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Sample records for ankle injuries

  1. Ankle ligament injuries

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    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

  2. Hydrocolonotherapy ankle joints after injuries

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    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...

  3. Hydrocolonotherapy ankle joints after injuries

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    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.

  4. 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.

  5. Foot and ankle injuries in theatrical dancers.

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    Hardaker, W T; Margello, S; Goldner, J L

    1985-10-01

    The theatrical dancer is a unique combination of athlete and artist. The physical demands of dance class, rehearsal, and performance can lead to injury, particularly to the foot and ankle. Ankle sprains are the most common acute injury. Chronic injuries predominate and relate primarily to the repeated impact loading of the foot and ankle on the dance floor. Contributing factors include anatomic variation, improper technique, and fatigue. Early and aggressive conservative management is usually successful and surgery is rarely indicated. Orthotics play a limited but potentially useful role in treatment. Following treatment, a structured rehabilitation program is fundamental to the successful return to dance.

  6. Posterior Ankle Structure Injury During Total Ankle Replacement.

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    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.

  7. Assessment and management of patients with ankle injuries.

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    Walker, Jennie

    2014-08-19

    Foot and ankle injuries are common and can have a significant effect on an individual's daily activities. Nurses have an important role in the assessment, management, ongoing care and support of patients with ankle injuries. An understanding of the anatomy and physiology of the ankle enables nurses to identify significant injuries, which may result in serious complications, and communicate effectively with the multidisciplinary team to improve patient care and outcomes.

  8. Optimal management of ankle syndesmosis injuries

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    Porter DA

    2014-08-01

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

  9. Understanding acute ankle ligamentous sprain injury in sports

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    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

  10. [PARTICULAR QUALITIES OF DIAGNOSTIC ACUTE LATERAL ANKLE LIGAMENT INJURIES].

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    Krasnoperov, S N; Shishka, I V; Golovaha, M L

    2015-01-01

    Delayed diagnosis of acute lateral ankle ligaments injury and subsequent inadequate treatment leads to the development of chronic instability and rapid progression of degenerative processes in the joint. The aim of our work was to improve treatment results by developing an diagnostic algorithm and treatment strategy of acute lateral ankle ligament injuries. The study included 48 patients with history of acute inversion ankle injury mechanism. Diagnostic protocol included clinical and radiological examination during 48 hours and after 7-10 days after injury. According to the high rate of inaccurate clinical diagnosis in the first 48 hours of the injury a short course of conservative treatment for 7-10 days is needed with follow-up and controlling clinical and radiographic instability tests. Clinical symptoms of ankle inversion injury showed that the combination of local tenderness in the projection of damaged ligaments, the presence of severe periarticular hematoma in the lateral department and positive anterior drawer and talar tilt tests in 7-10 days after the injury in 87% of cases shows the presence of ligament rupture. An algorithm for diagnosis of acute lateral ankle ligament injury was developed, which allowed us to determine differential indications for surgical repair of the ligaments and conservative treatment of these patients.

  11. Ultrasound of ankle and foot: overuse and sports injuries.

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    Khoury, Viviane; Guillin, Raphaël; Dhanju, Jag; Cardinal, Etienne

    2007-06-01

    Sports and overuse injuries of the ankle and foot are commonly encountered in clinical practice. Ultrasound (US) has been established as an excellent diagnostic modality for foot and ankle injuries, providing a rapid noninvasive, economical, and readily available tool that is well tolerated by the patient with acute or chronic pain. The opportunity for dynamic examination is another advantage of US in evaluating ankle and foot pathology, where maneuvers such as muscle contraction and stressing of the joint may be particularly helpful. In many cases, US can be used as a first-line and only imaging modality for diagnosis. This article focuses on ankle disorders related to sports or overuse that affect tendons, including tendinosis, tenosynovitis, paratendinitis, rupture, dislocation, and ligaments that are commonly torn. The sonographic features of certain common foot disorders related to physical activity and overuse are also discussed, including plantar fasciitis, Morton's neuroma, stress fractures, and plantar plate injury.

  12. Deltoid ligament in acute ankle injury: MR imaging analysis

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    Jeong, Min Sun; Choi, Yun Sun; Kim, Yun Jung; Jung, Yoon Young [Eulji University, Department of Radiology, Eulji Hospital, Seoul (Korea, Republic of); Kim, Jin Su; Young, Ki Won [Eulji University, Department of Orthopedic Surgery, Eulji Hospital, Seoul (Korea, Republic of)

    2014-05-15

    To identify the pattern of deltoid ligament injury after acute ankle injury and the relationship between ankle fracture and deltoid ligament tear by magnetic resonance imaging (MRI). Thirty-six patients (32 male, and 4 female; mean age, 29.8 years) with acute deltoid ligament injury who had undergone MRI participated in this study. The deltoid ligament was classified as having 3 superficial and 2 deep components. An image analysis included the integrity and tear site of the deltoid ligament, and other associated injuries. Association between ankle fracture and deltoid ligament tear was assessed using Fisher's exact test (P < 0.05). Of the 36 patients, 21 (58.3 %) had tears in the superficial and deep deltoid ligaments, 6 (16.7 %) in the superficial ligaments only, and 4 (11.1 %) in the deep ligaments only. The most common tear site of the three components of the superficial deltoid and deep anterior tibiotalar ligaments was their proximal attachments (94 % and 91.7 % respectively), and that of the deep posterior tibiotalar ligament (pTTL) was its distal attachment (82.6 %). The common associated injuries were ankle fracture (63.9 %), syndesmosis tear (55.6 %), and lateral collateral ligament complex tear (44.4 %). All the components of the deltoid ligament were frequently torn in patients with ankle fractures (tibionavicular ligament, P = 0.009). The observed injury pattern of the deltoid ligament was complex and frequently associated with concomitant ankle pathology. The most common tear site of the superficial deltoid ligament was the medial malleolar attachment, whereas that of the deep pTTL was near its medial talar insertion. (orig.)

  13. An Unusual Ankle Injury: The Bosworth-Pilon Fracture.

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    Peterson, Nicholas D; Shah, Feisal; Narayan, Badri

    2015-01-01

    The Bosworth injury occurs when the distal fibula becomes entrapped posterior to the posterior tibial tubercle, usually as a result of a supination external rotation injury. This uncommon occurrence is a recognized cause of an irreducible ankle dislocation. A pilon fracture is usually a high-energy injury caused by the talus being driven upward into the tibial plafond. The resulting bone and soft tissue injuries often require a staged approach to management. The present report is the first in the medical data to describe a Bosworth injury complicating a pilon fracture. We also discuss a management approach for this rare fracture.

  14. Long-term Results After Ankle Syndesmosis Injuries

    NARCIS (Netherlands)

    Vlijmen, N. van; Denk, K.; Kampen, A. van; Jaarsma, R.L.

    2015-01-01

    Syndesmotic disruption occurs in more than 10% of ankle fractures. Operative treatment with syndesmosis screw fixation has been successfully performed for decades and is considered the gold standard of treatment. Few studies have reported the long-term outcomes of syndesmosis injuries. This study in

  15. Radiographic evaluation of foot and ankle injuries in the athlete.

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    Rettig, A C; Shelbourne, K D; Beltz, H F; Robertson, D W; Arfken, P

    1987-10-01

    Injuries of the ankle and foot in athletes are quite common. They range from the extremely simple sprain to the difficult stress fracture, and may result in long-term disability. In all cases, the athlete is best treated after an accurate diagnosis is achieved.

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

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    Mirones Steven

    2009-04-01

    Full Text Available 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 the period of the Games. Results A total of 624 injuries (525 soft tissue injuries and 99 bony injuries were reported. The most frequent diagnoses were contusions, sprains, fractures, dislocations and lacerations. Significantly more injuries in male (58% versus female athletes (42% were recorded. The incidence, diagnosis and cause of injuries differed substantially between the team sports. Conclusion Our experience from the Athens Olympic Games will inform the development of public health surveillance systems for future Olympic Games, as well as other similar mass events.

  17. PROSPECTIVE EPIDEMIOLOGICAL STUDY OF BASKETBALL INJURIES DURING ONE COMPETITIVE SEASON: ANKLE SPRAINS AND OVERUSE KNEE INJURIES

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    Elke Cumps

    2007-06-01

    Full Text Available 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.

  18. Ankle Injuries: Reduce the Risk by Using a Soccer-Specific Warm-up Routine

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    Elliott, Steven; Ellis, Margery; Combs, Sue; Hunt Long, Lynn

    2015-01-01

    Injuries to the ankle are among the most common injuries for soccer players at any age. Soccer coaches should be aware of current research and best practices that suggest it is possible to decrease the incidence of soccer players' ankle injuries by providing an appropriate warm-up to utilize prior to practices and games. This article introduces…

  19. 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

  20. Predisposing factors to lateral ankle injury in male comrades marathon runners

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    J. Hiemstra

    2009-02-01

    Full Text Available Introduction: More than two million people experience ankle ligament traumaeach year in the United States. Half of these are severe ligament sprains, however verylittle is known about the factors that predispose individuals to these injuries. The purpose of this study, (which was conducted as an undergraduate research project,was to find a correlation between the characteristics of height, weight and limbdominance and lateral ankle ligament injuries. Method: A  retrospective study was conducted on 114 ultra distance runners whoparticipated in the 2006 Comrades Marathon. During race registration, the runners’ height and weight were measuredafter answering a questionnaire regarding their training. Results: 114 runners responded to the questionnaire. From this cohort, 38 (33.3% had sustained previous lateral ankle injuries. Of these 38 injuries, 47.4% of the injuries occurred on the runner’s dominant limb and 36.8% occurred on thenon-dominant side. 15.8% of the runners sustained previous ankle injuries to both ankles. There was a low negative correlation coefficient of 0.24 with regards to weight as a risk factor. This indicated that the power of the correlationwas 5.93%. The study demonstrates that there is no correlation between an increase in weight and an increase in theincidence of ankle injury. The correlation coefficient indicated a low correlation between an increase in height and the incidence of ankle injury. However, the power of the correlation at 18.37% makes inaccurate any attempt to predict the height at which a runner would be at most risk for lateral ankle injury. Conclusion: Height and weight are not risk factors predisposing subjects to lateral ankle injury. In addition, the studyillustrated that there was no effect of limb dominance on the incidence of lateral ankle injury.

  1. A one year prospective study on ankle stability and landing technique : The occurrence of ankle and knee injuries in elite ball team athletes

    NARCIS (Netherlands)

    Does, Henrike van der; Brink, M.S.; Lemmink, K.A.P.M.

    2014-01-01

    Background: In team sports lower extremity injuries account for more than 50% of all injuries, indicating the importance of early detection of athletes at risk. Objective: To investigate the predictive value of ankle stability and landing technique at baseline for ankle and knee injury occurrence du

  2. Tightrope fixation of ankle syndesmosis injuries: clinical outcome, complications and technique modification.

    LENUS (Irish Health Repository)

    Naqvi, Gohar A

    2012-06-01

    Ankle syndesmotic injuries are complex and require anatomic reduction and fixation. Tightrope fixation is a relatively new technique and we present the largest series of syndesmosis fixation using Arthrex Tightrope™ (Naples, FL, USA).

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

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    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...

  4. The Role of Ankle Proprioception for Balance Control in relation to Sports Performance and Injury.

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    Han, Jia; Anson, Judith; Waddington, Gordon; Adams, Roger; Liu, Yu

    2015-01-01

    Balance control improvement is one of the most important goals in sports and exercise. Better balance is strongly positively associated with enhanced athletic performance and negatively associated with lower limb sports injuries. Proprioception plays an essential role in balance control, and ankle proprioception is arguably the most important. This paper reviews ankle proprioception and explores synergies with balance control, specifically in a sporting context. Central processing of ankle proprioceptive information, along with other sensory information, enables integration for balance control. When assessing ankle proprioception, the most generalizable findings arise from methods that are ecologically valid, allow proprioceptive signals to be integrated with general vision in the central nervous system, and reflect the signal-in-noise nature of central processing. Ankle proprioceptive intervention concepts driven by such a central processing theory are further proposed and discussed for the improvement of balance control in sport.

  5. The Role of Ankle Proprioception for Balance Control in relation to Sports Performance and Injury

    Directory of Open Access Journals (Sweden)

    Jia Han

    2015-01-01

    Full Text Available Balance control improvement is one of the most important goals in sports and exercise. Better balance is strongly positively associated with enhanced athletic performance and negatively associated with lower limb sports injuries. Proprioception plays an essential role in balance control, and ankle proprioception is arguably the most important. This paper reviews ankle proprioception and explores synergies with balance control, specifically in a sporting context. Central processing of ankle proprioceptive information, along with other sensory information, enables integration for balance control. When assessing ankle proprioception, the most generalizable findings arise from methods that are ecologically valid, allow proprioceptive signals to be integrated with general vision in the central nervous system, and reflect the signal-in-noise nature of central processing. Ankle proprioceptive intervention concepts driven by such a central processing theory are further proposed and discussed for the improvement of balance control in sport.

