-guided intervention that may be used both as a diagnostic tool and a therapeutic option. There is a paucity of high-quality studies on the role of image-guided intervention in the foot and ankle after ligament/tendon repair. Many of the procedures used in this group are extrapolated from other areas of the body or the preoperative scenario. We review the role of imaging to identify the cause of postsurgical symptoms and to direct appropriate image-guided intervention. The available injectables and their roles are discussed. Specific surgical procedures are described including lateral ligament repair, Achilles repair, posterior tibialis tendon surgery, and peroneal tendon surgery. PMID:27077592

  13. Development of a Robotic Assembly for Analyzing the Instantaneous Axis of Rotation of the Foot Ankle Complex

    Science.gov (United States)

    Salb, Kelly N.; Wido, Daniel M.; Stewart, Thomas E.; DiAngelo, Denis J.

    2016-01-01

    Ankle instantaneous axis of rotation (IAR) measurements represent a more complete parameter for characterizing joint motion. However, few studies have implemented this measurement to study normal, injured, or pathological foot ankle biomechanics. A novel testing protocol was developed to simulate aspects of in vivo foot ankle mechanics during mid-stance gait in a human cadaveric specimen. A lower leg was mounted in a robotic testing platform with the tibia upright and foot flat on the baseplate. Axial tibia loads (ATLs) were controlled as a function of a vertical ground reaction force (vGRF) set at half body weight (356 N) and a 50% vGRF (178 N) Achilles tendon load. Two specimens were repetitively loaded over 10 degrees of dorsiflexion and 20 degrees of plantar flexion. Platform axes were controlled within 2 microns and 0.008 degrees resulting in ATL measurements within ±2 N of target conditions. Mean ATLs and IAR values were not significantly different between cycles of motion, but IAR values were significantly different between dorsiflexion and plantar flexion. A linear regression analysis showed no significant differences between slopes of plantar flexion paths. The customized robotic platform and advanced testing protocol produced repeatable and accurate measurements of the IAR, useful for assessing foot ankle biomechanics under different loading scenarios and foot conditions. PMID:27099456

  14. 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...

  15. Recurrence rates of burn contracture ankle equinus and other foot deformities in children treated with Ilizarov fixation.

    Science.gov (United States)

    Carmichael, Kelly D; Maxwell, Seth C; Calhoun, Jason H

    2005-01-01

    The purpose of this study was to determine recurrence rates of pediatric foot and ankle burn deformities treated with the Ilizarov method. A total of 19 patients with 29 foot and ankle deformities were studied. The most common deformity treated was equinus (23). Rocker-bottom and cavus foot deformities were each treated three times. The average age of the patient at the time of the burn injury was 3.2 years, and the average age at the time of fixation was 9.4 years. Equinus contractures averaged -34 degrees (34 degrees of plantarflexion) before surgery and +7 degrees (7 degrees of dorsiflexion) after treatment with the Ilizarov fixator. The recurrence rate for all 29 ankles and feet was 69% (20/29). The recurrence rate for equinus contractures was 74% (17/23). The average time to recurrence was 17.3 months. Only short-term follow-up was available on four of the six feet and ankles that did not recur. Deformity correction in burned feet and ankles is difficult to obtain by any means. The authors recommend using the Ilizarov method to obtain correction of moderate to severe foot and ankle deformities in pediatric burn patients, but the correction obtained is not stable and deformity will likely recur. Parents and patients should anticipate adjunctive nonoperative and operative procedures to keep their feet plantigrade as they grow. In young children, the possibility of having additional surgeries, including repeat Ilizarov procedures, should be discussed. Even older children should expect additional surgeries to prevent recurrent deformities. PMID:15958908

  16. Foot and ankle surgery in Australia: a descriptive analysis of the Medicare Benefits Schedule database, 1997–2006

    Directory of Open Access Journals (Sweden)

    Menz Hylton B

    2008-09-01

    Full Text Available Abstract Background Foot and ankle problems are highly prevalent in the general community and a substantial proportion of people seek surgical treatment to alleviate foot pain and deformity. However, the epidemiology of foot and ankle surgery has not been examined in detail. Therefore, the aim of this study was to examine patterns and costs of private sector foot surgery provision in Australia. Methods Data pertaining to all foot and ankle surgical procedures for the calendar years 1997–2006 were extracted from the Australian Medicare Benefits Schedule (MBS database and were cross-tabulated by sex and age. Descriptive analyses were undertaken to assess sex and age differences in the number and type of procedures performed and to assess for temporal trends over the ten year assessment period. The total cost to Medicare of subsiding surgeons' fees in 2006 was also determined. Results During the 1997–2006 period, 996,477 surgical procedures were performed on the foot and ankle by private surgeons in Australia. Approximately equal numbers of procedures were performed on males (52% and females (48%. However, males were more likely to undergo toenail, ankle, clubfoot, tarsal coalition and congenital vertical talus surgery, whereas females were more likely to undergo lesser toe, first metatarsophalangeal joint (MPJ, neuroma, heel, rearfoot and lesser MPJ surgery. The total number of procedures was stable over the assessment period, however there was a relative increase in the number of procedures performed on people aged over 55 years. The total contribution of Medicare to subsiding surgeons' fees for procedures performed in 2006 was $14 M. Conclusion Foot and ankle surgery accounts for a considerable degree of healthcare expenditure in Australia, and the number of procedures in those aged over 55 years is increasing. Given the ageing demographics of the Australian population, the future public health and economic impact of foot morbidity is likely

  17. Acral lentiginous melanoma of the foot and ankle: A case series and review of the literature

    Directory of Open Access Journals (Sweden)

    Acland Katharine

    2008-09-01

    Full Text Available Abstract Background Acral lentiginous melanoma (ALM is an uncommon, cutaneous malignant tumour which may arise on the foot. Its relative rarity, atypical appearance and late presentation frequently serve as poor prognostic indicators. Methods At a tertiary skin tumour centre, a retrospective review was undertaken of all patients diagnosed with the tumour at the level of ankle or below. Results Over a six year period, 27 cases (20 female, 7 male were identified with positive histology confirming the disease. The age ranged from 35–96 years of age (mean 62.7 years. The majority of the cohort were white (59% with plantar lesions (62%. 33% of patients were initially were diagnosed incorrectly. The average time taken from the point of recognition, by the patient, to the lesion being correctly diagnosed was around 13.5 months. Conclusion Earlier diagnosis of ALM requires education at both a patient and practitioner level.

  18. Bilateral Ankle and Subtalar Joint Fusion Secondary to Guillain Barré-Induced Foot Drop.

    Science.gov (United States)

    Seidel, Jay; Mathew, Bindu; Marks, Jeffrey

    2016-01-01

    Guillain-Barré syndrome is a serious disorder that occurs when the body's immune system mistakenly attacks the peripheral nervous system. This leads to nerve inflammation and damage that can cause muscle weakness and/or paralysis, including foot drop. Therapy ranges from supportive measures, such as physical therapy, to surgical intervention. It appears from the published data that these patients, generally, have been left to their own devices, because no known cure is available, necessitating reliance on others for their daily activities and ambulation. We present a unique surgical option, with a follow-up period of 24 months, in which bilateral subtalar and ankle fusion allowed unassisted ambulation to a patient who might otherwise have never walked again. PMID:25128306

  19. FEATURES OF THE X-RAY ANATOMICAL CONDITIONS OF THE FOOT AND ANKLE IN CHILDREN WITH FIBULAR APLASIA

    Directory of Open Access Journals (Sweden)

    Dmitry Stepanovich Buklaev

    2013-03-01

    Full Text Available The article contains the results of the analysis of radiographs of the foot and ankle in 84 children with malformations of the fibula. We found that infants’ relation to the ankle joint is often normal, as in the sagittal and frontal planes. With increasing age the number of posterior subluxation increases as well as anteriorly, laterally. Also dislocations of the foot were presented. The most significant relationships were violations of the subtalar joint. There were pronation, supinatsion, positions of calcaneus bone and its lateroposition, which was the most frequent cause of valgus deformity. Also we found a violation of the form of the talus such as a flattening of the block, smoothing of the neck. In rare cases of the varus deformity of the foot abnormalities of the tarsal bones were observed.

  20. A literature-based guide to the conservative and surgical management of the acute Charcot foot and ankle

    Directory of Open Access Journals (Sweden)

    Valerie L. Schade

    2015-03-01

    Full Text Available Acute Charcot neuroarthropathy of the foot and ankle presents with the insidious onset of a unilateral acutely edematous, erythematous, and warm lower extremity. The acute stages are typically defined as Eichenholtz Stage 1, or Stage 0, which was first described by Shibata et al. in 1990. The ultimate goal of treatment is maintenance of a stable, plantigrade foot which can be easily shod, minimizing the risk of callus, ulceration, infection, and amputation. The gold standard of treatment is non-weight-bearing immobilization in a total contact cast. Surgical intervention remains controversial. A review of the literature was performed to provide an evidenced-based approach to the conservative and surgical management of acute Charcot neuroarthropathy of the foot and ankle.

  1. A framework for parametric modeling of ankle ligaments to determine the in situ response under gross foot motion.

    Science.gov (United States)

    Nie, Bingbing; Panzer, Matthew Brian; Mane, Adwait; Mait, Alexander Ritz; Donlon, John-Paul; Forman, Jason Lee; Kent, Richard Wesley

    2016-09-01

    Ligament sprains account for a majority of injuries to the foot and ankle complex, but ligament properties have not been understood well due to the difficulties in replicating the complex geometry, in situ stress state, and non-uniformity of the strain. For a full investigation of the injury mechanism, it is essential to build up a foot and ankle model validated at the level of bony kinematics and ligament properties. This study developed a framework to parameterize the ligament response for determining the in situ stress state and heterogeneous force-elongation characteristics using a finite element ankle model. Nine major ankle ligaments and the interosseous membrane were modeled as discrete elements corresponding functionally to the ligamentous microstructure of collagen fibers and having parameterized toe region and stiffness at the fiber level. The range of the design variables in the ligament model was determined from existing experimental data. Sensitivity of the bony kinematics to each variable was investigated by design of experiment. The results highlighted the critical role of the length of the toe region of the ligamentous fibers on the bony kinematics with the cumulative influence of more than 95%, while the fiber stiffness was statistically insignificant with an influence of less than 1% under the given variable range and loading conditions. With the flexibility of variable adjustment and high computational efficiency, the presented ankle model was generic in nature so as to maximize its applicability to capture the individual ligament behaviors in future studies. PMID:26712301

  2. Study of occurrence, demography and pathomorphology of ankle and foot fractures and evaluation of the treatment outcome of calcaneal fractures

    International Nuclear Information System (INIS)

    This study highlights which injury has greatest burden, how frequent are the injuries of foot and ankle areas, which is an extremely neglected specialty in orthopedics and also the importance of proper diagnosis, classification of fractures, appropriate pre-operative planning and timely conservative as well as surgical intervention of ankle and foot fractures that resulted in a satisfactory outcome Despite the fact, foot and ankle is the most important locomotor unit of our lower limb, there have been few studies addressing the problem and treatment outcome of such fractures. Objective: To determine the occurrence, demography and pathomorphology of ankle and foot fractures, also evaluation of treatment outcome of calcaneal fractures. Methodology: This was a longitudinal interventional study which dealt with acute traumatic ankle and foot fracture patients coming to Accident and Emergency Department of MHL, DOST unit 1, with inclusion and exclusion criteria clearly defined. Results: Total 100 patients were included in the study. Mean age of patients was 35.71+-13.60 years. Minimum age of patients was 14 and maximum age of patients was 70 years respectively. Gender distribution of patients shows that 15 patients were female and the remaining 85 patients were male. Male patients were greater in number as compared to female patients ie. M: F, 6:1. Mechanism of the injury showed that there were 48 patients who suffered from RTA , 37 patients had trauma due to fall from height, 6 patients had industrial injuries, 5 patients had Fire Arm Injury, and 2 patients had injuries due to domestic activity, 1 had trauma due to sports activity and 1 had injury due to agricultural work. There were 41 patients with fractures of calcaneum and out of which 5 had bilateral fracture calcaneum. They were classified according to CT based Sanders classification. Out of these 22 patients were of Sanders type III, 12 patients were of Sander type II, 5 patients were of Sander type IV, 2

  3. My Experience as a Foot and Ankle Trauma Surgeon in Montreal, Canada: What's Not in the Books.

    Science.gov (United States)

    Leduc, Stéphane; Nault, Marie-Lyne; Rouleau, Dominique M; Hebert-Davies, Jonah

    2016-06-01

    Foot and ankle fractures are sometimes seen as routine and easy to treat. However, many fractures vary from typical patterns and require more complex management. Obtaining good outcomes in these situations can be challenging. Often, the difference between average and good results has to do with preoperative planning and good surgical technique. This article outlines numerous techniques and tricks that are not always mentioned in classic textbooks. It focuses on ankle, talus, calcaneus, and midfoot fractures, and discusses numerous techniques and aids to avoid potential problems that may be encountered intraoperatively. PMID:27261808

  4. Clinical Efficacy and Safety of a New Method for Pressure Off-load for Patients with Diabetic Foot Syndrome: Ankle-foot Pneumoorthosis with TM Orlett

    OpenAIRE

    Galina Yurevna Strakhova; Sergey Valentinovich Gorokhov; Irina Nikolaevna Ulyanova; Gagik Radikovich Galstyan

    2014-01-01

    AimThe purpose of this study was to assess the clinical efficacy, safety and consumer properties of ankle-foot pneumoorthosis with a HAS-337 TM Orlett compared with non-removable total contact cast (TCC) immobilization.Materials and methodsOur study included 40 patients with diabetes mellitus type 1 (DM1) and type 2 (DM2) with neuropathic diabetic foot syndrome and chronic uninfected wounds of the plantar surface of the forefoot, with wound duration of at least 3 weeks, wound areas not less t...

  5. Rates of ankle and foot injuries in active-duty U.S. Army soldiers, 2000-2006.

    Science.gov (United States)

    Wallace, Robert F; Wahi, Monika M; Hill, Owen T; Kay, Ashley B

    2011-03-01

    Ankle and foot injuries (AFI) are a major cause of Active-Duty Army (ADA) soldiers' time lost from training and combat operations. We used the Total Army Injury and Health Outcomes Database to compute the rates of AFI to identify high-risk ADA groups for the years 2000-2006. During this time, 16% of soldiers were clinically seen at least once for an AFI. Yearly, 60% to 70% of ADA soldiers with AFI had an ankle sprain/strain, and ankle sprain/strain had the highest 7-year rate of all AFIs (103 per 1,000). From 2000 to 2006, all AFI rates declined; however, enlisted male soldiers AFI in the previous 2 years increased AFI rates by 93% to 160%. Our findings provide preliminary evidence for identifying specific ADA groups at high risk of AFI; these groups should be targeted for preventive interventions. PMID:21456354

  6. Is immobilization of the ankle and metatarsophalangeal joint effective in suppressing the spread of infection in diabetic foot ulcers?

    Science.gov (United States)

    Sakakibara, Shunsuke; Tsuji, Yoriko; Hashikawa, Kazunobu; Terashi, Hiroto

    2014-09-01

    Diabetics with foot-related problems might eventually need to undergo major or minor amputation because of infection or cellulites. It has been suggested that immobilization of the ankle and the metatarsophalangeal joint suppresses the spread of infection; however, there is no evidence to support this inference. Here, we demonstrate by histological analysis how the immobilization works. The tendon from the amputated toe is harvested, and a hematoxylin-eosin stained paraffin-embedded section is prepared and analyzed. Necrosis occurred in only a single fiber of the tendon, and intact and necrotic or infected tendon fibers were found intermingled. The reciprocal movements of the tendon and the joint (extension and flexion) may be the pathogenic cause of cellulites and infection, leading to the massage effect and the spread of bacteria along the tendon itself. We suggest that immobilizing the ankle and the metatarsophalangeal joint with a removable contacting cast would suppress the spread of infection in foot ulcers. PMID:25106445

  7. Normal Anatomy and Compression Areas of Nerves of the Foot and Ankle: US and MR Imaging with Anatomic Correlation.

    Science.gov (United States)

    De Maeseneer, Michel; Madani, Hardi; Lenchik, Leon; Kalume Brigido, Monica; Shahabpour, Maryam; Marcelis, Stefaan; de Mey, Johan; Scafoglieri, Aldo

    2015-01-01

    The anatomy of the nerves of the foot and ankle is complex, and familiarity with the normal anatomy and course of these nerves as well as common anatomic variants is essential for correct identification at imaging. Ultrasonography (US) and magnetic resonance (MR) imaging allow visualization of these nerves and may facilitate diagnosis of various compression syndromes, such as "jogger's heel," Baxter neuropathy, and Morton neuroma. It may be difficult to distinguish the nerves from adjacent vasculature at MR imaging, and US can help in differentiation. The authors review the normal anatomy and common variants of the nerves of the foot and ankle, with use of dissected specimens and correlative US and MR imaging findings. In addition, the authors illustrate proper probe positioning, which is essential for visualizing the nerves at US. The authors' discussion focuses on the superficial and deep peroneal, sural, saphenous, tibial, medial and lateral plantar, medial and inferior calcaneal, common digital, and medial proper plantar digital nerves. PMID:26284303

  8. Visualisation to enhance biomechanical tuning of ankle-foot orthoses (AFOs) in stroke: study protocol for a randomised controlled trial

    OpenAIRE

    Carse Bruce; Bowers Roy J; Meadows Barry C; Rowe Philip J

    2011-01-01

    Abstract Background There are a number of gaps in the evidence base for the use of ankle-foot orthoses for stroke patients. Three dimensional motion analysis offers an ideal method for objectively obtaining biomechanical gait data from stroke patients, however there are a number of major barriers to its use in routine clinical practice. One significant problem is the way in which the biomechanical data generated by these systems is presented. Through the careful design of bespoke biomechanica...

  9. Do orthopaedic shoes improve local dynamic stability of gait? An observational study in patients with chronic foot and ankle injuries

    OpenAIRE

    Terrier P.; Luthi F.; Dériaz O.

    2013-01-01

    BACKGROUND: Complex foot and ankle fractures, such as calcaneum fractures or Lisfranc dislocations, are often associated with a poor outcome, especially in terms of gait capacity. Indeed, degenerative changes often lead to chronic pain and chronic functional limitations. Prescription footwear represents an important therapeutic tool during the rehabilitation process. Local Dynamic Stability (LDS) is the ability of locomotor system to maintain continuous walking by accommodating small perturba...

  10. Foot and ankle instability in flamenco dancing. Inestabilidad del pie y tobillo en el baile flamenco

    Directory of Open Access Journals (Sweden)

    Alfonso Vargas-Macías

    2012-05-01

    Full Text Available The foot is one of the most susceptible areas to get injured in flamenco dancing, due to footwork, characteristics of footwear and heel height. The aim of this article is to analyze the execution of high speed footwork in foot and/or ankle instability for determining differences regarding dance shoes. Ten professional flamenco dancers have taken part in this investigation, 5 female dancers (29,6+4,7 years, 55+3,5 kg, 163,8+7,3 cm and 5 male dancers (25,2+1,30 years, 61,4+7,2 kg, 171+3,1 cm. The participants had to repeat a dancing sequence consisting of 6 footworks for 15 s. This taping combined 4 different techniques. This sequence was repeated with both feet as many times as possible. The amount of footworks realized have been measured (female 171,2+7,40; male 180,6+11,8 as well as the percentage of cases carried out with ankle instability (female 9,2+1,3%; male 26,1+9,1%. Despite the female dance shoe has a higher heel, which is more associated to skin, toe and structural foot injuries, it is more stable than the flamenco boot. This is due to the necessary boot looseness to be put on/off, which causes a worse foot stability and more imbalance situations during the footwork.El pie es una de las zonas más susceptibles de lesión en el baile flamenco debido al gesto de zapateado, características del calzado y altura del tacón. El objetivo de este artículo es observar la ejecución de zapateados en situación de inestabilidad del pie y/o tobillo, para determinar diferencias en función del calzado de baile. Han participado en el estudio 10 profesionales de baile flamenco, 5 bailaoras (29,6+4,7 años, 55+3,5 kg, 163,8+7,3 cm y 5 bailaores (25,2+1,30 años, 61,4+7,2 kg, 171+3,1 cm. Los participantes debían repetir durante 15 s una secuencia de baile de 6 zapateados, que combinaban 4 gestos técnicos. Esta secuencia se repetía con ambos pies el mayor número de veces posible. Se han contabilizado el número zapateados realizados (bailaoras 171

  11. Parametric study of orthopedic insole of valgus foot on partial foot amputation.

    Science.gov (United States)

    Guo, Jun-Chao; Wang, Li-Zhen; Chen, Wei; Du, Cheng-Fei; Mo, Zhong-Jun; Fan, Yu-Bo

    2016-06-01

    Orthopedic insole was important for partial foot amputation (PFA) to achieve foot balance and avoid foot deformity. The inapposite insole orthosis was thought to be one of the risk factors of reamputation for foot valgus patient, but biomechanical effects of internal tissues on valgus foot had not been clearly addressed. In this study, plantar pressure on heel and metatarsal regions of PFA was measured using F-Scan. The three-dimensional finite element (FE) model of partial foot evaluated different medial wedge angles (MWAs) (0.0°-10.0°) of orthopedic insole on valgus foot. The effect of orthopedic insole on the internal bone stress, the medial ligament tension of ankle, plantar fascia tension, and plantar pressure was investigated. Plantar pressure on medial heel region was about 2.5 times higher than that of lateral region based on the F-Scan measurements. FE-predicted results showed that the tension of medial ankle ligaments was the lowest, and the plantar pressure was redistributed around the heel, the first metatarsal, and the lateral longitudinal arch regions when MWA of orthopedic insole ranged from 7.5° to 8.0°. The plantar fascias maintained about 3.5% of the total load bearing on foot. However, the internal stresses from foot bones increased. The simulation in this study would provide the suggestion of guiding optimal design of orthopedic insole and therapeutic planning to pedorthist. PMID:26291149

  12. The efficacy of using search engines in procuring information about orthopaedic foot and ankle problems from the World Wide Web.

    Science.gov (United States)

    Nogler, M; Wimmer, C; Mayr, E; Ofner, D

    1999-05-01

    This study has attempted to demonstrate the feasibility of obtaining information specific to foot and ankle orthopaedics from the World Wide Web (WWW). Six search engines (Lycos, AltaVista, Infoseek, Excite, Webcrawler, and HotBot) were used in scanning the Web for the following key words: "cavus foot," "diabetic foot," "hallux valgus,"and "pes equinovarus." Matches were classified by language, provider, type, and relevance to medical professionals or to patients. Sixty percent (407 sites) of the visited websites contained information intended for use by physicians and other medical professionals; 30% (206 sites) were related to patient information; 10% of the sites were not easily classifiable. Forty-one percent (169 sites) of the websites were commercially oriented homepages that included advertisements. PMID:10353772

  13. Return to athletic activity after foot and ankle surgery: a preliminary report on select procedures.

    Science.gov (United States)

    Saxena, A

    2000-01-01

    One hundred thirty-eight "athletic" patients from the author's practice underwent retrospective review of their foot and ankle surgery that was performed from 1990 to 1997 to evaluate the time to return to activity. Athletes were defined as follows: professional, varsity college and high school, runners amassing more than 25 miles per week, or those involved in regular competition. No recreational athletes were included. Average follow-up for the group as a whole was 49.4 months, (range, 12-108 months). One hundred seventeen of the 138 patients were able to be contacted and/or had been evaluated by September 1998. One hundred thirteen patients considered their surgery a success. All but two patients were able to return to the desired level of performance. Twenty-three of the patients increased their activity level after surgery. Twenty-eight athletes underwent Achilles tendon-related surgery (average follow-up was 44.5 months). Runners undergoing peritenolyses had an average return to activity of 4.0 weeks (range, 3-6 weeks). Patients undergoing Achilles procedure involving bone resection had an average return to activity of 13.8 weeks (range, 10-20 weeks). Forty-four bunionectomy procedures were performed, including 31 first metatarsal osteotomies. The group's average follow-up was 52.9 months (range, 13-100 months), and average return to activity for the first metatarsal osteotomies was 8.9 weeks. There were 48 rearfoot procedures. Lateral ankle stabilization procedures returned to activity on an average of 10 weeks (range, 7-16 weeks), while excised ossicles (os tibiale externum, os trigonum) had an average return to activity of 9.1 weeks (range, 8-14 weeks). Seven neuroma patients (via dorsal approach) had a return to activity of 4.0 weeks (range, 2.5-6 weeks), sesamoidectomy 7.5 weeks (range, 4-10 weeks), and Valenti arthroplasty of 6.5 weeks (range, 4-12 weeks), respectively. There were minimal complications. Two patients in the Achilles surgery group

  14. A Patient-Specific Foot Model for the Estimate of Ankle Joint Forces in Patients with Juvenile Idiopathic Arthritis.

    Science.gov (United States)

    Prinold, Joe A I; Mazzà, Claudia; Di Marco, Roberto; Hannah, Iain; Malattia, Clara; Magni-Manzoni, Silvia; Petrarca, Maurizio; Ronchetti, Anna B; Tanturri de Horatio, Laura; van Dijkhuizen, E H Pieter; Wesarg, Stefan; Viceconti, Marco

    2016-01-01

    Juvenile idiopathic arthritis (JIA) is the leading cause of childhood disability from a musculoskeletal disorder. It generally affects large joints such as the knee and the ankle, often causing structural damage. Different factors contribute to the damage onset, including altered joint loading and other mechanical factors, associated with pain and inflammation. The prediction of patients' joint loading can hence be a valuable tool in understanding the disease mechanisms involved in structural damage progression. A number of lower-limb musculoskeletal models have been proposed to analyse the hip and knee joints, but juvenile models of the foot are still lacking. This paper presents a modelling pipeline that allows the creation of juvenile patient-specific models starting from lower limb kinematics and foot and ankle MRI data. This pipeline has been applied to data from three children with JIA and the importance of patient-specific parameters and modelling assumptions has been tested in a sensitivity analysis focused on the variation of the joint reaction forces. This analysis highlighted the criticality of patient-specific definition of the ankle joint axes and location of the Achilles tendon insertions. Patient-specific detection of the Tibialis Anterior, Tibialis Posterior, and Peroneus Longus origins and insertions were also shown to be important. PMID:26374518

  15. A universal ankle-foot prosthesis emulator for human locomotion experiments.

    Science.gov (United States)

    Caputo, Joshua M; Collins, Steven H

    2014-03-01

    Robotic prostheses have the potential to significantly improve mobility for people with lower-limb amputation. Humans exhibit complex responses to mechanical interactions with these devices, however, and computational models are not yet able to predict such responses meaningfully. Experiments therefore play a critical role in development, but have been limited by the use of product-like prototypes, each requiring years of development and specialized for a narrow range of functions. Here we describe a robotic ankle-foot prosthesis system that enables rapid exploration of a wide range of dynamical behaviors in experiments with human subjects. This emulator comprises powerful off-board motor and control hardware, a flexible Bowden cable tether, and a lightweight instrumented prosthesis, resulting in a combination of low mass worn by the human (0.96 kg) and high mechatronic performance compared to prior platforms. Benchtop tests demonstrated closed-loop torque bandwidth of 17 Hz, peak torque of 175 Nm, and peak power of 1.0 kW. Tests with an anthropomorphic pendulum "leg" demonstrated low interference from the tether, less than 1 Nm about the hip. This combination of low worn mass, high bandwidth, high torque, and unrestricted movement makes the platform exceptionally versatile. To demonstrate suitability for human experiments, we performed preliminary tests in which a subject with unilateral transtibial amputation walked on a treadmill at 1.25 ms-1 while the prosthesis behaved in various ways. These tests revealed low torque tracking error (RMS error of 2.8 Nm) and the capacity to systematically vary work production or absorption across a broad range (from -5 to 21 J per step). These results support the use of robotic emulators during early stage assessment of proposed device functionalities and for scientific study of fundamental aspects of human-robot interaction. The design of simple, alternate end-effectors would enable studies at other joints or with

  16. Postural Control Characteristics during Single Leg Standing of Individuals with a History of Ankle Sprain: Measurements Obtained Using a Gravicorder and Head and Foot Accelerometry

    OpenAIRE

    Abe, Yota; Sugaya, Tomoaki; Sakamoto, Masaaki

    2014-01-01

    [Purpose] This study aimed to validate the postural control characteristics of individuals with a history of ankle sprain during single leg standing by using a gravicorder and head and foot accelerometry. [Subjects] Twenty subjects with and 23 subjects without a history of ankle sprain (sprain and control groups, respectively) participated. [Methods] The anteroposterior, mediolateral, and total path lengths, as well as root mean square (RMS) of each length, were calculated using the gravicord...

  17. The foot posture index, ankle lunge test, Beighton scale and the lower limb assessment score in healthy children: a reliability study

    Directory of Open Access Journals (Sweden)

    Evans Angela M

    2012-01-01

    Full Text Available Abstract Background Outcome measures are important when evaluating treatments and physiological progress in paediatric populations. Reliable, relevant measures of foot posture are important for such assessments to be accurate over time. The aim of the study was to assess the intra- and inter-rater reliability of common outcome measures for paediatric foot conditions. Methods A repeated measures, same-subject design assessed the intra- and inter-rater reliability of measures of foot posture, joint hypermobility and ankle range: the Foot Posture Index (FPI-6, the ankle lunge test, the Beighton scale and the lower limb assessment scale (LLAS, used by two examiners in 30 healthy children (aged 7 to 15 years. The Oxford Ankle Foot Questionnaire (OxAFQ-C was completed by participants and a parent, to assess the extent of foot and ankle problems. Results The OxAFQ-C demonstrated a mean (SD score of 6 (6 in adults and 7(5 for children, showing good agreement between parents and children, and which indicates mid-range (transient disability. Intra-rater reliability was good for the FPI-6 (ICC = 0.93 - 0.94, ankle lunge test (ICC = 0.85-0.95, Beighton scale (ICC = 0.96-0.98 and LLAS (ICC = 0.90-0.98. Inter-rater reliability was largely good for each of the: FPI-6 (ICC = 0.79, ankle lunge test (ICC = 0.83, Beighton scale (ICC = 0.73 and LLAS (ICC = 0.78. Conclusion The four measures investigated demonstrated adequate intra-rater and inter-rater reliability in this paediatric sample, which further justifies their use in clinical practice.

  18. 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 ...

  19. 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

  20. Lightweight modular orthosis.

    Science.gov (United States)

    Engen, T

    1989-12-01

    Background and highlights are presented concerning the development of a new orthotic system judged to be "the most outstanding innovation in prosthetics and/or orthotics practice" during the 1986-1989 period. The first Brian Blatchford Prize was awarded at the Sixth World Congress of ISPO held in Kobe, Japan. November 12-17, 1989. The new development selected as most deserving of this award consists of a system utilizing inexpensive, lightweight, modular components which can be quickly assembled with a few hand tools to provide custom-fitted knee-ankle-foot orthoses for persons with paraplegia and quadriplegia. These leg frames support standing and permit the patient to begin receiving the physical and psychological benefits of weightbearing as soon as medically feasible after injury. Later, if desired, specially designed knee-joints, with a variety of possible locking features, can be installed on the existing leg frames at a reasonable cost. PMID:2608419

  1. Extended ankle and foot fasciotomy as an enhancement to the surgical treatment of patients with prolonged ischemia of the lower extremities

    Directory of Open Access Journals (Sweden)

    Mišović Sidor

    2005-01-01

    Full Text Available Aim. To present the technique and efficacy of extended ankle and foot fasciotomy, as a surgical limb-salvage procedure associated with the successful revascularization after the gold interval. Method. A retrospective review of six patients at the age of 16−79 years (mean 39 in the period from 1996 to 2003, treated with the extended ankle and foot fasciotomy. There were four males undergoing the delayed treatment of war injuries to the lower extremity, and two females with atherosclerotic occlusive disease (a. illiacae dex and a. poplitealis dex.. The average ishemic time in the wounded patients was 22 hours (range, 14−30 hours, and ischemic time in occlusive disease (range, 48−72 hours. Clinical signs, indications, surgical access and the technique of extended ankle and foot fasciotomy was reported. Results. The obtained results were classified as early and late. There was no cases with lethal outcome. Incisional wounds closed 15 days after the intervention, using secondary suture or skin transplant sec. Thiersch. The satisfactory functional results were achieved in 4 of the patients, 1 had a small edema, while amputation was performed in 1 patient. Conclusion. In cases of prolonged foot ischemia with edema and paresthesia in the toes, extended ankle and foot fasciotomy should be performed as a surgical limb-salvage procedure.

  2. Validity, reliability, and responsiveness of a self-reported foot and ankle score (SEFAS)

    OpenAIRE

    Cöster, Maria; Karlsson, Magnus K; Nilsson, Jan-Åke; Carlsson, Åke

    2012-01-01

    Background and purpose A questionnaire was introduced by the New Zealand Arthroplasty Registry for use when evaluating the outcome of total ankle replacement surgery. We evaluated the reliability, validity, and responsiveness of the modified Swedish version of the questionnaire (SEFAS) in patients with osteoarthritis or inflammatory arthritis before and/or after their ankle was replaced or fused. Patients and methods The questionnaire was translated into Swedish and cross-culturally adapted a...

  3. Long-term effect on foot and ankle donor site following vascularized fibular graft resection in children.

    Science.gov (United States)

    Sulaiman, Abdul Razak; Wan, Zulmi; Awang, Shukrimi; Che Ahmad, Aminudin; Halim, Ahmad Sukari; Ahmad Mohd Zain, Rajaei

    2015-09-01

    This study was carried out to evaluate the long-term effect on the donor side of the foot and ankle following vascularized fibular graft resection in children. Eight patients underwent resection of the fibula for the purpose of a vascularized fibular graft by a surgical team who practiced leaving at least 6 cm residual distal fibula. The age of these children at the time of surgery was between 3 and 12 years. They were reviewed between 3 and 12 years after surgery. Two patients who underwent resection of the middle shaft of the fibula at 3 and 5 years of age developed abnormal growth of the distal tibia, leading to ankle valgus. They were treated with growth modulation of the distal tibial physis and supramalleolar osteotomy with tibiofibular synostosis. Another patient who underwent the entire proximal fibula resection at the age of 6 years had developed hindfoot valgus because of weakness of the tibialis posterior muscle. He required talonavicular fusion and flexor hallucis to tibialis posterior muscle transfer. Patients operated at the age of older than 8 years neither had ankle nor hindfoot deformity. We concluded that resection of the middle shaft of the fibula for the purpose of a vascularized fibula graft, leaving a 6 cm distal fibular stump in children younger than 6 years old, may give rise to abnormal growth of the distal tibial physis, leading to valgus ankle. The entire proximal fibular resection for the similar purpose in a 6-year-old child may give rise to weakness of tibialis posterior and hindfoot valgus. PMID:26049965

  4. Application of ankle joint adem position combined with foot inclined position in ankle sprain%踝关节正侧位联合足正斜位在足踝扭伤中的应用

    Institute of Scientific and Technical Information of China (English)

    施付强; 胡扬; 刘霞; 汪伟伟

    2015-01-01

    目的:探讨踝关节扭伤的X线检查技术及诊断,以降低误诊漏诊率。方法8例足踝扭伤并致骨折的患者,均行踝关节正侧位检查及足正斜位检查,观察检查结果。结果8例患者中,有1例外踝骨折,踝关节正侧位显示不如足正斜位,1例外踝骨折踝关节正侧位未能显示,而足正斜位能清晰显示,1例第五跖骨基底部骨折足正斜位显示不如踝关节正侧位。结论踝关节扭伤患者行踝关节正侧位联合足正斜位检查比单纯踝关节正侧位检查或单纯足正斜位检查能更好的显示骨折线,从而提高诊断符合率。%Objective To investigate X-ray examination technique and diagnosis of ankle joint sprain, in order to reduce misdiagnosis rate. Methods There were 8 patients with fractures caused by ankle joint sprain, and they all received ankle joint adem position examination and foot inclined position examination. Examination results were observed. Results Among the 8 patients, there was 1 case with lateral malleolus fracture, whose ankle joint adem position result was worse than foot inclined position, 1 case with lateral malleolus fracture, which was not showed by ankle joint adem position but was clearly showed by foot inclined position, and 1 case with fracture in basilar part of the fifth metatarsal bone, which had ankle joint adem position results better than foot inclined position. Conclusion Application of ankle joint adem position combined with foot inclined position examination can show the fracture line better than single examination by joint adem position or foot inclined position, thereby the coincidence rate of diagnosis can be improved.