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

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    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

  7. Isolated syndesmotic injury in acute ankle trauma: Comparison of plain film radiography with 3 T MRI

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    Schoennagel, B.P., E-mail: b.schoennagel@uke.uni-hamburg.de [Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg (Germany); Karul, M.; Avanesov, M.; Bannas, P.; Gold, G. [Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg (Germany); Großterlinden, L.G. [Department of Trauma-, Hand- and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg (Germany); Rupprecht, M. [Department of Pediatric Orthopedics, Children' s Hospital Hamburg-Altona, Bleickenallee 38, 22763 Hamburg (Germany); Adam, G.; Yamamura, J. [Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg (Germany)

    2014-10-15

    Highlights: • Isolated syndesmotic injury is a frequent finding after acute ankle trauma. • Cut-off values and accuracy of plain film radiograph measurements were determined. • The TFCS and the MCS have the potential to detect isolated syndesmotic injury. • Appropriate cut-off values allow detection of isolated syndesmotic injury. • Only MRI reveals severity of isolated syndesmotic injury and concomitant injuries. - Abstract: Objectives: To determine cut-off values and the accuracy of plain film measurements for the detection of isolated syndesmotic injury after acute ankle trauma and to investigate MRI findings of concomitant ankle injury. Methods: Eighty-four consecutive patients with absent fracture in plain film radiographs were prospectively evaluated for isolated syndesmotic injury after acute ankle trauma. The tibiofibular clear space (TFCS), the tibiofibular overlap (TFO), and the medial clear space (MCS) were independently assessed in plain radiographs by two readers. MRI performed at 3 T within 24 h served as the reference standard. MRI was evaluated for syndesmotic injury, using a four-scale grading system (0 = normal syndesmosis, 1a = periligamentous edema, 1b = intraligamentous edema, 2 = partial rupture, 3 = complete rupture), and for concomitant ankle injury. Inter-observer variability for x-ray measurements was assessed using Bland–Altman diagrams. ROC analyses were performed to determine cut-off values and sensitivity and specificity for TFCS, TFO, and MCS. Results: Eleven of 84 patients (13.1%) revealed syndesmotic injury (Grade 2 or 3) according to MRI. Between patients with and without syndesmotic injury significantly different measurements were obtained for TFCS (p = 0.003) and MCS (p = 0.04). ROC derived cut-off values were 5.3 mm for TFCS, 2.8 mm for TFO, and 2.8 mm for MCS. Sensitivity and specificity was 82% and 75% for TFCS, 36% and 78% for TFO, and 73% and 59% for MCS. The bias and limits of agreement were −0.04 mm and [−1

  8. Use of tightrope fixation in ankle syndesmotic injuries

    Institute of Scientific and Technical Information of China (English)

    Julian Maempel; Anthony Ward; Tim Chesser; Michael Kelly

    2014-01-01

    Objective:Conventional fixation of syndesmotic injuries with screws remains problematic.A novel fibrewire device (Tightrope(R)) has suggested advantages.However,small case series have reported high soft tissue complication rates.The purpose of our study was to quantify complication rates and further procedures in patients treated with Tightropes.A secondary objective was to determine incidence of complications and further procedures in those treated with syndesmotic screws over the same period.Methods:All patients undergoing syndesmotic fixation for ankle fracture between May 2008 and October 2009 were retrospectively reviewed.Incidence of complications,secondary procedures,maintenance of syndesmotic reduction and time spent on non-weight bearing were recorded.Family doctors were contacted for those treated with Tightropes to check for any complications managed elsewhere.Results:Thirty-five patients required syndesmotic fixation,in which 12 were treated with Tightropes.They were followed up in clinic for a mean of 12.4 weeks.Family doctors were contacted at mean 14.6 months after treatment to determine any complications suffered.There were no complications attributable to method of fixation.In this series,12 patients underwent 13 procedures and no patient had recurrent diastasis at discharge; 23 patients treated with screw fixation underwent 45 procedures (19 were screw removals).There was 1 case ofsyndesmotic diastasis.Screw removal resulted in 2 minor complications.Conclusion:Tightrope fixation provideds effective syndesmotic fixation that is maintained at discharge.We do not experience soft tissue complications reported elsewhere.

  9. Can patterns of segmental injuries of the foot and ankle predict amputation and disability?

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    Lantry, Jacob M; Perumal, Venkatachalapathy; Roberts, Craig S

    2009-01-01

    The purpose of the study was to determine the risk of digital or distal segmental amputation and permanent unemployment in patients with these injury patterns. A retrospective chart review of 23 patients with multiple, ipsilateral injuries of the foot and ankle was performed. Amputations occurred in five patients (21.7%) and were most common in those with three-level injuries. Odds ratios showed that patients with an amputation were 9.75 times more likely to have a three-level injury than a two-level injury. At a mean follow-up of 12.9 months, 12 patients had not returned to work (60%), seven returned with restrictions, and only one patient returned to preinjury activities. It was concluded that patients with segmental foot and ankle injuries are at risk for amputation of the distal portion of the involved extremity and inability to return to their preinjury employment level (disability).

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

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    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

  11. 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.

  12. 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

  13. Common injuries of the foot and ankle in the child and adolescent athlete.

    Science.gov (United States)

    Malanga, Gerard A; Ramirez-Del Toro, Jose A

    2008-05-01

    A myriad problems in the foot and ankle are specific to child and adolescent athletes. The anatomy of young athletes with respect to the presence of a growth plate makes their injury patterns different from those seen in adults. The main general injury patterns seen in the feet and ankles of children are related to growth and development or occur from overuse syndromes or acute trauma. In this article we outline in an anatomically oriented manner most of the common problems in this population.

  14. The hip strength:ankle proprioceptive threshold ratio predicts falls and injury in diabetic neuropathy

    Science.gov (United States)

    Richardson, James K.; DeMott, Trina; Allet, Lara; Kim; Ashton-Miller, James A.

    2014-01-01

    Introduction We determined lower limb neuromuscular capacities associated with falls and fall-related injuries in older people with declining peripheral nerve function. Methods Thirty-two subjects (67.4 ± 13.4 years; 19 with type 2 diabetes), representing a spectrum of peripheral neurologic function, were evaluated with frontal plane proprioceptive thresholds at the ankle, frontal plane motor function at the ankle and hip, and prospective follow-up for 1 year. Results Falls and fall-related injuries were reported by 20 (62.5%) and 14 (43.8%) subjects, respectively. The ratio of hip adductor rate of torque development to ankle proprioceptive threshold (HipSTR/AnkPRO) predicted falls (pseudo-R2 = .726) and injury (pseudo-R2 = .382). No other variable maintained significance in the presence of HipSTR/AnkPRO. Discussion Fall and injury risk in the population studied is related inversely to HipSTR/AnkPRO. Increasing rapidly available hip strength in patients with neuropathic ankle sensory impairment may decrease risk of falls and related injuries. PMID:24282041

  15. Ankle Injuries and Disorders - Multiple Languages: MedlinePlus

    Science.gov (United States)

    ... Information Translations Spanish (español) Lesiones y enfermedades del tobillo Ukrainian (Українська) Ankle Sprain Розтягування зв'язок гомілковостопного ...

  16. An Irreducible Ankle Fracture Dislocation: The Bosworth Injury

    NARCIS (Netherlands)

    T. Schepers (Tim); T. Hagenaars (Tjebbe); D. den Hartog (Dennis)

    2012-01-01

    textabstractIrreducible fracture dislocations of the ankle are rare and represent true orthopedic emergencies. We present a case of a fracture dislocation that was irreducible owing to a fixed dislocation of the proximal fibular fragment posterior to the lateral ridge of the tibia. This particular t

  17. Bicycle-spoke injuries of the foot and ankle: A prospective study

    Directory of Open Access Journals (Sweden)

    HK Gupta

    2014-04-01

    Full Text Available Objective Bicycle spoke wheel injuries can be as simple as minor abrasions and lacerations even to amputation of toes and heel injuries. The purpose of this study was to assess the severity of soft tissue damage and skeletal injuries in such injuries. Methods This prospective observational study included all the cases with spoke wheel injuries presenting between October 2012 to September 2013 in the College of Medical Sciences and Teaching Hospital, Bharatpur. Demographic information was collected from each patient including age, sex, injured side, position at the time of injury, and characteristic of injury. The soft tissue injury was classified according to Oestern and Tscherne classification and managed accordingly. Results A total of 50 cases were included in the study with 29 males ( 58% and 21 females (42% . Their age ranged from 6 yrs to 12 yrs (mean 9 yrs.. The mean interval from injury to presentation in hospital was 5 hrs (range 1-22 hrs. Majority had injury to right ankle and foot. Fore foot and mid foot injuries were more common when the feet got entrapped in front wheel. 36 cases had sustained injury while riding as pillion on the back seat and their injury was on posterior ankle (n=20 and posterolateral aspect of ankle and foot (n=16. Majority of cases were of grade 0 and 1 injury. Two patients had grade 3 injury, one with great toe amputation another with partial heel avulsion and exposed tendoachilles. All cases were managed with wound care, tetanus prophylaxis and splintage of the foot. Conclusion In our study we found that these spoke wheel related injuries were more common in children and are important cause of temporary loss of daily activities. Although all injuries healed properly, risk of severe injuries like amputations and heel pad loss and tendoachilles transaction and fractures of foot and ankle still prevails where bicycle is a common mode of transportation. Journal of College of Medical Sciences-Nepal, 2013, Vol-9

  18. THE FEATURES OF TIBIOFIBULAR INJURY IN PATENTS WITH ANKLE FRACTURES

    Directory of Open Access Journals (Sweden)

    N. F. Fomin

    2010-01-01

    Full Text Available The role of interposition of soft tissues into tibiofibular syndesmosis is analyzed as a cause of unsatisfactory outcomes in the ankle joint pronation fracture treatment. The study is based on clinical (452 patients and experimental material (36 experiments including unfixed anatomic objects. The elevator for minimal invasive operative elimination of interposition of stumps of distal tibiofibular syndesmosis anterior and posterior ligaments is developed and tested.

  19. Surgical Treatment of a Trimalleolar Ankle Fracture Diagnosed Six Weeks after the Injury

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    Yaniel Truffin Rodriguez

    2015-12-01

    Full Text Available Early diagnosis of traumatic injuries significantly changes patient outcomes. This statement remains true for the ankle since delay in treatment of ankle injuries can hinder its proper function. For these reasons, the case of a 29-year-old patient of rural origin treated at the Dr. Gustavo Aldereguía Lima University General Hospital in Cienfuegos is presented. The patient stated that he had suffered a horse fall six weeks earlier and presented with functional disability in addition to pain in his right ankle. A supra-syndesmotic fibular fracture, a medial malleolar fracture and a posterior malleolar fracture were diagnosed. To repair this injury, the Gatellier-Chastang approach was used for reduction and adequate fixation of the posterior malleolus. Osteosynthesis of the supra-syndesmotic fracture with a plate and screws was subsequently performed. Finally, the medial malleolar fracture was fixed with a malleolar screw. Six months after the surgery, the ankle showed normal ranges of dorsiflexion and plantar flexion; the edema was not significant and there was no pain when walking or resting.

  20. False negative rate of syndesmotic injury in pronation-external rotation stage IV ankle fractures

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    Kwang-Soon Song

    2013-01-01

    Full Text Available Background: To investigate false negative rate in the diagnosis of diastasis on initial static anteroposterior radiograph and reliability of intraoperative external rotational stress test for detection of concealed disruption of syndesmosis in pronation external rotation (PER stage IV (Lauge-Hansen ankle fractures. Materials and Methods: We prospectively studied 34 PER stage IV ankle fractures between September 2001 and September 2008. Twenty (59% patients show syndesmotic injury on initial anteroposterior radiographs. We performed an intraoperative external rotation stress test in other 14 patients with suspicious PER stage IV ankle fractures, which showed no defined syndesmotic injury on anteroposterior radiographs inspite of a medial malleolar fracture, an oblique fibular fracture above the syndesmosis and fracture of the posterior tubercle of the tibia. Results: All 14 fractures showed different degrees of tibiofibular clear space (TFCS and tibiofibular overlapping (TFO on the external rotation stress test radiograph compared to the initial plain anteroposterior radiograph. It is important to understand the fracture pattern characterstic of PER stage IV ankle fractures even though it appears normal on anteroposterior radiographs, it is to be confirmed for the concealed syndesmotic injury through a routine intraoperative external rotational stress radiograph.

  1. 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.