  5. Associations between static and functional measures of joint function in the foot and ankle.

    Science.gov (United States)

    Wrobel, James S; Connolly, John E; Beach, Michael L

    2004-01-01

    Clinicians have traditionally assessed range of motion of the first metatarsophalangeal and ankle joints in a static position. It is unclear, however, if these measurements accurately reflect functional sagittal plane limitations of these joints during gait. For 50 patients (100 feet), we assessed available dorsiflexion at the first metatarsophalangeal and ankle joints, as well as the presence of pinch callus. We then compared these findings with 11 functional gait parameters, as measured using a pressure sensor system. After adjusting for age, weight, smoking status, glycosylated hemoglobin, and insensitivity to monofilament, we found that patients with pinch callus demonstrated statistically significant compensatory gait patterns in 7 of 11 measures. Hallux limitus and equinus patients demonstrated six and three statistically significant associations, respectively. Pinch callus seems to be as predictive of functional gait alterations as static first metatarsophalangeal joint and ankle dorsiflexion. PMID:15547120

  6. Management of sports injuries of the foot and ankle: an update.

    Science.gov (United States)

    Ballal, M S; Pearce, C J; Calder, J D F

    2016-07-01

    Sporting injuries around the ankle vary from simple sprains that will resolve spontaneously within a few days to severe injuries which may never fully recover and may threaten the career of a professional athlete. Some of these injuries can be easily overlooked altogether or misdiagnosed with potentially devastating effects on future performance. In this review article, we cover some of the common and important sporting injuries involving the ankle including updates on their management and outcomes. Cite this article: Bone Joint J 2016;98-B:874-83. PMID:27365464

  7. Low-dose multi-slice CT with three dimensional rendering of the tendons of foot and ankle

    International Nuclear Information System (INIS)

    Objective: To study the feasibility and reasonability of low-dose multi-slice CT (MSCT) with three dimensional rendering of the tendons of foot, and ankle. The statistical methods including ANOVA and Kruskal-Wallis H was used. Methods: Forty-five consecutive patients with fractures of foot and ankle were enrolled and evenly grouped into A(80 kV, 100 mAs), B (110 kV, 60 mAs) and C (130 kV, 60 mAs). The MSCT scanning range was 6 slices of 1.0 mm. The CT value and standard deviation (SD) of the muscle and the CTDIvol were recorded. The image quality of volume rendering of the tendons was blindly evaluated. Results: The CT value of muscle in group A (71.6±12.0) HU was significantly higher than group B [(66.8±9.2) HU, P=0.010] and C [(66.1±7.1) HU, P=0.004]. The SD average values were 11.9, 6.1 and 7.0 HU for three groups, and there were significant differences among the three groups (F= 37.142, P=O.0000). Group A had the highest SD value, group C had the lowest. SD; CTDIvol average value were (3.01±0.08), (4.63±0.11), (7.02±0.24) mGy respectively, which were significant different among the three groups (H =39.185, P=0.000). Group A had the lowest CTDIvol, while group C had the highest CTDIvol. Volume rendering of the tendons was evaluated as 2.3±0.5, 3.7±0.5, 4.8± 0.4, and there were significant differences among the three groups (H=72.779, P=0.000). Group A had the worst VR images, while group C had the best VR images. All VR images in Group B were good for diagnosis. Conclusion: The protocol of 110 kV, 60 mAs, and 1 mm × 6 with three-dimensional volume rendering would be enough for evaluating the tendons of foot and ankle. (authors)

  8. Design and Preliminary Evaluation of a Two DOFs Cable-Driven Ankle-Foot Prosthesis with Active Dorsiflexion-Plantarflexion and Inversion-Eversion.

    Science.gov (United States)

    Ficanha, Evandro Maicon; Ribeiro, Guilherme Aramizo; Dallali, Houman; Rastgaar, Mohammad

    2016-01-01

    This paper describes the design of an ankle-foot robotic prosthesis controllable in the sagittal and frontal planes. The prosthesis was designed to meet the mechanical characteristics of the human ankle including power, range of motion, and weight. To transfer the power from the motors and gearboxes to the ankle-foot mechanism, a Bowden cable system was used. The Bowden cable allows for optimal placement of the motors and gearboxes in order to improve gait biomechanics such as the metabolic energy cost and gait asymmetry during locomotion. Additionally, it allows flexibility in the customization of the device to amputees with different residual limb sizes. To control the prosthesis, impedance controllers in both sagittal and frontal planes were developed. The impedance controllers used torque feedback from strain gages installed on the foot. Preliminary evaluation was performed to verify the capability of the prosthesis to track the kinematics of the human ankle in two degrees of freedom (DOFs), the mechanical efficiency of the Bowden cable transmission, and the ability of the prosthesis to modulate the impedance of the ankle. Moreover, the system was characterized by describing the relationship between the stiffness of the impedance controllers to the actual stiffness of the ankle. Efficiency estimation showed 85.4% efficiency in the Bowden cable transmission. The prosthesis was capable of properly mimicking human ankle kinematics and changing its mechanical impedance in two DOFs in real time with a range of stiffness sufficient for normal human walking. In dorsiflexion-plantarflexion (DP), the stiffness ranged from 0 to 236 Nm/rad and in inversion-eversion (IE), the stiffness ranged from 1 to 33 Nm/rad. PMID:27200342

  9. 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...

  10. Magic angle effect in MR imaging of ankle tendons: influence of foot positioning on prevalence and site in asymptomatic subjects and cadaveric tendons

    Energy Technology Data Exchange (ETDEWEB)

    Mengiardi, Bernard; Pfirrmann, Christian W.A.; Hodler, Juerg; Zanetti, Marco [Orthopedic University Hospital Balgrist, Department of Radiology, Zurich (Switzerland); Schoettle, Philip B.; Vienne, Patrick [Orthopedic University Hospital Balgrist, Department of Orthopedic Surgery, Zurich (Switzerland); Bode, Beata [Zurich University Hospital, Department of Pathology, Zurich (Switzerland)

    2006-10-15

    The influence of foot positioning on prevalence of the magic angle effect (MAE) in ankle tendons was investigated. In 30 asymptomatic volunteers and five cadaveric feet, MR imaging of the ankle was performed in the supine (neutral position of the foot) and prone (plantar-flexed foot) position. MAE was considered if increased T1-weighted signal at a certain site was seen in one position only. Histological correlation was obtained at 25 sites of the cadaveric posterior tibialis tendons (PTT). MAE occurred in 6/30 vs 1/30 (supine vs prone) anterior tibialis tendons (ATT), 30/30 vs 0/30 extensor hallucis longus and 27/30 vs 0/30 extensor digitorum longus tendons, 29/30 vs 0/30 PTTs, 30/30 vs 0/30 flexor digitorum and flexor hallucis longus tendons, 30/30 vs 1/30 peroneus brevis and 23/30 vs 1/30 peroneus longus tendons. At 12/25 cadaveric PTT sites where MAE was exclusively responsible for the increased signal, histology revealed normal tissue (11/12) or minimal degeneration (1/12). In conclusion, the supine body position with neutral position of the foot, a high prevalence (77-100%) of MAE in ankle tendons except for the ATT (20%) is seen. MAE is almost absent in the prone body position with plantar flexion of the foot. (orig.)

  11. The joints of the evolving foot. Part I. The ankle joint.

    OpenAIRE

    Lewis, O. J.

    1980-01-01

    Evidence is presented to suggest that the eutherian ankle joint has been derived from a meniscus-containing joint such as that found in extant arboreal marsupials. Probable morphological derivatives of this meniscus are identifiable in the Eutheria. The form and function of the joint are described in sub-human Primates and the adaptations which characterize the joint in bipedal man are noted. These morphological findings permit some speculation about the palaeocology of the earliest mammals w...

  12. Optimising Ankle Foot Orthoses for children with Cerebral Palsy walking with excessive knee flexion to improve their mobility and participation; protocol of the AFO-CP study

    OpenAIRE

    Kerkum Yvette L; Harlaar Jaap; Buizer Annemieke I; van den Noort Josien C; Becher Jules G; Brehm Merel-Anne

    2013-01-01

    Abstract Background Ankle-Foot-Orthoses with a ventral shell, also known as Floor Reaction Orthoses (FROs), are often used to reduce gait-related problems in children with spastic cerebral palsy (SCP), walking with excessive knee flexion. However, current evidence for the effectiveness (e.g. in terms of walking energy cost) of FROs is both limited and inconclusive. Much of this ambiguity may be due to a mismatch between the FRO ankle stiffness and the patient’s gait deviations. The primary ai...

  13. Construction of a finite element model of normal human foot and ankle%正常人足踝部有限元模型的构建研究

    Institute of Scientific and Technical Information of China (English)

    刘清华; 余斌; 金丹; 张美超; 胡岩君; 王丹; 罗吉伟

    2010-01-01

    目的 研究足踝部有限元模型的构建方法,为足踝部生物力学提供一个数字化研究平台. 方法 获取一名30岁男性志愿者的右足螺旋CT扫描图像,利用Mimics软件重建出足踝部28块骨骼及外围软组织的三维结构,通过Solidworks处理后导入Ansys的Workebench模块,建立足踝部三维有限元模型.在模型中还通过解剖和文献数据模拟建立各关节软骨、韧带、跖筋膜、小腿骨间膜,然后模拟踝关节正常站立状态下受力,选择相应边界条件进行加载分析. 结果建立了一个包含骨与外围软组织等复合结构的正常人体右足三维有限元模型,相埘客观地反映了人体足踝部的基本解剖结构和力学特性.模拟人体站立状态垂直加载600 N载荷于胫骨下端的上截面,踝关节胫骨下关节面应力主要分布于中部及前外侧,最大应力为3.97 MPa,平均接触应力为1.52 MPa,接触面积为343.6 mm~2. 结论本研究所建立的止常人体足躁部三维有限元模型经验证结果可靠,可进一步用于足踝部损伤的研究.%Objective To report the construction of a finite element (FE) model of normal human foot and ankle which can be used for biomechanical research. Methods Helical CT scan images of a 30-year-old male volunteer's right foot were obtained, The 3D structures of 28 bones and surrounding soft tissues of the foot and ankle were reconstructed with Mimics software. After processed by SolidWorks, the Workebench modules of Ansys were imported to establish a meshed accurate geometrical model of the foot and ankle. The articular cartilages, ligaments, plantar fascias, crural interosseous membranes were also simulated in the model according to anatomic and literature data. The normal standing status of the ankle joint was simulated for loading analysis using appropriate boundary conditions. Results The 3D FE model of normal human right foot complex, including bones and surrounding soft tissues

  14. Aqueous immersion technique for the irradiation with photons Kaposi's sarcoma multiple foot and ankle

    International Nuclear Information System (INIS)

    Classic Kaposi sarcoma presents as asymptomatic red-violaceus plaques, usually on the legs below the knees, ankles and soles preferentially. When the disease is spread on the skin preferential treatment is radiation therapy at low doses. Homogeneous irradiation of the various lesions could be very complex due to the irregular geometry of the feet, interdigital lesions on different planes. To overcome this problem, and in the case of disseminated disease and low doses, we propose the technique of dipping the tip in Cuba expanded polystyrene filled with saline with a methacrylate plate 2 cm in depth and irradiation with parallel opposed fields.

  15. Active Elbow Orthosis

    Directory of Open Access Journals (Sweden)

    Tomas Ripel

    2014-09-01

    Full Text Available This paper presents a novel approach to the design of a motorized rehabilitation device – active elbow orthosis (AEO – inspired by the principles of robotic exoskeletons. The device is currently designed for the elbow joint, but can be easily modified for other joints as well. AEO determines the motion activity of the patient using a strain gauge and utilizes this measurement to control the actuator that drives the forearm part of the orthosis. Patient activity level is related to a free arm measurement obtained via a calibration procedure prior to the exercise. A high-level control module offers several types of exercises mimicking the physiotherapist. The device was successfully verified by tests on a number of patients, resulting in extended range of elbow-joint motion.

  16. 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 ( ...

  17. 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.

  18. Biomechanics of Climbing Coconut Trees and its Implications in Ankle Foot Morphology- A Video Sequence analysis

    OpenAIRE

    Bincy M George; Kumar, Arunachalam; Rao, Muddanna S

    2013-01-01

    Introduction: Few studies regarding foot changes and health of professional coconut tree climbers of south India are reported. Medical emergencies are very common, especially due to accidental fall from coconut trees, while on job. Objective of the present study is to analyze the altered biomechanics of lower limb joints used by the coconut tree climbers.

  19. 3D MODELLING OF PROPHYLACTIC FOOTWEAR FOR A HIGH ARCHED FOOT

    Directory of Open Access Journals (Sweden)

    COSTEA Mariana

    2016-05-01

    Full Text Available This article approaches the methodology of designing customized footwear for high arched foot. The authors propose to reconsider the classical structure of footwear bottom components for people with high arched foot and recommend incorporating custom components, with the role of compensation or adjustment. This study continues the authors’ research, starting from a foot’s 3D shape obtained by 3D scanning, the anthropometrical and biomechanical parameters, shoe lasts’ 3D modelling and continuing with 3D footwear design. Including customized orthosis can help to stop the evolution of abnormalities, diminishes sensations of pain during walking and improves performance in various physical activities carried out during the day, walking, running, and standing. The prophylactic footwear has to meet four main requirements: to protect the foot and ankle during walking and static; to ensure the normal resistance systems (bones, muscle and joint of the foot; to prevent the installation of irreversible structural changes by reducing stress on the foot; to contribute to increased performance in conducting regular physical activity. It is presented the steps of modelling an orthosis, a virtual simulation of its cutting process, followed by the integration and development of the insole, filling and sole for a customized shoe. Delcam Crispin CAD system and its applications for orthopaedics are used to design the bottom components of prophylactic footwear for a high arched foot.

  20. The effects of powered ankle-foot orthoses on joint kinematics and muscle activation during walking in individuals with incomplete spinal cord injury

    Directory of Open Access Journals (Sweden)

    Domingo Antoinette

    2006-02-01

    Full Text Available Abstract Background Powered lower limb orthoses could reduce therapist labor during gait rehabilitation after neurological injury. However, it is not clear how patients respond to powered assistance during stepping. Patients might allow the orthoses to drive the movement pattern and reduce their muscle activation. The goal of this study was to test the effects of robotic assistance in subjects with incomplete spinal cord injury using pneumatically powered ankle-foot orthoses. Methods Five individuals with chronic incomplete spinal cord injury (ASIA C-D participated in the study. Each subject was fitted with bilateral ankle-foot orthoses equipped with artificial pneumatic muscles to power ankle plantar flexion. Subjects walked on a treadmill with partial bodyweight support at four speeds (0.36, 0.54, 0.72 and 0.89 m/s under three conditions: without wearing orthoses, wearing orthoses unpowered (passively, and wearing orthoses activated under pushbutton control by a physical therapist. Subjects also attempted a fourth condition wearing orthoses activated under pushbutton control by them. We measured joint angles, electromyography, and orthoses torque assistance. Results A therapist quickly learned to activate the artificial pneumatic muscles using the pushbuttons with the appropriate amplitude and timing. The powered orthoses provided ~50% of peak ankle torque. Ankle angle at stance push-off increased when subjects walked with powered orthoses versus when they walked with passive-orthoses (ANOVA, p Two of the five subjects were able to control the orthoses themselves using the pushbuttons. The other three subjects found it too difficult to coordinate pushbutton timing. Orthoses assistance and maximum ankle angle at push-off were smaller when the subject controlled the orthoses compared to when the therapist-controlled the orthoses (p Conclusion Mechanical assistance from powered ankle-foot orthoses improved ankle push-off kinematics without

  1. Effect of wearing a dorsiflexion assist orthosis on mobility, perceived fatigue and exertion during the six-minute walk test in people with multiple sclerosis: a randomised cross-over protocol

    Directory of Open Access Journals (Sweden)

    McLoughlin James

    2012-05-01

    Full Text Available Abstract Background Fatigue in combination with gait and balance impairments can severely limit daily activities in people with multiple sclerosis (PWMS. Generalised fatigue has a major impact on walking ability, with moderately disabled PWMS experiencing difficulty in walking extended distances. Localised motor fatigue in the ankle dorsiflexors can lead to foot drop, further reducing functional ambulation. The aim of this study is to evaluate the effect of a simple dynamic dorsiflexion assist orthosis on walking-induced fatigue, gait, balance and functional mobility in PWMS. Methods A randomised cross-over trial will be conducted with 40 community dwelling PWMS with mild to moderate mobility disability. Participants will initially be screened for disease severity, balance, strength, depression and fatigue at the South Australian Motion Analysis Centre. On two non-consecutive occasions, within two weeks, participants will undergo either the 6-minute walk test (6MWT or the 6MWT while wearing a dorsiflexion ankle orthosis (with a randomised condition order. Distance walked, perceived exertion, perceived fatigue and the physiological cost of walking (the primary outcome measures will be compared between the two walking conditions. Additional pre- and post-6MWT assessments for the two conditions will include tests of strength, reaction time, gait and balance. Discussion This study will increase our understanding of motor fatigue on gait and balance control in PWMS and elucidate the effect of a Dynamic Ankle Orthosis on fatigue-related balance and gait in PWMS. It will also examine relationships between mobility and balance performance with perceived fatigue levels in this group. Trial Registration Number ACTRN12612000218897

  2. Let me Google that for you: a time series analysis of seasonality in internet search trends for terms related to foot and ankle pain

    OpenAIRE

    Telfer, Scott; Woodburn, James

    2015-01-01

    Background The analysis of internet search traffic may present the opportunity to gain insights into general trends and patterns in information seeking behaviour related to medical conditions at a population level. For prevalent and widespread problems such as foot and ankle pain, this information has the potential to improve our understanding of seasonality and trends within these conditions and their treatments, and may act as a useful proxy for their true incidence/prevalence characteristi...

  3. The influence of push-off timing in a robotic ankle-foot prosthesis on the energetics and mechanics of walking

    OpenAIRE

    Malcolm, Philippe; Quesada, Roberto E; Caputo, Joshua; Steven H Collins

    2015-01-01

    Background Robotic ankle-foot prostheses that provide net positive push-off work can reduce the metabolic rate of walking for individuals with amputation, but benefits might be sensitive to push-off timing. Simple walking models suggest that preemptive push-off reduces center-of-mass work, possibly reducing metabolic rate. Studies with bilateral exoskeletons have found that push-off beginning before leading leg contact minimizes metabolic rate, but timing was not varied independently from pus...

  4. Postoperative MR imaging of the foot and ankle: tendon repair, ligament repair, and Morton's neuroma resection.

    Science.gov (United States)

    Zanetti, Marco; Saupe, Nadja; Espinosa, Norman

    2010-09-01

    This review article describes the postoperative magnetic resonance (MR) findings relating to surgery after tendon repair, ligament repair, and Morton's neuroma resection. The normal postoperative tendon is commonly thickened, showing signal changes that are most pronounced 3 to 6 months after surgery. Two years after tendon suture, the signal intensity should be low on T2-weighted images. The focus of the postoperative MR imaging after ankle repair is to detect the normal condition after the various surgical procedures (e.g., Broström, Watson-Jones, Evans, or Chrisman-Snook). The repaired ligament has to be visible, low signal intense on T2-weighted MR images, and the shape should be homogeneous. A high rate (26%) of so-called Morton's neuroma recurrences is seen in asymptomatic individuals after Morton's neuroma resection. Postoperatively, intermetatarsal bursitis MR abnormalities are more commonly encountered in symptomatic intermetatarsal spaces than in asymptomatic intermetatarsal spaces. PMID:20539960

  5. Inter-assessor reliability of practice based biomechanical assessment of the foot and ankle

    OpenAIRE

    Jarvis Hannah L; Nester Christopher J; Jones Richard K; Williams Anita; Bowden Peter D

    2012-01-01

    Abstract Background There is no consensus on which protocols should be used to assess foot and lower limb biomechanics in clinical practice. The reliability of many assessments has been questioned by previous research. The aim of this investigation was to (i) identify (through consensus) what biomechanical examinations are used in clinical practice and (ii) evaluate the inter-assessor reliability of some of these examinations. Methods Part1: Using a modified Delphi technique 12 podiatrists de...

  6. MDCT classification of osseous ankle and foot injuries; MDCT-Klassifikation knoecherner Verletzungen des oberen Sprunggelenks und des Fusses

    Energy Technology Data Exchange (ETDEWEB)

    Opherk, J.P.; Rosenthal, H.; Galanski, M. [Medizinische Hochschule, Abteilung Diagnostische Radiologie, Hannover (Germany)

    2007-03-15

    Conventional radiography plays an essential role in the primary evaluation of acute ankle and foot trauma. In the case of complex injuries, however, subsequent computed tomography (CT) is nowadays recommended. In this connection, multidetector computed tomography (MDCT) allows better temporal, spatial, and contrast resolution compared with the conventional single-slice spiral CT. Multiplanar reformation and three-dimensional reconstruction of the acquired data sets are also helpful tools for critical assessment of therapeutic intervention. This report reviews the potential of the MDCT technique for accurate fracture classification, precise illustration of displaced components, and postoperative control of arrangement of typical lesions. (orig.) [German] Die konventionelle Radiographie spielt bei der initialen Diagnostik akuter Verletzungen des oberen Sprunggelenks und des Fusses eine essenzielle Rolle. Im Falle komplexer Frakturen ist jedoch eine weiterfuehrende computertomographische Diagnostik empfehlenswert. Dabei ist die Multidetektorcomputertomographie (MDCT) der konventionellen Einzeilencomputertomographie hinsichtlich Zeit-, Orts- und Kontrastaufloesung deutlich ueberlegen. Die multiplanare Reformation und dreidimensionale Rekonstruktion des akquirierten Datensatzes sind zudem bei der Beurteilung therapeutischer Interventionen aussagekraeftige Werkzeuge. Der vorliegende Beitrag gibt einen Ueberblick ueber die exakte Frakturklassifikation, die praezise Abbildung dislozierter Komponenten und die postoperative Stellungskontrolle typischer Verletzungen mit dieser Technik. (orig.)

  7. Informing Ankle-Foot Prosthesis Prescription through Haptic Emulation of Candidate Devices

    Science.gov (United States)

    Caputo, Joshua M.; Adamczyk, Peter G.; Collins, Steven H.

    2016-01-01

    Robotic prostheses can improve walking performance for amputees, but prescription of these devices has been hindered by their high cost and uncertainty about the degree to which individuals will benefit. The typical prescription process cannot well predict how an individual will respond to a device they have never used because it bases decisions on subjective assessment of an individual’s current activity level. We propose a new approach in which individuals ‘test drive’ candidate devices using a prosthesis emulator while their walking performance is quantitatively assessed and results are distilled to inform prescription. In this system, prosthesis behavior is controlled by software rather than mechanical implementation, so users can quickly experience a broad range of devices. To test the viability of the approach, we developed a prototype emulator and assessment protocol, leveraging hardware and methods we previously developed for basic science experiments. We demonstrated emulations across the spectrum of commercially available prostheses, including traditional (e.g. SACH), dynamic-elastic (e.g. FlexFoot), and powered robotic (e.g. BiOM® T2) prostheses. Emulations exhibited low error with respect to reference data and provided subjectively convincing representations of each device. We demonstrated an assessment protocol that differentiated device classes for each individual based on quantitative performance metrics, providing feedback that could be used to make objective, personalized device prescriptions.

  8. EFFECTS OF COMBINED FOOT/ANKLE ELECTROMYOSTIMULATION AND RESISTANCE TRAINING ON THE IN-SHOE PLANTAR PRESSURE PATTERNS DURING SPRINT IN YOUNG ATHLETES

    Directory of Open Access Journals (Sweden)

    François Fourchet

    2011-06-01

    Full Text Available Several studies have already reported that specific foot/ankle muscle reinforcement strategies induced strength and joint position sense performance enhancement. Nevertheless the effects of such protocols on sprint performance and plantar loading distribution have not been addressed yet. The objective of the study is to investigate the influence of a 5-wk foot/ankle strength training program on plantar loading characteristics during sprinting in adolescent males. Sixteen adolescent male athletes of a national training academy were randomly assigned to either a combined foot/ankle electromyostimulation and resistance training (FAST or a control (C group. FAST consisted of foot medial arch and extrinsic ankle muscles reinforcement exercises, whereas C maintained their usual training routine. Before and after training, in-shoe loading patterns were measured during 30-m running sprints using pressure sensitive insoles (right foot and divided into nine regions for analysis. Although sprint times remained unchanged in both groups from pre- to post- training (3.90 ± 0.32 vs. 3.98 ± 0.46 s in FAST and 3.83 ± 0.42 vs. 3.81 ± 0.44 s in C, changes in force and pressure appeared from heel to forefoot between FAST and C. In FAST, mean pressure and force increased in the lateral heel area from pre- to post- training (67.1 ± 44.1 vs. 82.9 ± 28.6 kPa [p = 0.06]; 25.5 ± 17.8 vs. 34.1 ± 14.3 N [p = 0.05] and did not change in the medial forefoot (151.0 ± 23.2 vs. 146.1 ± 30.0 kPa; 142.1 ± 29.4 vs. 136.0 ± 33.8; NS. Mean area increased in FAST under the lateral heel from pre- to post- (4.5 ± 1.3 vs. 5.7 ± 1.6 cm2 [p < 0.05] and remained unchanged in C (5.5 ± 2.8 vs. 5.0 ± 3.0 cm2. FAST program induced significant promising lateral and unwanted posterior transfer of the plantar loads without affecting significantly sprinting performance

  9. Cost-effectiveness of the SEN-concept: Specialized Emergency Nurses (SEN treating ankle/foot injuries

    Directory of Open Access Journals (Sweden)

    van Tulder Maurits W

    2007-10-01

    Full Text Available Abstract Background Emergency Departments (EDs are confronted with progressive overcrowding. As a consequence, the workload for ED physicians increases and waiting times go up with the risk of unnecessary complications and patient dissatisfaction. To cope with these problems, Specialized Emergency Nurses (SENs, regular ED-nurses receiving a short, injury-specific course, were trained to assess and treat minor injuries according to a specific protocol. Methods An economic evaluation was conducted alongside a randomized controlled trial comparing House Officers (HOs and SENs in their assessment of ankle and foot injuries. Cost prices were established for all parts of healthcare utilization involved. Total costs of health care utilization were computed per patient in both groups. Cost-effectiveness was investigated by comparing the difference in total cost between groups with the difference in sensitivity and specificity between groups in diagnosing fractures and severe sprains. Finally, cost-effectiveness ratios were calculated and presented on a cost-effectiveness plane. Results No significant differences were seen between treatment groups for any of the health care resources assessed. However, the waiting times for both first assessment by a treatment officer and time spent waiting between hearing the diagnosis and final treatment were significantly longer in the HO group. There was no statistically significant difference in costs between groups. The total costs were € 186 (SD € 623 for patients in the SEN group and € 153 (SD € 529 for patients in the HO group. The difference in total costs was € 33 (95% CI: – € 84 to € 155. The incremental cost-effectiveness ratio was € 27 for a reduction of one missed diagnosis and € 18 for a reduction of one false negative. Conclusion Considering the benefits of the SEN-concept in terms of decreased workload for the ED physicians, increased patient satisfaction and decreased waiting times

  10. Tradução e validação do questionário FAOS - FOOT and ankle outcome score para língua portuguesa Translation, cultural adaptation and validation of FOOT and ankle outcome score (FAOS questionnaire into portuguese

    Directory of Open Access Journals (Sweden)

    Aline Mizusaki Imoto

    2009-01-01

    Full Text Available OBJETIVOS: (1 traduzir e validar a versão original da avaliação funcional de tornozelo e pé Foot and Ankle Outcome Score (FAOS da língua inglesa para a portuguesa em pacientes com história de entorse de tornozelo em inversão, (2 adaptar culturalmente à população brasileira e (3 correlacionar com o questionário de qualidade de vida SF-36. MÉTODO: O método de tradução e validação utilizado seguiu os critérios descritos por Guillemin et al. Foram incluídos 50 indivíduos com diagnóstico clínico de lesão ligamentar lateral do tornozelo por entorse. RESULTADOS: O questionário FAOS mostrou-se com reprodutibilidade de grau forte para todos os domínios intra e inter-examinador (pOBJECTIVE: (1 to translate and validate the original version of the Foot and Ankle Outcome Score (FAOS questionnaire from English into Portuguese in patients with diagnosis of lateral ligament injuries with ankle sprain history,(2 to provide cultural adaptation for Brazilian patients (3 to correlate it with the quality of life SF_36 questionnaire. METHOD: The method of translation and validation followed the criteria described by Guillemin et al. Fifty patients with ankle sprain were included. RESULTS AND CONCLUSION: FAOS questionnaire showed good reproducibility for patients with ankle sprain and good reliability for all intraand inter-interviewer sub-scales (p<0.05. The translation and cultural adaptation of FAOS questionnaire had its properties of assessment, reliability and validity measured, showing that this questionnaire is suitable for use in Brazilian patients with lateral ligament ankle injuries.

  11. Sesamoid Injuries in the Foot

    Science.gov (United States)

    ... FootNotes Newsletter Current Issue Archive Subscribe Home » Foot & Ankle Conditions » Sesamoid Injuries in the Foot A A A | Print | Share ... or certain activities. Diagnosis In diagnosing a sesamoid injury, the foot and ankle surgeon will examine the foot, focusing on the ...

  12. Founder's lecture of the ISS 2006: borderlands of normal and early pathological findings in MRI of the foot and ankle

    Energy Technology Data Exchange (ETDEWEB)

    Zanetti, Marco [University Hospital Balgrist, Radiology, Zurich (Switzerland)

    2008-10-15

    The purpose of this article is to highlight the anatomical variants, technical pitfalls, and the prevalence of abnormal conditions in the asymptomatic population in magnetic resonance imaging of the foot and ankle. Special attention is drawn to the complex anatomy of the deltoid ligament (the superficial tibionavicular ligament, tibiospring ligament, the tibiocalcaneal ligament, and the deep anterior and posterior tibiotalar ligaments) and the posterior tibial tendon insertion including the magic angle artifact and the high prevalence of asymptomatic findings such as ''hypertrophied'' peroneal tubercle (abnormal only when larger than 5 mm), peroneus quartus (prevalence 17%), and cysts (vascular remnants) just inferior to the angle of Gissane. (orig.)

  13. The risk factors for abnormal ankle-brachial index in type 2 diabetic patients and clinical predictive value for diabetic foot

    Institute of Scientific and Technical Information of China (English)

    张净

    2013-01-01

    Objective To investigate the prevalence of diabetic foot (DF) and the normal,high and low ankle brachial index (ABI) in type 2 diabetic patients and explore the risk factor for abnormal ABI and the clinical predictive value for DF.Methods A total of 2 681 type 2 diabetic patients who visited our hospital between January,2007and December,2009 were enrolled in the study.The clinical data were analyzed and the risk factors for abnormal ABI were determined by logistic regression analysis.Results ABI was normal (0.9-<1.3) in 2 362 cases

  14. The Postural Control Characteristics of Individuals with and without a History of Ankle Sprain during Single-leg Standing: Relationship between Center of Pressure and Acceleration of the Head and Foot Parameters

    OpenAIRE

    Abe, Yota; Sugaya, Tomoaki; Sakamoto, Masaaki

    2014-01-01

    [Purpose] This study aimed to investigate the postural control characteristics of individuals with and without a history of ankle sprain during single-leg standing by examining the relationship between various parameters of center of pressure (COP) and head and foot acceleration. [Subjects] Twenty subjects with and 23 subjects without a history of ankle sprain (sprain and control groups, respectively) participated. [Methods] Mean and maximum COP velocity and maximum COP range in the anteropos...

  15. 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 ...

  16. 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 ...

  17. 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 ...

  18. What Is the Clinical Utility of the Ankle-Brachial Index in Patients With Diabetic Foot Ulcers and Radiographic Arterial Calcification?

    Science.gov (United States)

    Álvaro-Afonso, Francisco Javier; Lázaro-Martínez, José Luis; Aragón-Sánchez, Javier; García-Morales, Esther; García-Álvarez, Yolanda; Molines-Barroso, Raúl Juan

    2015-12-01

    The purpose of this study was to analyze the influence of radiographic arterial calcification (RAC) on the clinical interpretation of ankle-brachial index (ABI) values in patients with diabetic foot ulcers. We analyzed a retrospective clinical database of 60 patients with diabetic foot ulcers from the Diabetic Foot Unit (Complutense University, Madrid, Spain) between January 2012 and March 2014. For each patient, anteroposterior XR-plains were evaluated, and the ABI and toe-brachial index (TBI) were assessed by an experienced clinician. To analyze the correlation among quantitative variables, we applied the Pearson correlation coefficient. Fifty percent (n = 9/18) of our patients with a normal ABI and RAC had a TBI Pearson correlation coefficient among the ABI and TBI in patients with an ABI < 1.4 (n = 46) was lesser (r = .484, P = .001) than in patients with an ABI < 1.4 but without RAC (n = 21; r = .686, P = .001). ABI values between 0.9 and 1.4 would be falsely considered as normal and could underestimate the prevalence of PAD, especially in patients with neuropathy, diabetic foot ulcers, or RAC. PMID:26216917

  19. Incidence and MR imaging features of fractures of the anterior process of calcaneus in a consecutive patient population with ankle and foot symptoms

    International Nuclear Information System (INIS)

    To determine the incidence, appearances and associated injuries of fractures affecting the anterior process of calcaneus from a general population with foot and ankle symptoms. A retrospective review of foot and ankle MR imaging procedures was performed for detection of cases with a fracture affecting the anterior process of calcaneus over a four year period. Radiographs, MR imaging studies, radiology reports, medical records, and operative notes were reviewed. Imaging analysis included fracture pattern, displacement, associated fractures, and presence of tendon and ligamentous injuries. The incidence of anterior process of calcaneus fracture on MR imaging was 0.5% (14/2577). Fractures were more common in female subjects (71%, 10/14). Fracture orientation was predominantly vertical (93%, 13/14). No comminuted fractures were seen and only three fractures were displaced. Three of the eight MR imaging evident fractures of anterior process of calcaneus were seen on radiographs. Associated fractures of the talus (n=5), navicular bone (n=3), cuboid (n=2), and calcaneal body (n=1) were noted. Associated injuries to the anterior talofibular ligament (n=3) and tears of the peroneus brevis (n=3) and peroneus longus (n=1) tendons were present. All fractures were treated non-operatively. Two patients had subtalar joint steroid injection for symptomatic relief

  20. Incidence and MR imaging features of fractures of the anterior process of calcaneus in a consecutive patient population with ankle and foot symptoms

    Energy Technology Data Exchange (ETDEWEB)

    Ouellette, H.; Salamipour, H.; Thomas, B.J.; Kassarjian, A.; Torriani, M. [Division of Musculoskeletal Radiology, Massachusetts General Hospital, Boston, MA (United States)

    2006-11-15

    To determine the incidence, appearances and associated injuries of fractures affecting the anterior process of calcaneus from a general population with foot and ankle symptoms. A retrospective review of foot and ankle MR imaging procedures was performed for detection of cases with a fracture affecting the anterior process of calcaneus over a four year period. Radiographs, MR imaging studies, radiology reports, medical records, and operative notes were reviewed. Imaging analysis included fracture pattern, displacement, associated fractures, and presence of tendon and ligamentous injuries. The incidence of anterior process of calcaneus fracture on MR imaging was 0.5% (14/2577). Fractures were more common in female subjects (71%, 10/14). Fracture orientation was predominantly vertical (93%, 13/14). No comminuted fractures were seen and only three fractures were displaced. Three of the eight MR imaging evident fractures of anterior process of calcaneus were seen on radiographs. Associated fractures of the talus (n=5), navicular bone (n=3), cuboid (n=2), and calcaneal body (n=1) were noted. Associated injuries to the anterior talofibular ligament (n=3) and tears of the peroneus brevis (n=3) and peroneus longus (n=1) tendons were present. All fractures were treated non-operatively. Two patients had subtalar joint steroid injection for symptomatic relief.