  2. Acupuncture Treatment for Acute Ankle Injury in the Emergency Department: A Preliminary Case Report.

    Science.gov (United States)

    Tantivesruangdet, Nopmanee

    2016-02-01

    Acupuncture is an ancient medical treatment that is increasingly attracting the interest of the public. It is a complementary therapy that is widely used for management of pain, especially chronic discomfort caused by migraine, low-back pain and osteoarthritis of the knee(¹⁻³). The evidence base for the effectiveness of acupuncture and its clinical applications is controversial, and although its efficacy and safety in the management of acute pain have been demonstrated, the quality of this modality is still questionable. The present study reports a case of acute ankle injury, which was treated with acupuncture. A 33-year-old man presented with acute twisted ankle injury. He had pain with swelling around the ankle, and he was experiencing difficulty in walking. His clinical diagnosis was acute ankle sprain with severe pain. Several drug treatments are used for pain control, but in this case, we used acupuncture. After treatment, his pain diminished significantly with a decrease in VAS pain level from 8 to 4 in 20 minutes. At follow-up after one month, we found no skin infection in this case.

  3. Semiextending Nailing for Combined Shaft and Ankle Injuries of the Leg.

    Science.gov (United States)

    Probe, Robert

    2016-08-01

    Over recent years, orthopaedic traumatologists have been gaining experience with tibial nailing in the extended position. Originally developed to address the complexities of alignment in proximal tibial fractures, this technique has also proven valuable in the treatment of tibial shaft fractures combined with ankle injuries. Depicted in this video presentation is the surgical techniques used to simultaneously address a spiral fracture of the distal tibia associated with a large coronal plane fracture of the tibial articular surface. Discussed are leg positioning, technical aspects of the medial approach, strategies for preliminary ankle stabilization, and fine details of aligning the tibial component of the injury. With a growing body of evidence suggesting similar knee outcomes with semiextended and conventional infrapatellar approaches, it is anticipated that this technique will become increasingly popular in coming years.

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

    Directory of Open Access Journals (Sweden)

    Matthias Aurich

    2014-12-01

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

  5. Influence of ankle injury on muscle activation and postural control during ballet grand plié.

    Science.gov (United States)

    Lin, Chia-Wei; Su, Fong-Chin; Lin, Cheng-Feng

    2014-02-01

    Ballet deep squat with legs rotated externally (grand plié) is a fundamental movement for dancers. However, performing this task is a challenge to ankle control, particularly for those with ankle injury. Thus, the purpose of this study was to investigate how ankle sprains affect the ability of postural and muscular control during grand plié in ballet dancers. Thirteen injured dancers and 20 uninjured dancers performed a 15 second grand plié consisting of lowering, squatting, and rising phases. The lower extremity motion patterns and muscle activities, pelvic orientation, and center of pressure (COP) excursion were measured. In addition, a principal component analysis was applied to analyze waveforms of muscle activity in bilateral medial gastrocnemius, peroneus longus, and tibialis anterior. Our findings showed that the injured dancers had smaller pelvic motions and COP excursions, greater maximum angles of knee flexion and ankle dorsiflexion as well as different temporal activation patterns of the medial gastrocnemius and tibialis anterior. These findings suggested that the injured dancers coped with postural challenges by changing lower extremity motions and temporal muscle activation patterns.

  6. Pseudo-aneurysm of the anterior tibial artery, a rare cause of ankle swelling following a sports injury

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    McAteer Eamon

    2005-10-01

    Full Text Available Abstract Background Ankle pain and swelling following sports injuries are common presenting complaints to the accident and emergency department. Frequently these are diagnosed as musculoskeletal injuries, even when no definitive cause is found. Vascular injuries following trauma are uncommon and are an extremely rare cause of ankle swelling and pain. These injuries may however be limb threatening and are important to diagnose early, in order that appropriate treatment can be delivered. We highlight the steps to diagnosis of these injuries, and methods of managing these injuries. It is important for clinicians to be aware of the potential for this injury in patients with seemingly innocuous trauma from sports injuries, who have significant ankle pain and swelling. Case presentation A young, professional sportsman presented with a swollen, painful ankle after an innocuous hyper-plantar flexion injury whilst playing football, which was initially diagnosed as a ligamentous injury after no bony injury was revealed on X-Ray. He returned 2 days later with a large ulcer at the lateral malleolus and further investigation by duplex ultrasound and transfemoral arteriogram revealed a Pseudo-Aneurysm of the Anterior Tibial Artery. This was initially managed with percutaneous injection of thrombin, and later open surgery to ligate the feeding vessel. The patient recovered fully and was able to return to recreational sport. Conclusion Vascular injuries remain a rare cause of ankle pain and swelling following sports injuries, however it is important to consider these injuries when no definite musculo-skeletal cause is found. Ultrasound duplex and Transfemoral arteriogram are appropriate, sensitive modalities for investigation, and may allow novel treatment to be directed percutaneously. Early diagnosis and intervention are essential for the successful outcome in these patients.

  7. Ankle sprain injuries in soccer players aged 7-15 years during a one-year season

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    NIKOLAOS KOFOTOLIS

    2014-10-01

    Full Text Available Although ankle sprains are common in soccer, the role of various risk factors in soccer players aged 7-15 is unclear. The purpose of this study was to examine whether incidence of ankle sprain injuries, associated time loss of participation, and injury risk factors are associated with chronological age in soccer players aged 7-15 years. A sample of 677 male soccer players was divided in three age groups: between 7 and 9 years (U9, between 9 and 12 years (U12 and between 12 and 15 years (U15. Ankle sprain injury incidence, participation time loss, injury mechanisms, ankle region injured, and other risk factors were recorded in games and practice sessions using questionnaires for one year. During the study 38 ankle injuries were recorded, of which 27 were ankle sprains. These led to 182.7 sessions lost (on average, 6.71 lost sessions per injury. There was an increased risk of ankle injury in U15 group compared with U12 (relative risk = 2.34; 95% confidence interval, 1.28 to 5.02 while no injuries for the U9 were observed. Most incidents (66.7% were contact injuries with the highest injury risk displayed by goalkeepers. Injury rate was higher in games than in practice and increased in the second half of the match (p< .05. Multinomial logistic regression showed that history of previous injury was a significant predictor of ankle sprain in the U15 group (relative risk = 1.69; 95% confidence interval, 1.0 to 2.9. Age is an important factor for soccer training because many clubs use chronological age to separate their young players into teams. This study showed that children less than 9 years showed no injury risk while players older than 12 years showed a higher risk. Injury rate was, however, lower than that reported previously for adult players. Injury prevention strategies may be particularly useful for young adolescent soccer players

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

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    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.

  9. 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.

  10. Methodical features of physical rehabilitation of sportsmen with intra articulate injuries of ankle joint at the out-patient stage

    Directory of Open Access Journals (Sweden)

    Youssef Charbel

    2016-12-01

    Full Text Available Purpose: the analysis of modern approaches to application of means and forms of physical rehabilitation of sportsmen with intra articulate injuries of ankle joint at the out-patient stage. Material & Methods: the analysis of urgent special references on the problem of treatment and rehabilitation at intra articulate injuries of ankle joint. Results: it is defined that together with the broad application of traditional complex techniques of medical physical culture, classical massage and physical therapy, the percent of use of nonconventional methods of non-drug therapy grows objectively and significantly in the last decade in physical rehabilitation. Conclusions: the connected application of east bath and special techniques of east massage for rehabilitation of sportsmen with intra articulate injuries of ankle joint at the out-patient stage in special literature is described not enough that in turn demands the additional practical researches among methods of non-drug therapy.

  11. Ankle Sprain Treatment

    Science.gov (United States)

    ... Emergencies > Sports Injuries > Ankle Sprain Treatment Health Issues Listen Español Text Size Email Print Share Ankle Sprain Treatment Page Content Article Body Acute ankle and foot injuries are common in athletes and other active young people. Sprains account for the greatest number ...

  12. 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.

  13. The proportion of distal fibula Salter-Harris type I epiphyseal fracture in the paediatric population with acute ankle injury

    DEFF Research Database (Denmark)

    Hofsli, Mikael; Torfing, Trine; Al-Aubaidi, Zaid

    2016-01-01

    Ankle injuries are common among the paediatric population. There are few prospective studies utilizing MRI to diagnose a clinically suspected Salter-Harris type I of the distal fibula (SH1FDF). The aim of this study was to examine the proportion of clinically suspected SH1FDF in children. All...

  14. Plantar talar head contusions and osteochondral fractures: associated findings on ankle MRI and proposed mechanism of injury

    Energy Technology Data Exchange (ETDEWEB)

    Gorbachova, Tetyana; Wang, Peter S.; Hu, Bing [Einstein Medical Center Philadelphia, Department of Radiology, Philadelphia, PA (United States); Horrow, Jay C. [Drexel University, Department of Anesthesiology and Perioperative Medicine, Philadelphia, PA (United States)

    2016-06-15

    To evaluate the significance of plantar talar head injury (PTHI) in predicting osseous and soft tissue injuries on ankle MRI. The IRB approved this HIPAA-compliant retrospective study. The study group consisted of 41 ankle MRIs with PTHI that occurred at our institution over a 5 1/2 year period. Eighty MRIs with bone injuries in other locations matched for age, time interval since injury, and gender formed a control group. Injuries to the following structures were recorded: medial malleolus, lateral malleolus/distal fibula, posterior malleolus, talus, calcaneus, navicular, cuboid, lateral, medial and syndesmotic ligaments, spring ligament complex, and extensor digitorum brevis (EDB) muscle. Twenty separate logistic regressions determined which injuries PTHI predicted, using the Holm procedure to control for family-wise alpha at 0.05. PTHI strongly predicted the occurrence of injuries involving the anterior process of the calcaneus [24 % of cases, odds ratio (OR) 12.66], plantar components of the spring ligament (27 %, OR 9.43), calcaneal origin of the EDB and attachment of the dorsolateral calcaneocuboid ligament (22 %, OR 7.22), cuboid (51 %, OR 6.58), EDB (27 %, OR 5.49), anteromedial talus (66 %, OR 4.78), and posteromedial talus (49 %, OR 4.48). PTHI strongly predicted lack of occurrence of syndesmotic ligament injury (OR 19.6). The PTHI group had a high incidence of lateral ligamentous injury (78 %), but not significantly different from the control group (53 %). PTHI is strongly associated with injury involving the transverse tarsal joint complex. We hypothesize it results from talo-cuboid and/or talo-calcaneal impaction from a supination injury of the foot and ankle. (orig.)

  15. Ankle replacement

    Science.gov (United States)

    Ankle arthroplasty - total; Total ankle arthroplasty; Endoprosthetic ankle replacement; Ankle surgery ... You may not be able to have a total ankle replacement if you have had ankle joint infections in ...

  16. Severe open ankle sprain (SOAS): a lesion presenting as a penetrating soft tissue injury.

    Science.gov (United States)

    Soubeyrand, Marc; Vincent-Mansour, César; Guidon, Julie; Asselineau, Alain; Ducharnes, Gildas; Molina, Véronique

    2010-01-01

    The objective of this retrospective case study was to describe the incidence and clinical features of severe open ankle sprain (SOAS), defined as a tear of the lateral or medial collateral ligaments with an associated transverse tear of the skin over the corresponding malleolus. To this end, we reviewed the medical records of patients with SOAS managed between January 2005 and January 2009, using the databases of 3 different orthopedic trauma centers. Our review revealed 9 patients with SOAS, 7 (77.77%) of which involved the lateral ligaments and 2 (22.22%) of which involved the medial ligaments. The median age was 32 (range 21 to 45) years, and the injury occurred as a result of a motor vehicle accident in 6 (66.67%) patients, and as a result of a fall from a height in 3 (33.33%) patients. Two tendons were damaged in 2 (22.22%) patients, the deep fibular nerve (deep peroneal nerve) in 2 (22.22%) patients, and the anterior tibial artery in 1 (11.11%) patient. The only abnormality on plain radiographs was pneumarthrosis, which was present in 5 (55.56%) patients. The incidence of SOAS is rare, accounting for 0.002% (9/438,000) of all trauma cases and 0.22% (9/4142) of all cases of ankle trauma. The diagnosis was confirmed by intraoperative stress-maneuvers in all 9 patients. In conclusion, SOAS should be suspected in patients who present with a traumatic skin wound over the malleolus.

  17. A Biomechanical Comparison of Locking Versus Conventional Plate Fixation for Distal Fibula Fractures in Trimalleolar Ankle Injuries.