  1. Back to School Foot Pain (Flip-Flops)

    Science.gov (United States)

    ... foot and ankle surgeons see an increase in ankle injuries among young athletes. Football, soccer and basketball are ... to School Soccer Season Prime time for foot, ankle injuries. Parents and coaches should think twice before coaxing ...

  2. 快速诊断规则用于鉴别足踝扭伤有无骨折的临床分析%Accuracy of ottawa ankle rules to exclude fractures of the ankle and mid-foot

    Institute of Scientific and Technical Information of China (English)

    孟世平; 庞显伦

    2012-01-01

    Objective To identify the reasons of missed diagnosis with ankle sprains by analyzing OAR in order to guide the rational use of OAR.Methods Outpatient with sprained ankles were recruited from the surgical clinic in Sichuan Luzhou Medical College from Mar.2005 to Mar.2010.OAR was used for clinical diagnosis of ankle sprains.The accuracy of OAR diagnosis was examined within 24 h and at 15 d by X-ray.Results In the 105 cases of ankle sprain,16 cases was diagnosed of fractures by OAR.X-ray results showed I case of missed diagnosis,with the rate of missed diagnosis of 6.2%.While both OAR and X-ray diagnosed 21 cases in 50 patients with sprained foot fractures,with a rate of missed diagnosis of 0.Conclusion OAR diagnosis for ankle sprains and fractures has high success rate although with the possibility of missed diagnosis which needs attention clinically.%目的 探讨应用快速诊断规则(OAR)鉴别足踝扭伤伴骨折的漏诊原因,指导OAR的合理应用.方法 选择2005年3月至2010年3月在泸州医学院外科门诊就诊的足踝扭伤患者,应用OAR进行临床检查并做出有无骨折的判断,于受伤后24 h内和第15天进行足踝X线摄片,验证OAR诊断结果的准确性.结果 根据OAR原则,踝关节扭伤105例中初步诊断16例合并骨折,经X线检查合并骨折17例,漏诊1例(6.2%);足扭伤50例患者中21例合并骨折,OAR原则与X线摄片诊断结果一致.结论 OAR对足踝扭伤并骨折的判断准确率高,但也有漏诊的可能,临床要警惕.

  3. 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

  4. Study protocol: the effect of whole body vibration on acute unilateral unstable lateral ankle sprain- a biphasic randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Baumbach Sebastian Felix

    2013-01-01

    Full Text Available Abstract Background Ankle sprains often result in ankle instability, which is most likely caused by damage to passive structures and neuromuscular impairment. Whole body vibration (WBV is a neuromuscular training method improving those impaired neurologic parameters. The aim of this study is to compare the current gold standard functional treatment to functional treatment plus WBV in patients with acute unilateral unstable inversion ankle sprains. Methods/Design 60 patients, aged 18–40 years, presenting with an isolated, unilateral, acute unstable inversion ankle sprain will be included in this bicentric, biphasic, randomized controlled trial. Samples will be randomized by envelope drawing. All patients will be allowed early mobilization and pain-dependent weight bearing, limited functional immobilization by orthosis, PRICE, NSARDs as well as home and supervised physiotherapy. Supervised physical therapy will take place twice a week, for 30 minutes for a period of 6 weeks, following a standardized intervention protocol. During supervised physical therapy, the intervention group will perform exercises similar to those of the control group, on a side-alternating sinusoidal vibration platform. Two time-dependent primary outcome parameters will be assessed: short-term outcome after six weeks will be postural control quantified by the sway index; mid-term outcome after one year will be assessed by subjective instability, defined by the presence of giving-way attacks. Secondary outcome parameters include: return to pre-injury level of activities, residual pain, recurrence, objective instability, energy/coordination, Foot and Ankle Disability Index and EQ 5D. Discussion This is the first trial investigating the effects of WBV in patients with acute soft tissue injury. Inversion ankle sprains often result in ankle instability, which is most likely due to damage of neurological structures. Due to its unique, frequency dependent, influence on various

  5. Comparison of SPECT/CT and MRI in diagnosing symptomatic lesions in ankle and foot pain patients: diagnostic performance and relation to lesion type.

    Directory of Open Access Journals (Sweden)

    Seunggyun Ha

    Full Text Available The purpose of this study was to compare the diagnostic performance of SPECT/CT and MRI in patients with ankle and foot pain, with regard to the lesion types.Fifty consecutive patients with ankle and foot pain, who underwent 99mTc-MDP SPECT/CT and MRI, were retrospectively enrolled in this study. Symptomatic lesions were determined based on clinical examination and response to treatment. On MRI and SPECT/CT, detected lesions were classified as bone, ligament/tendon, and joint lesions. Uptake on SPECT/CT was assessed using a 4-grade system. Sensitivity, specificity, positive predictive value (PPV and negative predictive value (NPV of SPECT/CT and MRI were evaluated in all detected lesions and each lesion type. Diagnostic value of uptake grade was analyzed using receiver-operating characteristics (ROC curve analysis, and diagnostic performance was compared using Chi-square or McNemar tests.In overall lesions, the sensitivity, PPV and NPV of SPECT/CT for symptomatic lesions were 93%, 56%, 91%, and they were 98%, 48%, 95% for MRI. There was no significant difference between SPECT/CT and MRI. However, the specificity of SPECT/CT was significantly higher than that of MRI (48% versus 24%, P = 0.016. Uptake grade on SPECT/CT was significantly higher in symptomatic lesions (P < 0.001, and its area under curve on ROC analysis was 0.787. In the analysis of each lesion type, the specificity of SPECT/CT was poor in joint lesions compared with other lesion types and MRI (P < 0.001, respectively. MRI exhibited lower specificity than SPECT/CT in bone lesions (P = 0.004 and ligament/tendon lesions (P < 0.001.SPECT/CT has MRI-comparable diagnostic performance for symptomatic lesions in ankle and foot pain patients. SPECT/CT and MRI exhibit different diagnostic specificity in different lesion types. SPECT/CT may be used as a complementary imaging method to MRI for enhancing diagnostic specificity.

  6. Malignant Melanoma of the Foot

    Science.gov (United States)

    ... Text Size Print Bookmark Malignant Melanoma of the Foot What is Malignant Melanoma? Melanoma is a cancer ... age groups, even the young. Melanoma in the Foot Melanoma that occurs in the foot or ankle ...

  7. A Patient-Specific Foot Model for the Estimate of Ankle Joint Forces in Patients with Juvenile Idiopathic Arthritis

    OpenAIRE

    Prinold, J.A.I.; Mazza, C; Di Marco, R.; Hannah, I.; Malattia, C; Magni-Manzoni, S; Petrarca, M.; Ronchetti, A.B.; de Horatio, L.T.; van Dijkhuizen, E.H.P.; Wesarg, S; Viceconti, M.

    2015-01-01

    Juvenile idiopathic arthritis (JIA) is the leading cause of childhood disability from a musculoskeletal disorder. It generally affects large joints such as the knee and the ankle, often causing structural damage. Different factors contribute to the damage onset, including altered joint loading and other mechanical factors, associated with pain and inflammation. The prediction of patients’ joint loading can hence be a valuable tool in understanding the disease mechanisms involved in structural...

  8. Optimising Ankle Foot Orthoses for children with Cerebral Palsy walking with excessive knee flexion to improve their mobility and participation; protocol of the AFO-CP study

    Directory of Open Access Journals (Sweden)

    Kerkum Yvette L

    2013-02-01

    Full Text Available Abstract Background Ankle-Foot-Orthoses with a ventral shell, also known as Floor Reaction Orthoses (FROs, are often used to reduce gait-related problems in children with spastic cerebral palsy (SCP, walking with excessive knee flexion. However, current evidence for the effectiveness (e.g. in terms of walking energy cost of FROs is both limited and inconclusive. Much of this ambiguity may be due to a mismatch between the FRO ankle stiffness and the patient’s gait deviations. The primary aim of this study is to evaluate the effect of FROs optimised for ankle stiffness on the walking energy cost in children with SCP, compared to walking with shoes alone. In addition, effects on various secondary outcome measures will be evaluated in order to identify possible working mechanisms and potential predictors of FRO treatment success. Method/Design A pre-post experimental study design will include 32 children with SCP, walking with excessive knee flexion in midstance, recruited from our university hospital and affiliated rehabilitation centres. All participants will receive a newly designed FRO, allowing ankle stiffness to be varied into three configurations by means of a hinge. Gait biomechanics will be assessed for each FRO configuration. The FRO that results in the greatest reduction in knee flexion during the single stance phase will be selected as the subject’s optimal FRO. Subsequently, the effects of wearing this optimal FRO will be evaluated after 12–20 weeks. The primary study parameter will be walking energy cost, with the most important secondary outcomes being intensity of participation, daily activity, walking speed and gait biomechanics. Discussion The AFO-CP trial will be the first experimental study to evaluate the effect of individually optimised FROs on mobility and participation. The evaluation will include outcome measures at all levels of the International Classification of Functioning, Disability and Health, providing a unique

  9. 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 ...

  10. 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 ...

  11. 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

  12. 21 CFR 890.3475 - Limb orthosis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Limb orthosis. 890.3475 Section 890.3475 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Prosthetic Devices § 890.3475 Limb orthosis. (a)...

  13. A Comparison of Two Injection Locations in Obese Patients Having Lower Leg/Foot Surgery

    Science.gov (United States)

    2015-10-13

    Strain of Muscle and/or Tendon of Lower Leg; Fracture of Lower Leg; Crushing Injury of Lower Leg; Fracture Malunion - Ankle and/ or Foot; Complete Tear, Ankle and/or Foot Ligament; Pathological Fracture - Ankle and/or Foot; Loose Body in Joint of Ankle and/or Foot

  14. Surgical Management of Charcot Deformity for the Foot and Ankle-Radiologic Outcome After Internal/External Fixation.

    Science.gov (United States)

    Ettinger, Sarah; Plaass, Christian; Claassen, Leif; Stukenborg-Colsman, Christina; Yao, Daiwei; Daniilidis, Kiriakos

    2016-01-01

    Charcot neuropathy (CN) is a severe joint disease that makes surgical planning very challenging, because it is combined with ankle instability, serious deformities, and recurrent ulceration. The aim of the present study was to examine the rate of bone fusion after external or internal fixation in patients with CN. We retrospectively examined 58 patients with CN who had undergone reconstruction of the ankle either with tibiotalocalcaneal or tibiocalcaneal arthrodesis. The mean age was 59.1 (range 26 to 81) years at surgery. Of the 58 patients, 38 were treated using intramedullary nail arthrodesis and 19 using an external fixator (1 patient received neither). At a mean follow-up period of 31.3 (range 12 to 57) months, limb salvage and bone fusion had been achieved in 94.83%. The mean time to bone fusion was 12 (range 6 to 18) months. Three patients (5.2%) required a more proximal amputation. All but these 3 patients gained independent mobilization in custom feet orthoses or off the shelf orthoses. Of the 58 patients in the present cohort, 56 (96.6%) would undergo surgery again. In conclusion, internal and external fixation both lead to promising results in the treatment of CN. Internal fixation should be preferred when no indications of ulcer or infection are present. PMID:26898396

  15. Effects of Aircast brace and elastic bandage on physical performance of athletes after ankle injuries

    OpenAIRE

    Gunay, Sevtap; Karaduman, Ayse; Ozturk, Burcu Bahar

    2014-01-01

    Objective: The aim of this study was to evaluate the effect of using Aircast® orthosis and elastic bandage application on the physical performance of athletes with ankle injuries. Methods: The study included 60 elite male football players with ankle injuries. Ankle range of motion on the sagittal and frontal plane was measured. One maximum repetition test for the tibialis anterior, tibialis posterior and peroneal muscles; fingertip rise test, single- and double-feet vertical jump tests and...

  16. Surface electrical stimulation for foot drop: Control aspects and walking performance

    Directory of Open Access Journals (Sweden)

    Stein Richard B.

    2008-01-01

    Full Text Available Use of electrical stimulation to correct foot drop in hemiplegia was proposed over 40 years ago. Recently, improved control strategies have been developed and implemented in commercially available devices. In this article we review the control methods that have been used and present some results from a multi-center clinical trial. A foot-drop stimulator improves the gait pattern and results in an immediate increase in walking speed. In this sense it acts like an ankle-foot orthosis and this immediate increase will be referred to as an orthotic effect. Prolonged use of a foot drop stimulator over a period of months results in further, large increases in walking speed both with the stimulator on and off. Evidence indicates that a part of this increase results from daily use that strengthens residual cortico-spinal connections. Therefore the improvement over time will be referred to as a therapeutic effect. We found that people with non-progressive and progressive conditions of the central nervous system have an orthotic benefit, as well as a therapeutic up to 3 months of use. In generally non-progressive conditions such as stroke, further therapeutic increases are seen up to at least 11 months of use. In disorders such as multiple sclerosis, the progression of the disease eventually overcomes the early therapeutic effects. In conclusion, many individuals can benefit from commercially available foot-drop stimulators with improved control strategies and cosmetic design.

  17. Cosmetic Foot Surgery: Fashion's Pandora's Box

    Science.gov (United States)

    ... News, Videos & Podcasts » Articles » Text Size Print Bookmark Cosmetic Foot Surgery: Fashion’s Pandora’s Box? Cosmetic Foot Surgery: Fashion’s Pandora’s Box? Foot and Ankle Surgeons Warn ...

  18. Foot Health Facts for Athletes

    Science.gov (United States)

    ... Health Facts for Athletes Text Size Print Bookmark Foot Health Facts for Athletes From the repeated pounding ... sports injuries. Prompt evaluation and treatment by a foot and ankle surgeon is important because sometimes that “ ...

  19. Foot pain

    Science.gov (United States)

    ... Elsevier; 2009:section D. Brodsky JW, Bruck N. Stress fractures of the foot and ankle. In: DeLee JC, Drez D Jr, Miller MD, eds. DeLee and Drez's Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2009: ...

  20. Development of Active Orthosis for Lumbago Relief- Improvement of Pneumatic Textile Actuator for Orthosis

    Directory of Open Access Journals (Sweden)

    Fujimoto Shinsaku

    2016-01-01

    Full Text Available It is important to develop the orthosis which improves the Quality of Life (QOL and maintains health conditions. As one of the treatment methods done to lumbago(low back pain, the waist fixation method with the spinal brace or the orthosis is prescribed. A waist active orthosis implemented with pneumatic flexible actuators have been developed. However, several problems of the previous actuator were that the strain and the generated force were small for the orthosis.Thus, this paper proposesthe improved actuator for the orthosis. Theimproved actuator is modeled and the reliability of static and dynamic model is validated through experiment. As a result, it was confirmed that the improved actuator had the strain of 2 times and the generated force of 1.3 times, in comparison with the previous actuator. And the dynamic model including volume of actuatorcould be represented by a second-order form with a dead time.

  1. An individual approach for optimizing ankle-foot orthoses to improve mobility in children with spastic cerebral palsy walking with excessive knee flexion.

    Science.gov (United States)

    Kerkum, Yvette L; Harlaar, Jaap; Buizer, Annemieke I; van den Noort, Josien C; Becher, Jules G; Brehm, Merel-Anne

    2016-05-01

    Ankle-Foot Orthoses (AFOs) are commonly prescribed to promote gait in children with cerebral palsy (CP). The AFO prescription process is however largely dependent on clinical experience, resulting in confusing results regarding treatment efficacy. To maximize efficacy, the AFO's mechanical properties should be tuned to the patient's underlying impairments. This study aimed to investigate whether the efficacy of a ventral shell AFO (vAFO) to reduce knee flexion and walking energy cost could be improved by individually optimizing AFO stiffness in children with CP walking with excessive knee flexion. Secondarily, the effect of the optimized vAFO on daily walking activity was investigated. Fifteen children with spastic CP were prescribed with a hinged vAFO with adjustable stiffness. Effects of a rigid, stiff, and flexible setting on knee angle and the net energy cost (EC) [Jkg(-1)m(-1)] were assessed to individually select the optimal stiffness. After three months, net EC, daily walking activity [stridesmin(-1)] and knee angle [deg] while walking with the optimized vAFO were compared to walking with shoes-only. A near significant 9% (p=0.077) decrease in net EC (-0.5Jkg(-1)m(-1)) was found for walking with the optimized vAFO compared to shoes-only. Daily activity remained unchanged. Knee flexion in stance was reduced by 2.4° (p=0.006). These results show that children with CP who walk with excessive knee flexion show a small, but significant reduction of knee flexion in stance as a result of wearing individually optimized vAFOs. Data suggest that this also improves gait efficiency for which an individual approach to AFO prescription is emphasized. PMID:27131186

  2. The reverse sural fasciocutaneous flap for the treatment of traumatic, infectious or diabetic foot and ankle wounds: A retrospective review of 16 patients

    Directory of Open Access Journals (Sweden)

    Ioannis A. Ignatiadis

    2011-01-01

    Full Text Available The authors present their experience with the use of sural fasciocutaneous flaps for the treatment of various soft tissue defects in the lower limb. This paper is a review of these flaps carried out between 2003 and 2008. The series consists of 16 patients, 11 men and 5 women with an average age of 41 years (17-81 and with a follow-up period between 2 and 7 years. The etiology was major velocity accident in six cases, diabetes mellitus with osteomyelitis after ORIF for fractures (2, work accident in five, and another two cases with complications of lower limb injuries. The defect areas were located on calcaneus, malleolar area, tarsal area and lower tibia. Associated risk factors in the patients for the flap performance were diabetes (five patients and cigarette smoking (ten patients.The technique is based on the use of a reverse-flow island sural flap combined with other flaps in three cases (cross-leg, peroneal, gastrocnemius. The anatomical structures which constituted the pedicle were the superficial and deep fascia, the sural nerve, the lesser saphenous vein and skin.The flap was viable in all 15 patients. On 8 cases was achieved direct closure, on three cases occurred a superficial necrosis and was skin grafted, on one case was observed partial necrosis which was treated with a second flap (posterior tibial perforator flap and another one occurred delayed skin healing.The sural fasciocutaneous flap is useful for the treatment of severe and complex injuries and their complications in diabetic and non diabetic lower limbs. Its technical advantages are easy dissection, preservation of more important vascular structures in the limb and complete coverage of the soft tissue defects in just one operation without the need of microsurgical anastomosis. Thus this flap offers excellent donor sites for repairing soft tissue defects in foot and ankle.

  3. Relationship between the effect of medial rotation of the foot axis by ankle dorsiflexion and the ability to visualize the femoral neck axis in the hip joint anterio-posterior radiography. Evaluation by magnetic resonance images

    International Nuclear Information System (INIS)

    In scanning of the hip joint anterio-posterior radiography, by changing the lower extremities to the extension position and moving the foot axis (base line of the foot) by medial rotation, the angle of anteversion of the femoral neck is corrected. In this study, we assessed the effects on medial rotation of the femoral neck when keeping the planta vertically-positioned by ankle dorsiflexion (intermediate position of the ankle) and making change of the medial rotation angle of the foot axis by scanning the magnetic resonance (MR) images of knee joints and hip joints. The subjects in this study were 12 males (age: 37.9±13.8, weight: 67.3±5.5 kg) and 7 females (age: 27.6±5.1, weight: 50.0±4.5 kg). We measured the medial rotation angles of knee joints and femoral necks on MR images. Also, differences of these angles between males and females were compared. Although the gender differences were not found in medial rotation angle of both joints at all leg positions (P>0.05), the medial rotation angles increased by approximately 1.5 to 2.0 times larger by putting them at the intermediate position, and there were significant differences between the naturally plantar-flexed position and the intermediate position (P<0.05). In conclusion, our results showed that the optimal leg position for correcting the angle of anteversion was 20 degrees medial rotation of the foot axis at the naturally plantar-flexed position, or 10 degrees medial rotation of the foot axis at the intermediate position, regardless of gender. (author)

  4. 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...

  5. 2型糖尿病足高危患者的踝肱指数与糖尿病足的关系%Relationship between ankle brachial index and diabetic foot in patients at high risk of type 2 diabetic foot

    Institute of Scientific and Technical Information of China (English)

    张成宗

    2014-01-01

    目的:对2型糖尿病足高危患者的踝肱指数和糖尿病足的发生率关系进行分析,同时对相关的危险因素进行探讨,以期对糖尿病足的发生早期采取有效的措施。方法对我院收治的已经确诊的438例2型糖尿病患者进行研究,其中391例为非糖尿病足组,47例为糖尿病足组,所有的患者都要进行糖化血红蛋白、总胆固醇、甘油三酯等生化资料、踝肱指数的检查,对两组的临床检查资料和不同踝肱指数组的糖尿病患者数的差异进行比较。结果两组患者踝肱指数与患者病程、收缩压、糖尿病肾病发生率、视网膜病变发生率呈负相关(P均<0.01);不同的踝肱指数和糖尿病足组的患病率比较,踝肱指数和糖尿病足组的患病率类似“U”型分布,踝肱指数>1.31组中糖尿病足组的患者发病率为18.1%;0.9<踝肱指数≤1.3组的发病率为26.0%;0.7<踝肱指数≤0.9组的发病率为32.5%;0.5<踝肱指数≤0.7组的发病率为47.6%;而踝肱指数≤0.5组中的糖尿病足患者发病率达到64.29%,各组患病率进行比较有明显的差异。结论踝肱指数和糖尿病足呈负相关,踝肱指数减低或是出现异常的升高能对早期糖尿病足的发生进行预测,对踝肱指数异常的糖尿病足高危患者要采用积极有效的干预措施。%ObjectiveTo understand the relationship between the ankle brachial index and diabetic foot in patients at high risk of type 2 diabetic foot and also discuss the related risk factors, in order to propose the effective measures for the early development of diabetic foot.Methods438 patients diagnosed as type 2 diabetes in this hospital were studied, including 391 patients with non-diabetic foot and 47 patients with diabetic foot.All patients received the examination of biochemical information of glycosylated hemoglobin,total cholesterol and triglyceride,as well as ankle brachial index. The

  6. 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...

  7. Repair of infected ankle and foot soft tissue defect with sural nerve nutritional vessel axial flap%应用腓肠神经营养皮瓣修复足踝部感染性缺损创面

    Institute of Scientific and Technical Information of China (English)

    陈斌; 郑松; 吴斌; 刘明

    2012-01-01

    Objective To shirty the operative technique and clinical results of repairing the infected ankle and foot soft tissue defect with sural nerve nutritional vessel axial flap. Methods 6 cases with infected soft tissue defect over the ankle and foot were debrided and repaired with sural nerve nutritional vessel axial flap. The flap area ranged 5 cm X 2 cm to 32 cm × 12 cm. Results Mild effusion occurred in 2 cases, and healed with dress changing. The time in hospital was 51~78 days. 6 cases were followed up for 3~5 months. All of the flaps were survived. And the wounds were repaired. From the surgery, 6 cases got satisfactory function of ankle and foot, had no relapse of infection, normal weight loading, no ulcer, and the restoration of flaps outlook were well. Conclusions The preparation of sural nerve nutritional vessel axial flap with effective debridement is simple and the blood supply of this flap is reliable. The flap can repair of infected ankle and foot soft tissue defect and get a better clinical effect.%目的 探讨腓肠神经营养皮瓣在足踝部感染性缺损创面中的应用和临床疗效.方法 6例足踝部感染缺损创面,通过清创联合腓肠神经营养皮瓣修复创面,皮瓣切取面积:5 cm×2 cm~32 cm×12 cm.结果 2例发生皮瓣边缘渗出,换药后治愈.住院时间15~78 d.6例均获随访,时间3~5个月.患者皮瓣均完全成活,创面有效修复,无感染复发,足踝部功能恢复良好,能正常负重,无皮瓣溃疡发生,皮瓣外观满意.结论 有效清创联合腓肠神经营养皮瓣操作简单,血运可靠,应用于修复足踝部感染缺损性创面,可获得较好的临床效果.

  8. 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

  9. 脑性瘫痪患儿踝足矫形器配戴前后对运动功能的量化评价%Quantitative assessment of motor function on children with cerebral palsy before and after wearing ankle foot orthopedic instruments

    Institute of Scientific and Technical Information of China (English)

    李润洁

    2002-01-01

    Objective To assess motor function quantitatively on children with cerebral palsy before and after wearing ankle foot orthopedic instruments.Method Ankle foot orthopedic instruments were made by Dalian Prosthesis Factory.Children' motor function was assessed with self made quantitative assessment scale according to the forth,fifth function area of motor assessment scale of children with cerebral palsy after one week of wearing orthopedic instruments. Result In all 23 patients, orthopedic instruments proved effective in controlling leg muscular tension,correcting equines,genu recurvatum,talips valgus and talipes varus,keeping erect posture and modifying gait.Motor function assessed show significant difference before and one week after wearing orthopedic instruments (P< 0.001).Conclusion Ankle foot orthopedic instruments play a positive role in improving motor function of lower extremity in cerebral palsy patients.

  10. 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...

  11. Joint Motion Control of a Powered Lower Limb Orthosis for Rehabilitation

    Institute of Scientific and Technical Information of China (English)

    Nelson Costa; Milan Bezdicek; Michael Brown; John O. Gray; Darwin G. Caldwell; Stephen Hutchins

    2006-01-01

    Many patients with spinal injures are confined to wheelchairs, leading to a sedentary lifestyle with secondary pathologies and increased dependence on a carer. Increasing evidence has shown that locomotor training reduces the incidence of these secondary pathologies, but the physical effort involved in this training is such that there is poor compliance. This paper reports on the design and control of a new "human friendly" orthosis (exoskeleton), powered by high power pneumatic Muscle Actuators (pMAs). The combination of a highly compliant actuation system, with an intelligent embedded control mechanism which senses hip, knee, and ankle positions, velocity, acceleration and force, produces powerful yet inherently safe operation for paraplegic patients. This paper analyzes the motion of ankle, knee, and hip joints under zero loading, and loads which simulate human limb mass, showing that the use of "soft" actuators can provide a smooth user friendly motion.The application of this technology will greatly improve the rehabilitative protocols for paraplegic patients.

  12. 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. ...

  13. 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...

  14. 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

  15. High-signal T2 changes of the bone marrow of the foot and ankle in children: red marrow or traumatic changes?

    Energy Technology Data Exchange (ETDEWEB)

    Shabshin, Nogah [Thomas Jefferson Medical College, Department of Radiology, Philadelphia, PA (United States); Chaim Sheba Medical Center, Department of Diagnostic Imaging, Tel-HaShomer (Israel); Schweitzer, Mark E. [NYU/Hospital for Joint Diseases, Department of Radiology, New York, NY (United States); Morrison, William B. [Thomas Jefferson Medical College, Department of Radiology, Philadelphia, PA (United States); Carrino, John A. [Thomas Jefferson Medical College, Department of Radiology, Philadelphia, PA (United States); Brigham and Women' s Hospital, Department of Radiology, Boston, MA (United States); Keller, Marc S.; Grissom, Leslie E. [DuPont Hospital for Children, Department of Medical Imaging, Wilmington, DE (United States)

    2006-07-15

    High-signal T2-weighted bone marrow changes can be found in both bone marrow edema and hematopoietic marrow and are often seen on pediatric MR images of the feet and ankle. To evaluate whether high-signal T2 changes of the bone marrow seen on pediatric MRI of feet and ankles represent residual hematopoietic marrow. A total of 402 bones in 41 pediatric MRI studies of feet and ankles (34 children, 1-18 years) were reviewed by two observers who were blinded to the patients' ages. The studies were reviewed for the presence of high-signal changes of the bone marrow on sagittal fluid-sensitive images. The frequency and location of these foci were correlated with the patients' ages. High-signal T2 changes of the bone marrow were seen in 45/402 bones (11%) and in 24/41 patients younger than 16 years (59%). The changes were most commonly located in the calcaneus (54%), followed by the talus (35%) and navicular bone (35%), invariably at the endosteal surface. In 16 ankles, such foci were seen in the feet but not in the distal tibia/fibula. Symmetric presence (two ankles) or absence (four ankles) of high-signal marrow were seen in six of seven patients with bilateral ankles. High-signal T2 changes of the bone marrow in pediatric feet and ankle MRIs have a symmetric, fairly consistent pattern and disappear after the age of 15 years. We believe that these high-signal areas are normal and represent residual hematopoietic marrow. (orig.)

  16. High-signal T2 changes of the bone marrow of the foot and ankle in children: red marrow or traumatic changes?

    International Nuclear Information System (INIS)

    High-signal T2-weighted bone marrow changes can be found in both bone marrow edema and hematopoietic marrow and are often seen on pediatric MR images of the feet and ankle. To evaluate whether high-signal T2 changes of the bone marrow seen on pediatric MRI of feet and ankles represent residual hematopoietic marrow. A total of 402 bones in 41 pediatric MRI studies of feet and ankles (34 children, 1-18 years) were reviewed by two observers who were blinded to the patients' ages. The studies were reviewed for the presence of high-signal changes of the bone marrow on sagittal fluid-sensitive images. The frequency and location of these foci were correlated with the patients' ages. High-signal T2 changes of the bone marrow were seen in 45/402 bones (11%) and in 24/41 patients younger than 16 years (59%). The changes were most commonly located in the calcaneus (54%), followed by the talus (35%) and navicular bone (35%), invariably at the endosteal surface. In 16 ankles, such foci were seen in the feet but not in the distal tibia/fibula. Symmetric presence (two ankles) or absence (four ankles) of high-signal marrow were seen in six of seven patients with bilateral ankles. High-signal T2 changes of the bone marrow in pediatric feet and ankle MRIs have a symmetric, fairly consistent pattern and disappear after the age of 15 years. We believe that these high-signal areas are normal and represent residual hematopoietic marrow. (orig.)

  17. Foot and Ankle Conditioning Program

    Science.gov (United States)

    ... your doctor’s supervision. Talk to your doctor or physical therapist about which exercises will best help you meet ... weeks, unless otherwise specified by your doctor or physical therapist. After your recovery, these exercises can be continued ...

  18. 足踝部急性损伤的治疗要点与最新进展%PROGRESS AND MAIN POINTS IN TREATMENT OF ACUTE FOOT AND ANKLE INJURIES

    Institute of Scientific and Technical Information of China (English)

    俞光荣; 赵宏谋

    2011-01-01

    Objective To give a review and commentary on the treatment of acute foot and ankle injuries. Methods Based on the treatment experience and recent literature, a commentary on acute foot and ankle injuries were given, included the basic and clinical research results, evaluation before operation, and treatment methods of the soft tissue and bone injuries. Results The treatment of acute foot and ankle injuries is still a hot point in orthopaedic surgery. Operative and non-operative treatment of fresh Achilles tendon rupture can achieve satisfactory results, and early weight-bearing do not increase the re-rupture rate. The time delay between first debridement and injury within 24 hours does not increase the infection rate. For the treatment of severe ankle fractures, attentions should be paid to the cartilage injury, and anatomic reduction, good realignment, and the congruity recovery are very important. The treatment determination of calcaneal fractures depends on the fully understanding injury mechanisms, classifications, and treatment method. Talus fractures should try to be treated by experienced surgeons. Operation and fixation methods of Lisfranc injury depends on different injury types. Conclusion Acute foot and ankle injuries are common in clinical, to achieve a satisfactory result in evaluation and treatment, it is important to have a fully evaluation of the injury type, and choose the best operation time and suitable treatment methods, as well as to fully understand the biomechanical characteristics of different regions.%目的 对足踝部急性损伤的评估、治疗要点及相关进展进行评述.方法 根据临床治疗经验和近期文献报道结果,对常见的足踝部损伤,包括软组织损伤和骨性损伤的相关基础研究结果 、术前评估、合理及个体化的治疗方案选择进行分析评述,并对相关临床报道进行总结.结果 足踝部急性损伤的修复仍是临床和基础研究的热点.急性跟腱断裂手术

  19. Imaging diagnostics of the foot

    International Nuclear Information System (INIS)

    The book on imaging diagnostics of the foot contains the following chapters: (1) Imaging techniques. (2) Clinical diagnostics. (3) Ankle joint and hind foot. (4) Metatarsus. (5) Forefoot. (6) Pathology of plantar soft tissue. (7) Nervous system diseases. (8) Diseases without specific anatomic localization. (9) System diseases including the foot. (10) Tumor like lesions. (11) Normative variants.

  20. 腓肠神经营养血管皮瓣修复足踝部皮肤缺损%Clinical Application of Flap Pedicled with Sural Nerve Nutrient Vessel in Repairing Soft Tissue Defect of the Ankle and Foot

    Institute of Scientific and Technical Information of China (English)

    彭德飞; 程代薇; 李自力; 朱文; 杜娇

    2011-01-01

    Objective To explore the application of flap pedicled with sural nerve nutritional vessel axial in repairing soft tissue defect of the ankle and foot. Methods From January 2003 to January 2011, according to the position and size of the soft tissue defects, the modified flaps were applied in 13 cases with soft tissue defects of the ankle and foot on the anatomical basis of the inter-musclar septum perforating branches of peroneal artery and the sural nerve nutrient vessel. The flap size ranged from 9 cm x 8.5 cm to 28 cm x 13 cm. The vessel pedicle of perforating branches ranged from 1.7 cm to 3.3 cm. Results Among the 13 cases, 11 flaps survived completely, 2 patients suffered from distal edge necrosis and healed after dressing change. The outline and function were satisfactory during 6-12 months follow-up. Conclusion This flap is easy, reliable and large enough to repair skin defect of the ankle and foot.%目的 探讨改进腓肠神经营养血管皮瓣修复足踝部皮肤软组织缺损的方法及效果.方法 2003年1月至2011年1月,在腓动脉穿支与腓肠神经营养血供的解剖基础上,根据足踝部皮肤缺损大小,设计腓肠神经营养血管皮瓣,逆行移位修复足踝部皮肤软组织缺损13例.切取皮瓣而积9 cm×8.5 cm~ 28 cm×13 cm,穿支血管蒂长1.7~3.3 cm.结果 本组中11例皮瓣全部存活,2例皮瓣远端边缘坏死,经换药治愈.全部患者随访6~12个月,皮瓣外形及功能满意.结论 腓动脉穿支蒂腓肠神经营养血管皮瓣手术操作简便,血供可靠,切取面积大,适用于修复足踝部大面积皮肤软组织缺损.

  1. 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

  2. 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 ...

  3. 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 ( ...

  4. 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...

  5. [Surgical technique and advantages of the free temporal fascia flap for covering loss of substance of the dorsum of the foot and around the ankle: report of 12 cases].