    Science.gov (United States)

    Nguyentat, Annie; Camisa, William; Patel, Sandeep; Lagaay, Pieter

    2016-01-01

    Previous biomechanical studies have advocated the use of locking plates for isolated distal fibula fractures in osteoporotic bone. Complex rotational ankle injuries involve an increased number of fractures, which can result in instability, potentially requiring the same fixed angle properties afforded by locking plates. However, the mechanical indication for locking plate technology has not been tested in this fracture model. The purpose of the present study was to compare the biomechanical properties of locking and conventional plate fixation for distal fibula fractures in trimalleolar ankle injuries. Fourteen (7 matched pairs) fresh-frozen cadaver leg specimens were used. The bone mineral density of each was obtained using dual x-ray absorptiometry scans. The fracture model simulated an OTA 44-B3.3 fracture. The syndesmosis was not disrupted. Each fracture was fixated in the same fashion, except for the distal fibula plate construct: locking (n = 7) and one-third tubular (n = 7). The specimens underwent axial and torsional cyclic loading, followed by torsional loading to failure. No statistically significant differences were found between the locking and conventional plate constructs during both fatigue and torque to failure testing (p > .05). Our specimen bone mineral density averages did not represent poor bone quality. The clinical implication of the present study is that distal fibular locking plates do not provide a mechanical advantage for trimalleolar ankle injuries in individuals with normal bone density and in the absence of fracture comminution.

  18. Evaluating the Reliability and Reproducibility of the AO and Lauge-Hansen Classification Systems for Ankle Injuries.

    Science.gov (United States)

    Yin, Meng-Chen; Yuan, Xue-Fei; Ma, Jun-Ming; Xia, Ye; Wang, Tao; Xu, Xiao-Li; Yan, Yin-Jie; Xu, Jin-Hai; Ye, Jie; Tong, Zheng-Yi; Feng, Yan-Qi; Wang, Hong-Bo; Wu, Xue-Qun; Mo, Wen

    2015-07-01

    Ankle injuries are responsible for more than 5 million emergency department visits each year. The AO and Lauge-Hansen classification systems are widely used in the clinical diagnosis of ankle injuries. This study aimed to analyze the intraobserver reliability and interobserver reproducibility of the AO and Lauge-Hansen classification systems. In addition, the authors explored the differences among physicians' classification responses and evaluated the clinical value for diagnosis. Fifty-six patients with an ankle injury with complete clinical and radiologic data were enrolled. The definition of injury type, the index score typing methods, and the specific study criteria were explained in detail. Five observers, who were orthopedic surgeons, determined the classifications according to both the AO and Lauge-Hansen systems. The classification was repeated 1 month later. Cronbach's alpha and Cohen's kappa test were used to determine interobserver reliability and intraobserver reproducibility. The physicians conducted 560 classifications (56 cases × 5 physicians × 2 times per patient). Average inter- and intraobserver kappa values for the AO system were 0.708 and 0.608, respectively. Average inter- and intraobserver kappa values for the Lauge-Hansen system were 0.402 and 0.398, respectively. Cronbach's alpha coefficient was 96.7% for the AO system and 76.0% for the Lauge-Hansen system. The Lauge-Hansen classification system is a comprehensive yet cumbersome system. Comparatively, the AO classification system is easier to understand. This study shows that the AO classification system has more reliability and reproducibility, and thus has more value in clinical practice, than the Lauge-Hansen classification system.

  19. Mechanical instability after acute ankle ligament injury: randomized prospective comparison of two forms of conservative treatment

    Directory of Open Access Journals (Sweden)

    Marcelo Pires Prado

    2013-08-01

    Full Text Available OBJECTIVE: This trial has the objective to investigate the incidence of mechanical ankle instability after the conservative treatment of first episode, severe ankle ligamentar lesions. This common lesion affects young, professional and physical active patients, causing important personal and economic consequences. There are difficulties related to adequate diagnosis and treatment for these lesions. METHOD: 186 patients with severe ankle ligament lesions were included in this trial. They were randomized in two treatment options. In group A patients were treated using ankle long orthoosis, weight bearing allowed as confortable, pain care, ice, elevation with restricted joint mobilization for three weeks. After that they were maintained in short, functional orthosis (air cast, starting the reabilitation program. In group B patients were immobilized using a functional orthosis (air cast, following the same other sequences that patients in group A. RESULTS: We did not find significant differences in relation to the residual mechanical ankle instability between both groups. We did not find differences in the intensity of pain, but the functional evaluation using AOFAS score system showed better results in the functional treatment group. CONCLUSION: The functional treatment (Group B had better AOFAS score and few days off their professional activities, comparing with patients treated with rigid orthosis (Group A, without increased chance in developing ankle mechanical instability.

  20. Standing with electrical stimulation and splinting is no better than standing alone for management of ankle plantarflexion contractures in people with traumatic brain injury: a randomised trial

    Directory of Open Access Journals (Sweden)

    Joan Leung

    2014-12-01

    Full Text Available Question: Is a combination of standing, electrical stimulation and splinting more effective than standing alone for the management of ankle contractures after severe brain injury? Design: A multi-centre randomised trial with concealed allocation, assessor blinding and intention-to-treat analysis. Participants: Thirty-six adults with severe traumatic brain injury and ankle plantarflexion contractures. Intervention: All participants underwent a 6-week program. The experimental group received tilt table standing, electrical stimulation and ankle splinting. The control group received tilt table standing alone. Outcome measures: The primary outcome was passive ankle dorsiflexion with a 12 Nm torque. Secondary outcomes included: passive dorsiflexion with lower torques (3, 5, 7 and 9 Nm; spasticity; the walking item of the Functional Independence Measure; walking speed; global perceived effect of treatment; and perceived treatment credibility. Outcome measures were taken at baseline (Week 0, end of intervention (Week 6, and follow-up (Week 10. Results: The mean between-group differences (95% CI for passive ankle dorsiflexion at Week 6 and Week 10 were –3 degrees (–8 to 2 and –1 degrees (–6 to 4, respectively, in favour of the control group. There was a small mean reduction of 1 point in spasticity at Week 6 (95% CI 0.1 to 1.8 in favour of the experimental group, but this effect disappeared at Week 10. There were no differences for other secondary outcome measures except the physiotherapists’ perceived treatment credibility. Conclusion: Tilt table standing with electrical stimulation and splinting is not better than tilt table standing alone for the management of ankle contractures after severe brain injury. Trial registration: ACTRN12608000637347. [Leung J, Harvey LA, Moseley AM, Whiteside B, Simpson M, Stroud K (2014 Standing with electrical stimulation and splinting is no better than standing alone for management of ankle plantarflexion

  1. Acute inversion injury of the ankle without radiological abnormalities: assessment with high-field MR imaging and correlation of findings with clinical outcome

    Energy Technology Data Exchange (ETDEWEB)

    Langner, Inga; Frank, Matthias; Hinz, Peter; Ekkernkamp, Axel [Ernst-Moritz-Arndt-University Greifswald, Department of Trauma and Orthopedic Surgery, Emergency Department, Greifswald (Germany); Kuehn, Jens Peter; Hosten, Norbert; Langner, Soenke [Ernst-Moritz-Arndt-University Greifswald, Institute for Diagnostic Radiology and Neuroradiology, Greifswald (Germany)

    2011-04-15

    Acute inversion injuries of the ankle are the most common sports accidents, accounting for approximately 10% of emergency room admissions. In up to 85%, an injury of the lateral collateral ligaments is observed. Classically, the assessment of these injuries has relied on clinical examination and radiographs, including stress views. The aim of our study was to correlate prospectively the findings of high-field 3 T MRI in acute ankle distortion with clinical outcome. During a 6-month period, 38 patients were prospectively included. MRI was performed within 48 h of trauma and clinical examination using a protocol consisting of axial T2-weighted and coronal and sagittal T1-weighted images and a sagittal proton density (PDw) sequence. Each ligament injury was graded on a three-point scale. Functional outcome was evaluated using the AOFAS ankle-hindfoot scale. In 24/38 patients (63.12%), ligament injury was observed. In 22/24 cases, this was an injury of the lateral ligaments and in 2/24 cases of the medial ligaments. Injury of the syndesmosis occurred in three patients, a bone bruise in four, and an osteochondral lesion in three cases. Patients with an injury of two or more ligaments or a bone bruise had a lower AOFAS score and returned to sports activities and full weight-bearing later (P < 0.01). MR imaging at 3 Tesla is an independent predictor for clinical outcome. Therefore MRI may be beneficial in those cases where the findings influence further treatment. (orig.)

  2. Trunk and hip muscle recruitment patterns during the prone leg extension following a lateral ankle sprain: A prospective case study pre and post injury

    Directory of Open Access Journals (Sweden)

    Lehman Gregory J

    2006-02-01

    Full Text Available Abstract Background and case presentation The prone leg extension (PLE is commonly used to identify dysfunction of muscle recruitment patterns. The prone leg extension is theorized to identify proximal muscle disturbances which are a result of distal injury or dysfunction (i.e. an ankle sprain. This case study compares the trunk and hip muscle (bilateral lower erector spine, ipsilateral hamstring and ipsilateral gluteus maximus timing during a PLE of a 27 year old female runner during a healthy state (pre ankle sprain and 2 and 8 weeks post ankle sprain. Results and discussion The gluteus maximus muscle onsets at 8 weeks post injury appeared to occur earlier compared with 2 weeks post injury. The Right Erector Spinae at 8 weeks post injury was also active earlier compared with the participant's non-injured state. A large degree of variability can be noted within trials on the same day for all muscle groups. Conclusion An acute ankle injury did not result in a delay in gluteus maximus muscle activation. The utility of the prone leg extension as a clinical and functional test is questionable due to the normal variability seen during the test and our current inability to determine what is normal and what is dysfunctional.

  3. Outcome and patients' satisfaction after functional treatment of acute lateral ankle injuries at emergency departments versus family doctor offices

    Directory of Open Access Journals (Sweden)

    Zimmermann Heinz

    2008-12-01

    Full Text Available Abstract Background In some Western countries, more and more patients seek initial treatment even for minor injuries at emergency units of hospitals. The initial evaluation and treatment as well as aftercare of these patients require large amounts of personnel and logistical resources, which are limited and costly, especially if compared to treatment by a general practitioner. In this study, we investigated whether outsourcing from our level 1 trauma center to a general practitioner has an influence on patient satisfaction and compliance. Methods This prospective, randomized study, included n = 100 patients who suffered from a lateral ankle ligament injury grade I-II (16, 17. After radiological exclusion of osseous lesions, the patients received early functional treatment and were shown physical therapy exercises to be done at home, without immobilization or the use of stabilizing ortheses. The patients were randomly assigned into two groups of 50 patients each: Group A (ER: Follow-up and final examination in the hospital's emergency unit. Group B (GP: Follow-up by general practitioner, final examination at hospital's emergency unit. The patients were surveyed regarding their satisfaction with the treatment and outcome of the treatment. Results Female and male patients were equally represented in both groups. The age of the patients ranged from 16 – 64 years, with a mean age of 34 years (ER and 35 years (GP. 98% (n = 98 of all patients were satisfied with their treatment, and 93% (n = 93 were satisfied with the outcome. For these parameters no significant difference between the two groups could be noted (p = 0.7406 and 0.7631 respectively. 39% of all patients acquired stabilizing ortheses like ankle braces (Aircast, Malleoloc etc. on their own initiative. There was a not significant tendency for more self-acquired ortheses in the group treated by general practicioners (p = 0,2669. Conclusion Patients who first present at the ER with a lateral

  4. Comparative study on isokinetic capacity of knee and ankle joints by functional injury.

    Science.gov (United States)

    Jeon, Kyoungkyu; Seo, Byoung-Do; Lee, Sang-Ho

    2016-01-01

    [Purpose] To collect basic data for exercise programs designed to enhance functional knee and ankle joint stability based on isokinetic measurement and muscle strength evaluations in normal and impaired functional states. [Subjects and Methods] Twenty-four subjects were randomly assigned to the athlete group and the control group (n = 12 each). Data were collected of isokinetic knee extensor and flexor strength at 60°/sec, 180°/sec, and 240°/sec and ankle plantar and dorsiflexor strength at 30°/sec and 120°/sec. [Results] Significant intergroup differences were observed in peak torque of the right extensors at 60°/sec, 180°/sec, and 240°/sec and the right flexors at 240°/sec. Significant differences were observed in peak torque/body weight in the right extensors at 60°/sec, 180°/sec, and 240°/sec and in the right flexors at 180°/sec and 240°/sec. Significant peak torque differences were noted in the left ankle joint dorsiflexor at 30°/sec and 120°/sec, right plantar flexor at 120°/sec, left plantar flexor at 30°/sec, left dorsiflexor at 30°/sec and 120°/sec, and right dorsiflexor at 120°/sec. [Conclusion] Isokinetic evaluation stimulates muscle contraction at motion-dependent speeds and may contribute to the development of intervention programs to improve knee and ankle joint function and correct lower-extremity instability.

  5. 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

  6. The proportion of distal fibula Salter-Harris type I epiphyseal fracture in the paediatric population with acute ankle injury: a prospective MRI study.