    Science.gov (United States)

    Duteille, F; Sartre, J Y; Perrot, P; Gouin, F; Pannier, M

    2008-10-01

    The authors report a series of twelve patients with loss of substance of the dorsum of the foot or around the ankle who underwent coverage with a free temporal fascia flap. There were no failure of flaps and no vascular complication at the microanastomosis. There were three complications: partial burn of the flap with a lamp, failure of the split thickness skin graft and an area of scar alopecia at the donor site. With one year of follow up, there were no problems of cicatrisation and no patients had difficulty to the use of normal footwear. The different advantages of this flap led us to recommend it for the covering of wound in this area. PMID:17959294

  6. 组合性手术治疗脊柱裂后遗踝足畸形%Combined procedure for the treatment of ankle and foot deformities secondary to spina bifida

    Institute of Scientific and Technical Information of China (English)

    焦绍锋; 秦泗河; 任龙喜; 葛建忠; 吴鸿飞; 王振军; 郑学建

    2012-01-01

    目的:探讨脊柱裂后遗踝足畸形的外科治疗策略以及不同踝足的畸形手术组合方法及其疗效.方法:回顾性分析1990年1月至2009年7月收治的107例脊柱裂后遗踝足部畸形患者的病例资料.其中男44例,女63例;年龄1.3~52岁,平均17.7岁;双踝足畸形58例,单侧49例(左侧22例,右侧27例).马蹄足畸形类99足,行跟腱延长及肌腱移位术;跟行足畸形类25足,行踝前肌腱松解及肌腱移位术;内外翻足畸形类17足,行肌腱移位及跟骨截骨术;连枷足畸形15足,行跟距关节融合及跟腱短缩术;爪形趾畸形9足,行趾间关节融合或Ilizarov技术牵拉矫正.采用AOFAS综合评分系统从主观疼痛感觉、客观功能检查等方面评定疗效.结果:107例中79例127足获得随访,时间48~180个月,平均64个月.根据AOFAS综合评分系统,结果优89足,良26足,中9足,差3足.结论:脊柱裂踝足畸形外科治疗策略包括矫正畸形、平衡肌力、稳定关节和保留足的弹性4个基本原则.针对不同类型足畸形,采用相应的组合性手术方案进行治疗,不但可以有效的矫正畸形,而且能改善患者的行走功能,获得满意的疗效.%Objective: To study surgical strategies for ankle and foot deformities secondary to spina bifida and treatment methods for different types of deformities. Methods: From January 1990 and July 2009,107 patients with ankle and foot deformities secondary to spina bifida were retrospectively analyzed. There were 44 males and 63 females,with an average age of 17.7 years (rangd from 1.3 to 52 years). Among the patients,58 patients had double ankle deformities,49 patients had unilateral deformities(22 cases on the left side,27 cases on the right). Ninety-nine patients with equinus deformities were treated by achilles tendon lengthening and tendon transfering;25 patients with talipes were treated by release of anterior tendon of ankle and tendon transfer; 17 patients with valgus

  7. 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 ...

  8. Once-per-step control of ankle-foot prosthesis push-off work reduces effort associated with balance during walking

    OpenAIRE

    Kim, Myunghee; Collins, Steven H.

    2015-01-01

    Background Individuals with below-knee amputation have more difficulty balancing during walking, yet few studies have explored balance enhancement through active prosthesis control. We previously used a dynamical model to show that prosthetic ankle push-off work affects both sagittal and frontal plane dynamics, and that appropriate step-by-step control of push-off work can improve stability. We hypothesized that this approach could be applied to a robotic prosthesis to partially fulfill the a...

  9. 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

  10. 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...

  11. 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 ...

  12. 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 ...

  13. 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.

  14. Acute bilateral isolated foot drop: Report of two cases

    OpenAIRE

    Kertmen, H.; Gürer, B.; Yimaz, E. R.; Sekerci, Z.

    2015-01-01

    Foot drop is defined as the weakness of the foot and ankle dorsiflexion. Acute unilateral foot drop is a well-documented entity, whereas bilateral foot drop is rarely documented. Slowly progressing bilateral foot drop may occur with various metabolic causes, parasagittal intracranial pathologies, and cauda equina syndrome. Acute onset of bilateral foot drop due to disc herniation is extremely rare. Here we present two cases of acute bilateral foot drop due to disc herniation. The first patien...

  15. Parents: Avoid Kids Foot Problems with the Right Shoes

    Science.gov (United States)

    ... Bookmark Parents: Avoid kids' foot problems with the right shoes Before you head to the store to ... College of Foot and Ankle Surgeons (ACFAS), All Rights Reserved. | Privacy Statement | Disclaimer | Terms and Conditions | Site ...

  16. Parents: Avoid Kids Foot Problems with the Right Shoes

    Science.gov (United States)

    ... Print | Share Avoid Kids Foot Problems with the Right Shoes Before you head to the store to ... College of Foot and Ankle Surgeons (ACFAS), All Rights Reserved. Privacy Statement | Disclaimer | Terms and Conditions | Site ...

  17. Estudo epidemiológico das lesões do pé e tornozelo na prática desportiva recreacional Epidemiological study of foot and ankle injuries in recreational sports

    Directory of Open Access Journals (Sweden)

    Alexandre de Paiva Luciano

    2012-12-01

    Full Text Available OBJETIVO: Trata-se de estudo retrospectivo apresentando a incidência, tipo e extensão das lesões ocorridas no pé e / ou tornozelo como resultado da prática esportiva recreacional. MÉTODOS: Foram atendidos 131 pacientes, destes 123 do sexo masculino e oito do feminino, com história de trauma e dor no pé e/ou tornozelo após a prática de esportes recreacionais. A média de idade dos pacientes masculinos foi de 24,53 anos. A avaliação foi realizada através de um protocolo de pesquisa, que continha as variáveis de idade, sexo, diagnóstico e o tipo de esporte recreativo. RESULTADOS: Os esportes foram classificados, segundo a American Medical Association, que os divide em: de contato e de não contato. 82,4% da amostra praticavam esportes de contacto, contra 17,6% dos de não contacto classificados. CONCLUSÕES: A entorse do tornozelo foi significativamente o tipo de lesão mais encontrada, principalmente as do grau I e II. O futebol foi o esporte responsável pela maior incidência das lesões e dentre as suas várias modalidades prevaleceu o futsal (35%. Nos esportes de não contacto o principal esporte em ocorrências foi a corrida. Nível de Evidência IV, Série de Casos.OBJECTIVE: This is a retrospective study showing the incidence, type and extent of injuries occurring in the foot and/or ankle as a result of recreational sports practice. METHODS: We treated 131 patients, of which 123 were male and 8 female, with a history of trauma and pain in the foot and/or ankle after the practicing recreational sports. The average age of the male patients was 24.53 years. The evaluation was done through a research protocol, which contained the variables age, sex, diagnosis, and type of recreational sport. RESULTS: The sports were classified according to the American Medical Association, which divides them into contact and non-contact sports. 82.4% of the sample practiced contact sports, while 17.6% practicedsports classified as non

  18. 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.

  19. Aspectos epidemiológicos das lesões no pé e tornozelo do paciente diabético Epidemiological aspects of foot and ankle injury in the diabetic patient

    Directory of Open Access Journals (Sweden)

    Ricardo Cardenuto Ferreira

    2010-01-01

    their glycemia levels. Problems affecting the function of the foot and ankle were found in 405 limbs, with: 102 osteoarticular deformities associated with Charcot's neuroarthropathy (34%; 181 chronic ulcers (60.4%; and 97 infected limbs (32.4%. After the average follow-up time, 14 patients (4.6% died. CONCLUSION: Ulceration of the sole of the foot was the most common complication in our series of patients, the majority of whom were in their seventies, presented type II diabetes, were insulin dependent, and did not have adequate control of glycemia. Loss of sensitivity of the foot, associated with pre-existing deformities, were identified as the main causes of secondary infections culminating in amputation of the limb.

  20. 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...

  1. 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 ...

  2. Voluntary driven elbow orthosis with speed controlled tremor suppression

    Directory of Open Access Journals (Sweden)

    Gil eHerrnstadt

    2016-03-01

    Full Text Available Robotic technology is gradually becoming commonplace in the medical sector and in the service of patients. Medical conditions that have benefited from significant technological development include stroke, for which rehabilitation with robotic devices is administered, and surgery assisted by robots. Robotic devices have also been proposed for assistance of movement disorders. Pathological tremor, among the most common movement disorders, is such one example. In practice, the dissemination and availability of tremor suppression robotic systems has been limited. Devices in the marketplace tend to either be non-ambulatory or to target specific functions such as eating and drinking.We have developed a one degree-of-freedom (DOF elbow orthosis that could be worn by an individual with tremor. A speed controlled voluntary driven suppression approach is implemented with the orthosis. Typically tremor suppression methods estimate the tremor component of the signal and produce a canceling counterpart signal. The suggested approach, instead estimates the voluntary component of the motion. A controller then actuates the orthosis based on the voluntary signal while simultaneously rejecting the tremorous motion.In this work, we tested the suppressive orthosis using a 1 DOF robotic system that simulates the human arm. The suggested suppression approach does not require a model of the human arm. Moreover, the human input along with the orthosis forearm gravitational forces, of nonlinear nature, are considered as part of the disturbance to the suppression system. Therefore, the suppression system can be modeled linearly. Nevertheless, the orthosis forearm gravitational forces can be compensated by the suppression system.The electromechanical design of the orthosis is presented, and data from an Essential Tremor patient is used as the human input. Velocity tracking results demonstrate an RMS error of 0.31 rad/s, and a power spectral density shows a reduction of

  3. 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 ...

  4. 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

  5. Study of Diabetic Burn Patients with Foot and Ankle Soft Tissue Defect Re-pair Effect%糖尿病烧伤患者足踝部软组织缺损的修复效果研究

    Institute of Scientific and Technical Information of China (English)

    施占军

    2015-01-01

    目的:探讨糖尿病患者应用前锯肌皮瓣对烧伤造成的足踝部软组织缺损的修复效果。方法选取2012年1月—2012年12月间该院收治的足部因烧伤造成的不同程度感染、钢板外露的患者21例,采用前锯肌瓣游离移植,肌瓣上游离植皮的方法进行修复。结果21例患者中手术平均用时(5.91±0.9)h,术后皮瓣均存活。3例患者与术后早期并发肩胛区局部血肿,用胸带固定之后稳定。3例患者主诉瘢痕部位有摩擦疼痛,但在可忍受范围内;2例患者术后侧胸壁出现麻木感,与2个月后症状自行好转;4例患者和对侧相比,存在程度不同的肩关键活动幅度和力量降低,与4个月后恢复正常;1例患者存在轻度翼状肩胛,但无功能受限。结论前锯肌皮瓣对烧伤患者足踝部软组织缺损的修复可获得理想的效果,尤其适用于糖尿病患者。%Objective To investigate the diabetic patients with anterior saw myocutaneous flap to burn caused by the ankle soft tissue defect repair effect. Methods The 2012 January to 2012 December in our hospital from the foot burns caused by different degrees of infection and plate exposure patients 21 cases, the serratus anterior muscle flap free transplantation, muscle flap upstream from the method of skin grafting repair. Results In the 21 patients, the average operation time (5.91+0.9) h, the skin flap survived. 3 patients were treated with local hematoma in the early postoperative period, and the chest band was stable after fixation. 3 patients complained of scar friction of pain, but in the tolerable range; 2 cases of patients with postoperative lateral chest wall appears numbness, and 2 months after symptoms self improved; 4 cases of patients and compared to the contralateral side, there varying degrees of shoulder the key range of motion and strength reduce, and after 4 months to restore normal; 1 patients have mild winging scapula, but no

  6. An overview of the Charcot foot pathophysiology

    OpenAIRE

    ÖĞÜT, Tahir; Kaynak, Gökhan; Birsel, Olgar; Güven, Mehmet Fatih

    2013-01-01

    Charcot arthropathy of the foot is a rare but devastating complication of diabetes that remains to be a challenging issue for the foot and ankle surgeons. Charcot foot fails to be an obvious diagnostic option that comes to mind, even in a pathognomonic clinical appearance. The rarity of the disorder, more common pathologies that mimic the condition, and the self-limiting prognosis deviate the clinician from the right diagnosis. The clinical challenges in the diagnosis of Charcot foot require ...

  7. [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

  8. Effect analysis of children’s ankle dorsiflexion in foot clearance action in later period of walking%儿童踝关节背屈在步行中后期完成足廓清动作的作用分析

    Institute of Scientific and Technical Information of China (English)

    万凯; 尚清

    2014-01-01

    Objective To discuss the importance of children’s ankle dorsiflexion in foot clearance action in later period of walking.Methods 100 cases of children with abnormal gait were randomly divided into two groups, one group as the late treatment group given to strengthen the swing phase ankle dorsiflexion rehabilitation training, another group as control group given conventional rehabilitation training.Results Special strengthen ankle dorsiflexion walking foot indexes of exercise group significantly improve, abnormal gait corrected obviously.Conclusion For children with abnormal gait, the therapist in the treatment of ankle dorsiflexion when should pay more attention to the training of the ability and right walk pattern input, let the children to form the correct sports cognition, restore normal walking posture.%目的:探讨儿童踝关节背屈在步行中后期完成足廓清动作的重要性分析。方法将100例存在异常步态患儿随机分成两组,一组作为治疗组给予加强摆动相中后期踝关节背屈活动的康复训练,另一组作为对照组只给予常规康复训练。结果特别加强踝关节背屈训练组步行时足廓清动作显著改善,异常步态明显纠正。结论踝关节背屈对步行中后期完成足廓清动作进而纠正异常步行姿势有重要作用。

  9. Diagnostic radiology of the foot

    International Nuclear Information System (INIS)

    The X-ray radiography continues to be the first and most applied method for diagnostic imaging of the foot and ankle joint. The application of magnetic resonance imaging (MRI) for examination of the foot and ankle joint is on the rise, due to the excellent imaging of soft tissue lesions. A basic requirement of purposeful application, and correct diagnosis, of the various radiological modalities available is a profound knowledge of the anatomy as well as the pathology of the morphological and functional features. (orig./CB)

  10. The foot of Homo naledi.

    Science.gov (United States)

    Harcourt-Smith, W E H; Throckmorton, Z; Congdon, K A; Zipfel, B; Deane, A S; Drapeau, M S M; Churchill, S E; Berger, L R; DeSilva, J M

    2015-01-01

    Modern humans are characterized by a highly specialized foot that reflects our obligate bipedalism. Our understanding of hominin foot evolution is, although, hindered by a paucity of well-associated remains. Here we describe the foot of Homo naledi from Dinaledi Chamber, South Africa, using 107 pedal elements, including one nearly-complete adult foot. The H. naledi foot is predominantly modern human-like in morphology and inferred function, with an adducted hallux, an elongated tarsus, and derived ankle and calcaneocuboid joints. In combination, these features indicate a foot well adapted for striding bipedalism. However, the H. naledi foot differs from modern humans in having more curved proximal pedal phalanges, and features suggestive of a reduced medial longitudinal arch. Within the context of primitive features found elsewhere in the skeleton, these findings suggest a unique locomotor repertoire for H. naledi, thus providing further evidence of locomotor diversity within both the hominin clade and the genus Homo. PMID:26439101

  11. Trench Foot or Immersion Foot

    Science.gov (United States)

    ... Weather Information on Specific Types of Emergencies Trench Foot or Immersion Foot DISASTER RECOVERY FACT SHEET Recommend on Facebook Tweet Share Compartir What is trench foot? Trench foot, also known as immersion foot, occurs ...

  12. Trench Foot or Immersion Foot

    Science.gov (United States)

    ... Tsunamis Volcanoes Wildfires Winter Weather Trench Foot or Immersion Foot DISASTER RECOVERY FACT SHEET Recommend on Facebook ... is trench foot? Trench foot, also known as immersion foot, occurs when the feet are wet for ...

  13. Cosmetic Foot Surgery: Fashion's Pandora's Box

    Science.gov (United States)

    ... Fashion’s Pandora’s Box? A A A | Print | Share Cosmetic Foot Surgery: Fashion’s Pandora’s Box? Foot and ankle ... extreme and imprudent as it may sound, the cosmetic surgery craze isn't just for faces anymore- ...

  14. Roentgenofunctional investigation of the ankle joint in a long-term period after crural bone fracture

    International Nuclear Information System (INIS)

    On the basis of the results of clinicoroentgenological and tensographic investigations of 119 patients after traumas of the crural bones and ankle joint (2-36 yrs. ago) the authors showed the importance of roentgenofunctional investigation of the ankle joint. A specially designed footing was proposed. Of 77 patients after intra-articular fractures of the ankle bones various disorders in articular proportions, undetectable on routine roengenography, were diagnosed in 29 by functional roentgenography. Articular changes on roentgenofunctional investigation were revealed in one patient only out of 42 patients with extra-articular fractures of the crural bones. Tensography showed disorders of foot biomechanics in all patients with subluxations in the ankle

  15. Surgical treatment of the Charcot foot.

    Science.gov (United States)

    Pinzur, Michael S

    2016-01-01

    With the increased number of diabetics worldwide and the increased incidence of morbid obesity in more prosperous cultures, there has become an increased awareness of Charcot arthropathy of the foot and ankle. Outcome studies would suggest that patients with deformity associated with Charcot Foot arthropathy have impaired health related quality of life. This awareness has led reconstructive-minded foot and ankle surgeons to develop surgical strategies to treat these acquired deformities. This article outlines the current clinical approach to this disabling medical condition. PMID:26813619

  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. Imaging diagnostics of the foot; Bildgebende Diagnostik des Fusses

    Energy Technology Data Exchange (ETDEWEB)

    Szeimies, Ulrike; Staebler, Axel [Radiologie in Muenchen-Harlaching, Muenchen (Germany); Walther, Markus (eds.) [Schoen-Klinik Muenchen-Harlaching, Muenchen (Germany). Zentrum fuer Fuss- und Sprunggelenkchirurgie

    2012-11-01

    The book on imaging diagnostics of the foot contains the following chapters: (1) Imaging techniques. (2) Clinical diagnostics. (3) Ankle joint and hind foot. (4) Metatarsus. (5) Forefoot. (6) Pathology of plantar soft tissue. (7) Nervous system diseases. (8) Diseases without specific anatomic localization. (9) System diseases including the foot. (10) Tumor like lesions. (11) Normative variants.

  18. Effect of Custom-Molded Foot Orthoses on Foot Pain and Balance in Children With Symptomatic Flexible Flat Feet

    Science.gov (United States)

    Lee, Hong-Jae; Lim, Kil-Byung; Yoo, JeeHyun; Yun, Hyun-Ju; Jeong, Tae-Ho

    2015-01-01

    Objective To evaluate the effect of custom-molded foot orthoses on foot pain and balance in children with symptomatic flexible flat foot 1 month and 3 months after fitting foot orthosis. Method A total of 24 children over 6 years old with flexible flat feet and foot pain for at least 6 months were recruited for this study. Their resting calcaneal stance position and calcaneal pitch angle were measured. Individual custom-molded rigid foot orthoses were prescribed using inverted orthotic technique to control foot overpronation. Pain questionnaire was used to obtain pain sites, degree, and frequency. Balancing ability was determined using computerized posturography. These evaluations were performed prior to custom-molded foot orthoses, 1 month, and 3 months after fitting foot orthoses. Result Of 24 children with symptomatic flexible flat feet recruited for this study, 20 completed the study. Significant (p<0.001) improvements in pain degree and frequency were noted after 1 and 3 months of custom-molded foot orthoses. In addition, significant (p<0.05) improvement in balancing ability was found after 3 months of custom-molded foot orthoses. Conclusion Short-term use of custom-molded foot orthoses significantly improved foot pain and balancing ability in children with symptomatic flexible flat foot. PMID:26798604

  19. [Foot equipment of diabetic arteriopathy].

    Science.gov (United States)

    Miault, D; Brun, J P; Dupre, J C; Pill, M; Miault, P; Deschamps, E; Priollet, P; Laurian, C; Fichelle, J M; Cormier, J M

    1993-01-01

    Surgical appliances have a place of choice in the care of the foot with trophic lesions in diabetics, after partial amputation and as a preventive measure when it is free from trophic disorders. The type of appliance will depend on the footwear and the possibility of wearing orthopedic soles, whatever the stage of the affection. For the foot free from trophic disorders the shoes should be wide fitting, in soft leather and of the seamless type. Made to measure shoes should be reserved for badly deformed feet. The soles should be molded in silicone or polyurethane to distribute weight bearing and to avoid it over zones at risk. Appliances for the foot with trophic lesions should allow the resumption of walking. If the lesions are too extensive an orthosis is performed or a specific type of slipper with molded soles is worn to avoid pressure on the wounds. After amputation of toes a silicone orthoplasty is used to fill the interdigital space to avoid deformity of the other toes. If a front of foot has been amputated a corrected silicone molded sole with false extremity is applied. For a back of foot amputation an orthoprosthesis is made, preferentially in silicone introductible in a regular high sided shoe. In order to fulfil its preventive or temporary role, the appliance should evolve with time and be followed up regularly with close collaboration between the diabetic specialist the podologist and the orthotist. PMID:8473812

  20. American College of Foot and Ankle Surgeons

    Science.gov (United States)

    ... Log In Education & Professional Development Education Calendar Annual Scientific Conference Surgical Skills Courses Specialty Seminars ACFAS On the Road - Regional Programs Practice Management Practice Management Education Opportunities Practice Management e-Learning ...

  1. Entrapment Neuropathies of the Foot and Ankle.

    Science.gov (United States)

    Ferkel, Eric; Davis, William Hodges; Ellington, John Kent

    2015-10-01

    Posterior tarsal tunnel syndrome is the result of compression of the posterior tibial nerve. Anterior tarsal tunnel syndrome (entrapment of the deep peroneal nerve) typically presents with pain radiating to the first dorsal web space. Distal tarsal tunnel syndrome results from entrapment of the first branch of the lateral plantar nerve and is often misdiagnosed initially as plantar fasciitis. Medial plantar nerve compression is seen most often in running athletes, typically with pain radiating to the medial arch. Morton neuroma is often seen in athletes who place their metatarsal arches repetitively in excessive hyperextension. PMID:26409596

  2. Glossary of Foot and Ankle Terms

    Science.gov (United States)

    ... a number of problems. The most common is plantar fasciitis . Other pain-causing conditions include Achilles tendinitis , stress ... Heel spur - Heel spurs are commonly associated with plantar fasciitis . On X-rays, they appear as a spur ...

  3. Mimetic orthosis for lower limbs to be applied on rehabilitation for hemiplegic persons

    OpenAIRE

    P.S. Luna; E. Cardiel; R. Muñoz; Urrutia, R.; Villanueva, D.; P.R.Hernández

    2008-01-01

    A rehabilitation tool based on an innovative mimetic active orthosis for hemiplegics is presented. It follows concepts of neuronal learning from afferent information from movements, similar to those lost after brain damage. An artificial gait pattern is applied on knee and hip articulations of a functional modified limb by using an exoskeleton powered by pneumatic muscles. Key Words: Key Words: Key Words: Key Words: Key Words: Active orthosis, mimetic orthosis, gait rehabilitation.

  4. Effect of prosthetic ankle units on roll-over shape characteristics during walking in persons with bilateral transtibial amputations

    Directory of Open Access Journals (Sweden)

    Steven A. Gard, PhD

    2011-11-01

    Full Text Available Some important walking functions are adversely affected or eliminated in prosthesis users because of reduced or absent ankle motion. This retrospective data analysis determined 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. Quantitative gait analyses were performed as subjects walked with (1 Seattle Lightfoot II feet (baseline condition and (2 the prosthetic ankle units added. Roll-over shape radii and effective foot length ratio were calculated and compared for the two prosthetic configurations. When subjects walked with the ankle units, ankle motion increased (p < 0.001, peak ankle plantarflexion moment during stance decreased slightly, and ankle-foot roll-over shape radii were significantly decreased (p < 0.001 compared with the baseline condition. The effective foot length ratio of the roll-over shape was found to increase with walking speed (p < 0.001, but it was not significantly affected by the prosthetic ankle units (p = 0.07. Prosthetists and manufacturers are encouraged to consider the effect of combining prosthetic components on the overall characteristics of the prosthesis and the functions they impart to the user.

  5. Obese older adults suffer foot pain and foot-related functional limitation.

    Science.gov (United States)

    Mickle, Karen J; Steele, Julie R

    2015-10-01

    There is evidence to suggest being overweight or obese places adults at greater risk of developing foot complications such as osteoarthritis, tendonitis and plantar fasciitis. However, no research has comprehensively examined the effects of overweight or obesity on the feet of individuals older than 60 years of age. Therefore we investigated whether foot pain, foot structure, and/or foot function is affected by obesity in older adults. Three hundred and twelve Australian men and women, aged over 60 years, completed validated questionnaires to establish the presence of foot pain and health related quality of life. Foot structure (anthropometrics and soft tissue thickness) and foot function (ankle dorsiflexion strength and flexibility, toe flexor strength, plantar pressures and spatiotemporal gait parameters) were also measured. Obese participants (BMI >30) were compared to those who were overweight (BMI=25-30) and not overweight (BMI <25). Obese participants were found to have a significantly higher prevalence of foot pain and scored significantly lower on the SF-36. Obesity was also associated with foot-related functional limitation whereby ankle dorsiflexion strength, hallux and lesser toe strength, stride/step length and walking speed were significantly reduced in obese participants compared to their leaner counterparts. Therefore, disabling foot pain and altered foot structure and foot function are consequences of obesity for older adults, and impact upon their quality of life. Interventions designed to reduce excess fat mass may relieve loading of the foot structures and, in turn, improve foot pain and quality of life for older obese individuals. PMID:26260010

  6. 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

  7. 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...

  8. 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 ...

  9. 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…

  10. 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.)

  11. Plastazote abduction orthosis in the management of neonatal hip instability.

    Science.gov (United States)

    Eberle, Charles F

    2003-01-01

    Since 1987, 113 consecutive newborns with either Ortolani-positive or provocative-positive hip examinations in the newborn nursery have been treated with a Plastazote hip abduction orthosis when diagnosed and followed to determine if the method was safe, effective, and easy to use. Ortolani-positive hips often had bilateral abnormalities in the hip examination, were frequently associated with breech position, and were anatomically more dysplastic than those hips that were unstable by provocative testing. No patient developed ischemic necrosis during follow-up. Only two had additional treatment of their unstable hips. The rest had excellent results. Parents and caregivers found the device easy to use. The orthosis is recommended as the primary method for managing newborns with clinical instability to either the provocative or Ortolani test as being safe, effective, and easy to use across all skill levels. PMID:12960623

  12. A Motor Learning Oriented, Compliant and Mobile Gait Orthosis

    Directory of Open Access Journals (Sweden)

    A. Calanca

    2012-01-01

    Full Text Available People affected by Cerebral Palsy suffer from physical disabilities due to irreversible neural impairment since the very beginning of their life. Difficulties in motor control and coordination often relegate these patients to the use of a wheelchair and to the unavoidable upcoming of disuse syndromes. As pointed out in recent literature Damiano [7] physical exercise, especially in young ages, can have a deep impact on the patient health and quality of life. For training purposes is very important to keep an upright position, although in some severe cases this is not trivial. Many commercial mobile orthoses are designed to facilitate the standing, but not all the patients are able to deploy them. ARGO, the Active Reciprocated Gait Orthosis we developed, is a device that overcomes some of the limitations of these devices. It is an active device that is realized starting from a commercial reciprocated Gait Orthosis applying sensors and actuators to it. With ARGO we aim to develop a device for helping limbs in a non-coercive way accordingly to user’s intention. In this way patients can drive the orthosis by themselves, deploying augmented biofeedback over movements. In fact Cerebral Palsy patients usually have weak biofeedback mechanisms and consequently are hardly inclined to learn movements. To achieve this behavior ARGO deploys a torque planning algorithm and a force control system. Data collected from a single case of study shows benefits of the orthosis. We will show that our test patient reaches complete autonomous walking after few hour of training with prototype.

  13. Intensive Health Education for Patients with Diabetic Foot Based on Ankle-brachial Index and Vibration Perception Threshold%根据踝臂指数和感觉阈值实施糖尿病足强化健康教育

    Institute of Scientific and Technical Information of China (English)

    吴丽琴; 胡朝晖; 陈育群

    2012-01-01

    目的 观察对糖尿病患者根据踝臂指数和感觉阈值实施糖尿病足强化健康教育的效果.方法 对60例糖尿病患者实施踝臂指数和感觉阈值测定、足部评估,根据测定值和评估结果,对患者进行知识宣教和强化;对足部问题及时进行处理;给予糖尿病足部知识指导和生活方式指导.结果 干预后(出院时)60例糖尿病患者的足部皮肤干燥、皲裂、甲沟炎、皮肤损伤较干预前明显改善(P<0.05);干预后(出院3个月)患者对糖尿病足的重视程度提高,足部自护行为改善(P<0.05).结论 对糖尿病患者进行踝臂指数、感觉阈值测定和足部评估,并根据结果进行健康指导和干预,能明显提高健康教育效果;对于糖尿病足高危患者,在出院后给予进一步的电话随访,能强化其足部知识和改善生活方式,预防或减少糖尿病足的发生.%Objective To observe the effect of intensive health education for diabetic foot patients based on ankle-brae hi al index and vibration perception threshold.Methods After the determination of ankle-brachial index and vibration perception threshold and the evaluation of feet conditions,patients were received intensive health education and guidance for diabetic foot and life style.Results There existed less feet rhagadia,paronychia and skin damage after the education and patients' skin become less dehydrated as well (P<0,05),Three months after discharge,patients attached more importance to diabetic foot and conduct more self-care to their feet (P<0.05).Conclusion Health education based on ankle-brachial index and vibration perception threshold is beneficial to the improvement of patients' life style and their knowledge of feet conditions.

  14. Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

    Institute of Scientific and Technical Information of China (English)

    Timothy A.McGuine

    2008-01-01

    @@ Introduction Ankle sprains are the most common musculoskeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).

  15. Repair of acute injuries of the lateral ligament complex of the ankle by suture anchors

    OpenAIRE

    Liu, Xiang-Fei; Fang, Yang; Cao, Zhong-Hua; Li, Guang-Feng; Guo-qing YANG

    2015-01-01

    Objective: The objective of this study was to investigate the clinical curative effect of stage I repair of acute injuries of the lateral ligament complex of the ankle by the application of suture anchors. Methods: We retrospectively analyzed 18 cases of III degree acute injuries of the lateral ligament complex of the ankle. Results: There were statistically significant differences in preoperative and last follow-up VAS pain scores and AOFAS ankle hind-foot function scores. The X-ray talus di...

  16. Intrinsic risk factors for acute ankle injuries among male soccer players : a prospective cohort study

    OpenAIRE

    Engebretsen, Anders Hauge; Myklebust, Grethe; Holme, Ingar Morten K.; Engebretsen, Lars; Bahr, Roald

    2009-01-01

    This prospective cohort study was conducted to identify risk factors for acute ankle injuries among male soccer players. A total of 508 players representing 31 amateur teams were tested during the 2004 pre-season through a questionnaire on previous injury and function score (foot and ankle outcome score; FAOS), functional tests (balance tests on the floor and a balance mat) and a clinical examination of the ankle. Generalized estimating equations were used in univariate analyses to identify c...

  17. 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.

  18. 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.)

  19. The influence of the external ankle support on the dynamic balance in volleyball athletes

    OpenAIRE

    Manuela Azevedo Correia de Lima; Germanna de Medeiros Barbosa; Joseanne Daniele Cezar Ribeiro; José Jamacy de Almeida Ferreira; Palloma Rodrigues de Andrade; Heleodório Honorato dos Santos

    2015-01-01

    AbstractThe purpose of this study was to assess the effect of ankle external supports on proprioception and dynamic balance in volleyball players. Seventeen female volleyball players (18.94±2.49 years; 65.45±9.49 kg; 1.71±0.05 m; BMI=22.0±2.67 kg/m²) took part in this study. The dynamic balance was assessed through the Star Excursion Balance Test (SEBT). Comparisons between stabilization (no stabilizer/NS, orthosis/ORT and functional bandaging/FB) modes and the SEBT grid lines and inter-limb ...

  20. Neuroma of medial dorsal cutaneous nerve of superficial peroneal nerve after ankle arthroscopy.

    Science.gov (United States)

    Shim, Jae Sun; Lee, Ji Hyun; Han, Soo Hong; Kim, MinYoung; Lee, Hang Jae; Min, Kyunghoon

    2014-09-01

    Superficial peroneal neuropathy is a known complication of foot and ankle arthroscopy. A 27-year-old man developed pain and paresthesia on the medial side of the dorsum of his left foot after ankle arthroscopy. An electrodiagnostic study revealed conduction abnormality in the medial branch of superficial peroneal nerve, in which neuroma-in-continuity was subsequently detected by ultrasonography. After neuroma excision and nerve graft, the subject's neuropathic pain was substantially improved. PMID:24486918

  1. Muscle performance and ankle joint mobility in long-term patients with diabetes

    OpenAIRE

    Macellari Velio; Cesinaro Stefano; D'Ambrogi Emanuela; Giacomozzi Claudia; Uccioli Luigi

    2008-01-01

    Abstract Background Long-term patients with diabetes and peripheral neuropathy show altered foot biomechanics and abnormal foot loading. This study aimed at assessing muscle performance and ankle mobility in such patients under controlled conditions. Methods Forty six long-term diabetes patients with (DN) and without (D) peripheral neuropathy, and 21 controls (C) were examined. Lower leg muscle performance and ankle mobility were assessed by means of a dedicated equipment, with the patient se...

  2. Non-sagittal plane foot movement during late swing

    OpenAIRE

    VAN ZWIETEN, Koos Jaap; Biesmans, Steven; REYSKENS, Ann; ROBEYNS, Inge; VANDERSTEEN, Marjan; Schmidt, Klaus; LIPPENS, Peter; NARAIN, Faridi; MAHABIER, Roberto; Lamur, K. S.

    2009-01-01

    Introduction: Foot dorsiflexor m.tibialis anterior causes foot inversion too. Foot inversion turns the footsole inwards; eversion turns it outwards. Backgrounds: Quadrupedalism in primates and precursors is characterized by moving forward in a parasagittal plane, while the forefoot keeps clinging to the substratum. This imposes external rotation on the lower leg, tranferred to foot inversion by cardan-like functions of the ankle-joint. Such rotational movements include calcaneo-cuboid pivot i...

  3. Cerebral Infarction Presenting with Unilateral Isolated Foot Drop

    OpenAIRE

    Kim, Ki-Wan; Park, Jung-Soo; Koh, Eun-Jeong; Lee, Jong-Myong

    2014-01-01

    Weakness of the dorsiflexor muscles of the ankle or toe, referred to as foot drop, is a relatively common presentation. In most cases, foot drop is caused by a lower motor neuron disease such as peroneal peripheral neuropathy, L4-5 radiculopathic sciatic neuropathy, or polyneuropathy. Although upper motor neuron lesions can present as foot drop, the incidence is very rare. Here, we report an extremely rare case in which foot drop was the only presenting symptom of cerebral infarction.