    Science.gov (United States)

    Hofsli, Mikael; Torfing, Trine; Al-Aubaidi, Zaid

    2016-03-01

    Ankle injuries are common among the paediatric population. There are few prospective studies utilizing MRI to diagnose a clinically suspected Salter-Harris type I of the distal fibula (SH1FDF). The aim of this study was to examine the proportion of clinically suspected SH1FDF in children. All paediatric patients with ankle injury, seen at the emergency room from September 2012 to May 2013 at a single institution, underwent a standardized clinical examination, and their radiographs were obtained if found necessary. All images and data were recorded prospectively and patients suspected of having SH1FDF were referred for MRI of the ankle joint. Out of 391 paediatric patients seen at the emergency room with ankle injury, 38 patients had a clinical suspicion of SH1FDF. A total of 31 patients, 18 male and 13 female, with a mean age of 10 ± 2.86 years, were included in the study. Only seven patients were excluded from the study. MRI was obtained on an average of 6.9 ± 2.87 days. None of the included patients had evidence of SH1FDF on MRI. Our study and review of the literature verifies the high false-positive rate of clinically suspected SH1FDF. Most children had ligamentous lesions, bone contusion or joint effusion, rather than SH1FDF.

  7. The effect of talo-crural joint manipulation on range of motion at the ankle joint in subjects with a history of ankle injury.

    Science.gov (United States)

    Andersen, Skye; Fryer, Gary A; McLaughlin, Patrick

    2003-07-01

    Introduction: There is little research available on the effects of peripheral joint manipulation. Only a few studies have examined the effect of manipulation on ankle range of motion, with conflicting results. This study aimed to determine whether a single high-velocity, low-amplitude (HVLA) thrust manipulation to the talo-crural joint altered ankle range of motion in subjects with a history of lateral ligament sprain.Methods: Male and female volunteers (N=52) with a history of lateral ligament sprain were randomly assigned into either an experimental group (n=26) or a control group (n=26). Those in the experimental group received a single HVLA thrust to the talo-crural joint, whilst those in the control group received no treatment intervention. Pre-test and post-test measurements of passive dorsiflexion range of motion were taken.Results: No significant changes in dorsiflexion range of motion were detected between manipulated ankles and those of control subjects using dependent and independent t-tests. Ankles that cavitated displayed a greater mean DFR and large effect size (d=0.8) compared to those that did not gap and cavitate, but analysis with ANOVA revealed these differences to be not significant.Conclusion: HVLA manipulation of the ankle did not increase dorsiflexion range of motion in subjects with a history of lateral ligament sprain.

  8. 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

  9. 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…

  10. Integrated Weber and Lauge-Hansen classification of ankle injuries%踝关节损伤Weber与Lauge-Hansen综合分型分度读片法

    Institute of Scientific and Technical Information of China (English)

    刘经武; 谭利华; 田雨; 刘翠丽; 屈长征; 高劲松

    2014-01-01

    目的:介绍Danis-Weber与Lauge-Hansen综合分型分度法对踝关节损伤平片诊断的应用。方法:应用Danis-Weber与Lauge-Hansen综合分型分度法对287例踝关节创伤的平片重新读片,总结综合分型分度法对踝关节骨折与韧带损伤的诊断价值。结果:287例踝关节损伤照片常规平片共报告骨折343处,韧带损伤176处,应用综合分型分度法读片新发现骨折19处,新发现韧带损伤36处。结论:应用Danis-Weber与Large-Hansen综合分型分度读片法有利于提高影像学医师对踝关节损伤平片诊断的病变发现率。%To intrduce the integrated Danis-Weber and Lauge-Hansen classification of ankle injuries Methods:287 digital ra-diographies with ankle injuries were reviewed and sorted again with integrated Weber and Lauge -Hansen classification.Results:343 fractures and 176 ligamental injuries were found on the conventional ankle digital radiographic reports, and other 19 fractures and 36 ligamental injuries were confirmed with integrated Weber and Lauge-Hansen classification.Conclusion:It would increase the findings of the fractures and ligamen-tal injuries of the ankle joint when the imaging doctors report the injuries with the integrated Weber and Lauge-Hansen classification.

  11. Progress in diagnosis and treatment of ankle syndesmosis injury%下胫腓韧带联合损伤的诊治新进展

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    下胫腓联合韧带损伤虽然常见,但是诊断和治疗具有一定的挑战性.下胫腓联合损伤的治疗方法主要为手术治疗,其关键是解剖复位.随着一些新的治疗方法提出,下胫腓联合螺钉的治疗效果越来越受到质疑,并且针对是否去除下胫腓联合螺钉仍然存在争议.我们针对下胫腓联合损伤的诊治进行综述.%Ankle syndesmosis injury is one of the most common ankle fractures complicated with injury,but there is certain challenges with diagnosis and treatment.The treatment of lower tibia and fibula injury is the main surgical treatment,the key is anatomical reduction.Along with some new treatment methods,the treatment effect of the lower tibia and fibula screws has been questioned more and more,And there is still a controversy on whether the removal of the lower tibia and fibula screws.Now for the ankle syndesmosis injury treatment were summarized.

  12. Amateur Soccer Player Causes and Treatment of Ankle Injury%业余足球运动员踝关节损伤的原因及治疗

    Institute of Scientific and Technical Information of China (English)

    张扬; 王太林

    2011-01-01

    In soccer sport, the ankle joint injury is a common acute injury; Through access to relevant information, But amateur football players also need a scientific and effective treatment and rehabilitation training. Taiyuan Province and participated in a number of amateur soccer matches, In the game of the ankle injury in the acute phases of treatment for athletes and contrast. After the ankle injury untreated, the recovery rate of 17%; the front-end processing cure rate of 50%, the front-end, medium-term, post-treatment recovery rate of 100%. In addition to the acute ankle injury outside of the front-end processing and post-treatment persist in the medium-term rehabilitation, Better access to treatment.%通过查阅相关资料,并参与山西省太原市业余足球比赛若干场次,对在比赛中踝关节急性损伤的运动员进行各期治疗并进行对比,观察疗效。结果显示:业余足球运动员踝关节损伤后未处理的,痊愈率为17%;只进行前期处理的,痊愈率为50%;进行前期、中期、后期治疗的,痊愈率为100%。

  13. Knee and ankle injuries from playing football; Knie- und Sprunggelenkverletzungen beim Fussballspiel

    Energy Technology Data Exchange (ETDEWEB)

    Kramer, J.; Scheurecker, G. [Roentgeninstitut am Schillerpark, Linz (Austria)

    2010-05-15

    Soccer is the most common sport activity worldwide. Over the last two decades the increase in soccer players has mainly been due to increased interest by females. In general, soccer is a relatively safe sport activity, especially if minor injuries resulting in short periods of absence from playing or training are neglected. However, due to the high number of soccer players severe injuries are also frequent. These are a problem not only for the injured player and the team but may also become problematic for the socio-economic system. In up to 80-90% structures of the lower extremities are injured. For sufficient radiological diagnosis knowledge of the biomechanics of the soccer game and some details about the history of the injury may be of help. To prevent soccer injuries or keep the degree of injury low, special programs had been developed. (orig.) [German] Fussball ist die weltweit am meisten verbreitete Sportart. Der Zuwachs an Fussballspieler(innen) in den letzten beiden Jahrzehnten wird jedoch hauptsaechlich auf das verstaerkte Interesse an weiblichen Spielern zurueckgefuehrt. Das Fussballspiel gilt grundsaetzlich, insbesondere wenn man geringfuegige Verletzungen, die keine therapeutischen Massnahmen notwendig machen, sondern lediglich eine kurzfristige Trainings- oder Spielpause bedingen, als eine relativ sichere Sportart. Auf Grund der Vielzahl an SpielerInnen kommt es allerdings doch zu einer betraechtlichen Anzahl durchaus sehr schwerer Verletzungen. Diese Tatsache stellt ein Problem fuer Spieler und Team dar und mag moeglicherweise auch fuer das soziooekonomische System problematisch werden. Von Verletzungen sind v. a. auf Grund der Natur des Spieles die unteren Extremitaeten betroffen. Zur Durchfuehrung einer suffizienten radiologischen Diagnostik sind Kenntnisse der moeglichen Verletzungsmechanismen und eine Anamneseerhebung von nicht zu unterschaetzendem Wert. Um jedoch derartige Laesionen zu vermeiden bzw. gering zu halten, wurde ueber die Jahre

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  15. 足踝部肌腱损伤的MSCT诊断%MSCT diagnosis of foot and ankle tendon injury

    Institute of Scientific and Technical Information of China (English)

    俞冠民; 张玲红; 吕冬亮; 祝莹; 李惠民; 黄求理

    2013-01-01

    Objective:To study the MSCT features and diagnosis of foot and ankle tendon injury and improve the recognition to avoid the missed. Methods:From January 2009 to December 2010,32 patients suspected of foot and ankle tendon injury were enrolled and included 24 males and 8 females with an average age of 43 years ranging from 23 to 68 years. All patients had pain, tenderness, swelling or disfunction in the diseased foot and were finally confirmed with surgery, MRI, contralat-eral contrast and followed-up. The MSCT was performed with a multi-detector CT scanner (Emotion 6; Siemens) within 7 days after injury. Two experienced radiologists evaluated the tendon abnormalities before told the outcome. Results; With 5 patients lost, the final study included 27 patients. Thirty-one tendon injuries were finally confirmed in 23 cases. Thirty-five tendon abnormalities were diagnosed on CT images among all 243 tendons but 4 of them were misdiagnoses. The CT overall diagnostic sensitivity,specificity,and accuracy was 88.8% (31/35) ,98.1% (208/212) ,and 98.4% (239/243). Eleven tendon dislocations showed as the tendon partially or completely off the tendon groove. Thirteen tendon entrapment showed no less than half section of the tendon embedded the fracture in the axial images,and 7 tendons located in the fracture gap or 6 tendons closely related with widened fracture in VR images (2 misdiagnosis). Four bone chip insertion showed the chip inserted in the tendons both in the axial images and VR images (1 misdiagnosis). Four tendon ruptures showed discontinuity and shortening of the tendon (1 misdiagnosis). Three tendon injuries showed thickening,density reduction and blurring of tendons,and misty surrounding fat space. Conclusion: With comprehensive MSCT examination (thin-slice scanning and volume rendering) of foot and ankle,the tendon dislocation,tendon entrapment,bone chip intercalation,and tendon rupture/ injury could be confidently diagnose.%目的:探讨足踝部肌腱损伤

  16. 青少年篮球运动员踝关节防治措施%The Biological Characteristics Analysis of Young Basketball Athletes Ankle Injury

    Institute of Scientific and Technical Information of China (English)

    许永娟

    2012-01-01

      本文将青少年篮球运动员在运动训练的过程中,容易发生的扭伤情况,尤其是踝关节损伤情况进行分析,并针对篮球技术的动作特点以及踝关节自身的结构特点,提出了一些预防性的措施,希望青少年篮球运动员树立起一种科学的篮球训练和预防方法,以健康的体魄来提高篮球运动的成绩。%  As a set of athletic and entertainment in one of the sports, basketball has the history of a century, and with the continuous improvement of its charm, it gradually becomes a worldwide sport, and has more and more participants. This article presents a youth basketbal athletes in the sports training process, prone to sprain, especial y the ankle injury characteristics of biology, and summed up the mechanism and causes of ankle injury for basketbal skil s action, based on the characteristics and ankle structural characteristics, present some preventive measures to ensure that young basketbal players to establish a scientific basketball training and methods, so as to improve the results of the basketball with a good health.

  17. Characteristics of myogenic response and ankle torque recovery after lengthening contraction-induced rat gastrocnemius injury

    Directory of Open Access Journals (Sweden)

    Song Hongsun

    2012-10-01

    Full Text Available Abstract Background Although muscle dysfunction caused by unfamiliar lengthening contraction is one of most important issues in sports medicine, there is little known about the molecular events on regeneration process. The purpose of this study was to investigate the temporal and spatial expression patterns of myogenin, myoD, pax7, and myostatin after acute lengthening contraction (LC-induced injury in the rat hindlimb. Methods We employed our originally developed device with LC in rat gastrocnemius muscle (n = 24. Male Wistar rats were anesthetized with isoflurane (aspiration rate, 450 ml/min, concentration, 2.0%. The triceps surae muscle of the right hindlimb was then electrically stimulated with forced isokinetic dorsi-flexion (180°/sec and from 0 to 45°. Tissue contents of myoD, myogenin, pax7, myostatin were measured by western blotting and localizations of myoD and pax7 was measured by immunohistochemistry. After measuring isometric tetanic torque, a single bout of LC was performed in vivo. Results The torque was significantly decreased on days 2 and 5 as compared to the pre-treatment value, and recovered by day 7. The content of myoD and pax7 showed significant increases on day 2. Myogenin showed an increase from day 2 to 5. Myostatin on days 5 and 7 were significantly increased. Immunohistochemical analysis showed that myoD-positive/pax7-positive cells increased on day 2, suggesting that activated satellite cells play a role in the destruction and the early recovery phases. Conclusion We, thus, conclude that myogenic events associate with torque recovery after LC-induced injury.