  4. 三氧包裹治疗糖尿病足的踝肱压及趾肱压指数研究分析%Study on the ankle brachial pressure and toe brachial pressure index in the treatment of diabetic foot with three oxygen therapy

    Institute of Scientific and Technical Information of China (English)

    刘兴华; 邓跃生; 张遵峰

    2016-01-01

    Objective To study the ankle brachial pressure and toe brachial pressure index in the treatment of diabetic foot with three oxygen therapy. Methods From our hospital from September 2014 to September 2015, 100 cases of diabetic foot patients,all patients were randomly divided into two groups, the control group was treated with conventional therapy, and the observation group was treated with three oxygen therapy,50 patients in each group, the clinical efficacy of the two groups of patients and the ankle brachial pressure index (ABPI) and toe brachial pressure index (TBPI) were statistically analyzed and compared. Results The ankle brachial pressure index (ABPI) and toe brachial pressure index (TBPI) were performed in the control group treated by conventional therapy,there was no significant difference in the treatment before and after treatment, no significant difference (P > 0.05);the ankle brachial pressure index (ABPI) and toe brachial pressure index (TBPI) were used in the observation group treated with three oxygen therapy,before and after treatment were compared, the treatment was significantly better than before treatment, the difference was obvious, the curative effect was significant, and it was statistically significant (P<0.05). Conclusion Three oxygen therapy for diabetic foot, the effect is remarkable, for promoting the early recovery of diabetic foot patients, save the limb, improve the quality of life of patients with positive significance, it is worth widely used in clinical practice.%目的:对三氧包裹治疗糖尿病足的踝肱压及趾肱压指数进行研究分析。方法选取本院2014年9月~2015年9月收治的糖尿病足患者100例,按照随机数字表法将所有患者分为两组,分别为采用常规治疗方法进行治疗的对照组,和采用三氧包裹治疗的观察组,每组50例患者,对两组患者的临床疗效及踝肱压指数(ABPI)及趾肱压指数(TBPI)进行统计学分析和比较。结

  5. 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.

  6. Estimating Ground Inclination Using Strain Sensors with Fourier Series Representation

    OpenAIRE

    Ulf Holmberg; Wolfgang Svensson

    2010-01-01

    An embedded measurement system for foot orthosis during gait is proposed. Strain gauge sensors were mounted on a foot orthosis to give information about strain in the sagittal plane. The ankle angle of the orthosis was fixed and strain characteristics were therefore changed when walking on slopes. With a Fourier series representation of the strain during a gait cycle, ground angle at different walking speeds and inclinations could be estimated with similar accuracy as previous studies using k...

  7. Adding Stiffness to the Foot Modulates Soleus Force-Velocity Behaviour during Human Walking.

    Science.gov (United States)

    Takahashi, Kota Z; Gross, Michael T; van Werkhoven, Herman; Piazza, Stephen J; Sawicki, Gregory S

    2016-01-01

    Previous studies of human locomotion indicate that foot and ankle structures can interact in complex ways. The structure of the foot defines the input and output lever arms that influences the force-generating capacity of the ankle plantar flexors during push-off. At the same time, deformation of the foot may dissipate some of the mechanical energy generated by the plantar flexors during push-off. We investigated this foot-ankle interplay during walking by adding stiffness to the foot through shoes and insoles, and characterized the resulting changes in in vivo soleus muscle-tendon mechanics using ultrasonography. Added stiffness decreased energy dissipation at the foot (p body metabolic cost during walking increased with added foot stiffness (p < 0.001). This increased metabolic cost is likely due to the added force demand on the plantar flexors, as walking on a more rigid foot/shoe surface compromises the plantar flexors' mechanical advantage. PMID:27417976

  8. Foot Health

    Science.gov (United States)

    ... toenails straight across and not too short Your foot health can be a clue to your overall ... disease, heart disease, or high blood pressure. Good foot care and regular foot checks are an important ...

  9. Foot Drop

    Science.gov (United States)

    ... Awards Enhancing Diversity Find People About NINDS NINDS Foot Drop Information Page Table of Contents (click to ... research is being done? Clinical Trials What is Foot Drop? Foot drop describes the inability to raise ...

  10. 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)

  11. Effects of a flat prosthetic foot rocker section on balance and mobility

    OpenAIRE

    Andrew Hansen, PhD; Eric Nickel, MS; Joseph Medvec, CP; Steven Brielmaier, DPT; Alvin Pike, CP; Marilyn Weber, MD

    2014-01-01

    Previous studies have shown that the effective rocker shape of the physiologic ankle-foot system during standing and fore-aft swaying is much flatter than that used during walking, which indicates a more stable base of support for the standing/swaying activity. Previous work suggests that flat regions within the effective rocker shapes of prosthetic ankle-foot systems could provide enhanced stability for standing balance tasks. An experimental prosthetic foot was altered to provide three diff...

  12. Effects of a Resting Foot Splint in Early Brain Injury Patients

    OpenAIRE

    Sung, Eun Jung; Chun, Min Ho; Hong, Ja Young; Do, Kyung Hee

    2016-01-01

    Objective To assess the effectiveness of the resting foot splint to prevent ankle contracture. Methods We performed a randomized controlled trial in 33 patients with brain injury with ankle dorsiflexor weakness (muscle power ≤grade 2). Both groups continued conventional customized physical therapy, but the patients in the foot splint group were advised to wear a resting foot splint for more than 12 hours per day for 3 weeks. The data were assessed before and 3 weeks after the study. The prima...

  13. The prevention of ankle sprains in sports. A systematic review of the literature.

    Science.gov (United States)

    Thacker, S B; Stroup, D F; Branche, C M; Gilchrist, J; Goodman, R A; Weitman, E A

    1999-01-01

    To assess the published evidence on the effectiveness of various approaches to the prevention of ankle sprains in athletes, we used textbooks, journals, and experts in the field of sports medicine to identify citations. We identified 113 studies reporting the risk of ankle sprains in sports, methods to provide support, the effect of these interventions on performance, and comparison of prevention efforts. The most common risk factor for ankle sprain in sports is history of a previous sprain. Ten citations of studies involving athletes in basketball, football, soccer, or volleyball compared alternative methods of prevention. Methods tested included wrapping the ankle with tape or cloth, orthoses, high-top shoes, or some combination of these methods. Most studies indicate that appropriately applied braces, tape, or orthoses do not adversely affect performance. Based on our review, we recommend that athletes with a sprained ankle complete supervised rehabilitation before returning to practice or competition, and those athletes suffering a moderate or severe sprain should wear an appropriate orthosis for at least 6 months. Both coaches and players must assume responsibility for prevention of injuries in sports. Methodologic limitations of published studies suggested several areas for future research. PMID:10569362

  14. An unusual cause of pain post ankle arthrodesis in patients with rheumatoid arthritis.

    LENUS (Irish Health Repository)

    Burke, Neil G

    2012-02-01

    Rheumatoid arthritis is an autoimmune disease which frequently affects the ankle and foot. End stage ankle arthritis from rheumatic disease is commonly managed by the established practice of ankle arthrodesis. Among the adverse sequelae causing pain following this surgery is infection, pseudo-arthrosis and non-union. Stress fracture of the distal third is a recognised but unusual cause of pain of tibia following ankle arthrodesis. The authors\\' present three patients with rheumatoid arthritis who sustained a stress fracture of the distal tibia following arthrodesis, and discuss the contributing factors and highlight the need for orthopaedic surgeons to be suspicious of this complication post surgery.

  15. Simulation of human walking with powered orthosis for designing practical assistive device.

    Science.gov (United States)

    Uchiyama, Yoshiho; Nagai, Chikara; Obinata, Goro

    2012-01-01

    To design a powered assistive orthosis for human walking, we have simulated walking motion with an orthosis. The model dynamics of the coupled human-orthosis is represented by a 10-rigid-link system. In this model there exist rotational joints at lumbar, both thighs and both legs for orthosis, and each joints are controlled by a couple of central pattern generators (CPG) which imitates neuronal system in the spinal cord of mammals. The CPG controller modeled by 18 oscillators which have the sensory feedbacks and generates the joint torques to move the skeletal model of the coupled human-orthosis. This means that we use five actuators for controlling orthosis in the both of sagittal and frontal plane. The parameters of the CPG and the connecting gains are optimized by using a genetic algorithm. We have achieved the successful simulation of stable walking against disturbances with this model. The simulation results indicate the possibility of a practical assistive orthosis with five active joints for stable walking. PMID:23367005

  16. 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

  17. SCRIPT passive orthosis: design and technical evaluation of the wrist and hand orthosis for rehabilitation training at home.

    Science.gov (United States)

    Ates, Serdar; Lobo-Prat, Joan; Lammertse, Piet; van der Kooij, Herman; Stienen, Arno H A

    2013-06-01

    In this paper, a new hand and wrist exoskeleton design, the SCRIPT Passive Orthosis (SPO), for the rehabilitation after stroke is presented. The SPO is a wrist, hand, and finger orthosis that assists individuals after stroke that suffer from impairments caused by spasticity and abnormal synergies. These impairments are characterized in the wrist and hand by excessive involuntary flexion torques that make the hand unable to be used for many activities in daily life. The SPO can passively offset these undesired torques, but it cannot actively generate or control movements. The user needs to use voluntary muscle activation to perform movements and thus needs to have some residual muscle control to successfully use the SPO. The SPO offsets the excessive internal flexion by applying external extension torques to the joints of the wrist and fingers. The SPO physically interacts with the users using the forearm shell, the hand plate and the digit caps from the Saebo Flex, but is otherwise a completely novel design. It applies the external extension torques via passive leaf springs and elastic tension cords. The amount of this support can be adjusted to provide more or less offset force to wrist, finger, or thumb extension, manually. The SPO is equipped with sensors that can give a rough estimate of the joint rotations and applied torques, sufficient to make the orthosis interact with our interactive gaming environment. Integrated inertial and gyroscopic sensors provide limited information on the user's forearm posture. The first home-based patient experiences have already let to several issues being resolved, but have also made it clear that many improvement are still to be made. PMID:24187220

  18. 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.)

  19. Non operative treatment of chronic ankle sprain: a study conducted in teaching general hospital, Telangana, India

    Directory of Open Access Journals (Sweden)

    Sanjay Mattam

    2015-06-01

    Conclusion: The study concludes that lateral elevated foot wear made of micro cellular rubber of 0.75 cm is the choice of treatment for grade 2 and 3 ankle sprains. This foot wear helps in biomechanical correction from varus and also decreases symptoms and signs. Cosmetically acceptable. [Int J Res Med Sci 2015; 3(3.000: 635-639

  20. Aqueous immersion technique for the irradiation with photons Kaposi's sarcoma multiple foot and ankle; Tecnica de inmersion acuosa para la irradiacion con fotones del sarcoma de Kaposi multiple en pies y tobillos

    Energy Technology Data Exchange (ETDEWEB)

    Velazquez Miranda, S.; Munoz Carmona, D. M.; Ortyiz Seidel, M.; Gomez-Millan Barrachina, J.; Delgado Gil, M. M.; Ortega Rodriguez, M. J.; Dominguez Rodriguez, M.; Marquez Garcia Salazar, M.; Bayo Lozano, E.

    2011-07-01

    Classic Kaposi sarcoma presents as asymptomatic red-violaceus plaques, usually on the legs below the knees, ankles and soles preferentially. When the disease is spread on the skin preferential treatment is radiation therapy at low doses. Homogeneous irradiation of the various lesions could be very complex due to the irregular geometry of the feet, interdigital lesions on different planes. To overcome this problem, and in the case of disseminated disease and low doses, we propose the technique of dipping the tip in Cuba expanded polystyrene filled with saline with a methacrylate plate 2 cm in depth and irradiation with parallel opposed fields.

  1. Gustilo ⅢB、ⅢC型小腿及足踝部开放性骨折的一期修复与重建%One-stage reconstruction of open fractures of leg, ankle and foot of Gustilo types Ⅲ B and Ⅲ C

    Institute of Scientific and Technical Information of China (English)

    陈雪松; 徐永清; 陈建明; 何金顺; 张黎明; 余晓军; 江珉; 吉丽; 李小松

    2014-01-01

    目的 探讨GustiloⅢB、ⅢC型小腿及足踝部开放性骨折一期修复与重建的临床疗效及手术要点.方法 回顾性分析2001年1月至2012年4月收治的160例GustiloⅢB、ⅢC型小腿及足踝部开放性骨折患者,男103例,女57例;平均年龄为36.3岁.骨折部位及Gustilo分型:胫骨干1 13例(ⅢB型91例,ⅢC型22例),胫骨远端4例(ⅢB型3例,ⅢC型1例),足踝部43例(ⅢB型37例,ⅢC型6例).受伤至手术时间为3~37 h,平均12.7h.彻底清创后应用穿支皮瓣、皮神经营养血管皮瓣、传统轴型皮瓣及肌皮瓣、局部皮瓣一期修复关键创面,选择外固定支架(121例)、钢板(20例)、螺钉或克氏针(14例)及髓内钉(5例)确定性固定骨折,同时完成其他必要的肢体结构及功能重建.结果 本组患者平均住院时间为28.0 d(9 ~76 d),关键创面均经初次手术获得修复.除1例GustiloⅢC型胫腓骨骨折患者因主诉伤肢持续性疼痛而截肢外,其余159例保肢成功患者术后获12~ 83个月(平均21.3个月)随访.随访期间均未发生严重或持续的骨感染,骨性愈合时间为6~19个月(平均11.7个月),肢体功能、外形恢复满意.结论 应用标准的修复重建外科技术及骨折固定技术一期修复与重建GustiloⅢB、ⅢC型小腿及足踝部开放性骨折可显著缩短治疗周期,减少并发症;新鲜创面解剖清晰,手术更为灵活;仅修复关键创面可减少供区牺牲,避免外形臃肿.%Objective To explore one-stage reconstruction of open fractures of leg,ankle and foot of Gustilo types Ⅲ B and ⅢC.Methods From January 2001 to April 2012,160 open fractures of leg,ankle and foot of Gustilo types Ⅲ B and Ⅲ C were treated with one-stage reconstruction.They were 103 men and 57 women,with an average age of 36.3 years.There were 113 cases of tibial shaft fracture (type ⅢB in 91 and type ⅢC in 22),4 cases of tibial distal end fracture (ⅢB in 3 and type ⅢC in one),and 43 cases of

  2. Inversion injury biomechanics in functional ankle instability: a cadaver study of simulated gait.

    Science.gov (United States)

    Konradsen, Lars; Voigt, Michael

    2002-12-01

    The purpose of this study was to test pathogenetic models for the "unprovoked" ankle inversion injuries seen in functional ankle unstable subjects. The consequence of spatial mal-alignment of the ankle/foot complex on the risk of producing an ankle inversion torque at heel-strike and during swing-phase follow through was analyzed in cadaver simulations. Heel-strike was simulated using a 5 degrees of freedom rig in a material testing machine. A set-up capable of accelerating lower limb specimens towards a support surface simulated swing-phase follow through. Joint excursions were monitored with flexible wire goniometers. The unloaded ankle/foot complex was placed in increasing positions of talar and subtalar joint excursions. The consequences of these settings on the behavior of the ankle/foot complex at heel-strike and when the lateral part of the foot "caught" the ground during swing-phase follow through were monitored. An inversion torque at heel-strike was first seen when the unloaded foot was set in positions exceeding 30 degrees of inversion combined with full plantar flexion and 10 degrees of internal tibial rotation. A collision between the lateral border of a 20 degrees inverted, but otherwise neutral ankle/foot complex and the ground surface during swing-phase follow through forced the foot into the full limit of inversion, plantar flexion and internal tibial rotation measurable in this set-up. Clinical consequence: The study showed that the foot/ankle complex exhibits a high degree of intrinsic stability at heel-strike. The foot will thus stabilize itself and move into normal eversion at the beginning of the stance-phase even though it is set to the ground in a substantial degree of mal-alignment. In contrast, the swing-phase collision model provides a link that can connect the small deficits in inversion angle awareness measured in chronic functional ankle unstable subjects with an increased risk in this group of sustaining ankle inversion injuries. PMID

  3. 逆行胫后动脉穿支蒂隐神经营养血管(肌)皮瓣修复足踝部软组织缺损%Clinical Application of Reversed Tibialis Posterior Artery Perforator-Based Saphenous Neurocutaneous Flap for Treatment of Skin and Soft Tissue Defect Around the Foot and Ankle Joint

    Institute of Scientific and Technical Information of China (English)

    陈明; 文根; 吕一鸣; 汪春阳; 柴益民

    2012-01-01

    Objective To discuss clinical application of reversed tibialis posterior artery perforator-based saphe-nous neurocutaneous flap for treatment of skin and soft tissue defect around the foot and ankle joint. Methods 48 patients had been treated with perforator-based saphenous neurocutaneous flap for repairing skin and soft tissue defect around the foot and ankle joint. Simple reversed tibialis posterior artery perforator-based saphenous neurocutaneous flap was applied in 43 cases; musculocutaneous flap was applied in 5 cases. There are 29 fascial-perforator-based saphenous neurocutaneous flaps and 19 perforator-based saphenous neurocutaneous flaps. The area of soft tissue defects ranged from 10 cm X 9 cm to 4 cm X 3 cm. The area of flaps ranged from 11 cm × 9. 5 cm to 6 cm × 5 cm. Results 43 flaps survived completely;5 flaps encountered partial necrosis of distal portion,were treated by dressing change or secondary skin graft. All flaps were slightly swelling postoperatively without congestion. All the patients have been followed up for 6 to 18 months. The cosmetic appearance and texture of flaps were satisfied without corpulenced pedicle, the protective sensation was renewed in donor site after transplanting cellulocutaneous flap. Conclusion Reversed tibialis posterior artery perforator-based saphenous neurocutaneous flap with reliable in blood-supply and modest texture is a good option for repair of skin and soft tissue defect around the foot and ankle joint.%目的 报道逆行胫后动脉穿支蒂隐神经营养血管(肌)皮瓣修复足踝关节周围软组织缺损的手术方法和临床效果.方法 对48例足踝关节周围皮肤软组织缺损的患者采用逆行胫后动脉穿支蒂隐神经营养血管(肌)皮瓣修复,单纯逆行胫后动脉穿支蒂隐神经营养血管皮瓣39例,肌皮瓣9例;其中胫后动脉穿支筋膜蒂神经营养血管皮瓣29例,胫后动脉穿支血管蒂营养血管皮瓣19例,软组织缺损大小12 cm×9 cm~4 cm

  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. Characterizing multisegment foot kinematics during gait in diabetic foot patients

    Directory of Open Access Journals (Sweden)

    Denti Paolo

    2009-10-01

    Full Text Available Abstract Background The prevalence of diabetes mellitus has reached epidemic proportions, this condition may result in multiple and chronic invalidating long term complications. Among these, the diabetic foot, is determined by the simultaneous presence of both peripheral neuropathy and vasculopathy that alter the biomechanics of the foot with the formation of callosity and ulcerations. To diagnose and treat the diabetic foot is crucial to understand the foot complex kinematics. Most of gait analysis protocols represent the entire foot as a rigid body connected to the shank. Nevertheless the existing multisegment models cannot completely decipher the impairments associated with the diabetic foot. Methods A four segment foot and ankle model for assessing the kinematics of the diabetic foot was developed. Ten normal subjects and 10 diabetics gait patterns were collected and major sources of variability were tested. Repeatability analysis was performed both on a normal and on a diabetic subject. Direct skin marker placement was chosen in correspondence of 13 anatomical landmarks and an optoelectronic system was used to collect the data. Results Joint rotation normative bands (mean plus/minus one standard deviation were generated using the data of the control group. Three representative strides per subject were selected. The repeatability analysis on normal and pathological subjects results have been compared with literature and found comparable. Normal and pathological gait have been compared and showed major statistically significant differences in the forefoot and midfoot dorsi-plantarflexion. Conclusion Even though various biomechanical models have been developed so far to study the properties and behaviour of the foot, the present study focuses on developing a methodology for the functional assessment of the foot-ankle complex and for the definition of a functional model of the diabetic neuropathic foot. It is, of course, important to evaluate

  7. A study of structural foot deformity in stroke patients

    OpenAIRE

    Jang, Gwon Uk; Kweon, Mi Gyoug; Park, Seol; Kim, Ji Young; Park, Ji Won

    2015-01-01

    [Purpose] The aim of this study was to evaluate the structural deformity of the foot joint on the affected side in hemiplegic patients to examine factors that affect this kind of structural deformity. [Subjects and Methods] Thirty-one hemiplegic patients and 32 normal adults participated. The foot posture index (FPI) was used to examine the shape of the foot, the modified Ashworth scale test was used to examine the degree of ankle joint rigidity, the navicular drop test was used to investigat...

  8. Design and Evaluation of the AIRGAIT Exoskeleton: Leg Orthosis Control for Assistive Gait Rehabilitation

    Directory of Open Access Journals (Sweden)

    Mohd Azuwan Mat Dzahir

    2013-01-01

    Full Text Available This paper introduces the body weight support gait training system known as the AIRGAIT exoskeleton and delves into the design and evaluation of its leg orthosis control algorithm. The implementation of the mono- and biarticular pneumatic muscle actuators (PMAs as the actuation system was initiated to generate more power and precisely control the leg orthosis. This research proposes a simple paradigm for controlling the mono- and bi-articular actuator movements cocontractively by introducing a cocontraction model. Three tests were performed. The first test involved control of the orthosis with monoarticular actuators alone without a subject (WO/S; the second involved control of the orthosis with mono- and bi-articular actuators tested WO/S; and the third test involved control of the orthosis with mono- and bi-articular actuators tested with a subject (W/S. Full body weight support (BWS was implemented in this study during the test W/S as the load supported by the orthosis was at its maximum capacity. This assessment will optimize the control system strategy so that the system operates to its full capacity. The results revealed that the proposed control strategy was able to co-contractively actuate the mono- and bi-articular actuators simultaneously and increase stiffness at both hip and knee joints.

  9. 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.

  10. 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.)

  11. Relação entre a mobilidade do tornozelo e pé e a magnitude da força vertical de reação do solo Relationship between ankle and foot mobility and the magnitude of the vertical ground reaction force

    Directory of Open Access Journals (Sweden)

    DL Vianna

    2006-09-01

    Full Text Available OBJETIVO: Verificar a relação entre a mobilidade do tornozelo e do pé, e o pico da força vertical de reação do solo, considerada como porcentagem do peso corporal, gerada durante a fase de apoio da marcha. MÉTODOS: foram estudados pés normais do lado direito e esquerdo de 15 homens com 22,1±2,7 anos (19-28 e 15 mulheres 24,20±5,24 anos (19-34. Os parâmetros de exclusão foram: deformidades nos pés, doenças ou traumas, que pudessem acometer o sistema musculoesquelético e a marcha. A mobilidade do tornozelo e dos pés foi obtida através da goniometria da flexão plantar, dorsiflexão, extensão do hálux e extensão dos dedos, o pico da força vertical de reação do solo FRS, foi obtido pela baropodometria computadorizada do sistema FSCAN R. A correlação entre ambas foi feita pelo teste estatístico de Spearman. RESULTADOS: os indivíduos do grupo masculino apresentaram menores valores de mobilidade, e maiores valores do pico da força vertical de reação do solo, quando comparados com o grupo feminino. Não houve diferença entre os pés direito e esquerdo. No sexo feminino foi encontrada correlação negativa estatisticamente significante entre os valores da flexão plantar e a força vertical, e entre os valores da extensão dos dedos e a foça vertical. No sexo masculino, houve correlação negativa estatisticamente significante entre os valores da dorsiflexão e a força vertical. Entre os demais valores não foi encontrada correlação significante. CONCLUSÃO: Há relação entre a mobilidade e a força vertical gerada durante a marcha.OBJECTIVE: To investigate the relationship between ankle and foot mobility and the peak of the vertical ground reaction force, as a percentage of body weight, generated during the gait stance phase. METHOD: Fifteen men with mean age of 22.1 ± 2.7 years (range: 19-28 and fifteen women with mean age of 24.20 ± 5.24 years (range: 19-34 with normal feet were studied. The exclusion criteria

  12. Athlete's foot

    Science.gov (United States)

    Tinea pedis; Fungal infection - feet; Tinea of the foot; Infection - fungal - feet; Ringworm - foot ... 77. Hay RJ. Dermatophytosis (ringworm) and other superficial mycoses. In: Bennett JE, Dolin R, Blaser MJ, eds. ...

  13. Foot Problems

    Science.gov (United States)

    ... much higher rates of foot problems. For women, pain in the toes and ball of the foot is much more common than in men, and it gets worse with age. However, pain in the heel tends to decrease as we ...

  14. Athlete's Foot

    Science.gov (United States)

    Athlete's foot is a common infection caused by a fungus. It most often affects the space between the toes. ... skin between your toes. You can get athlete's foot from damp surfaces, such as showers, swimming pools, ...

  15. 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.

  16. 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

  17. 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

  18. Foot pain

    OpenAIRE

    Formosa, Aaron

    2005-01-01

    Foot complaints are very common in general practice and their incidence increases with age. Three out of four people complain of foot pain during the course of a lifetime, while approximately 20% of people aged 65 years or older complain of non-traumatic foot problems.

  19. Foot Health

    Science.gov (United States)

    ... straight across and not too short Your foot health can be a clue to your overall health. For example, joint stiffness could mean arthritis. Tingling ... foot checks are an important part of your health care. If you have foot problems, be sure ...

  20. Ankle Kinematics Described By Means Of Stereophotogrammetry And Mathematical Modelling

    Science.gov (United States)

    Allard, Paul; Nagata, Susan D.; Duhaime, Morris; Labelle, Hubert; Murphy, Norman

    1986-07-01

    The ankle is a complex structure allowing foot mobility while providing stability. In an attempt to improve the knowledge of the kinematics of the ankle, an approach incorporating both experimental and analytical techniques was developed. Stereophotogrammetry combined with the Direct Linear Transformation (DLT) technique, was used to quantify the spatial displacements of the foot. Four motorized cameras were fixed on a baseboard 0.62 m from a support frame so as to obtain two stereopairs, one medial and one lateral. For a pair, the cameras were 0.52 m apart and maintained a convergent angle of 21.5°. The support frame was designed to fix the tibia while allowing foot motion. A device comprised of 76 markers, 38 of which were visible to each pair of cameras was used for the calibration. The spatial position of each marker was measured to a precision of 0.05 mm whereas their computed spatial position using the DLT technique was accurate to 0.4 mm. For the experiment, two embalmed cadaver legs and feet, amputated at midshank and of normal appearance were used. After a partial dissection, three pin markers were embedded into each of the medial and lateral sides of the talus permitting the calculation of its center of rotation. Each foot was photographed in 5 positions at 10° intervals, ranging from 30 ° of plantarflexion to 10° of dorsiflexion. An analytical model was developed to spatially describe the rotation of the foot about the ankle. The model calculates the plane of motion and the orientation of the axis of rotation relative to the sagittal, frontal and transverse planes. These were found respectively to be for foot one: 100°, 86°, 15° and for foot two: 91°, 69°, 21°.

  1. 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

  2. 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

  3. Mudanças no padrão temporal da EMG de músculos do tornozelo e pé pré e pós-aterrissagem em jogadores de voleibol com instabilidade funcional Changes in the EMG temporal pattern of pre and post-landing of ankle and foot muscles in volleyball players with functional instability

    Directory of Open Access Journals (Sweden)

    Eneida Yuri Suda

    2008-08-01

    ômica.INTRODUCTION: The ankle sprain is one of the most common injuries in athletes, including volleyball. 90% of ankle injuries in volleyball occur during landing after a blocking maneuver. The most common complication following ankle sprains is functional instability (FI, a condition that affect about 52% of the patients that suffered an ankle sprains . Functional ankle instability (FI has been defined as a tendency for the foot to give way after an ankle sprain with no evidence of ligament injury. Hence, FI is an impairing condition for volleyball performance since it interferes in its basic skills. AIMS: The purpose of this study was to compare the EMG activation patterns of tibialis anterior (TA, peroneus longus (PL and gastrocnemius lateralis (GL in volleyball players with and without FI during landing after the blocking movement. METHODS: EMG activity was acquired for 21 subjects (mean age 20 ± 4 yrs with FI (IG and 19 control ones (CG. Linear envelopes were calculated for both groups for the time period between 200 ms before and 200 ms after the instant of impact, and time and magnitude of peak occurrence were extracted from the envelopes. Groups were compared using T test (α < 0.05. RESULTS: IG subjects showed a later peak occurrence for TA (CG = -107.4 ± 29.6 ms; IG = -134.0 ± 26.0 ms and PL (CG = -11.0 ± 55.9 ms; IG = -41.7 ± 49.8 ms and a lower peak magnitude for TA (CG = 68.5 ± 17.2%; FIG = 81.2 ± 28.8% and PL (CG = 72.9 ± 27.3%; FIG = 59.1 ± 16.0%. CONCLUSIONS: These results suggest that individuals with FI present a later and lower activation pattern of muscular activity and different activation magnitudes that predispose them to ankle sprains, even in the absence of an anatomical damage.

  4. 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 ...

  5. Total Ankle Replacement for Treatment of End-Stage Osteoarthritis in Elderly Patients

    OpenAIRE

    Beat Hintermann; Markus Knupp; Lukas Zwicky; Alexej Barg

    2012-01-01

    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 r...

  6. Basketball shoe height and the maximal muscular resistance to applied ankle inversion and eversion moments.

    Science.gov (United States)

    Ottaviani, R A; Ashton-Miller, J A; Kothari, S U; Wojtys, E M

    1995-01-01

    To determine if the height of a basketball shoe alters the maximal inversion and eversion moment that can be actively resisted by the ankle in the frontal plane, we tested 20 healthy, young adult men with no recent ankle injuries. Subjects underwent unipedal functional ankle strength testing under weightbearing conditions at 0 degrees, 16 degrees, and 32 degrees of ankle plantar flexion using a specially designed testing apparatus. Testing was performed with the subject wearing either a low- or a three quarter-top basketball shoe. Shoe height did not significantly affect an individual's ability to actively resist an eversion moment at any angle of ankle plantar flexion. However, tests at 0 degrees of ankle plantar flexion demonstrated that the three quarter-top basketball shoe we tested significantly increased the maximal resistance to an inversion moment by 29.4%. At 16 degrees of ankle plantar flexion, inversion resistance was also significantly improved by 20.4%. These results show that athletic shoe height can significantly increase the active resistance to an inversion moment in moderate ankle plantar flexion. The findings apply to a neutral foot position in the frontal plane, an orientation equivalent to the early phase of a potential ankle sprain. PMID:7573650

  7. 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)

  8. Comparison of Extension Orthosis Versus Percutaneous Pinning of the Distal Interphalangeal Joint for Closed Mallet Injuries.

    Science.gov (United States)

    Renfree, Kevin J; Odgers, Ryan A; Ivy, Cynthia C

    2016-05-01

    We compared a static extension orthosis with percutaneous pinning of the distal interphalangeal joint (DIPJ) for treatment of closed mallet injuries. After receiving counsel about treatment options, 44 patients (25 women and 19 men; mean age, 57 years) freely chose orthosis and 18 patients (5 women and 13 men; mean age, 51 years) chose pinning. Both the extension orthosis and the pin remained in place for 6 weeks; the pin then was removed, and the care in both groups was transitioned to nighttime orthosis use for an additional 6 weeks. The patients in the pin group were allowed to immediately resume unrestricted activity postoperatively. The mean follow-up was 32 months in the orthosis group and 19 months in the pin group. Final residual extensor lag was better in the pin group (5 vs 10 degrees, P = 0.048). Improvement between the groups was in favor of percutaneous pinning (36 vs 17 degrees, P = 0.001). No correlation was seen between time to treatment (≤14 vs >14 days from injury) and final extensor lag in either group (P = 0.85). The final mean DIPJ flexion was 53 degrees for orthosis and 46 degrees for pinning. Among the patients, 93% of the orthosis group and 100% of the pin group said that they would choose the same treatment again. Both groups had a mean of 5 hand therapy visits during treatment. Two complications occurred in the orthosis group (5%) and 3 (17%) occurred in the pin group. Extension orthotics and pinning are both well-tolerated, effective treatments of mallet injury. The techniques produce satisfactory correction of extensor lag and have high patient satisfaction. Pinning allows better correction of DIPJ extensor lag and results in a smaller degree of final extensor lag. Pinning is more expensive and may result in more DIPJ stiffness (ie, loss of active flexion), but it may be justified in certain patients (eg, medical professionals, food service workers) who would have difficulty working with an orthosis. PMID:25144418

  9. Evaluation of safety and reliability in an infant reciprocal walking orthosis.

    Science.gov (United States)

    Miller, K; Woollam, P J; Jones, N; Poiner, R; Farmer, I R; Stallard, J

    2002-08-01

    In response to new demands for infant walking orthoses consideration was given to the development of a device for this category of patient. A specially developed hip joint with the required structural properties (Woollam et al., 2001) provided an opportunity for this development. Earlier structural assessment, and limited cyclic load testing of key elements of the orthosis (primarily the body brace), confirmed that a safe device for evaluation with patients could, theoretically, be produced. A provisional prototype was therefore designed and manufactured for initial structural testing of the complete infant orthosis (Stallard et al., 2001). Efficiency of walking is strongly influenced by the lateral rigidity of the orthosis. Monitoring the structural performance of the provisional infant design indicated it would equal or improve on the stiffness of that achieved in the adult specification. Additionally, relative strength was comparable with the adult version, which has proven to be safe and reliable in many years of routine prescription. This, together with the limited cyclic testing of the complete orthosis (Stallard et al., 2001), gave confidence that it was safe to proceed with controlled field evaluation of the infant design when supplied as a rehabilitation engineering device within the provisions of an ISO9001 and EN46001 QA System. This additional study of controlled patient use, and further representative cyclic load testing in parallel with the field evaluation, had established the long-term structural safety of the orthosis. Wider application is now to be introduced through completion of the EC (European Community) Medical Devices Directive formalities. PMID:12227452

  10. 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 ...

  11. Effectiveness of elastic band-type ankle–foot orthoses on postural control in poststroke elderly patients as determined using combined measurement of the stability index and body weight-bearing ratio

    Directory of Open Access Journals (Sweden)

    Kim JH

    2015-11-01

    Full Text Available Jong Hyun Kim, Woo Sang Sim, Byeong Hee Won Usability Evaluation Technology Center, Advanced Biomedical and Welfare R&D Group, Korea Institute of Industrial Technology, Cheonan-si, Chungcheongnam-do, South Korea Purpose: Poor recovery of postural stability poststroke is the primary cause of impairment in activities and social participation in elderly stroke survivors. The purpose of our study was to experimentally evaluate the effectiveness of our new elastic ankle–foot orthosis (AFO, compared to a traditional AFO fabricated with hard plastic, in improving postural stability in elderly chronic stroke survivors. Patients and methods: Postural stability was evaluated in ten chronic stroke patients, 55.7±8.43 years old. Postural stability was evaluated using the standardized methods of the Biodex Balance System combined with a foot pressure system, under three experimental conditions, no AFO, rigid plastic AFO, and elastic AFO (E-AFO. The following dependent variables of postural stability were analyzed: plantar pressure under the paretic and nonparetic foot, area of the center of balance (COB and % time spent in each location, distance traveled by the COB away from the body center, distance traveled by the center of pressure, and calculated index of overall stability, as well as indices anterior–posterior and medial–lateral stability. Results: Both AFO designs improved all indices of postural stability. Compared to the rigid plastic AFO, the E-AFO produced additional positive effects in controlling anterior–posterior body sway, equalizing weight bearing through the paretic and nonparetic limbs, and restraining the displacement of the center of pressure and of the COB. Conclusion: Based on our outcomes, we recommend the prescription of E-AFOs as part of a physiotherapy rehabilitation program to promote recovery of postural stability poststroke. When possible, therapeutic outcomes should be documented using the Biodex Balance System and

  12. Effects of a Resting Foot Splint in Early Brain Injury Patients

    Science.gov (United States)

    Sung, Eun Jung; Hong, Ja Young; Do, Kyung Hee

    2016-01-01

    Objective To assess the effectiveness of the resting foot splint to prevent ankle contracture. Methods We performed a randomized controlled trial in 33 patients with brain injury with ankle dorsiflexor weakness (muscle power ≤grade 2). Both groups continued conventional customized physical therapy, but the patients in the foot splint group were advised to wear a resting foot splint for more than 12 hours per day for 3 weeks. The data were assessed before and 3 weeks after the study. The primary outcome was the change in ankle dorsiflexion angle after 3 weeks. Results Before the study, there were no differences between groups in gender, age, time post-injury, brain injury type, initial edema, spasticity, passive range of ankle dorsiflexion, Fugl-Meyer score (FMS), or Functional Ambulation Classification. A significant improvement in ankle dorsiflexion angle, and FMS was found after 3 weeks in both groups. The splint group showed more spasticity than the control group after 3 weeks (p=0.04). The change of ankle dorsiflexion angle, foot circumference, spasticity, and FMS after adjusting initial value and spasticity were not significantly different between the 2 groups. Conclusion Wearing a resting foot splint for 3 weeks did not affect joint mobility in patients with subacute brain injury regularly attending personalized rehabilitation programs. Further studies of larger sample sizes with well controlled in spasticity are required to evaluate the effects of the resting foot splint. PMID:26949680

  13. Bone stress injury of the ankle in professional ballet dancers seen on MRI

    OpenAIRE

    Besser Marcus P; Peterson Judith R; Raikin Steven M; Zoga Adam C; Elias Ilan; Morrison William B; Schweitzer Mark E

    2008-01-01

    Abstract Background Ballet Dancers have been shown to have a relatively high incidence of stress fractures of the foot and ankle. It was our objective to examine MR imaging patterns of bone marrow edema (BME) in the ankles of high performance professional ballet dancers, to evaluate clinical relevance. Methods MR Imaging was performed on 12 ankles of 11 active professional ballet dancers (6 female, 5 male; mean age 24 years, range 19 to 32). Individuals were imaged on a 0.2 T or 1.5 T MRI uni...