  18. Assessment of acute foot and ankle sprains.

    Science.gov (United States)

    Lynam, Louise

    2006-07-01

    Acute ankle and foot trauma is a regular emergency presentation and prompt strategic assessment skills are required to enable nurses to categorise and prioritise these injuries appropriately. This article provides background information on the anatomy and physiology of the lower limb to help nurses to identify various grades of ankle sprain as well as injuries that are limb threatening

  19. Temporary transarticular K-wire fixation of critical ankle injuries at risk: a neglected "damage control" strategy?

    Science.gov (United States)

    Friedman, Jamie; Ly, Anhchi; Mauffrey, Cyril; Stahel, Philip F

    2015-02-01

    High-energy ankle fracture-dislocations are at significant risk for postoperative complications. Closed reduction and temporary percutaneous transarticular K-wire fixation was first described more than 50 years ago. This simple and effective "damage control" strategy is widely practiced in Europe, yet appears largely forgotten and abandoned in the United States. Anecdotal opposing arguments include the notion that drilling K-wires through articular cartilage may damage the joint and contribute to postinjury arthritis. This article describes the experience in a US academic level I trauma center with transarticular pinning of selected critical ankle fracture-dislocations followed by delayed definitive fracture fixation once the soft tissues are healed. Median patient follow-up of 2 years showed that the transarticular pinning technique was performed safely, not associated with increased postoperative complication rates, and characterized by good subjective outcomes using the American Academy of Orthopaedic Surgeons Foot and Ankle Outcome Score questionnaire.

  20. Ultrasonography as a diagnostic tool in assessing deltoid ligament injury in supination external rotation fractures of the ankle.

    LENUS (Irish Health Repository)

    Henari, Shwan

    2011-10-01

    The medial deltoid ligament is the primary stabilizing structure in the ankle joint following lateral malleolar fracture. However, medial deltoid ligament ruptures are difficult to diagnose using current imaging modalities. We hypothesized that ultrasonography can be used to accurately allow early clinical assessment of ankle fracture stability, thereby negating the need to perform plain film stress views of the acutely injured ankle. This prospective study included 12 patients (age range, 18-72) with supination external rotation fractures requiring operative fixation. Following induction of anesthesia, ultrasonography examination was performed, followed by an arthrogram under fluoroscopic screening. Radiographs, ultrasonography, and arthrographic findings were compared. There was 100% correlation between ultrasonography and arthrogram findings. Ultrasonography accurately diagnosed medial deltoid rupture with a sensitivity of 100% and specificity of 100%. Plain film radiographs of the ankle had a sensitivity of 57.1% and a specificity of 60%. The difference between these was significant (χ(2)=.0091). This study demonstrates diagnostic ultrasonography to be an accurate diagnostic modality in assessing medial deltoid ligament integrity in patients with supination external rotation fractures. It offers the same sensitivity and specificity as arthrography without the need for additional invasive procedures. Its relative ease of use and lack of ionizing radiation make it a potentially useful tool, particularly in a busy trauma service.

  1. Distinguishing active from passive components of ankle plantar flexor stiffness in stroke, spinal cord injury and multiple sclerosis

    DEFF Research Database (Denmark)

    Lorentzen, Jakob; Grey, Michael J; Crone, Clarissa

    2010-01-01

    -controlled robotic device applied stretches to the ankle plantar flexor muscles at different velocities (8-200deg/s; amplitude 6 degrees ). The reflex threshold was determined by soleus EMG. Torque and EMG data were normalized to the maximal torque and EMG evoked by supramaximal stimulation of the tibial nerve...

  2. Ankle pain

    Science.gov (United States)

    ... which cushions joints) Infection in the ankle joint Osteoarthritis , gout , rheumatoid arthritis , Reiter syndrome , and other types ... Ma, MD, assistant professor, chief, sports medicine and shoulder service, UCSF Department of Orthopaedic Surgery, San Francisco, ...

  3. 高校体育专业学生篮球运动中踝关节损伤的调查分析%Investigation and Analysis of Ankle Injuries in Basketball Sport of Professional Sports Students in University

    Institute of Scientific and Technical Information of China (English)

    李泽清

    2014-01-01

    踝关节损伤是篮球运动中常见的一种损伤。本文通过问卷调查对普通高校体育专业学生在篮球运动中踝关节损伤的类型、程度、原因等进行了调查,根据踝关节生理结构和篮球运动特点对损伤原因进行了研究,并对踝关节损伤的预防提出了合理的建议。%Ankle injury is one of the common phenomena in basketball sport .This paper investigates injury types, degree and causes of ankle in basketball sport of professional sports students of ordinary college through questionnaire .The injury reasons were studied according to the physiological structure of ankle and characteristics of basketball sport .And reasonable suggestions to prevent the ankle injuries are raised .

  4. Maisonneuve-hyperplantarflexion variant ankle fracture.

    Science.gov (United States)

    Hinds, Richard M; Tran, Wesley H; Lorich, Dean G

    2014-11-01

    Maisonneuve fractures are rare ankle injuries, accounting for up to 7% of all ankle fractures. They consist of a proximal third fibula fracture, syndesmotic disruption, and medial ankle injury (either a deltoid ligament disruption or a medial malleolus fracture), and are often successfully managed with nonoperative treatment of the proximal fibula fracture and open reduction and internal fixation (ORIF) of the medial ankle injury and syndesmotic disruption. The hyperplantarflexion variant ankle fracture comprises approximately 7% of all ankle fractures and features dual posterior tibial lip fractures featuring a posterolateral fragment and a posteromedial fragment. Good functional results have been reported in the literature after ORIF of both the posterolateral and posteromedial fragments of this variant fracture that is not described by the Lauge-Hansen classification. In this report, the authors present the unique case of an isolated ankle fracture demonstrating characteristics of both a Maisonneuve fracture and a hyperplantarflexion variant ankle fracture. They also highlight the diagnostic imaging characteristics, including magnetic resonance imaging (MRI) and preoperative radiograph findings, surgical treatment, and postoperative clinical outcome for this patient with a Maisonneuve-hyperplantarflexion variant ankle fracture. To the authors' knowledge, this unique fracture pattern has not been reported previously in the literature. The authors conclude that although good results were seen postoperatively in this case, the importance of ORIF of both the posteromedial and posterolateral fragments of variant fractures cannot be overstated. They also found MRI to be a particularly helpful adjunct in formulating the correct diagnosis and treatment plan.

  5. Design, modelling and simulation aspects of an ankle rehabilitation device

    Science.gov (United States)

    Racu, C. M.; Doroftei, I.

    2016-08-01

    Ankle injuries are amongst the most common injuries of the lower limb. Besides initial treatment, rehabilitation of the patients plays a crucial role for future activities and proper functionality of the foot. Traditionally, ankle injuries are rehabilitated via physiotherapy, using simple equipment like elastic bands and rollers, requiring intensive efforts of therapists and patients. Thus, the need of robotic devices emerges. In this paper, the design concept and some modelling and simulation aspects of a novel ankle rehabilitation device are presented.

  6. Diagnosis, treatment and prevention of ankle sprains: an evidence-based clinical guideline.

    NARCIS (Netherlands)

    Kerkhoffs, G.M.; Bekerom, M. van den; Elders, L.A.; Beek, P.A. van; Hullegie, W.A.; Bloemers, G.M.; Heus, E.M. de; Loogman, M.C.; Rosenbrand, K.C.; Kuipers, T.; Hoogstraten, J.W.; Dekker, R.; Duis, H.J. Ten; Dijk, C.N. van; Tulder, M.W. van; Wees, P.J. van der; Bie, R.A. de

    2012-01-01

    Ankle injuries are a huge medical and socioeconomic problem. Many people have a traumatic injury of the ankle, most of which are a result of sports. Total costs of treatment and work absenteeism due to ankle injuries are high. The prevention of recurrences can result in large savings on medical cost

  7. Diagnosis, treatment and prevention of ankle sprains : an evidence-based clinical guideline

    NARCIS (Netherlands)

    Kerkhoffs, Gino M.; van den Bekerom, Michel; Elders, Leon A. M.; van Beek, Peter A.; Hullegie, Wim A. M.; Bloemers, Guus M. F. M.; de Heus, Elly M.; Loogman, Masja C. M.; Rosenbrand, Kitty C. J. G. M.; Kuipers, Ton; Hoogstraten, J. W. A. P.; Dekker, Rienk; ten Duis, Henk-Jan; van Dijk, C. Niek; van Tulder, Maurits W.; van der Wees, Philip J.; de Bie, Rob A.

    2012-01-01

    Ankle injuries are a huge medical and socioeconomic problem. Many people have a traumatic injury of the ankle, most of which are a result of sports. Total costs of treatment and work absenteeism due to ankle injuries are high. The prevention of recurrences can result in large savings on medical cost

  8. 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.

  9. [Ankle joint arthritis--etiology, diagnosis and treatment].

    Science.gov (United States)

    Uri, Ofir; Haim, Amir

    2008-11-01

    Ankle joint arthritis causes functional limitation and affects the quality of life many patients. It follows traumatic injuries, inflammatory joint arthritis, primary osteoarthritis, hemochromatosis and infections. Understanding the unique anatomy and biomechanics of the ankle is important for diagnosis and treatment of ankle joint pathology. The treatment of ankle joint arthritis has advanced considerably in recent years and it is still a surgical challenge. Total ankle replacement seems to be a promising form of treatment, even though current data does not demonstrate advantages over ankle joint arthrodesis.

  10. The Study of Cryotherapy Combined with Exercise Cure of Ankle Injury%冷却结合运动治疗踝关节损伤的研究

    Institute of Scientific and Technical Information of China (English)

    王晓东; 陈民盛

    2012-01-01

    冷却疗法具有止痛、防肿、减少继发性损伤等作用。在确保关节可动范围条件下尽可能早的开始运动对防止肌肉组织的萎缩和关节的僵硬、缩短康复时间有很大作用。近年来,在欧美和日本等一些国家运用冷却与运动相结合来治疗运动损伤与伤后康复取得了很好的效果。依据国内外文献及临床的实际应用经验,对冷却结合运动的康复疗法,以踝关节扭伤作为病例,做了介绍。%Cryotherapy can relievepain,prevent edema and reduce secondary injury after sports injury.To ensure that under the conditions of joint movement range in motion as early as possible to prevent muscle atrophy and joint stiffness,the time for recovery plays a significant role.Recently,some countries such as Europe,America and Japan,the use of combined cryotherapy and exercise to treat sports injuries and rehabilitation after injury,achieved good results.The author based on literature review and clinical experience in the practical application of rehabilitation exercise therapy combined with cryotherapy to a sprained ankle as the case is introduced.

  11. 踝关节三角韧带损伤的诊疗进展%Diagnosis and treatment of ankle deltoid ligament injury

    Institute of Scientific and Technical Information of China (English)

    李鹏

    2016-01-01

    三角韧带是踝关节内侧柱的一部分,在维持踝关节的稳定性和力学传导上有重要作用,其发病机制主要为外旋、外展暴力,而损伤的诊断及治疗还没有统一的标准.目前诊断主要依据踝关节内侧间隙和临床检查,核磁与关节镜有助于明确诊断,却没有得到早期应用,治疗上存在保守和手术两大分歧,手术方式的选择也有所不同,国内倾向于断裂韧带的修复,国外则更加注重三角韧带的重建.本文就目前国内外有关踝关节三角韧带的研究,在解剖、生物力学、诊断和治疗上做一综述.%Deltoid ligament is part of the medial ankle.It plays an important role in maintaining the stability of the ankle and biomechanical conduction.Deltoid ligament injury is always caused by the violence of external rotation and abduction.However,the consistent standard for its diagnosis and treatment has not yet formed.At present diagnosis relies mainly on the medial clear space and clinical examination.Magnetic resonance imaging and arthroscopic contribute to the diagnosis,but did not get an early application.The conservative treatment and surgical treatment has been existing two major differences.The choice of surgical treatment is different,too.Domestic scholars prefer to repair the fractured ligament,while foreign experts emphasis in reconstructing it.According to research of ankle deltoid ligament at home and abroad,this paper do a review on the anatomy,biomechanics,diagnosis and treatment.