  14. Audit on the use of radiography and the management of ankle sprains in A&E

    OpenAIRE

    Borg, Malcolm; Cachia Pickard, Agnes

    2008-01-01

    Objective: To determine the need for a local implementation strategy of the Ottawa Ankle and Foot rule in the A& E Department of St. Luke' s Hospital, Malta and to examine the current management practices of ankle sprains. Methods: A prospective study was conducted on all patients aged 16 years and over presenting to the A& E department of St. Luke’s Hospital, Malta over a six week period with ankle and midfoot injuries. Data collected included time and mechanism of injury, clinical examinati...

  15. 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.

  16. Effect of exercise therapy combining electrical therapy and balance training on functional instability resulting from ankle sprain—focus on stability of jump landing

    OpenAIRE

    Yoshida, Takaki; Tanino, Yoshitsugu; Suzuki, Toshiaki

    2015-01-01

    [Purpose] Functional instability leads to a delay in the muscle reaction time and weakness of the peroneal muscles. The present study examined the effects of transcutaneous electrical nerve stimulation during balance exercise on patients with functional instability of the ankles, including the ability to land after jumping at the center of foot pressure. [Subjects] The subjects were seven males with a history of ankle sprain. All had a sprained ankle score of ≤80 points on Karlson’s functiona...

  17. Ergonomy of paraplegic patients working with a reciprocating gait orthosis.

    Science.gov (United States)

    Bernardi, M; Canale, I; Felici, F; Macaluso, A; Marchettoni, P; Sproviero, E

    1995-08-01

    A reciprocating gait orthosis (RGO) is, among others, the most widely adopted device to restore the standing and walking capability of paraplegic patients. The aim of the present study was the evaluation of the energy demand (VO2), and cardiopulmonary load (HR and VE) imposed on the subject by different working tasks while sitting in a wheelchair or standing using a RGO. In addition, a comparison with the performance of normal subjects was also attempted. The RGO use allowed a dramatic improvement of patients' mobility and reach space in the workplace. A further advantage provided by the use of the RGO was represented by the increased mobility of the subjects with respect to the wheelchair confined situation. The energy demand and the cardiorespiratory load imposed on the subjects by the use of the RGO were not different from those observed both in the same subjects sitting in a wheelchair and in the controls. The energy demand slightly exceeded the values typical of light work and was, thus, compatible with the normal duration of a working day. On the other hand, the cardiac load corresponded to that typical of moderate activity, thus limiting the duration of the working task to 5-8 h. Based on the ergometry test, all of the working activities considered can be classified as aerobic activities, energy demand being under the ventilatory threshold. PMID:7478740

  18. Estudo da confiabilidade e validade da utilização do hidropletismômetro para medida de edema no tornozelo Study of the reliability and validity of the water plethysmographer for use in measurement of the edema at the ankle/foot

    Directory of Open Access Journals (Sweden)

    Ian Lara Lamounier Andrade

    2011-03-01

    measurements obtained by graduated cylinders from 10 to 1000 ml, water displacement device (gold standart. Intraclass correlation coefficients (ICCs evaluated intra- and inter-raters reliability, whereas paired Student t-tests and Pearson's correlation coefficients were used to establish validity of the water plethysmography.The results demonstrated excellent intra- and inter-rater reliability levels with levels with CCI3,1=0.99 and CCI3,2=0.99 respectively. No differences were found between the measures obtained with the water plethysmography compared to those of the water displacement device (p=0.40. Pearson's correlation coefficient showed a high magnitude and significance level between the measures (r=1,0; p<0.0001.The findings demonstrated that the water plethysmography is a reliable and valid instrument for measuring ankle/foot volume.

  19. 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.

  20. 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.)

  1. 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

  2. Engineering evaluation of the energy-storing orthosis FES gait system.

    Science.gov (United States)

    Kangude, Abhijit; Burgstahler, Brett; Durfee, William

    2010-01-01

    A system to restore walking in the vicinity of a wheelchair for people with paraplegia resulting from spinal cord injury is under development. The approach combines single channel surface electrical stimulation with an orthosis. The orthosis is spring loaded and contains a pneumatic system that stores energy during knee extension caused by quadriceps stimulation and transfers it to hip joint for hip extension. A laboratory version of the prototype of the gait system has been fabricated and engineering bench tests were performed. The paper presents the design of the wearable prototype and results of bench testing. PMID:21096941

  3. Ankle and knee kinetics between strike patterns at common training speeds in competitive male runners.

    Science.gov (United States)

    Kuhman, Daniel; Melcher, Daniel; Paquette, Max R

    2016-01-01

    The purpose of this study was to investigate the interaction of foot strike and common speeds on sagittal plane ankle and knee joint kinetics in competitive rear foot strike (RFS) runners when running with a RFS pattern and an imposed forefoot strike (FFS) pattern. Sixteen competitive habitual male RFS runners ran at two different speeds (i.e. 8 and 6 min mile(-1)) using their habitual RFS and an imposed FFS pattern. A repeated measures analysis of variance was used to assess a potential interaction between strike pattern and speed for selected ground reaction force (GRF) variables and, sagittal plane ankle and knee kinematic and kinetic variables. No foot strike and speed interaction was observed for any of the kinetic variables. Habitual RFS yielded a greater loading rate of the vertical GRF, peak ankle dorsiflexor moment, peak knee extensor moment, peak knee eccentric extensor power, peak dorsiflexion and sagittal plane knee range of motion compared to imposed FFS. Imposed FFS yielded greater maximum vertical GRF, peak ankle plantarflexor moment, peak ankle eccentric plantarflexor power and sagittal plane ankle ROM compared to habitual RFS. Consistent with previous literature, imposed FFS in habitual RFS reduces eccentric knee extensor and ankle dorsiflexor involvement but produce greater eccentric ankle plantarflexor action compared to RFS. These acute differences between strike patterns were independent of running speeds equivalent to typical easy and hard training runs in competitive male runners. Current findings along with previous literature suggest differences in lower extremity kinetics between habitual RFS and imposed FFS running are consistent among a variety of runner populations. PMID:26371382

  4. Ankle trauma significantly impairs posture control--a study in basketball players and controls.

    Science.gov (United States)

    Perrin, P P; Béné, M C; Perrin, C A; Durupt, D

    1997-07-01

    Both ankle and hip movements are used to maintain balance in strategies defined as bottom up and top down models. This suggests that pathological impairment of either of these articulations could modify the parameters of balance control. In order to appreciate the bearing of ankle damage on the proper control of equilibrium, posturographic recordings were compared, in a static and two dynamic tests, between 15 professional national basketball players, with histories of 10 to 15 ankle sprains, and 50 controls. In statokinesigrams obtained with eyes open or closed, center of foot pressure displacements were of similar length (way) between controls and players, while the area covered was increased for the latter and related to the history of ankle trauma. In a toes-up dynamic test (4 degrees, 50 degrees/s) coupled with electromyographic recordings, the short latency response (myotatic reflex in the triceps surae muscle) normalized to one meter body height, was shorter in players without relationship to histories of ankle damage. In a prolonged sinusoidal dynamic test, players with the largest number of ankle trauma showed greater difficulties in maintaining posture control. These data pinpoint the role of ankles in the control of both static and dynamic balance and demonstrate that the role of the hip joints becomes more important (top down strategy) in the case of damaged ankles. PMID:9298781

  5. Comparative gait initiation kinematics between simulated unilateral and bilateral ankle hypomobility: Does bilateral constraint improve speed performance?

    Science.gov (United States)

    Delafontaine, A; Honeine, J-L; Do, M-C; Gagey, O; Chong, R K

    2015-08-31

    Improvement of motor performance in unilateral upper limb motor disability has been shown when utilizing inter-limb coupling strategies during physical rehabilitation. This suggests that 'default' bilateral central motor commands are facilitated. Here, we tested whether this bilateral motor control principle may be generalized to the lower limbs during gait initiation, which involves alternate bilateral actions. Disability was simulated by strapping to produce ankle hypomobility. Healthy adult subjects initiated gait at a self-paced speed with no ankle constraint (control), or with the stance, swing or bilateral ankles strapped. The duration of the anticipatory postural adjustments lengthened and the center of mass instantaneous progression velocity at foot-off decreased when the ankle was strapped. During the step execution phase, progression velocity at foot-contact was higher when both ankles were strapped compared to unilateral strapping of the stance ankle. These findings suggest that bilateral central motor commands are favored during walking tasks. Indeed, unilateral constraint of the stance ankle should compel the central nervous system to adapt specific commands to the constraint and normal sides whereas the 'default' bilateral motor commands would be utilized when both ankles are strapped leading to better kinematics performance. Bilateral in-phase upper limb coordination and bilateral alternating lower limb locomotor movements may share similar control mechanisms. PMID:26197055

  6. Design of a Simple and Modular 2-DOF Ankle Physiotherapy Device Relying on a Hybrid Serial-Parallel Robotic Architecture

    Directory of Open Access Journals (Sweden)

    Christos E. Syrseloudis

    2011-01-01

    Full Text Available The aim of this work is to propose a new 2-DOF robotic platform with hybrid parallel-serial structure and to undertake its parametric design so that it can follow the whole range of ankle related foot movements. This robot can serve as a human ankle rehabilitation device. The existing ankle rehabilitation devices present typically one or more of the following shortcomings: redundancy, large size, or high cost, hence the need for a device that could offer simplicity, modularity, and low cost of construction and maintenance. In addition, our targeted device must be safe during operation, disallow undesirable movements of the foot, while adaptable to any human foot. Our detailed study of foot kinematics has led us to a new hybrid architecture, which strikes a balance among all aforementioned goals. It consists of a passive serial kinematics chain with two adjustable screws so that the axes of the chain match the two main ankle-axes of typical feet. An active parallel chain, which consists of two prismatic actuators, provides the movement of the platform. Thus, the platform can follow the foot movements, thanks to the passive chain, and also possesses the advantages of parallel robots, including rigidity, high stiffness and force capabilities. The lack of redundancy yields a simpler device with lower size and cost. The paper describes the kinematics modelling of the platform and analyses the force and velocity transmission. The parametric design of the platform is carried out; our simulations confirm the platform's suitability for ankle rehabilitation.

  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. Anatomy and arthrokinematics of the human ankle and intertarsal joints

    International Nuclear Information System (INIS)

    In the ankle (talocrural) joint, the lower end of the tibia and fibula embrace the trochlea tali. Thus, an approximately uniaxial joint is formed which permits dorsiflexion and plantarflexion of the foot against the leg. Due to the geometry of the trochlea tali, conjunct lateral rotation of the fibula against the tibia occurs at the tibiofibular articulations synchronously with active dorsiflexion at the ankle joint. Movements at the talocrural joints are mainly limited by the opposing muscles as well as by strong collateral ligaments. Talus and calcaneus form a functional unit connected by posterior and anterior articulations. The posterior articulation is the subtalar (talocalcaneal) joint; in the anterior articulation, talar facets of the calcaneus together with the posterior surface of the navicular and the superior fibrocartilaginous surface of the plantar calcaneonavicular ligament form a concavity for the talar head. Thus, the talocalcaneonavicular joint is a compound and - like the subtalar joint - a multiaxial articulation. On the weightbearing foot, the distal tarsus and metatarsus are pronated and supinated against the talus in order to maintain plantigrade contact. When the foot is off the ground, these movements are modified to eversion and inversion, also involving the calcaneocuboid joint. In addition, movements between the calcaneus and cuboid also occur during pronative or supinative changes between the fore- and hindfoot. Limitation of movements is due to leg muscles as well as strong ligaments. Finally, the cuneonavicular, cuboideonavicular, intercuneiform and cuneocuboid joints permit some additional alterations of the loaded foot in contact with the ground. (orig.)

  9. Club foot

    DEFF Research Database (Denmark)

    Engell, V; Damborg, F; Andersen, M;

    2006-01-01

    The aetiology of congenital club foot is unclear. Although studies on populations, families and twins suggest a genetic component, the mode of inheritance does not comply with distinctive patterns. The Odense-based Danish Twin Registry contains data on all 73,000 twin pairs born in Denmark over the...... last 130 years. In 2002 all 46 418 twins born between 1931 and 1982 received a 17-page questionnaire, one question of which was 'Were you born with club foot?' A total of 94 twins answered 'Yes', giving an overall self-reported prevalence of congenital club foot of 0.0027 (95% confidence interval (CI.......09 (95% CI 0.01 to 0.32) for DZss and 0.05 (95% CI 0.006 to 0.18) for all dizygotic (DZtot) twins. We have found evidence of a genetic component in congenital club foot, although non-genetic factors must play a predominant role....

  10. Foot Surgery

    Science.gov (United States)

    ... in the toe to maintain realignment. Neuroma Surgery: Neuroma surgery involves removing a benign enlargement of a nerve, usually between the metatarsal heads in the ball of the foot. This soft tissue surgery tends to have a ...

  11. Foot Problems

    Science.gov (United States)

    ... irritation of the arch ligament and tissues, called PLANTAR FASCIITIS. Try to keep weight off your foot until ... bone, but more likely to be due to PLANTAR FASCIITIS. See your doctor. He or she can suggest ...

  12. Muscle performance and ankle joint mobility in long-term patients with diabetes

    Directory of Open Access Journals (Sweden)

    Macellari Velio

    2008-07-01

    Full Text Available Abstract Background Long-term patients with diabetes and peripheral neuropathy show altered foot biomechanics and abnormal foot loading. This study aimed at assessing muscle performance and ankle mobility in such patients under controlled conditions. Methods Forty six long-term diabetes patients with (DN and without (D peripheral neuropathy, and 21 controls (C were examined. Lower leg muscle performance and ankle mobility were assessed by means of a dedicated equipment, with the patient seated and the examined limb unloaded. 3D active ranges of motion and moments of force were recorded, the latter during maximal isometric contractions, with the foot blocked in different positions. Results All patients showed reduced ankle mobility. In the sagittal and transversal planes reduction vs C was 11% and 20% for D, 20% and 21% for DN, respectively. Dorsal-flexing moments were significantly reduced in all patients and foot positions, the highest reduction being 28% for D and 37% for DN. Reductions of plantar-flexing moments were in the range 12–15% for D (only with the foot blocked in neutral and in dorsal-flexed position, and in the range 10–24% for DN. In all patients, reductions in the frontal and transversal planes ranged 14–41%. Conclusion The investigation revealed ankle functional impairments in patients with diabetes, with or without neuropathy, thus suggesting that other mechanisms besides neuropathy might contribute to alter foot-ankle biomechanics. Such impairments may then play a role in the development of abnormal gait and in the onset of plantar ulcers.

  13. 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.)

  14. 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

  15. 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.)

  16. 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...

  17. 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 ...

  18. Ankle fracture: radiographic approach according to the Lauge-Hansen classification.

    Science.gov (United States)

    Russo, A; Reginelli, A; Zappia, M; Rossi, C; Fabozzi, G; Fabozzi, O; Cerrato, M; Macarini, L; Coppolino, F

    2013-08-01

    Ankle fractures account for 9 % of fractures (Clare in Foot Ankle Clin 13(4):593-610, 1) representing a significant portion of the trauma workload; proximal femoral fractures are the only lower limb fracture to present more frequently. Ankle fractures have a bimodal age distribution with peaks in younger males and older females (Arimoto and Forrester in AJR Am J Roentgenol 135(5):1057-1063, 2). There has been threefold increase in the incidence among elderly females over the past three decades (Haraguchi and Armiger in J Bone Joint Surg Am 91(4):821-829, 3). In 1950, Lauge-Hansen devised a classification of ankle fractures based on the position of the foot and the deforming force at the time of injury. This has been widely accepted by orthopedists, but is not in general use by radiologists. Identification of the fractures and classification of the type of injury allows diagnosis of the otherwise occult ligamentous injuries. Three radiographic views of the ankle (anteroposterior, mortise, and lateral) are necessary to classify an injury with the Lauge-Hansen system. Two additional criteria are also necessary: the position of the foot at the time of injury and the direction of the deforming force. PMID:23949937

  19. 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.)

  20. The Use of Model Matching Video Analysis and Computational Simulation to Study the Ankle Sprain Injury Mechanism

    OpenAIRE

    Daniel Tik-Pui Fong; Feng Wei

    2012-01-01

    Lateral ankle sprains continue to be the most common injury sustained by athletes and create an annual healthcare burden of over $4 billion in the U.S. alone. Foot inversion is suspected in these cases, but the mechanism of injury remains unclear. While kinematics and kinetics data are crucial in understanding the injury mechanisms, ligament behaviour measures ‐ such as ligament strains ‐ are viewed as the potential causal factors of ankle sprains. This review article demonstrates a novel met...

  1. Magnetic resonance imaging of the ankle in female ballet dancers en pointe

    International Nuclear Information System (INIS)

    Background: Ballet dancers require extreme range of motion of the ankle, especially weight-bearing maximum plantar flexion (en pointe). In spite of a high prevalence of foot and ankle injuries in ballet dancers, the anatomy and pathoanatomy of this position have not been sufficiently studied in weight-bearing. Magnetic resonance imaging (MRI) is a beneficial method for such study. Purpose: To develop an MRI method of evaluating the ankles of female ballet dancers standing en pointe and to assess whether pathological findings from the MR images were associated with ankle pain reported by the subjects. Material and Methods: Nine female ballet dancers (age, 21±2.9 years; dance experience, 16±4.1 years; en pointe dance experience, 7±4.9 years) completed an ankle pain visual analog scale questionnaire and underwent T1- and T2-weighted scans using a 0.25 T open MRI device. The ankle was scanned in three positions: supine with full plantar flexion, standing with the ankle in anatomical position, and standing en pointe. Results: Obtaining MR images of the ballet dancers en pointe was successful in spite of limitations imposed by the difficulty of remaining motionless in the en pointe position during scanning. MRI signs of ankle pathology and anatomical variants were observed. Convergence of the posterior edge of the tibial plafond, posterior talus, and superior calcaneus was noted in 100% of cases. Widened anterior joint congruity and synovitis/joint effusion were present in 71% and 67%, respectively. Anterior tibial and/or talar spurs and Stieda's process were each seen in 44%. However, clinical signs did not always correlate with pain reported by the subjects. Conclusion: This study successfully established an ankle imaging technique for ballet dancers en pointe that can be used in the future to assess the relationship between en pointe positioning and ankle pathoanatomy in ballet dancers

  2. Magnetic resonance imaging of the ankle in female ballet dancers en pointe

    Energy Technology Data Exchange (ETDEWEB)

    Russell, Jeffrey A. (Dept. of Dance, Univ. of California-Irvine, Irvine, CA (United States)), e-mail: jeff.russell@uci.edu; Shave, Ruth M. (Dept. of Radiology, Russells Hall Hospital, Dudley (United Kingdom)); Yoshioka, Hiroshi (Dept. of Radiological Sciences, Univ. of California-Irvine, Irvine, CA (United States)); Kruse, David W. (Dept. of Orthopaedic Surgery and Family Medicine, Univ. of California-Irvine, Irvine, CA (United States)); Koutedakis, Yiannis; Wyon, Matthew A. (School of Sport, Performing Arts and Leisure, Univ. of Wolverhampton, Walsall (United Kingdom))

    2010-07-15

    Background: Ballet dancers require extreme range of motion of the ankle, especially weight-bearing maximum plantar flexion (en pointe). In spite of a high prevalence of foot and ankle injuries in ballet dancers, the anatomy and pathoanatomy of this position have not been sufficiently studied in weight-bearing. Magnetic resonance imaging (MRI) is a beneficial method for such study. Purpose: To develop an MRI method of evaluating the ankles of female ballet dancers standing en pointe and to assess whether pathological findings from the MR images were associated with ankle pain reported by the subjects. Material and Methods: Nine female ballet dancers (age, 21+-2.9 years; dance experience, 16+-4.1 years; en pointe dance experience, 7+-4.9 years) completed an ankle pain visual analog scale questionnaire and underwent T1- and T2-weighted scans using a 0.25 T open MRI device. The ankle was scanned in three positions: supine with full plantar flexion, standing with the ankle in anatomical position, and standing en pointe. Results: Obtaining MR images of the ballet dancers en pointe was successful in spite of limitations imposed by the difficulty of remaining motionless in the en pointe position during scanning. MRI signs of ankle pathology and anatomical variants were observed. Convergence of the posterior edge of the tibial plafond, posterior talus, and superior calcaneus was noted in 100% of cases. Widened anterior joint congruity and synovitis/joint effusion were present in 71% and 67%, respectively. Anterior tibial and/or talar spurs and Stieda's process were each seen in 44%. However, clinical signs did not always correlate with pain reported by the subjects. Conclusion: This study successfully established an ankle imaging technique for ballet dancers en pointe that can be used in the future to assess the relationship between en pointe positioning and ankle pathoanatomy in ballet dancers

  3. Prevalence of chronic ankle instability and associated symptoms in university dance majors: an exploratory study.

    Science.gov (United States)

    Simon, Janet; Hall, Emily; Docherty, Carrie

    2014-01-01

    Previous investigations have established that dancers suffer a large number of injuries to the lower leg, foot, and ankle, with a portion of these being significant time loss injuries or in some cases career ending. Lateral ankle sprain is a common injury in dancers and can often lead to recurrent instability and repetitive injuries. Research in other active populations has linked ankle sprains to the development of chronic ankle instability (CAI). Therefore, the purpose of this study was to identify the prevalence of CAI and related symptoms of ankle sprain in a student dance population. Individuals were included if they were currently a modern or ballet dance major at the investigators' university (exclusion criterion: a history of fracture or surgery in the lower extremities). A self-reported demographic questionnaire and the Identification of Functional Ankle Instability survey were used to identify the presence and characteristics of CAI. A total of 83 questionnaires were collected, and after exclusions, 77 participants remained: 43 modern dancers and 34 ballet dancers (10 males and 67 females, mean age 19.61 ± 2.53 years, mean dance experience 13.61 ± 3.16 years). Of all dancers surveyed, 41 (53.2%) had CAI, and of those 24 (58.5%) were modern dancers, and 17 (41.5%) were ballet dancers. When looking only at those dancers who had a previous lateral ankle sprain, 75.9% were identified as having CAI. Chronic Ankle Instability can create long-term problems for anyone but especially female dancers, who place extreme stress on their feet and ankles from being en pointe or demi-pointe. It is important to educate dancers, instructors, and medical staff of the importance of recognizing CAI and seeking medical care for ankle sprains and their residual symptoms. PMID:25474297

  4. A review on the mechanical design elements of ankle rehabilitation robot.

    Science.gov (United States)

    Khalid, Yusuf M; Gouwanda, Darwin; Parasuraman, Subramanian

    2015-06-01

    Ankle rehabilitation robots are developed to enhance ankle strength, flexibility and proprioception after injury and to promote motor learning and ankle plasticity in patients with drop foot. This article reviews the design elements that have been incorporated into the existing robots, for example, backdrivability, safety measures and type of actuation. It also discusses numerous challenges faced by engineers in designing this robot, including robot stability and its dynamic characteristics, universal evaluation criteria to assess end-user comfort, safety and training performance and the scientific basis on the optimal rehabilitation strategies to improve ankle condition. This article can serve as a reference to design robot with better stability and dynamic characteristics and good safety measures against internal and external events. It can also serve as a guideline for the engineers to report their designs and findings. PMID:25979442

  5. SHADE: A Shape-Memory-Activated Device Promoting Ankle Dorsiflexion

    Science.gov (United States)

    Pittaccio, S.; Viscuso, S.; Rossini, M.; Magoni, L.; Pirovano, S.; Villa, E.; Besseghini, S.; Molteni, F.

    2009-08-01

    Acute post-stroke rehabilitation protocols include passive mobilization as a means to prevent contractures. A device (SHADE) that provides repetitive passive motion to a flaccid ankle by using shape memory alloy actuators could be of great help in providing this treatment. A suitable actuator was designed as a cartridge of approximately 150 × 20 × 15 mm, containing 2.5 m of 0.25 mm diameter NiTi wire. This actuator was activated by Joule’s effect employing a 7 s current input at 0.7 A, which provided 10 N through 76 mm displacement. Cooling and reset by natural convection took 30 s. A prototype of SHADE was assembled with two thermoplastic shells hinged together at the ankle and strapped on the shin and foot. Two actuators were fixed on the upper shell while an inextensible thread connected each NiTi wire to the foot shell. The passive ankle motion (passive range of motion, PROM) generated by SHADE was evaluated optoelectronically on three flaccid patients (58 ± 5 years old); acceptability was assessed by a questionnaire presented to further three flaccid patients (44 ± 11.5 years old) who used SHADE for 5 days, 30 min a day. SHADE was well accepted by all patients, produced good PROM, and caused no pain. The results prove that suitable limb mobilization can be produced by SMA actuators.

  6. Reliability of clinically relevant 3D foot bone angles from quantitative computed tomography

    OpenAIRE

    Gutekunst, David J; Liu, Lu; Ju, Tao; Prior, Fred W.; Sinacore, David R

    2013-01-01

    Background Surgical treatment and clinical management of foot pathology requires accurate, reliable assessment of foot deformities. Foot and ankle deformities are multi-planar and therefore difficult to quantify by standard radiographs. Three-dimensional (3D) imaging modalities have been used to define bone orientations using inertial axes based on bone shape, but these inertial axes can fail to mimic established bone angles used in orthopaedics and clinical biomechanics. To provide improved ...

  7. Determinants of Microbial Load in Infected Diabetic Foot Ulcers: A Pilot Study

    OpenAIRE

    2013-01-01

    We examined the determinants of microbial load in infected diabetic foot ulcers in 62 patients (38 men and 24 women, mean age: 65.63 ± 12.71 years) with clinically infected diabetic foot ulcers. Tissue cultures were taken from ulcers by 4 mm punches. Ulcer grade (University of Texas classification), neuropathy disability score (NDS), neuropathy symptom score (NSS), ankle-brachial index (ABI), perfusion, extent, depth, infection, and sensation (PEDIS) grade of diabetic foot infection, and labo...

  8. Validity and reliability of a self-administered foot evaluation questionnaire (SAFE-Q)

    OpenAIRE

    Niki, Hisateru; Tatsunami, Shinobu; Haraguchi, Naoki; Aoki, Takafumi; Okuda, Ryuzo; Suda, Yasunori; Takao, Masato; Tanaka, Yasuhito

    2013-01-01

    Background The Japanese Society for Surgery of the Foot (JSSF) is developing a QOL questionnaire instrument for use in pathological conditions related to the foot and ankle. The main body of the outcome instrument (the Self-Administered Foot Evaluation Questionnaire, SAFE-Q version 2) consists of 34 questionnaire items, which provide five subscale scores (1: Pain and Pain-Related; 2: Physical Functioning and Daily Living; 3: Social Functioning; 4: Shoe-Related; and 5: General Health and Well-...

  9. 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

  10. 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)

  11. MRI of injuries of the lateral ankle ligaments; MRT bei Verletzungen der lateralen und angrenzenden Baender des Sprunggelenks

    Energy Technology Data Exchange (ETDEWEB)

    Breitenseher, Martin [Landesklinikum Waldviertel Horn, Horn (Austria). Inst. fuer Radiologie und Interventionelle Radiologie

    2011-09-15

    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.)

  12. Ankle Proprioception Pattern in Women Across Various Trimesters of Pregnancy and Postpartum

    Directory of Open Access Journals (Sweden)

    Ramachandra P

    2016-01-01

    Full Text Available Background and Objectives: Ankle foot complex is the part of the body which is in contact with the ground and it is important to have an intact proprioceptive system in order to maintain postural control. Previous study has established that there is significant difference between ankle proprioception in pregnant women in their third trimester and non-pregnant women. There is lack of literature regarding when the ankle does the ankle proprioception gets affected during pregnancy and whether this change reverts back during postpartum and hence this study. Method: A cohort of 70 primiparous women were included in the study and the women were followed through 12th week, 24th week, 32nd week , immediate postpartum and 6 weeks postpartum. The ankle repositioning error was measured using photography method and was analyzed using UTHSCSA Image tool software. Repeated measures ANOVA was used to measure the differences across various time periods. Results: It was found that there was a significant differences (p<0.001 in ankle repositioning error in pregnant women across the trimesters and in the postpartum period and the value did not reach the first trimester value even after six weeks postpartum. Conclusion: Ankle proprioception was significantly affected across the various trimesters of pregnancy with the peak variability observed in the third trimester and the value did not reach back to the first trimester value even after 6 weeks postpartum.

  13. Inverse Dynamics Model for the Ankle Joint with Applications in Tibia Malleolus Fracture

    Science.gov (United States)

    Budescu, E.; Merticaru, E.; Chirazi, M.

    The paper presents a biomechanical model of the ankle joint, in order to determine the force and the torque of reaction into the articulation, through inverse dynamic analysis, in various stages of the gait. Thus, knowing the acceleration of the foot and the reaction force between foot and ground during the gait, determined by experimental measurement, there was calculated, for five different positions of the foot, the joint reaction forces, on the basis of dynamic balance equations. The values numerically determined were compared with the admissible forces appearing in the technical systems of osteosynthesis of tibia malleolus fracture, in order to emphasize the motion restrictions during bone healing.

  14. Adding Stiffness to the Foot Modulates Soleus Force-Velocity Behaviour during Human Walking

    Science.gov (United States)

    Takahashi, Kota Z.; Gross, Michael T.; van Werkhoven, Herman; Piazza, Stephen J.; Sawicki, Gregory S.

    2016-07-01

    Previous studies of human locomotion indicate that foot and ankle structures can interact in complex ways. The structure of the foot defines the input and output lever arms that influences the force-generating capacity of the ankle plantar flexors during push-off. At the same time, deformation of the foot may dissipate some of the mechanical energy generated by the plantar flexors during push-off. We investigated this foot-ankle interplay during walking by adding stiffness to the foot through shoes and insoles, and characterized the resulting changes in in vivo soleus muscle-tendon mechanics using ultrasonography. Added stiffness decreased energy dissipation at the foot (p lever arms) (p < 0.001). Added foot stiffness also altered soleus muscle behaviour, leading to greater peak force (p < 0.001) and reduced fascicle shortening speed (p < 0.001). Despite this shift in force-velocity behaviour, the whole-body metabolic cost during walking increased with added foot stiffness (p < 0.001). This increased metabolic cost is likely due to the added force demand on the plantar flexors, as walking on a more rigid foot/shoe surface compromises the plantar flexors’ mechanical advantage.

  15. 跟腱延长及胫骨肌与肌腱移植修复脑瘫致马蹄内翻足:恢复踝关节及足功能的评价%Achilles tendon extension and tibialis transfer combined with tendon transposition for cerebral palsy-induced talipes equinovarus:ankle recovery and foot function evaluation

    Institute of Scientific and Technical Information of China (English)

    郭景泉; 罗毅; 高宇; 任尚立; 郑紫磊

    2015-01-01

    tendon transposition. Postoperative plaster external fixation was done for 6 weeks, and then rehabilitation training was given. RESULTS AND CONCLUSION:Al the 22 patients were folowed for an average of 1-2 years, and then were evaluated according to the degree of patient’s satisfaction and the degree of foot deformity. Satisfactory results were obtained from al the patients. Achiles tendon “Z”-type extension, tibialis anterior and posterior transfer combined with tendon transposition to treat spastic cerebral palsy combined with equinovarus is a good method, and it is characterized as good appearance of the ankle and favorable foot function.

  16. The effect of prosthetic ankle energy storage and return properties on muscle activity in below-knee amputee walking.

    Science.gov (United States)

    Ventura, Jessica D; Klute, Glenn K; Neptune, Richard R

    2011-02-01

    In an effort to improve amputee gait, energy storage and return (ESAR) prosthetic feet have been developed to provide enhanced function by storing and returning mechanical energy through elastic structures. However, the effect of ESAR feet on muscle activity in amputee walking is not well understood. Previous studies have analyzed commercial prosthetic feet with a wide range of material properties and geometries, making it difficult to associate specific ESAR properties with changes in muscle activity. In contrast, prosthetic ankles offer a systematic way to manipulate ESAR properties while keeping the prosthetic heel and keel geometry intact. In the present study, ESAR ankles were added to a Seattle Lightfoot2 to carefully control the energy storage and return by altering the ankle stiffness and orientation in order to identify its effect on lower extremity muscle activity during below-knee amputee walking. A total of five foot conditions were analyzed: solid ankle (SA), stiff forward-facing ankle (FA), compliant FA, stiff reverse-facing ankle (RA) and compliant RA. The ESAR ankles decreased the activity of muscles that contribute to body forward propulsion and increased the activity of muscles that provide body support. The compliant ankles generally caused a greater change in muscle activity than the stiff ankles, but without a corresponding increase in energy return. Ankle orientation also had an effect, with RA generally causing a lower change in muscle activity than FA. These results highlight the influence of ESAR stiffness on muscle activity and the importance of prescribing appropriate prosthetic foot stiffness to improve rehabilitation outcomes. PMID:21145747

  17. 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…

  18. 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.

  19. Foot Disorders, Foot Posture, and Foot Function: The Framingham Foot Study

    OpenAIRE

    Hagedorn, Thomas J; Alyssa B Dufour; RISKOWSKI, JODY L.; Hillstrom, Howard J; Menz, Hylton B.; Casey, Virginia A.; Hannan, Marian T

    2013-01-01

    Introduction: Foot disorders are common among older adults and may lead to outcomes such as falls and functional limitation. However, the associations of foot posture and foot function to specific foot disorders at the population level remain poorly understood. The purpose of this study was to assess the relation between specific foot disorders, foot posture, and foot function. Methods: Participants were from the population-based Framingham Foot Study. Quintiles of the modified arch index and...

  20. 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)

  1. 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)

  2. Athlete's Foot

    Science.gov (United States)

    ... um) too small to be seen by the naked eye. This fungus eats old skin cells. And plenty of them can be found on the feet! Although athlete's foot occurs mostly among teen and young adult guys, kids and women can get it, too. People with sweaty or ...

  3. Biomechanical evaluation of wrist-driven flexor hinge orthosis in persons with spinal cord injury

    OpenAIRE

    Yeoun-Seung Kang, MD, PhD, CPO; Yoon-Ghil Park, MD, PhD; Bum-Suk Lee, MD; Hyung-Soon Park, PhD

    2013-01-01

    The wrist-driven flexor hinge orthosis (WDFHO) is a device used to restore hand function in persons with tetraplegic spinal cord injury by furnishing three-point prehension. We assessed the effectiveness and biomechanical properties of the WDFHO in 24 persons with cervical 6 or 7 tetraplegia who have severely impaired hand function. This study introduces a mechanical operating model to assess the efficiency of the WDFHO. Experimental results showed that pinch force increased significantly (p ...

  4. The Effect of Using Anti spastic Orthosis on the Reduction of Spasticity in Diplegic Spastic Children

    OpenAIRE

    Ashkan Irani; Azadeh Imani; Seyyed Ali Hosseini

    2012-01-01

    Background and aim: Cerebral palsy is a non progressive brain disorder and, cerebral plasy is the most common type of spastic paralysis which can be the cause of motor and postural deficits during child development. The purpose of this study was to investigate the effect of using Anti spastic Orthosis on the Reduction of Spasticity and in diplegic spastic children between 2 – 5 years in Tehran.Materials & Methods: 20 diplegic spastic children between 2- 5 years were selected randomly and divi...

  5. Preliminary design of an energy storing orthosis for providing gait to people with spinal cord injury.

    Science.gov (United States)

    Boughner, Kyle J; Durfee, William K

    2014-01-01

    A new design is proposed for an energy storing orthosis (ESO) that restores walking to people with spinal cord injury by combining functional electrical stimulation of the quadriceps muscle with a mechanical brace that uses elastic elements to store and transfer energy between hip and knee joints. The new ESO is a variation of a previous design and uses constant force springs for energy storage. Based on the detailed design and on dynamic simulations, the concept has demonstrated preliminary technical feasibility. PMID:25570518

  6. 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...

  7. Exoskeleton Technology in Rehabilitation: Towards an EMG-Based Orthosis System for Upper Limb Neuromotor Rehabilitation

    Directory of Open Access Journals (Sweden)

    Luis Manuel Vaca Benitez

    2013-01-01

    Full Text Available The rehabilitation of patients should not only be limited to the first phases during intense hospital care but also support and therapy should be guaranteed in later stages, especially during daily life activities if the patient’s state requires this. However, aid should only be given to the patient if needed and as much as it is required. To allow this, automatic self-initiated movement support and patient-cooperative control strategies have to be developed and integrated into assistive systems. In this work, we first give an overview of different kinds of neuromuscular diseases, review different forms of therapy, and explain possible fields of rehabilitation and benefits of robotic aided rehabilitation. Next, the mechanical design and control scheme of an upper limb orthosis for rehabilitation are presented. Two control models for the orthosis are explained which compute the triggering function and the level of assistance provided by the device. As input to the model fused sensor data from the orthosis and physiology data in terms of electromyography (EMG signals are used.

  8. A Critical Analysis of a Hand Orthosis Reverse Engineering and 3D Printing Process.

    Science.gov (United States)

    Baronio, Gabriele; Harran, Sami; Signoroni, Alberto

    2016-01-01

    The possibility to realize highly customized orthoses is receiving boost thanks to the widespread diffusion of low-cost 3D printing technologies. However, rapid prototyping (RP) with 3D printers is only the final stage of patient personalized orthotics processes. A reverse engineering (RE) process is in fact essential before RP, to digitize the 3D anatomy of interest and to process the obtained surface with suitable modeling software, in order to produce the virtual solid model of the orthosis to be printed. In this paper, we focus on the specific and demanding case of the customized production of hand orthosis. We design and test the essential steps of the entire production process with particular emphasis on the accurate acquisition of the forearm geometry and on the subsequent production of a printable model of the orthosis. The choice of the various hardware and software tools (3D scanner, modeling software, and FDM printer) is aimed at the mitigation of the design and production costs while guaranteeing suitable levels of data accuracy, process efficiency, and design versatility. Eventually, the proposed method is critically analyzed so that the residual issues and critical aspects are highlighted in order to discuss possible alternative approaches and to derive insightful observations that could guide future research activities. PMID:27594781

  9. A Critical Analysis of a Hand Orthosis Reverse Engineering and 3D Printing Process

    Directory of Open Access Journals (Sweden)

    Gabriele Baronio

    2016-01-01

    Full Text Available The possibility to realize highly customized orthoses is receiving boost thanks to the widespread diffusion of low-cost 3D printing technologies. However, rapid prototyping (RP with 3D printers is only the final stage of patient personalized orthotics processes. A reverse engineering (RE process is in fact essential before RP, to digitize the 3D anatomy of interest and to process the obtained surface with suitable modeling software, in order to produce the virtual solid model of the orthosis to be printed. In this paper, we focus on the specific and demanding case of the customized production of hand orthosis. We design and test the essential steps of the entire production process with particular emphasis on the accurate acquisition of the forearm geometry and on the subsequent production of a printable model of the orthosis. The choice of the various hardware and software tools (3D scanner, modeling software, and FDM printer is aimed at the mitigation of the design and production costs while guaranteeing suitable levels of data accuracy, process efficiency, and design versatility. Eventually, the proposed method is critically analyzed so that the residual issues and critical aspects are highlighted in order to discuss possible alternative approaches and to derive insightful observations that could guide future research activities.

  10. Mycetoma foot

    Directory of Open Access Journals (Sweden)

    Somnath Gooptu

    2013-01-01

    Full Text Available Mycetoma is an uncommon chronic granulomatous infective disease of the skin, dermis and subcutaneous tissues predominantly seen in tropical countries. A patient presented to our hospital with the swelling of the left foot with a healed sinus and a painful nodule. He gave a history of sinuses in the left foot from which there was discharge of yellow granules. Culture of the ultrasound guided fine needle aspiration cytology of the nodule revealed growths of Nocardia species. The patient was treated with a multi-drug therapy along with debridement of the painful nodule. He experienced symptomatic relief and a regression of the swelling within the three months of follow-up so far. Due to the relatively slow progression of the disease, patients are diagnosed at a late stage. Hence, emphasis should be placed on health education and the importance of wearing footwear.

  11. Effects of prosthetic foot forefoot flexibility on gait of unilateral transtibial prosthesis users

    Directory of Open Access Journals (Sweden)

    Elizabeth Klodd, MS

    2010-12-01

    Full Text Available Five solid-ankle experimental prosthetic feet were used in this double-blind randomized crossover study to determine the effects of forefoot flexibility on gait of 14 unilateral transtibial prosthesis users. Flexibility in experimental feet was altered by changing the number of flexural hinges in their forefoot sections. When experimental prosthetic foot conditions were compared, measured prosthetic ankle dorsiflexion range of motion increased as much as 3.3° with increasing flexibility (p < 0.001 and the foot's anterior moment arm (measured as the effective foot length ratio increased as much as 23% of the foot length with decreasing flexibility (p < 0.001. Subjects also showed increases in the difference between sound and prosthetic ankle moments as high as 0.53 Nm/kg in late stance phase of walking as flexibility decreased (p < 0.001. The difference between first peaks of the vertical ground reaction forces on the sound and prosthetic sides increased as much as 9% of body weight when subjects used the foot with the greatest flexibility (p = 0.001. The results of this study suggest solid-ankle prosthetic foot designs with overly flexible forefoot sections can cause a "drop-off" effect in late stance phase and during the transition of loading between prosthetic and contralateral limbs.

  12. 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

  13. How To Prevent Foot Ulcers In Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Ghada Morshed

    2012-03-01

    Full Text Available The prevalence of development of foot ulcers in diabetic patients is 4% to 10%, these ulcers may be infected, cause morbidity and may lead to lower extremity amputation.Objective: Prevention of diabetic foot ulcers in patients known to be diabetics by fasting blood sugar (FBS, HbA1C tests.Material and Methods: The study was done on 120 patients between March 2010 and July 2011 diagnosed as diabetics and they performed simple screening tests for peripheral neuropathy (Semmes-Weinstein monofilament examination (SWME, superficial pain, vibration testing by the on-off method, the timed method. Nerve conduction studies (NCS were used as standard criterion for detection of neuropathy, they also underwent Doppler ultrasound and ankle-brachial pressure index (ABPI measurement to assess the vascularity of their lower limbs. All patients were given proper education to prevent foot ulcers, including optimising glycemic control, cessation of smoking, debridement of calluses, appropriate foot wear and foot care with periodic foot examination.Results: In our study we succeeded in increasing the prevention of foot ulceration in our diabetic patients by 95%, compared to results achieved with the previous measures.Conclusion: Screening tests are effective for all diabetic patients to identify patients at risk of foot ulceration. They may benefit from prophylactic interventions including, optimising glycemic control, cessation of smoking, debridement of calluses, appropriate foot wear and intensive foot care.Also, we take care of patients with low risk of foot ulceration by adequate foot care and periodic foot examination to prevent foot ulceration.

  14. The use of a combined bipedicled axial perforator based fasciocutaneous flap for the treatment of a traumatic diabetic foot wound: a case report

    OpenAIRE

    Ignatiadis, Ioannis A.; Georgakopoulos, Georgios D.; Tsiampa, Vassiliki A.; Matei, Ileana R.; Georgescu, Alexandru V.; Polyzois, Vasilios D.

    2011-01-01

    The axial and perforator vascularised fasciocutaneous flaps are reliable and effective treatment methods for covering lower limb post-traumatic, septic, Charcot, and diabetic foot wounds. The authors describe the unique utilisation of a hybrid flap as an axial-perforator flap combination for the treatment of a traumatic diabetic foot wound. Keywords: diabetic foot; trauma; calcaneus; fasciocutaneous flap; plastic surgery(Published: 7 February 2011)Citation: Diabetic Foot & Ankle 2011, 2: ...

  15. 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...

  16. 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

  17. Short-term effects and long-term use of a hybrid orthosis for neuromuscular electrical stimulation of the upper extremity in patients after chronic stroke.

    NARCIS (Netherlands)

    Meijer, J.W.; Voerman, G.E.; Santegoets, K.M.; Geurts, A.C.H.

    2009-01-01

    OBJECTIVE: To associate the short-term effects of the Handmaster orthosis on disabling symptoms of the affected upper extremity with long-term Handmaster orthosis use after stroke. DESIGN: Historic cohort study. PATIENTS: Patients with chronic stroke. METHODS: The Modified Ashworth Scale (0-5) for w

  18. Toe clearance when walking in people with unilateral transtibial amputation: Effects of passive hydraulic ankle

    Directory of Open Access Journals (Sweden)

    Louise Johnson, PhD

    2014-06-01

    Full Text Available Most clinically available prosthetic feet have a rigid attachment or incorporate an “ankle” device allowing elastic articulation during stance, with the foot returning to a “neutral” position at toe-off. We investigated whether using a foot with a hydraulically controlled articulating ankle that allows the foot to be relatively dorsiflexed at toe-off and throughout swing would increase minimum toe clearance (MTC. Twenty-one people with unilateral transtibial amputation completed overground walking trials using their habitual prosthetic foot with rigid or elastic articulating attachment and a foot with a hydraulic ankle attachment (hyA-F. MTC and other kinematic variables were assessed across multiple trials. When using the hyA-F, mean MTC increased on both limbs (p = 0.03. On the prosthetic limb this was partly due to the device being in its fully dorsiflexed position at toe-off, which reduced the “toes down” foot angle throughout swing (p = 0.01. Walking speed also increased when using the hyA-F (p = 0.001 and was associated with greater swing-limb hip flexion on the prosthetic side (p = 0.04, which may have contributed to the increase in mean MTC. Variability in MTC increased on the prosthetic side when using the hyA-F (p = 0.03, but this did not increase risk of tripping.

  19. 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

  20. Finite Element Analysis Of Large Deformation Of Articular Cartilage In Upper Ankle Joint Of Occupant In Military Vehicles During Explosion

    Directory of Open Access Journals (Sweden)

    Klekiel T.

    2015-09-01

    Full Text Available The paper presents the analysis of the load of lower limbs of occupants in the armoured military vehicle, which has been destroyed by detonation of the Improvised Explosive Device (IED charge under the vehicle. A simplified model of the human lower limb focused on upper ankle joint was developed in order to determine the reaction forces in joints and load in particular segments during the blast load. The model of upper ankle joint, include a tibia and an ankle bone with corresponding articular cartilage, has been developed. An analysis of the stress distribution under the influence of forces applied at different angles to the biomechanical axis of a limb has been performed. We analyzed the case of the lower limb of a sitting man leaning his feet on the floor. It has been shown that during a foot pronation induced by a knee outward deviation, the axial load on the foot causes significantly greater tension in the tibia. At the same time it has been shown that within the medial malleolus, tensile stresses occur on the surface of the bone which may lead to fracture of the medial malleolus. It is a common case of injuries caused by loads on foot of passengers in armored vehicles during a mine or IED load under the vehicle. It was shown that the outward deviation of the knee increases the risk of the foot injury within the ankle joint.

  1. Foot amputation - discharge

    Science.gov (United States)

    Amputation - foot - discharge; Trans-metatarsal amputation - discharge ... You have had a foot amputation. You may have had an accident, or your foot may have had an infection or disease and doctors could ...

  2. Common Foot Problems

    Science.gov (United States)

    ... and rashes clinical tools newsletter | contact Share | Common Foot Problems A A A Trauma, infection, skin disease, ... the sole of the front part of the foot and on the toes. Foot infections include warts; ...

  3. Foot sprain - aftercare

    Science.gov (United States)

    Mid-foot sprain ... There are many bones and ligaments in your foot. A ligament is a strong flexible tissue that holds bones together. When the foot lands awkwardly, some ligaments can stretch and tear. ...

  4. Protocol for the Foot in Juvenile Idiopathic Arthritis trial (FiJIA): a randomised controlled trial of an integrated foot care programme for foot problems in JIA

    OpenAIRE

    Hendry Gordon J; Turner Deborah E; McColl John; Lorgelly Paula K; Sturrock Roger D; Watt Gordon F; Browne Michael; Gardner-Medwin Janet; Friel Lorraine; Woodburn Jim

    2009-01-01

    Abstract Background Foot and ankle problems are a common but relatively neglected manifestation of juvenile idiopathic arthritis. Studies of medical and non-medical interventions have shown that clinical outcome measures can be improved. However existing data has been drawn from small non-randomised clinical studies of single interventions that appear to under-represent the adult population suffering from juvenile idiopathic arthritis. To date, no evidence of combined therapies or integrated ...

  5. 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...

  6. 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.

  7. 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...

  8. 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

  9. Gait training reduces ankle joint stiffness and facilitates heel strike in children with Cerebral Palsy

    DEFF Research Database (Denmark)

    Willerslev-Olsen, Maria; Lorentzen, Jakob; Nielsen, Jens Bo

    2014-01-01

    facilitate heel strike in children with CP? METHODS: Seventeen children with CP (4-14 years) were recruited. Muscle stiffness and gait ability were measured twice before and twice after training with an interval of one month. Passive and reflex-mediated stiffness were measured by a dynamometer which applied......BACKGROUND: Foot drop and toe walking are frequent concerns in children with cerebral palsy (CP). Increased stiffness of the ankle joint muscles may contribute to these problems. OBJECTIVE: Does four weeks of daily home based treadmill training with incline reduce ankle joint stiffness and...... stiffness following training (P = 0.01). Toe lift in the swing phase (P = 0.014) and heel impact (P = 0.003) increased significantly following the training during both treadmill and over-ground walking. CONCLUSIONS: Daily intensive gait training may influence the elastic properties of ankle joint muscles...

  10. 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...

  11. 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...

  12. Effect of wearing a dorsiflexion assist orthosis on mobility, perceived fatigue and exertion during the six-minute walk test in people with multiple sclerosis: a randomised cross-over protocol

    OpenAIRE

    McLoughlin James; Barr Christopher; Sturnieks Daina; Lord Stephen; Crotty Maria

    2012-01-01

    Abstract Background Fatigue in combination with gait and balance impairments can severely limit daily activities in people with multiple sclerosis (PWMS). Generalised fatigue has a major impact on walking ability, with moderately disabled PWMS experiencing difficulty in walking extended distances. Localised motor fatigue in the ankle dorsiflexors can lead to foot drop, further reducing functional ambulation. The aim of this study is to evaluate the effect of a simple dynamic dorsiflexion assi...

  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. Optimization of MR imaging of the most commonly injured structures of the ankle

    International Nuclear Information System (INIS)

    MR images of the ankles of seven cadavers, nine healthy volunteers, and seven injured patients were correlated with cadaver dissections and cryosections to determine the optimum imaging plane and foot position for demonstrating each ligament's injury parameters. Axial images of the neutral-positioned foot allowed full-length visualization of the anterior and posterior talofibular ligaments, while the calcaneofibular ligament was paraxially imaged in 400 of plantar flexion. Coronal images allowed paraaxial visualization of major parts of the deltoid ligament: the tibionavicular ligament in 400 of plantar flexion and the tibospring and posterior tibiotalar ligaments in 150 of plantar flexion. Acute ligament rupture was well delineated on T2-weighted images by the high signal intensity of the overlying subcutaneous edema and hemorrhage and the underlying joint effusion. In chronically unstable ankles, ligament rupture, thinning, and lengthening were best demonstrated by placing that ligament in its stress position

  16. Injury of the ankle joint ligaments; Bandverletzungen des Sprunggelenks

    Energy Technology Data Exchange (ETDEWEB)

    Breitenseher, M.J. [Institut fuer Radiologie, Landesklinikum Waldviertel Horn, Horn (Austria); Karl Landsteiner Institut, St. Poelten (Austria)

    2007-03-15

    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.) [German] Die Diagnose einer lateralen Bandverletzung nach einem Sprunggelenktrauma basiert auf der Anamnese, der klinischen Untersuchung und klinischen Stresstests. Bei positiven klinischen Stresstests kann eine Stressradiographie durchgefuehrt werden. Es gibt keine Uebereinstimmung hinsichtlich des Stellenwerts der Stressradiographie beim frischen Supinationstrauma des Sprunggelenks, insbesondere fuer den Winkel der Aufklappbarkeit bei einer Zweibandverletzung, der von 5 -30 reicht. Die MRT wird bei dieser Indikation zurzeit nur in Einzelfaellen benutzt, obwohl sie mit definierter Fusspositionierung und Ausrichtung der Untersuchungsebene eine ausgezeichnete Beurteilung der Sprunggelenkbaender erlaubt. Sie ist im besonderen Masse geeignet, akute und chronische Verletzungen des Sinus tarsi zu beurteilen. Bei chronischen Beschwerden nach Bandverletzung ist die MRT zur

  17. Minimally invasive surgery for diabetic plantar foot ulcerations

    Directory of Open Access Journals (Sweden)

    Caio Nery

    2011-11-01

    Full Text Available Complications of diabetes mellitus constitute the most common indications for hospitalization and non-traumatic amputations in the USA. The most important risk factors for the development of diabetic foot ulcerations include the presence of peripheral neuropathy, vasculopathy, limited joint mobility, and pre-existing foot deformities. In our study, 500 diabetic patients treated for plantar forefoot ulcerations were enrolled in a prospective study from 2000 to 2008 at the Federal University of São Paulo, Brazil. Fifty-two patients in the study met the criteria and underwent surgical treatment consisting of percutaneous Achilles tendon lengthening to treat plantar forefoot ulcerations. The postoperative follow-up demonstrated prevention of recurrent foot ulcerations in 92% of these diabetic patients that maintained an improved foot function. In conclusion, our study supports that identification and treatment of ankle equinus in the diabetic population may potentially lead to decreased patient morbidity, including reduced risk for both reulceration, and potential lower extremity amputation.

  18. Use of infrared thermography for the diagnosis and grading of sprained ankle injuries

    Science.gov (United States)

    Oliveira, João; Vardasca, Ricardo; Pimenta, Madalena; Gabriel, Joaquim; Torres, João

    2016-05-01

    Ankle joint sprains are a common medical condition estimated to be responsible for 15-25% of all musculoskeletal injuries worldwide. The pathophysiology of the lesion can represent considerable time lost to injury, as well as long-term disability in up to 60% of patients. A percentage between 10% and 20% may complicate with chronic instability of the ankle joint and disability in walking, contributing to morbidity and poor life quality. Ankle sprains can be classified as grade I, II, or III, based on the extent of damage and number of ligaments affected. The diagnostic grading is important for setting further treatment and rehabilitation, since more severe injuries carries risk of recurrence, added morbidity and decrease in life quality. The aim of this work was to evaluate the adequacy of infrared thermography as a potential complimentary diagnostic tool of the distinct lesions grades. Evaluation of different thermographic values of the ankle region (in both affected and non-affected foot) was conducted for this purpose. The principal results to be highlighted are that some of the regions, namely anterior view for non defined time after injury analysis, and anterior, frontal, posterior and anterior talofibular ligament regions and proximal calcaneofibular ligament regions in acute lesions (herein defined as less than 6 h post-traumatic event) presented consistent profiles of variation. The analyses were performed considering affected and non-affected ankles results on plotted graphics representing termographic evaluation and grading of these lesions performed using ultrasound by experimented medical radiologists. An increase in temperature values was observed when progressing from mild to severe ankle sprain injuries, with these regions presenting lower values for the affected ankle when compared to the non-affected ankle in all the analysis performed. The remaining analysed regions did not present the same variations. Statistical analysis using Kruskal

  19. Wearing an active spinal orthosis improves back extensor strength in women with osteoporotic vertebral fractures

    DEFF Research Database (Denmark)

    Valentin, Gitte Hoff; Pedersen, Louise Nymann; Maribo, Thomas

    2014-01-01

    Background:Vertebral fractures are the most common clinical manifestations of osteoporosis. Vertebral fractures and reduced back extensor strength can result in hyperkyphosis. Hyperkyphosis is associated with diminished daily functioning and an increased risk of falling. Improvements in back...... extensor strength can result in decreased kyphosis and thus a decreased risk of falls and fractures.Objectives:The aim was to examine the effects of an active spinal orthosis - Spinomed III - on back extensor strength, back pain and physical functioning in women with osteoporotic vertebral fractures...

  20. 截瘫步行器的仿生效果%Bionic effect of reciprocating gait orthosis

    Institute of Scientific and Technical Information of China (English)

    陈文远

    2011-01-01

    BACKGROUND: Reciprocating gait orthosis makes the paraplegia patients walking, but reciprocating gait orthosis can only perform walking rehabilitation training and simple walking, which was far from real walking function compensation.OBJECTIVE: To summarize and analyze construction features, action mechanism and bionic effect of reciprocating gait orthosis.METHODS: We retrieved PubMed Database and Wanfang Database for articles concerning features, bionic effect and clinical application of reciprocating gait orthosis published from January 1990 to December 2008. The key words were "reciprocation gait orthosis, walkabout, bionice". A total of 32 articles were researched.RESULTS AND CONCLUSION: At present, unpowered reciprocating gait orthosis has been extensively utilized , but it can only perform walking rehabilitation training and simple walking, which was far from real walking function compensation for paraplegia patients. The bionic effects of reciprocation gait orthosis and walkabout were poor; gait lacked fidelity; physical ability was greatly consumed. However, the gait orthosis that requires outer energy for supplement can overcome the disadvantage of unpowered gait orthosis. With the wide usage of artificial intellectual technology in robot and many industry fields, its development can provide gait orthosis that has good function, safety, reliability, and bionics.%背景:截瘫步行器的临床应用,使截瘫患者重建步行功能成为可能,但截瘫步行器只为进行步行康复训练及简单的行走,距离真正意义上的步行功能代偿相差还很远.目的:对目前几种截瘫步行器的结构特点、作用机制及仿生效果进行归纳、分析.方法:应用计算机检索1990-01/2008-12 PubMed数据库及万方数据库有关截瘫步行器的特点、仿生效果及临床应用方面的相关文献,英文检索词"reciprocation gait orthosis,walkabout,bionice",中文检索词"截瘫步行器,仿生".检索文献量总计32篇.

  1. Efficient foot motor control by Neymar’s brain

    Directory of Open Access Journals (Sweden)

    Eiichi eNaito

    2014-08-01

    Full Text Available How very long-term (over many years motor skill training shapes internal motor representation remains poorly understood. We provide valuable evidence that the football brain of Neymar da Silva Santos Júnior (the Brasilian footballer recruits very limited neural resources in the motor-cortical foot regions during foot movements. We scanned his brain activity with a 3-tesla functional magnetic resonance imaging (fMRI while he rotated his right ankle at 1Hz. We also scanned brain activity when three other age-controlled professional footballers, two top-athlete swimmers and one amateur footballer performed the identical task. A comparison was made between Neymar’s brain activity with that obtained from the others. We found activations in the left medial-wall foot motor regions during the foot movements consistently across all participants. However, the size and intensity of medial-wall activity was smaller in the four professional footballers than in the three other participants, despite no difference in amount of foot movement. Surprisingly, the reduced recruitment of medial-wall foot motor regions became apparent in Neymar. His medial-wall activity was smallest among all participants with absolutely no difference in amount of foot movement. Neymar may efficiently control given foot movements probably by largely conserving motor-cortical neural resources. We discuss this possibility in terms of over-years motor skill training effect, use-dependent plasticity, and efficient motor control.

  2. Error signals driving locomotor adaptation

    DEFF Research Database (Denmark)

    Choi, Julia T; Jensen, Peter; Nielsen, Jens Bo; Bouyer, Laurent J

    2016-01-01

    perturbations. Forces were applied to the ankle joint during the early swing phase using an electrohydraulic ankle-foot orthosis. Repetitive 80 Hz electrical stimulation was applied to disrupt cutaneous feedback from the superficial peroneal nerve (foot dorsum) and medial plantar nerve (foot sole) during...... anaesthesia (n = 5) instead of repetitive nerve stimulation. Foot anaesthesia reduced ankle adaptation to external force perturbations during walking. Our results suggest that cutaneous input plays a role in force perception, and may contribute to the 'error' signal involved in driving walking adaptation when...

  3. Wii Fit™ exercise therapy for the rehabilitation of ankle sprains: Its effect compared with physical therapy or no functional exercises at all.

    Science.gov (United States)

    Punt, I M; Ziltener, J-L; Monnin, D; Allet, L

    2016-07-01

    Lateral ankle sprains represent the most common sports-related injuries. The Nintendo Wii Fit™ could be useful in the treatment of ankle sprains. The aim of this study was to compare the effectiveness of exercise training using the Wii Fit™ in ankle sprain patients: (a) with physical therapy; and (b) a control group not receiving any treatment. Ninety lateral ankle sprain patients were randomized to a Wii Fit™, physical therapy, or control group. We assessed the following outcome measures before, and 6 weeks after starting the allocated treatment: Foot and Ankle Ability Measure, pain during rest and walking, delay before return to sport, patient satisfaction, and effectiveness of the allocated treatment. Six weeks after the baseline measures, foot and ankle ability scores had improved in all groups, and pain had decreased during walking (P  0.050). In conclusion, the Wii Fit™ could be used as an exercise therapy to treat ankle sprain patients. However, Wii Fit™ was not more effective than only physical therapy, or no exercise therapy at all. Patients who did not receive treatment showed similar results as people who got any kind of exercise therapy. PMID:26076737

  4. Protocol for the Foot in Juvenile Idiopathic Arthritis trial (FiJIA: a randomised controlled trial of an integrated foot care programme for foot problems in JIA

    Directory of Open Access Journals (Sweden)

    Hendry Gordon J

    2009-06-01

    Full Text Available Abstract Background Foot and ankle problems are a common but relatively neglected manifestation of juvenile idiopathic arthritis. Studies of medical and non-medical interventions have shown that clinical outcome measures can be improved. However existing data has been drawn from small non-randomised clinical studies of single interventions that appear to under-represent the adult population suffering from juvenile idiopathic arthritis. To date, no evidence of combined therapies or integrated care for juvenile idiopathic arthritis patients with foot and ankle problems exists. Methods/design An exploratory phase II non-pharmacological randomised controlled trial where patients including young children, adolescents and adults with juvenile idiopathic arthritis and associated foot/ankle problems will be randomised to receive integrated podiatric care via a new foot care programme, or to receive standard podiatry care. Sixty patients (30 in each arm including children, adolescents and adults diagnosed with juvenile idiopathic arthritis who satisfy the inclusion and exclusion criteria will be recruited from 2 outpatient centres of paediatric and adult rheumatology respectively. Participants will be randomised by process of minimisation using the Minim software package. The primary outcome measure is the foot related impairment measured by the Juvenile Arthritis Disability Index questionnaire's impairment domain at 6 and 12 months, with secondary outcomes including disease activity score, foot deformity score, active/limited foot joint counts, spatio-temporal and plantar-pressure gait parameters, health related quality of life and semi-quantitative ultrasonography score for inflammatory foot lesions. The new foot care programme will comprise rapid assessment and investigation, targeted treatment, with detailed outcome assessment and follow-up at minimum intervals of 3 months. Data will be collected at baseline, 6 months and 12 months from baseline

  5. Topography of human ankle joint: focused on posterior tibial artery and tibial nerve

    OpenAIRE

    Kim, Deog-Im; Kim, Yi-Suk; Han, Seung-Ho

    2015-01-01

    Most of foot pain occurs by the entrapment of the tibial nerve and its branches. Some studies have reported the location of the tibial nerve; however, textbooks and researches have not described the posterior tibial artery and the relationship between the tibal nerve and the posterior tibial artery in detail. The purpose of this study was to analyze the location of neurovascular structures and bifurcations of the nerve and artery in the ankle region based on the anatomical landmarks. Ninety f...

  6. Isolated talonavicular arthrodesis in patients with rheumatoid arthritis of the foot and tibialis posterior tendon dysfunction

    OpenAIRE

    Pokorný David; Štursa Pavel; Vavřík Pavel; Hromádka Rastislav; Popelka Stanislav; Jahoda David; Sosna Antonín

    2010-01-01

    Abstract Background The foot is often affected in patients with rheumatoid arthritis. Subtalar joints are involved more frequently than ankle joints. Deformities of subtalar joints often lead to painful flatfoot and valgus deformity of the heel. Major contributors to the early development of foot deformities include talonavicular joint destruction and tibialis posterior tendon dysfunction, mainly due to its rupture. Methods Between 2002 and 2005 we performed isolated talonavicular arthrodesis...

  7. The clinical assessment study of the foot (CASF: study protocol for a prospective observational study of foot pain and foot osteoarthritis in the general population

    Directory of Open Access Journals (Sweden)

    Menz Hylton B

    2011-09-01

    Full Text Available Abstract Background Symptomatic osteoarthritis (OA affects approximately 10% of adults aged over 60 years. The foot joint complex is commonly affected by OA, yet there is relatively little research into OA of the foot, compared with other frequently affected sites such as the knee and hand. Existing epidemiological studies of foot OA have focussed predominantly on the first metatarsophalangeal joint at the expense of other joints. This three-year prospective population-based observational cohort study will describe the prevalence of symptomatic radiographic foot OA, relate its occurrence to symptoms, examination findings and life-style-factors, describe the natural history of foot OA, and examine how it presents to, and is diagnosed and managed in primary care. Methods All adults aged 50 years and over registered with four general practices in North Staffordshire, UK, will be invited to participate in a postal Health Survey questionnaire. Respondents to the questionnaire who indicate that they have experienced foot pain in the preceding twelve months will be invited to attend a research clinic for a detailed clinical assessment. This assessment will consist of: clinical interview; physical examination; digital photography of both feet and ankles; plain x-rays of both feet, ankles and hands; ultrasound examination of the plantar fascia; anthropometric measurement; and a further self-complete questionnaire. Follow-up will be undertaken in consenting participants by postal questionnaire at 18 months (clinic attenders only and three years (clinic attenders and survey participants, and also by review of medical records. Discussion This three-year prospective epidemiological study will combine survey data, comprehensive clinical, x-ray and ultrasound assessment, and review of primary care records to identify radiographic phenotypes of foot OA in a population of community-dwelling older adults, and describe their impact on symptoms, function and

  8. 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.

  9. 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

  10. 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

  11. Thoraco-pelvic orthosis: a portable and removable bassinet for secure patient immobilization after primary bladder exstrophy closure.

    Science.gov (United States)

    Castagnetti, Marco; Berrettini, Alfredo; Beniamin, Francesco; Rigamonti, Waifro

    2010-12-01

    A portable and removable thoraco-pelvic orthosis for patient immobilization after neonatal primary bladder exstrophy closure is described. The device is made of a polyethylene shell, moulded at 170°C, coated inside with a 5 mm pad of plastazote and works applying a constant gentle pressure on the hips. PMID:20857296

  12. The Effect of Using Anti spastic Orthosis on the Reduction of Spasticity in Diplegic Spastic Children

    Directory of Open Access Journals (Sweden)

    Ashkan Irani

    2012-10-01

    Full Text Available Background and aim: Cerebral palsy is a non progressive brain disorder and, cerebral plasy is the most common type of spastic paralysis which can be the cause of motor and postural deficits during child development. The purpose of this study was to investigate the effect of using Anti spastic Orthosis on the Reduction of Spasticity and in diplegic spastic children between 2 – 5 years in Tehran.Materials & Methods: 20 diplegic spastic children between 2- 5 years were selected randomly and divided into two groups. The first lower limb spasticity was assessed by a neurologist, and then by an experienced occupational therapist whitout being aware of research process before the intervention, The experimental group went under treatment using positioning therapeutic intervention and neurodevelopmental treatment, while the control group was treated and only with NDT. The research Instrument used was the Modified Ashworth scale (MAS and the H-Reflex and, H/M ratio in the lower limb spasticity was assessed, Utilizing Experimental pretest - post test with control group design. The data of this study was analyzed using t Test k square test and the findings showed meaningful differences between the two groups.Result: The findings of this study reveraled meaningful differences between the two groups, scores of mean spasticity in interference group was significantly less than control group (p=0/003 Conclusion: Application of Anti spastic Orthosis before rehabilitation exercises is recommended for diplegic spastic children.

  13. 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...

  14. 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

  15. 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 __________________________________________________________________ ...

  16. Walking cycle control for an active ankle prosthesis with one degree of freedom monitored from a personal computer.

    Science.gov (United States)

    Cordero Andrés, Guzhñay; Arévalo Luis, Calle; Abad Julio, Zambrano

    2015-08-01

    This paper proposes a fuzzy control algorithm for human walking cycle of an active ankle prosthesis for people who have suffered amputation of the lower limb, the system has one degree of freedom in the sagittal plane. Also, a biomechanical analysis of foot and ankle is shown to define the phases of plantar support and swinging. The used actuator is an intelligent servomotor, Dynamixel MX-106T which has torque, current and position feedback, among others, allowing real-time telemetry of the prototype implemented in a microcontroller system. PMID:26737084

  17. Acute injury of the ankle joint; Akutes Trauma des Sprunggelenks

    Energy Technology Data Exchange (ETDEWEB)

    Breitenseher, M.J. [Univ. Klinik fuer Radiodiagnostik, Abt. fuer Osteologie und Besondere Klinische Einrichtung Magnet Resonanz, AKH, Wien (Austria)]|[Ludwig-Boltzmann-Institut fuer Radiologisch-Physikalische Tumordiagnostik, Vienna (Austria)

    1999-01-01

    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.) [Deutsch] Die Diagnose einer lateralen Bandverletzung beim frischen Sprunggelenkstrauma fusst auf der Anamnese, der klinischen Untersuchung und klinischen Stresstests. Bei positiven klinischen Stresstests kann eine Stressradiographie durchgefuehrt werden. Es gibt keine Uebereinstimmung fuer den Wert der Stressradiographie beim frischen Supinationstrauma des Sprunggelenks, insbesonders fuer den Winkel der Aufklappbarkeit bei einer Zweibandverletzung, der von 5 -30 reicht. Die MRT wird zur Zeit bei dieser Indikation nur in Einzelfaellen benutzt, obwohl sie mit definierter Fusspositionierung und Ausrichtung der Untersuchungsebene eine ausgezeichnete Beurteilung der Sprunggelenksbaende erlaubt. Bei knoecherner Sprunggelenksverletzungen ist die Verwendung des konventionellen Roentgen die etablierte Methode und meist

  18. 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.