  12. Review of running injuries of the foot and ankle: clinical presentation and SPECT-CT imaging patterns

    Science.gov (United States)

    Pelletier-Galarneau, Matthieu; Martineau, Patrick; Gaudreault, Maxime; Pham, Xuan

    2015-01-01

    Distance running is among the fastest growing sports, with record registration to marathons worldwide. It is estimated that more than half of recreational runners will experience injuries related to the practice of their sport. Three-phase bone scintigraphy is a very sensitive tool to identify sports injury, allowing imaging of hyperemia, stress reaction, enthesopathy and fractures, often before abnormalities can be detected on conventional anatomical modalities. In this article, we review the most common running related injuries and their imaging findings on bone scintigraphy with SPECT-CT. PMID:26269770

  13. Finite element analysis of effect of ankle ligment injury on stability of talus%踝关节周围韧带损伤对距骨稳定性影响的有限元分析

    Institute of Scientific and Technical Information of China (English)

    戴海飞; 余斌; 张凯瑞; 熊小龙; 陈志刚; 崔壮; 卢昌怀

    2012-01-01

    Objective To explore the biomechanical properties of the talus in different ankle ligament injury through finite element analysis and therefore to provide theoretical basis for the clinic treatment of ankle ligament injury. Methods CT scan data, three-dimensional anatomically detailed finite element models was used to simulate human ankle joint internal rotation, external rotation stress state of the finite element analysis. The contact pressure and Von Mises stress distribution of the talar articular surface were compared in different ankle ligament injury. Results The three-dimensional finite element model of bone, cartilage and ligaments of the normal human ankle was established. The biomechanical stability of the talus which influenced by the ankle ligament was different in the internal rotation and external rotation force. Conclusion The anterior tibio-talar ligament playes an important role in ankle stability under external rotation force while under internal rotation force, calca-neofibular ligament playes an important role.%目的 有限元法分析踝关节周围韧带损伤对距骨生物力学稳定性的影响,为临床踝关节周围韧带损伤的治疗提供理论依据.方法 基于正常男性的足踝部螺旋CT扫描数据,运用三维重建软件,建立足踝部三维几何模型,最后导人Abaqus 6.9软件中,模拟人体踝关节内旋、外旋的受力状况,分析踝关节周围韧带损伤后距骨各关节面的接触压力及Von Mises应力分布.结果 建立包括骨、软骨、韧带在内的正常人体足踝部三维有限元模型,踝关节周围韧带在踝关节内旋、外旋时对距骨的生物力学影响不同.结论 在外旋作用力下胫距后韧带对踝关节的稳定性具有重要作用,而在内旋作用力下跟腓韧带对踝关节的稳定性具有重要作用.

  14. Research on Ankle-joint Injury of Basketball Fans in Baoji University of Arts and Sciences%宝鸡文理学院篮球运动爱好者踝关节损伤的浅析

    Institute of Scientific and Technical Information of China (English)

    魏俊民

    2011-01-01

    本文通过问卷调查的方式,对宝鸡文理学院91名学生篮球爱好者在篮球运动中踝关节损伤的原因及性质进行调查分析,提出合理的预防措施,以便减少篮球爱好者在篮球运动中踝关节的损伤的概率.%Through the questionnaire survey, the paper investigates and analyzes ankle-joint injury reason and nature to 91 fans of Baoji University of Arts and Sciences in basketball, advances reasonablely preventive measures, to ruduce ankle-joint injury probability in basketball.

  15. Current concepts review: ankle fractures.

    Science.gov (United States)

    Arastu, M H; Demcoe, R; Buckley, R E

    2012-01-01

    Ankle fractures are common injuries that require meticulous technique in order to optimise outcome. The Lauge-Hansen and Danis-Weber classifications in addition to careful evaluation of the injury mechanism can help guide treatment but surgeons must be aware that there are injury patterns that will not always fit the afore mentioned patterns. The principles of atraumatic soft tissue handling, rigid internal fixation and early range of motion exercises are critical for successfully treating these injuries. There are still areas of treatment uncertainty and future directed research is needed in order to address some of these questions.

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

    Science.gov (United States)

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

    2015-12-01

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

  17. "Logsplitter" injury in clinical treatment and prognosis evaluation in ankle fractures%“Logsplitter”损伤的治疗方法与预后评价

    Institute of Scientific and Technical Information of China (English)

    宫良丰; 李盛龙; 齐志明; 李庆; 仲涛; 王志坚; 汤欣

    2016-01-01

    aration caused by varieties of violence does not catch the attention of domestic orthopedic surgeons enough in the past years.This passage is to discuss the damage mechanism,clinical treatment and prognosis evaluation of this kind of injury through the analysis of the case of "Logsplitter" injury.Methods Retrospective analysis 23 patients of "Logsplitter" injury from December 2006 to December 2014,male in 17 cases,female in 6 cases,average age (43.68±12.67) years (21-60 years).Hurt injury in 9 cases,sports injury in 1 case,falling injury in 2 cases,traffic injuries in 10 cases,crushing injury in 1 case.Open injures in 10 cases,of which the Gustilo Ⅱ type in 7 cases,Gustilo Ⅲ A type or above in 3 cases,closed injuries in 13 cases.According to the AO/OTA fracture classification,44c type in 19 cases,44b type in 3 cases,44a type in 1 case.Fibula fractures in 22 cases,19 cases of medial malleolus fracture.Results 23 patients received follow-up,with an average period was (0.91±0.26) years (0.4-2.37 years).21 cases underwent open reduction internal fixation (ORIF),2 cases underwent closed reduction external fixation and K-wire fixation.17 cases were fixed with the syndesmosis screws,among them,1 screw was used to fix 14 cases,two screws were used to fix 3 cases;the utilization rate of 3.5 mm screws is higher,at 94.1%,and all screws were entered through 3 layers of cortical;Combined with medial malleolus fracture cases were fixed with cannulated screws/K-wire internal fixation.Average healing time of the skin surrounding the ankle skin was (2.26±1.91) weeks;average healing time of fracture was (15.34±5.13) weeks;Joint pain ocurred combined with joint space narrowing after loading in 18 cases,at 78.3%;Postoperative infection,2 cases,the proportion was 8.7%;Fracture delayed union 1 case.Functional examination of the ankle joint (angle measurement method):Dorsiflexion average angle (23.9±2.21)degrees,Plantar flexion average angle (32.1 ±4.13) degrees

  18. Imaging study of ankle injury in professional soccer player of males%男性职业足球运动员踝关节损伤影像学特征分析

    Institute of Scientific and Technical Information of China (English)

    李绍林; 赵文吉; 郝帅; 胡绍勇; 张锐; 张鑫涛

    2015-01-01

    Objective To analyze the imaging abnormal findings of ankle injuries in professional soccer player of males.Methods The thirty-two professional soccer players in local region soccer club had been selected as research objects from March 2014 to January 2015,and all were men.Average age was 22.03 + 3.0 years old (19-33 years);the average age was 8.6 + 2.0 years old that began to engage in professional football training,and average time of engaged in football sports was 13 ±+4 years(7-27 years).X-ray examination was used VM DR (Philips Co.),anteroposterior and lateral position of ankle joints.CT scan was used MSCT of 64 rows detector(Aquilion 64,TOSHIBA Co.).After routine scan,raw data was transmitted to the workstation and then reconstructed to be axial,sagittal,coronal imaging.MR examination was used 1.5 T superconducting equipment system(Achieva Dual,Philips Co.) and with ankle joint special phased array coil.TSE sequence be used to scan routine axial T2-weighted imaging;coronal T1-weighted imaging;coronal PWI;and sagittal T2-weighted imaging with fat suppressed.The sagittal PWI scan was used with Isotropic with fat suppressed FFE sequence.Results The X-ray examination was finished for 28 person and 51 ankle joints.26 person and 52 ankle joints were completed CT scan and reconstructed imaging for all joints.MR examination was finished in 30 person and 51 ankle joints.On X-ray and CT display that the abnormal changes of the talus is most commonly found that the incidence of "dolphin mouth" like protrusion at posterior edge was 35 ankles (rate of occurrence was 68.6%),the triangle prominence at out edge was 45 ankles (rate of occurrence was 88.2%).It also was found that 8 lateral malleolus have osteophytes,5 ankles have medial malleolus osteophytes and 12 ankles have loose bodies at posterior ankle.MRI showed that 30 ankles were the anterior talofibular ligaments injury and incidence was 58.82%,26 ankles were posterior talofibular ligaments injury (incidence

  19. Treatment of open injury of foot and ankle in children%儿童足踝部开放性损伤的处理

    Institute of Scientific and Technical Information of China (English)

    宋卫东; 陈皓; 高峻青; 王光耀; 邱太彬; 侯念宗; 张金明

    2012-01-01

    目的 探讨儿童足踝部开放性损伤的特点、治疗方法及临床疗效.方法 回顾性分析2004年2月至2010年6月收治的35例足踝部损伤的病历资料,男22例,女13例;年龄3~14岁,平均8.4岁.交通伤28例,利器切割及机器辗绞伤7例.左18例,右17例,均为单侧;前中足5例,后足及踝部30例.其中合并骨折30例.按照Gustilo分型,Ⅰ型5例、Ⅱ型8例、Ⅲ型22例.Ⅰ型、Ⅱ型及早期收治的10例Ⅲ型病例在急诊行清创缝合或(和)骨折复位内固定术+皮瓣移植术;后期收治的12例Ⅲ型病例一期行清创、闭式负压引流术+石膏外固定或克氏针临时固定,二期行骨折复位(伴或不伴植骨)内固定+皮瓣移植术.结果 30例患儿获得随访,随访时间6~89个月,平均38.7月.2例Ⅱ型患儿术后伤口皮肤局部坏死,行植皮术愈合;10例Ⅲ型患儿一期行急诊手术,手术次数2~6次,平均3.6次;创面愈合时间3~15周,平均8.3周.1例出现慢性骨髓炎,窦道残留,经多次病灶清除植骨后痊愈;2例足踝及小腿外侧肌肉坏死行皮瓣移植,术后3年因瘢痕组织挛缩出现足踝部内翻畸形,行外固定架矫形后正常行走.12例行分期治疗的Ⅲ型患儿皮瓣均存活,色泽及弹性良好,愈合时间3~8周,平均6.8周.伴发足踝部骨折者骨折愈合良好.按Maryland标准评分[1],优17足、良9足、中3例、差1例,优良率为86.7%.结论 儿童足踝部创伤以车祸伤为多见;按损伤程度分级分期治疗可取得较好临床疗效.%Objective To investigate the clinical characteristics,treatment methods,and clinical outcomes of open injury of foot and ankle in children.Methods From February 2004 to June 2010,35 children with open injury of foot and ankle were treated,including 22 males and 13 females,aged from 3 years to 14 years (average,8.4 years).Twenty-eight cases resulted from traffic accidents; 7 cases occurred from sharp instruments and machine-related crush injuries

  20. Position versus force control: using the 2-DOF robotic ankle trainer to assess ankle's motor control.

    Science.gov (United States)

    Farjadian, Amir B; Nabian, Mohsen; Hartman, Amber; Corsino, Johnathan; Mavroidis, Constantinos; Holden, Maureen K

    2014-01-01

    An estimated of 2,000,000 acute ankle sprains occur annually in the United States. Furthermore, ankle disabilities are caused by neurological impairments such as traumatic brain injury, cerebral palsy and stroke. The virtually interfaced robotic ankle and balance trainer (vi-RABT) was introduced as a cost-effective platform-based rehabilitation robot to improve overall ankle/balance strength, mobility and control. The system is equipped with 2 degrees of freedom (2-DOF) controlled actuation along with complete means of angle and torque measurement mechanisms. Vi-RABT was used to assess ankle strength, flexibility and motor control in healthy human subjects, while playing interactive virtual reality games on the screen. The results suggest that in the task with 2-DOF, subjects have better control over ankle's position vs. force.

  1. Sprained Ankles

    Science.gov (United States)

    ... Genitals and Urinary Tract Glands & Growth Head Neck & Nervous System Heart Infections Learning Disabilities Obesity Orthopedic Prevention Sexually Transmitted Skin Tobacco Treatments Injuries & ...

  2. Outcome and patients' satisfaction after functional treatment of acute lateral ankle injuries at emergency departments versus family doctor offices

    OpenAIRE

    Zimmermann Heinz; Eggli Stefan; Benneker Lorin M; Schwab Patrik R; Exadaktylos Aristomenis K

    2008-01-01

    Abstract Background In some Western countries, more and more patients seek initial treatment even for minor injuries at emergency units of hospitals. The initial evaluation and treatment as well as aftercare of these patients require large amounts of personnel and logistical resources, which are limited and costly, especially if compared to treatment by a general practitioner. In this study, we investigated whether outsourcing from our level 1 trauma center to a general practitioner has an in...

  3. Total ankle replacement - surgical treatment and rehabilitation.

    Science.gov (United States)

    Prusinowska, Agnieszka; Krogulec, Zbigniew; Turski, Piotr; Przepiórski, Emil; Małdyk, Paweł; Księżopolska-Orłowska, Krystyna

    2015-01-01

    Functions of the ankle joint are closely connected with the gait and ability to maintain an upright position. Degenerative lesions of the joint directly contribute to postural disorders and greatly restrict propulsion of the foot, thus leading to abnormal gait. Development of total ankle replacement is connected with the use of the method as an efficient treatment of joint injuries and continuation of achievements in hip and knee surgery. The total ankle replacement technique was introduced as an alternative to arthrodesis, i.e. surgical fixation, which made it possible to preserve joint mobility and to improve gait. Total ankle replacement is indicated in post-traumatic degenerative joint disease and joint destruction secondary to rheumatoid arthritis. In this paper, total ankle replacement and various types of currently used endoprostheses are discussed. The authors also describe principles of early postoperative rehabilitation as well as rehabilitation in the outpatient setting.