  19. 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.

  20. Factors affecting the range of motion of the ankle and first metatarsophalangeal joints in patients undergoing hemodialysis who walk daily.

    Science.gov (United States)

    Matsui, Nobumasa; Shoji, Morio; Kitagawa, Takashi; Terada, Shigeru

    2016-05-01

    [Purpose] Increased plantar pressure during walking is a risk factor for foot ulcers because of reduced range of motion at the ankle and first metatarsophalangeal joints. However, the range of motion in patients undergoing hemodialysis has not yet been determined. A cross-sectional study was performed to investigate the factors affecting the range of motion of the ankle and first metatarsophalangeal joints in patients undergoing hemodialysis who walk daily. [Subjects and Methods] Seventy feet of 35 patients receiving hemodialysis therapy were examined. Measurements included the passive range of motion of plantar flexion and dorsiflexion of the ankle joint, and flexion and extension of the first metatarsophalangeal joint. [Results] Hemodialysis duration was not associated with ankle and first metatarsophalangeal joint range of motion in patients undergoing hemodialysis. Diabetes duration was significantly associated with limited ankle joint mobility. Finally, blood hemoglobin levels, body mass index, and age were associated with first metatarsophalangeal joint range of motion. [Conclusion] The present study identified age, diabetes, and decreased physical activity, but not hemodialysis duration, to be risk factors for limited joint mobility of the ankle and first metatarsophalangeal joints in patients undergoing hemodialysis. PMID:27313371

  1. The influence of the external ankle support on the dynamic balance in volleyball athletes

    Directory of Open Access Journals (Sweden)

    Manuela Azevedo Correia de Lima

    2015-09-01

    Full Text Available AbstractThe purpose of this study was to assess the effect of ankle external supports on proprioception and dynamic balance in volleyball players. Seventeen female volleyball players (18.94±2.49 years; 65.45±9.49 kg; 1.71±0.05 m; BMI=22.0±2.67 kg/m² took part in this study. The dynamic balance was assessed through the Star Excursion Balance Test (SEBT. Comparisons between stabilization (no stabilizer/NS, orthosis/ORT and functional bandaging/FB modes and the SEBT grid lines and inter-limb were carried out. The SEBT assessment showed a significant difference between the groups NS x ORT and NS x FB (p < .01, and between the lines (p< .01. Significant line/limb interaction in DL and NDL (p< .01 was detected. The external supports tested herein showed similar effects on balance, restricting lower limb's reach in the SEBT execution in some of tested directions.

  2. 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...

  3. 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...

  4. Effects of Bone Young’s Modulus on Finite Element Analysis in the Lateral Ankle Biomechanics

    Directory of Open Access Journals (Sweden)

    W. X. Niu

    2013-01-01

    Full Text Available Finite element analysis (FEA is a powerful tool in biomechanics. The mechanical properties of biological tissue used in FEA modeling are mainly from experimental data, which vary greatly and are sometimes uncertain. The purpose of this study was to research how Young’s modulus affects the computations of a foot-ankle FEA model. A computer simulation and an in-vitro experiment were carried out to investigate the effects of incremental Young’s modulus of bone on the stress and strain outcomes in the computational simulation. A precise 3-dimensional finite element model was constructed based on an in-vitro specimen of human foot and ankle. Young’s moduli were assigned as four levels of 7.3, 14.6, 21.9 and 29.2 GPa respectively. The proximal tibia and fibula were completely limited to six degrees of freedom, and the ankle was loaded to inversion 10° and 20° through the calcaneus. Six cadaveric foot-ankle specimens were loaded as same as the finite element model, and strain was measured at two positions of the distal fibula. The bone stress was less affected by assignment of Young’s modulus. With increasing of Young’s modulus, the bone strain decreased linearly. Young’s modulus of 29.2 GPa was advisable to get the satisfactory surface strain results. In the future study, more ideal model should be constructed to represent the nonlinearity, anisotropy and inhomogeneity, as the same time to provide reasonable outputs of the interested parameters.

  5. 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...

  6. 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...

  7. 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 ...

  8. 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

  9. 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...

  10. Biomechanical evaluation of wrist-driven flexor hinge orthosis in persons with spinal cord injury

    Directory of Open Access Journals (Sweden)

    Yeoun-Seung Kang, MD, PhD, CPO

    2013-11-01

    Full Text Available The wrist-driven flexor hinge orthosis (WDFHO is a device used to restore hand function in persons with tetraplegic spinal cord injury by furnishing three-point prehension. We assessed the effectiveness and biomechanical properties of the WDFHO in 24 persons with cervical 6 or 7 tetraplegia who have severely impaired hand function. This study introduces a mechanical operating model to assess the efficiency of the WDFHO. Experimental results showed that pinch force increased significantly (p < 0.001 after using the WDFHO and was found to positively correlate with the strength of wrist extensor muscles (r = 0.41, p < 0.001. However, when the strength of the wrist extensors acting on the WDFHO was greater, the reciprocal wrist and finger motion that generates three-point prehension was less effective (r = 0.79, p < 0.001. Reliable and valid biomechanical evaluation of the WDFHO could improve our understanding of its biomechanics.

  11. Mechanical Performance of Actuators in an Active Orthosis for the Upper Extremities

    Directory of Open Access Journals (Sweden)

    Roland Wiegand

    2011-01-01

    Full Text Available The aim of the project OrthoJacket is to develop a lightweight, portable, and active orthosis for the upper limps. The system consists of two special designed fluidic actuators which are used for supporting the elbow function and the internal rotation of the shoulder. A new design of flexible fluid actuator (FFA is presented that enables more design options of attaching parts, as it is allowed by conventional actuators with a stationary centre of rotation. This advantage and the inherent flexibility and the low weight of this kind of actuator predestined them for the use in exoskeletons, orthoses, and prostheses. The actuator for the elbow generates a maximum torque of 32 Nm; the internal rotation is supported with 7 Nm. Both actuators support the movement with up to 100% of the necessary power. The shells for the arm and forearm are made of carbon reinforced structures in combination with inflatable cushions.

  12. Fuzzy-logic-based hybrid locomotion mode classification for an active pelvis orthosis: Preliminary results.

    Science.gov (United States)

    Yuan, Kebin; Parri, Andrea; Yan, Tingfang; Wang, Long; Munih, Marko; Vitiello, Nicola; Wang, Qining

    2015-08-01

    In this paper, we present a fuzzy-logic-based hybrid locomotion mode classification method for an active pelvis orthosis. Locomotion information measured by the onboard hip joint angle sensors and the pressure insoles is used to classify five locomotion modes, including two static modes (sitting, standing still), and three dynamic modes (level-ground walking, ascending stairs, and descending stairs). The proposed method classifies these two kinds of modes first by monitoring the variation of the relative hip joint angle between the two legs within a specific period. Static states are then classified by the time-based absolute hip joint angle. As for dynamic modes, a fuzzy-logic based method is proposed for the classification. Preliminary experimental results with three able-bodied subjects achieve an off-line classification accuracy higher than 99.49%. PMID:26737144

  13. Ankle torque control that shifts the center of pressure from heel to toe contributes non-zero sagittal plane angular momentum during human walking.

    Science.gov (United States)

    Gruben, Kreg G; Boehm, Wendy L

    2014-04-11

    A principle objective of human walking is controlling angular motion of the body as a whole to remain upright. The force of the ground on each foot (F) reflects that control, and recent studies show that in the sagittal plane F exhibits a specific coordination between F direction and center-of-pressure (CP) that is conducive to remaining upright. Typical walking involves the CP shifting relative to the body due to two factors: posterior motion of the foot with respect to the hip (stepping) and motion of the CP relative to the foot (foot roll-over). Recent research has also shown how adjusting ankle torque alone to shift CP relative to the foot systematically alters the direction of F, and thus, could play a key role in upright posture and the F measured during walking. This study explores how the CP shifts due to stepping and foot roll-over contribute to the observed F and its role in maintaining upright posture. Experimental walking kinetics and kinematics were combined with a mechanical model of the human to show that variation in F that was not attributable to foot roll-over had systematic correlation between direction and CP that could be described by an intersection point located near the center-of-mass. The findings characterize a component of walking motor control, describe how typical foot roll-over contributes to postural control, and provide a rationale for the increased fall risk observed in individuals with atypical ankle muscle function. PMID:24524989

  14. Diagnosis and treatment of acute ankle injuries: development of an evidence-based algorithm

    Directory of Open Access Journals (Sweden)

    Hans Polzer

    2012-01-01

    Full Text Available Acute ankle injuries are among the most common injuries in emergency departments. However, a standardized examination and an evidence-based treatment are missing. Therefore, aim of this study was to systematically search the current literature, classify the evidence and develop an algorithm for diagnosis and treatment of acute ankle injuries. We systematically searched PubMed and the Cochrane Database for randomized controlled trials, meta-analysis, systematic reviews, or if applicable observational studies and classified them according to their level of evidence. According to the currently available literature, the following recommendations are given. The Ottawa Ankle/Foot Rule should be applied in order to rule out fractures, Physical examination is sufficient for diagnosing injuries to the lateral ligament complex. Classification into stable and unstable injuries is applicable and of clinical importance. The squeeze-, crossed leg- and external rotation test are indicative for injuries of the syndesmosis. Magnetic resonance imaging is recommended to verify such injuries. Stable ankle sprains have a good prognosis, while for unstable ankle sprains conservative treatment is at least as effective as operative treatment without carrying possible complications. Early functional treatment leads to the fastest recovery and the least rate of re-injury. Supervised rehabilitation reduces residual symptoms and re-injuries. Taken these recommendations into account, we here present an applicable and evidence-based step by step decision pathway for the diagnosis and treatment of acute ankle injuries, which can be implemented in any emergency department or doctor’s practice. It provides quality assurance for the patient and confidence for the attending physician.

  15. Bone stress injury of the ankle in professional ballet dancers seen on MRI

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    Besser Marcus P

    2008-03-01

    Full Text Available Abstract Background Ballet Dancers have been shown to have a relatively high incidence of stress fractures of the foot and ankle. It was our objective to examine MR imaging patterns of bone marrow edema (BME in the ankles of high performance professional ballet dancers, to evaluate clinical relevance. Methods MR Imaging was performed on 12 ankles of 11 active professional ballet dancers (6 female, 5 male; mean age 24 years, range 19 to 32. Individuals were imaged on a 0.2 T or 1.5 T MRI units. Images were evaluated by two musculoskeletal radiologists and one orthopaedic surgeon in consensus for location and pattern of bone marrow edema. In order to control for recognized sources of bone marrow edema, images were also reviewed for presence of osseous, ligamentous, tendinous and cartilage injuries. Statistical analysis was performed to assess the strength of the correlation between bone marrow edema and ankle pain. Results Bone marrow edema was seen only in the talus, and was a common finding, observed in nine of the twelve ankles imaged (75% and was associated with pain in all cases. On fluid-sensitive sequences, bone marrow edema was ill-defined and centered in the talar neck or body, although in three cases it extended to the talar dome. No apparent gender predilection was noted. No occult stress fracture could be diagnosed. A moderately strong correlation (phi = 0.77, p= 0.0054 was found between edema and pain in the study population. Conclusion Bone marrow edema seems to be a specific MRI finding in the talus of professional ballet dancers, likely related to biomechanical stress reactions, due to their frequently performed unique maneuvers. Clinically, this condition may indicate a sign of a bone stress injury of the ankle.

  16. The influence of ankle dorsiflexion and self-reported patient outcomes on dynamic postural control in participants with chronic ankle instability.

    Science.gov (United States)

    Terada, Masafumi; Harkey, Matthew S; Wells, Ashley M; Pietrosimone, Brian G; Gribble, Phillip A

    2014-01-01

    We investigated the influence of ankle dorsiflexion range of motion (DF-ROM) and self-reported patient outcomes on dynamic postural control assessed with the Star Excursion Balance Test (SEBT) in individuals with chronic ankle instability (CAI). Twenty-nine participants with self-reported CAI volunteered. The primary outcome measurements were categorized into clinician-and patient-generated. Clinician-generated outcome measurements included anterior (SEBT-A), posteriormedial (SEBT-PM) and posteriorlateral (SEBT-PL) reach distances (cm) normalized by leg length (cm) of the SEBT, maximum weight-bearing dorsiflexion (WB-DF) (cm), and open-chain DF-ROM (°). Self-reported patient-generated outcome measures included the foot and ankle ability measure and the level of perceived pain, stiffness, stability, and function of their involved ankle on a 10-cm visual analog scale (VAS). Pearson product moment correlations were used to examine the relationship of the SEBT performances with DF-ROM and self-reported patient outcome measures. A multiple linear regression was performed to determine the influence of patient- and clinician-generated measures on the SEBT. SEBT-A performance was significantly and fairly correlated with WB-DF (r=0.410, p=0.014), perceived ankle stiffness (r=0.477, p=0.014), and open-chain DF-ROM (r=0.404, p=0.015). The strongest predictor of the variance in SEBT-A was the combination of the variance in WB-DF and VAS-stiffness (R2=0.348, p=0.004). There were no significant correlations with the SEBT-PM and SEBT-PL. WB-DF and VAS-stiffness may represent targets for intervention that need to be addressed to produce the best outcome in participants with CAI when altered dynamic postural control is detected on the SEBT-A. PMID:24768526

  17. Gait characteristics following Achilles tendon elongation: the foot rocker perspective.

    Science.gov (United States)

    Bober, Tadeusz; Dziuba, Alicja; Kobel-Buys, Krystyna; Kulig, Kornelia

    2008-01-01

    The action of three functional rockers, namely the heel, ankle and forefoot rocker, assist the progression of the leg over the supporting foot. The purpose of this case series was to analyze the occurrence of foot rockers during gait in three children with cerebral palsy (CP) who had undergone the tendo-Achilles lengthening (TAL), procedure followed by a clinic- or home-based intervention and in one child with CP without history of surgery. Self-selected gait was video-recorded in a laboratory during six testing sessions at half-year intervals rendering a 3 year period of observation. One child had pre- and post-surgical gait data and the other two had post surgical data only. Sagittal plane knee angular velocity, as well as foot to ground positions, and foot rocker occurrence were analyzed. In a child with history of CP, and without history of surgery, mean angular velocities of the 1st, 2nd and 3rd foot rocker were 3.7, 0.57 and 6.67 rad/s, respectively, and the step length and cadence were normal. In children who underwent TAL the 1st and 2nd rocker was absent, as the initial contact of the foot with the ground was either with foot-flat or forefoot. The mean velocity of the 3rd rocker in children who underwent TAL was lower by approximately 50-80% than that of the nonsurgical case. Furthermore, the characteristic pattern of the knee joint to foot-floor position during gait was not observed in these cases. Foot rocker analysis identified children with abnormal gait characteristics. Following surgery these gait characteristics remained abnormal. PMID:18634352

  18. 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.

  19. Orthosis reduces breast pain and mechanical forces through natural and augmented breast tissue in women lying prone

    OpenAIRE

    Ried, Karin; Armstrong, Simon; Sali, Avni; McLaughlin, Patrick

    2014-01-01

    Background Breast implant displacement or rupture can cause aesthetic problems and serious medical complications. Activities with prone positioning and loading of the anterior chest wall, such as massage, chiropractic or osteopathic therapies may increase the risk of implant failure and can also cause discomfort in women with natural breast tissue. Here we test the effectiveness of a newly developed orthosis on pain, mechanical pressure and displacement of breast tissue in women with cosmetic...

  20. Combined circular external fixation and open reduction internal fixation with pro-syndesmotic screws for repair of a diabetic ankle fracture

    Directory of Open Access Journals (Sweden)

    Zacharia Facaros

    2010-10-01

    Full Text Available The surgical management of ankle fractures among the diabetic population is associated with higher complication rates compared to the general population. Efforts toward development of better methods in prevention and treatment are continuously evolving for these injuries. The presence of peripheral neuropathy and the possible development of Charcot neuroarthropathy in this high risk patient population have stimulated much surgical interest to create more stable osseous constructs when open reduction of an ankle fracture/dislocation is required. The utilization of multiple syndesmotic screws (pro-syndesmotic screws to further stabilize the ankle mortise has been reported by many foot and ankle surgeons. In addition, transarticular Steinmann pins have been described as an adjunct to traditional open reduction with internal fixation (ORIF of the ankle to better stabilize the talus, thus minimizing risk of further displacement, malunion, and Charcot neuroarthropathy. The authors present a unique technique of ORIF with pro-syndesmotic screws and the application of a multi-plane circular external fixator for management of a neglected diabetic ankle fracture that prevented further deformity while allowing a weight-bearing status. This technique may be utilized for the management of complex diabetic ankle fractures that are prone to future complications and possible limb loss.

  1. 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

  2. Plantar-flexion of the ankle joint complex in terminal stance is initiated by subtalar plantar-flexion: A bi-planar fluoroscopy study.

    Science.gov (United States)

    Koo, Seungbum; Lee, Kyoung Min; Cha, Young Joo

    2015-10-01

    Gross motion of the ankle joint complex (AJC) is a summation of the ankle and subtalar joints. Although AJC kinematics have been widely used to evaluate the function of the AJC, the coordinated movements of the ankle and subtalar joints are not well understood. The purpose of this study was to accurately quantify the individual kinematics of the ankle and subtalar joints in the intact foot during ground walking by using a bi-planar fluoroscopic system. Bi-planar fluoroscopic images of the foot and ankle during walking and standing were acquired from 10 healthy subjects. The three-dimensional movements of the tibia, talus, and calcaneus were calculated with a three-dimensional/two-dimensional registration method. The skeletal kinematics were quantified from 9% to 86% of the full stance phase because of the limited camera speed of the X-ray system. At the beginning of terminal stance, plantar-flexion of the AJC was initiated in the subtalar joint on average at 75% ranging from 62% to 76% of the stance phase, and plantar-flexion of the ankle joint did not start until 86% of the stance phase. The earlier change to plantar-flexion in the AJC than the ankle joint due to the early plantar-flexion in the subtalar joint was observed in 8 of the 10 subjects. This phenomenon could be explained by the absence of direct muscle insertion on the talus. Preceding subtalar plantar-flexion could contribute to efficient and stable ankle plantar-flexion by locking the midtarsal joint, but this explanation needs further investigation. PMID:26238571

  3. 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.

  4. THE INFLUENCE OF A FOOT ORTHOTIC ON LOWER EXTREMITY TRANSVERSE PLANE KINEMATICS IN COLLEGIATE FEMALE ATHLETES WITH PES PLANUS

    Directory of Open Access Journals (Sweden)

    Christopher R. Carcia

    2006-12-01

    Full Text Available Non-contact anterior cruciate ligament (ACL injuries in female athletes remain prevalent. Athletes with excessive foot pronation have been identified to be at greater risk for non-contact ACL injury. Excessive foot pronation has been linked to increased medial tibial rotation. Increased medial tibial rotation heightens ACL strain and has been observed at or near the time of ACL injury. Foot orthotics have been shown to decrease medial tibial rotation during walking and running tasks. The effect of a foot orthotic on activities that simulate a non-contact ACL injury mechanism (i.e. landing however is unknown. Therefore, the objective of this study was to determine whether a foot orthotic was capable of altering transverse plane lower extremity kinematics in female athletes during landing. Twenty uninjured collegiate female athletes participating in the sports of basketball, soccer or volleyball with pes planus volunteered. Utilizing a repeated measures counterbalanced design, subjects completed two landing tasks with and without a foot orthotic using standardized footwear. The prefabricated orthotic had a rigid shell and a 6 extrinsic rear-foot varus post. Dependent measures included initial contact angle, peak angle, excursion and time to peak angle for both the tibia and femur. Statistical analysis suggested that the selected foot orthosis had little influence over lower extremity transverse plane kinematics. Several factors including: the limitation of a static measure to predict dynamic movement, inter-subject variability and the physical characteristics of the orthotic device likely account for the results. Future research should examine the influence of different types of foot orthotics not only on lower extremity kinematics but also tibiofemoral kinetics

  5. 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

  6. Knee and ankle joint forces during steps and jumps down from two different heights.

    Science.gov (United States)

    Nisell, R; Mizrah, J

    1988-05-01

    Two healthy subjects were filmed on TV-video when performing 14 different steps and jumps from two different heights (0·20 m and 0·43 m) onto two Kistler force platforms that recorded the reaction forces. The ankle and knee load moments and joint forces were calculated using a sagittal plane semi-dynamic biomechanical model. Steps with the ball of the foot from the lower height induced a vertical ground reaction force (Fz) close to 1 body weight (bw) and around 2 bw from the greater height. From the greater height the knee moments for the majority of the step-downs studied were about 100 Nm, which gave knee joint compressive forces of 4-7 bw. The ankle was exposed to loads of similar magnitude but not so much influenced by step height. The reasons why patients with knee pain prefer performing backward step-downs are discussed. PMID:23915840

  7. Ankle rehabilitation device with two degrees of freedom and compliant joint

    Science.gov (United States)

    Racu (Cazacu, C.-M.; Doroftei, I.

    2015-11-01

    We propose a rehabilitation device that we intend to be low cost and easy to manufacture. The system will ensure functionality but also have a small dimensions and low mass, considering the physiological dimensions of the foot and lower leg. To avoid injure of the ankle joint, this device is equipped with a compliant joint between the motor and mechanical transmission. The torque of this joint is intended to be adjustable, according to the degree of ankle joint damage. To choose the material and the dimensions of this compliant joint, in this paper we perform the first stress simulation. The minimum torque is calculated, while the maximum torque is given by the preliminary chosen actuator.

  8. Treatment of acute lateral ankle ligament rupture in the athlete. Conservative versus surgical treatment.

    Science.gov (United States)

    Lynch, S A; Renström, P A

    1999-01-01

    Acute lateral ankle ligament sprains are common in young athletes (15 to 35 years of age). Diagnostic and treatment protocols vary. Therapies range from cast immobilisation or acute surgical repair to functional rehabilitation. The lateral ligament complex includes 3 capsular ligaments: the anterior tibiofibular (ATFL), calcaneofibular (CFL) and posterior talofibular (PTFL) ligaments. Injuries typically occur during plantar flexion and inversion; the ATFL is most commonly torn. The CFL and the PTFL can also be injured and, after severe inversion, subtalar joint ligaments are also affected. Commonly, an athlete with a lateral ankle ligament sprain reports having 'rolled over' the outside of their ankle. The entire ankle and foot must be examined to ensure there are no other injuries. Clinical stability tests for ligamentous disruption include the anterior drawer test of ATFL function and inversion tilt test of both ATFL and CFL function. Radiographs may rule out treatable fractures in severe injuries or when pain or tenderness are not associated with lateral ligaments. Stress radiographs do not affect treatment. Ankle sprains are classified from grades I to III (mild, moderate or severe). Grade I and II injuries recover quickly with nonoperative management. A non-operative 'functional treatment' programme includes immediate use of RICE (rest, ice, compression, elevation), a short period of immobilisation and protection with a tape or bandage, and early range of motion, weight-bearing and neuromuscular training exercises. Proprioceptive training on a tilt board after 3 to 4 weeks helps improve balance and neuromuscular control of the ankle. Treatment for grade III injuries is more controversial. A comprehensive literature evaluation and meta-analysis showed that early functional treatment provided the fastest recovery of ankle mobility and earliest return to work and physical activity without affecting late mechanical stability. Functional treatment was complication

  9. The clinimetric qualities of patient-assessed instruments for measuring chronic ankle instability: A systematic review

    Directory of Open Access Journals (Sweden)

    Asman Sara

    2007-01-01

    Full Text Available Abstract Background The assessment of outcomes from the patient's perspective becomes more recognized in health care. Also in patients with chronic ankle instability, the degree of present impairments, disabilities and participation problems should be documented from the perspective of the patient. The decision about which patient-assessed instrument is most appropriate for clinical practice should be based upon systematic reviews. Only rating scales constructed for patients with acute ligament injuries were systematically reviewed in the past. The aim of this study was to review systematically the clinimetric qualities of patient-assessed instruments designed for patients with chronic ankle instability. Methods A computerized literature search of Medline, Embase, Cinahl, Web of Science, Sport Discus and the Cochrane Controlled Trial Register was performed to identify eligible instruments. Two reviewers independently evaluated the clinimetric qualities of the selected instruments using a criteria list. The inter-observer reliability of both the selection procedure and the clinimetric evaluation was calculated using modified kappa coefficients. Results The inter-observer reliability of the selection procedure was excellent (k = .86. Four instruments met the eligibility criteria: the Ankle Joint Functional Assessment Tool (AJFAT, the Functional Ankle Outcome Score (FAOS, the Foot and Ankle Disability Index (FADI and the Functional Ankle Ability Measure (FAAM. The inter-observer reliability of the quality assessment was substantial to excellent (k between .64 and .88. Test-retest reliability was demonstrated for the FAOS, the FADI and the FAAM but not for the AJFAT. The FAOS and the FAAM met the criteria for content validity and construct validity. For none of the studied instruments, the internal consistency was sufficiently demonstrated. The presence of floor- and ceiling effects was assessed for the FAOS but ceiling effects were present for all

  10. 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...

  11. Effects of a flat prosthetic foot rocker section on balance and mobility

    Directory of Open Access Journals (Sweden)

    Andrew Hansen, PhD

    2014-03-01

    Full Text Available Previous studies have shown that the effective rocker shape of the physiologic ankle-foot system during standing and fore-aft swaying is much flatter than that used during walking, which indicates a more stable base of support for the standing/swaying activity. Previous work suggests that flat regions within the effective rocker shapes of prosthetic ankle-foot systems could provide enhanced stability for standing balance tasks. An experimental prosthetic foot was altered to provide three different flat region lengths within its effective rocker shape. It was hypothesized that longer flat regions of the effective rocker shape would lead to improved standing balance outcomes and reduced walking performance for unilateral transtibial prosthesis users. However, no significant changes were seen in the balance and mobility outcomes of 12 unilateral transtibial prosthesis users when using the three prosthetic foot conditions. Subjects in the study significantly preferred prosthetic feet with relatively low to moderate flat regions over those with long flat regions. All the subjects without loss of light touch or vibratory sensation selected the prosthetic foot with the shortest flat region. More work is needed to investigate the effects of prosthetic foot properties on balance and mobility of prosthesis users.

  12. The Use of Model Matching Video Analysis and Computational Simulation to Study the Ankle Sprain Injury Mechanism

    Directory of Open Access Journals (Sweden)

    Daniel Tik-Pui Fong

    2012-10-01

    Full Text Available Lateral ankle sprains continue to be the most common injury sustained by athletes and create an annual healthcare burden of over $4 billion in the U.S. alone. Foot inversion is suspected in these cases, but the mechanism of injury remains unclear. While kinematics and kinetics data are crucial in understanding the injury mechanisms, ligament behaviour measures ‐ such as ligament strains ‐ are viewed as the potential causal factors of ankle sprains. This review article demonstrates a novel methodology that integrates model matching video analyses with computational simulations in order to investigate injury‐producing events for a better understanding of such injury mechanisms. In particular, ankle joint kinematics from actual injury incidents were deduced by model matching video analyses and then input into a generic computational model based on rigid bone surfaces and deformable ligaments of the ankle so as to investigate the ligament strains that accompany these sprain injuries. These techniques may have the potential for guiding ankle sprain prevention strategies and targeted rehabilitation therapies.

  13. Trigger Point Dry Needling and Proprioceptive Exercises for the Management of Chronic Ankle Instability: A Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Jaime Salom-Moreno

    2015-01-01

    Full Text Available Objective. To compare the effects of combined trigger point dry needling (TrP-DN and proprioceptive/strengthening exercises to proprioceptive/strengthening exercises on pain and function in ankle instability. Methods. Twenty-seven (44% female, mean age: 33±3 years individuals with unilateral ankle instability were randomly assigned to an experimental group who received proprioceptive/strengthening exercises combined with TrP-DN into the lateral peroneus muscle and a comparison group receiving the same proprioceptive/strengthening exercise program alone. Outcome included function assessed with the Foot and Ankle Ability Measure (FAAM and ankle pain intensity assessed with a numerical pain rate scale (NPRS. They were captured at baseline and 1-month follow-up after the intervention. Results. The ANOVAs found significant Group ∗ Time Interactions for both subscales of the FAAM (ADL: F=8.211; P=0.008; SPORTS: F=13.943; P 2.1 in favor of the TrP-DN group. Conclusions. This study provides evidence that the inclusion of TrP-DN within the lateral peroneus muscle into a proprioceptive/strengthening exercise program resulted in better outcomes in pain and function 1 month after the therapy in ankle instability.

  14. Trigger Point Dry Needling and Proprioceptive Exercises for the Management of Chronic Ankle Instability: A Randomized Clinical Trial.

    Science.gov (United States)

    Salom-Moreno, Jaime; Ayuso-Casado, Blanca; Tamaral-Costa, Beatriz; Sánchez-Milá, Zacarías; Fernández-de-Las-Peñas, César; Alburquerque-Sendín, Francisco

    2015-01-01

    Objective. To compare the effects of combined trigger point dry needling (TrP-DN) and proprioceptive/strengthening exercises to proprioceptive/strengthening exercises on pain and function in ankle instability. Methods. Twenty-seven (44% female, mean age: 33 ± 3 years) individuals with unilateral ankle instability were randomly assigned to an experimental group who received proprioceptive/strengthening exercises combined with TrP-DN into the lateral peroneus muscle and a comparison group receiving the same proprioceptive/strengthening exercise program alone. Outcome included function assessed with the Foot and Ankle Ability Measure (FAAM) and ankle pain intensity assessed with a numerical pain rate scale (NPRS). They were captured at baseline and 1-month follow-up after the intervention. Results. The ANOVAs found significant Group ∗ Time Interactions for both subscales of the FAAM (ADL: F = 8.211; P = 0.008; SPORTS: F = 13.943; P 2.1) in favor of the TrP-DN group. Conclusions. This study provides evidence that the inclusion of TrP-DN within the lateral peroneus muscle into a proprioceptive/strengthening exercise program resulted in better outcomes in pain and function 1 month after the therapy in ankle instability. PMID:26064172

  15. 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

  16. Tool for Rapid & Easy Identification of High Risk Diabetic Foot: Validation & Clinical Pilot of the Simplified 60 Second Diabetic Foot Screening Tool.

    Directory of Open Access Journals (Sweden)

    M Gail Woodbury

    Full Text Available Most diabetic foot amputations are caused by ulcers on the skin of the foot i.e. diabetic foot ulcers. Early identification of patients at high risk for diabetic foot ulcers is crucial. The 'Simplified 60-Second Diabetic Foot Screening Tool' has been designed to rapidly detect high risk diabetic feet, allowing for timely identification and referral of patients needing treatment. This study aimed to determine the clinical performance and inter-rater reliability of 'Simplified 60 Second Diabetic Foot Screening Tool' in order to evaluate its applicability for routine screening.The tool was independently tested by n=12 assessors with n=18 Guyanese patients with diabetes. Inter-rater reliability was assessed by calculating Cronbach's alpha for each of the assessment items. A minimum value of 0.60 was considered acceptable. Reliability scores of the screening tool assessment items were: 'monofilament test' 0.98; 'active ulcer' 0.97; 'previous amputation' 0.97; 'previous ulcer' 0.97; 'fixed ankle' 0.91; 'deformity' 0.87; 'callus' 0.87; 'absent pulses' 0.87; 'fixed toe' 0.80; 'blisters' 0.77; 'ingrown nail' 0.72; and 'fissures' 0.55. The item 'stiffness in the toe or ankle' was removed as it was observed in only 1.3% of patients. The item 'fissures' was also removed due to low inter-rater reliability. Clinical performance was assessed via a pilot study utilizing the screening tool on n=1,266 patients in an acute care setting in Georgetown, Guyana. In total, 48% of patients either had existing diabetic foot ulcers or were found to be at high risk for developing ulcers.Clinicians in low and middle income countries such as Guyana can use the Simplified 60-Second Diabetic Screening Tool to facilitate early detection and appropriate treatment of diabetic foot ulcers. Implementation of this screening tool has the potential to decrease diabetes related disability and mortality.

  17. 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...

  18. 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...

  19. A Phase-Dependent Hypothesis for Locomotor Functions of Human Foot Complex

    Institute of Scientific and Technical Information of China (English)

    Lei Ren; David Howard; Lu-quan Ren; Chris Nester; Li-mei Tian

    2008-01-01

    The human foot is a very complex structure comprising numerous bones, muscles, ligaments and synovial joints. As the only component in contact with the ground, the foot complex delivers a variety of biomechanical functions during human locomotion, e.g. body support and propulsion, stability maintenance and impact absorption. These need the human foot to be rigid and damped to transmit ground reaction forces to the upper body and maintain body stability, and also to be compliant and resilient to moderate risky impacts and save energy. How does the human foot achieve these apparent conflicting functions? In this study, we propose a phase-dependent hypothesis for the overall locomotor functions of the human foot complex based on in-vivo measurements of human natural gait and simulation results of a mathematical foot model. We propse that foot functions are highly dependent on gait phase, which is a major characteristics of human locomotion. In early stance just after heel strike,the foot mainly works as a shock absorber by moderating high impacts using the viscouselastic heel pad in both. vertical and horizontal directions. In mid-stance phase(~80% of stance phase), the foot complex can be considered as a springy rocker,reserving external mechanical work using the foot arch whilst moving ground contact point forward along a curved path to maintain body stability. In late stance after heel off, the foot complex mainly serves as a force modulator like a gear box,modulating effective mechanical advantages of ankle plantiflexor muscles using metatarsal-phalangeal joints. A sound understanding of how diverse functions are implemented in a simple foot segment during human locomotion might be useful to gain insight into the overall foot locomotor functions and hence to facilitate clinical diagnosis, rehabilitation product design and humanoid robot development.

  20. Prospective epidemiological study of basketball injuries during one competitive season: ankle sprains and overuse knee injuries.

    Science.gov (United States)

    Cumps, Elke; Verhagen, Evert; Meeusen, Romain

    2007-01-01

    This prospective cohort study aims to assess the overall incidence of acute and overuse basketball injuries and identifies risk factors associated with ankle sprains and knee overuse injuries. In total, 164 senior players (23.7 years ± 7.0) of all levels of play, and including both men and women, participated voluntarily during one season. A total of 139 acute and 87 overuse injuries were reported, resulting in an overall injury incidence of 9.8 (8.5 to 11.1) per 1,000 hours. The incidence of acute injuries was 6.0/1,000 hours. Ankle sprains (n = 34) accounted for most acute injuries, and 52.9% of all players with ankle sprains reported a previous ankle sprain. Relative Risks (RR) and Odds Ratio (OR) with their 95% Confidence Intervals (CI) were calculated to determine significant differences. Landing on an opponent's foot was the major inciting event, significantly more so than non contact mechanisms (RR=2.1 [95% CI: 1.0-4.2]). Acute knee injuries resulted in the highest playing absence (7 weeks 2 days ± 9 weeks 1 day). Overuse injury incidence was 3.8/1,000 hours. The knee (1.5/1,000 hours) was the most common site. Forward players sustained less knee overuse injuries than players of all other playing positions, and significantly less than center players (OR=0.5 [95% CI: 0.2-0.9]). This study showed that ankle sprains and overuse knee injuries are the most common injuries in basketball, both accounting for 14.8%. Injury prevention programmes however should not concentrate on those injuries only, but might one to consider that acute knee injuries, in spite of the fact that they occur less frequently, also merit further research. Key pointsAnkle sprains are the most common acute injuries in basketball with the inciting event being landing on an opponent's foot or changing direction.Anterior knee pain is the most common overuse injury. Etiologic factors are well described in literature, but prevention strategies are lacking.Acute knee injuries account for the