  4. 篮球运动踝关节损伤的原因及预防研究%Research on the Cause and Prevention of Ankle Injury in Basketball

    Institute of Scientific and Technical Information of China (English)

    贾嘉琳; 王厚雷

    2016-01-01

    为了提高篮球运动参与者自我保护意识,提高自我保护的能力,进而避免踝关节损伤的发生,主要通过查阅资料、访谈、发放调查问卷等方法探究体育专业学生从事篮球运动时出现踝关节损伤的原因主要包括技术动作不合理、自我保护意识差,踝关节专项准备活动不足、体能不足这四个方面,并提出了相应的预防措施。%In order to improve the basketball participants ego to protect consciousness, improve the ability of self-protection, to avoid the happening of the ankle injury, mainly through the check data, interviews, questionnaires and other methods to explore the professional sports students play basketball sports in the cause of the ankle injury mainly includes unreasonable techniques, ego to protect consciousness is poor, insufficient ankle special exercises and fitness of the four aspects, and puts forward the corresponding prevention measures.

  5. 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.

  6. The Ankle Injury Management (AIM) trial: a pragmatic, multicentre, equivalence randomised controlled trial and economic evaluation comparing close contact casting with open surgical reduction and internal fixation in the treatment of unstable ankle fractures in patients aged over 60 years.

    Science.gov (United States)

    Keene, David J; Mistry, Dipesh; Nam, Julian; Tutton, Elizabeth; Handley, Robert; Morgan, Lesley; Roberts, Emma; Gray, Bridget; Briggs, Andrew; Lall, Ranjit; Chesser, Tim Js; Pallister, Ian; Lamb, Sarah E; Willett, Keith

    2016-01-01

    BACKGROUND Close contact casting (CCC) may offer an alternative to open reduction and internal fixation (ORIF) surgery for unstable ankle fractures in older adults. OBJECTIVES We aimed to (1) determine if CCC for unstable ankle fractures in adults aged over 60 years resulted in equivalent clinical outcome compared with ORIF, (2) estimate cost-effectiveness to the NHS and society and (3) explore participant experiences. DESIGN A pragmatic, multicentre, equivalence randomised controlled trial incorporating health economic evaluation and qualitative study. SETTING Trauma and orthopaedic departments of 24 NHS hospitals. PARTICIPANTS Adults aged over 60 years with unstable ankle fracture. Those with serious limb or concomitant disease or substantial cognitive impairment were excluded. INTERVENTIONS CCC was conducted under anaesthetic in theatre by surgeons who attended training. ORIF was as per local practice. Participants were randomised in 1 : 1 allocation via remote telephone randomisation. Sequence generation was by random block size, with stratification by centre and fracture pattern. MAIN OUTCOME MEASURES Follow-up was conducted at 6 weeks and, by blinded outcome assessors, at 6 months after randomisation. The primary outcome was the Olerud-Molander Ankle Score (OMAS), a patient-reported assessment of ankle function, at 6 months. Secondary outcomes were quality of life (as measured by the European Quality of Life 5-Dimensions, Short Form questionnaire-12 items), pain, ankle range of motion and mobility (as measured by the timed up and go test), patient satisfaction and radiological measures. In accordance with equivalence trial US Food and Drug Administration guidance, primary analysis was per protocol. RESULTS We recruited 620 participants, 95 from the pilot and 525 from the multicentre phase, between June 2010 and November 2013. The majority of participants, 579 out of 620 (93%), received the allocated treatment; 52 out of 275 (19%) who received CCC later

  7. An epidemiological survey on ankle sprain.

    OpenAIRE

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

    1994-01-01

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

  8. Potential savings of a program to prevent ankle sprain recurrence: Economic evaluation of a randomized controlled trial

    NARCIS (Netherlands)

    Hupperets, M.D.W.; Verhagen, E.A.L.M.; Heymans, M.W.; Bosmans, J.E.; Tulder, M.W. van; Mechelen, W. van

    2010-01-01

    Background: The most common ankle injury is the lateral ankle sprain. Dutch annual sports-related ankle sprain costs can roughly be estimated at 187,200,000. Research has shown that proprioceptive training accounts for an approximated overall 50% reduction in ankle sprain recurrence rate. Hypothesis

  9. Exploração operatória e redução de sindesmose em lesão de tornozelo de Weber tipo C Operative exploration and reduction of syndesmosis in Weber type C ankle injury

    Directory of Open Access Journals (Sweden)

    Yunfeng Yang

    2013-04-01

    Full Text Available OBJETIVO: Investigar os métodos cirúrgicos no tratamento de fratura de tornozelo de Weber tipo C e estimar a necessidade de exploração cirúrgica da sindesmose. MÉTODOS: Quarenta e três pacientes que apresentavam fratura de tornozelo de Weber tipo C foram tratados com redução aberta e fixação interna de outubro de 2004 a dezembro de 2009. Vinte e nove pacientes foram tratados com o procedimento de rotina, que envolve redução aberta e fixação interna, exploração de sindesmose. Nos outros pacientes, foram realizados reparos adicionais. Trinta e quatro pacientes foram acompanhados durante um período médio de 31,2 meses (faixa, 18 a 50 meses, 22 pacientes desse total foram tratados com procedimentos de rotina e 12 foram tratados com exploração cirúrgica adicional da sindesmose. RESULTADOS: Todas as fraturas estavam unidas no período médio de 13,1 semanas (faixa, 10 a 18 semanas, tendo início o apoio de peso total. A escala média de tornozelo e retropé do escore da american orthopaedics foot and ankle society foi 79,86 (faixa, 65 a 98 no grupo procedimentos de rotina e 86,67 (faixa, 78 a 100 no grupo exploração da sindesmose. Os valores do escore de Olerud-Molander foram 77,27 (faixa, 55 a 100 e 86,67 (faixa, 75 a 100, respectivamente. Constatou-se diferença estatisticamente significante entre os dois grupos (P OBJECTIVE: to investigate the surgical methods in treating weber type C ankle injury and estimate the necessity of syndesmosis operative exploration. METHODS: forty three patients presenting weber type C ankle injury were treated with open reduction and internal fixation from october 2004 to december 2009. twenty nine patients were treated with routine procedure involving open reduction and internal fixation, syndesmosis exploration. additional repair was performed in the others. thirty four patients were followed during an average time of 31.2 months (range, 18 to 50 months, 22 patients of those were treated with

  10. 踝关节内侧韧带损伤及其病理机制初探%Preliminary investigation on the medial ankle ligament injury and its pathomechanism

    Institute of Scientific and Technical Information of China (English)

    徐向阳; 刘津浩; 朱渊; 王碧菠

    2010-01-01

    目的 探讨踝关节内韧带损伤后内侧不稳定的病理机制.方法 患者15例,男8例,女7例;年龄22~58岁,平均40岁.其中踝关节急性扭伤患者2例,踝关节慢性损伤3例,先天性平足3例,胫后肌腱失能5例,旋前外旋骨折1例,陈旧性的内踝撕脱骨折1例.所有患者均行三角韧带修补术,同时行跟骨延长术8例,内侧楔骨闭合截骨5例,跟骨截骨内移术1例.全部患者术后随访7~56个月,运用美国足踝外科协会(America Orthopedic Foot and Ankle Society,AOFAS)踝-后足功能评分进行评估,统计学分析采用t检验.结果 1例踝关节急性骨折患者,由于术前无法评分,不放在统计分析内.其余14例患者术前评分为(42.4±10.6)分,术后评分(89.8±6.2)分(P<0.05).结论 三角韧带是一个重要的解剖结构,在以下几种情况下须注意其修复:(1)三角韧带损伤范围较广,涉及前部的胫弹簧韧带和胫舟韧带.(2)先天性的平足以及获得性的胫后肌腱失能患者.(3)以往有经常的踝关节扭伤,有外侧韧带的损伤,此次发生了伴有内侧韧带损伤的骨折.%Objective To discuss the pathomechanism of medial ankle instability after medial ligament injury. Methods The study involved 15 patients including eight males and seven females, at average age of 40 years (range 22-58 years). There were two patients with acute ankle sprain, three with chronic ankle injury, three with congenital pes planus, five with posterior tibial tendon dysfunction, one with pronation external rotation ankle fracture and one with old avulsion medial malleolus. All patients were treated surgically with deltoid ligament repair, when eight patients further received calcaneal lengthing osteotomy, five received medial cuneiform close wedge osteotomy and one received medial shift calcaneal osteotomy. All patients were followed up for 7-56 months. American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale was used for pre- and post

  11. Modified Blair ankle fusion for ankle arthritis

    Institute of Scientific and Technical Information of China (English)

    Wang Shuangli; Huang Zhang; Xiong Gaoxin; Chen Guang; Yin Zhongxiang; Jiang Hua

    2014-01-01

    Objective:To investigate the clinical outcome of modified Blair ankle fusion for ankle arthritis.Methods:Between November 2009 and June 2012,28 patients with ankle arthritis were treated,among whom 11 had obvious foot varus deformity,and 17 were almost normal in appearance.There were 13 males and 15 females with an average age of 49.4 years (range,23-67 years).The main symptoms included swelling,pain,and a limited range of motion of the ankles.The ankle joints functions were assessed by American Orthopedic Foot and Ankle Society (AOFAS) ankle and hindfoot score and visual analog scale (VAS) preoperatively and at 1 year follow-up.Results:Twenty-eight patients were followed up for 19.8 months on average (range,1-2 years).Superficial wound infection occurred in 3 cases,and was cured after debridement; the other incisions healed by first intention without complications.All ankles were fused at 1 year follow-up after operation.The symptom was relieved completely in all patients at last follow-up without complication of implant failure,or nonunion.The postoperative AOFAS ankle and hindfoot score was 83.13±3.76,showing significant difference when compared with the preoperative score (45.38±3.21,P<0.01).VAS was significantly decreased from 8.01±0.63 to 2.31±1.05 at 1 year follow-up (P<0.05).Conclusion:Modified Blair ankle fusion has the advantages of high feasiblity,less cost and rigid fixation.It shows high reliability in pain relief and may obtain a good clinical effectiveness.

  12. Perineural fibrosis of superficial peroneal nerve complicating ankle sprain: a case report.

    Science.gov (United States)

    Acus, R W; Flanagan, J P

    1991-02-01

    The peroneal nerve is susceptible to traction injury during inversion ankle sprains. Previously, these traction lesions have been identified only at the fibular neck and popliteal fossa level. This report illustrates a previously unreported condition of perineural fibrosis of the superficial peroneal nerve at the level of the ankle following an inversion ankle sprain. Perineural fibrosis should be considered in the differential diagnosis of patients with persistent pain after ankle sprain.

  13. Total ankle replacement for posttraumatic arthritis

    Science.gov (United States)

    Weme, Rebecca A Nieuwe; van Solinge, Guido; N Doornberg, Job; Sierevelt, Inger; Haverkamp, Daniël; Doets, H Cornelis

    2015-01-01

    Background and purpose Most studies on total ankle replacement (TAR) have used a case mix of patients. We evaluated the outcome of TAR performed for end-stage arthritis either because of fracture or ligamentous injury. Patients and methods We prospectively followed 88 consecutive patients (50 postfracture ankles and 40 ankles with instability arthritis (2 bilateral)) who underwent TAR between 2001 and 2009. Mean follow-up for both groups was 5 years. Results Preoperative varus deformity of 10° or more was present in 23 ankles in the instability group. At 6 years, survival with revision or salvage fusion as an endpoint was 87% (95% CI: 74–99) in the postfracture group and 79% (95% CI: 63–94) in the instability group. Progressive periprosthetic osteolysis was seen in 23 ankles, and required salvage fusion in 6. The number of reoperations was similar in both groups. Clinical outcome, as assessed with 2 ankle scores and 2 questionnaires, showed good results and was similar at the latest follow-up. Interpretation The outcome was similar in the postfracture and instability groups and also similar to that reported in series including a case mix of patients. In contrast to earlier reports, preoperative frontal plane deformity in this series was not identified as a risk factor for failure. PMID:25772269

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

    Directory of Open Access Journals (Sweden)

    Sophia Chui-Wai Ha

    2015-10-01

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

  15. Total ankle arthroplasty in end-stage ankle arthritis

    OpenAIRE

    Demetracopoulos, Constantine A.; Halloran, James P.; Maloof, Paul; Samuel B Adams; Parekh, Selene G.

    2013-01-01

    Recent advancements in ankle prosthesis design, combined with improved surgical techniques for correction of coronal plane deformity and ligamentous balancing, have led to a resurgence of interest in total ankle arthroplasty for the treatment of end-stage ankle arthritis. Although ankle arthrodesis has long been considered the gold standard treatment for ankle arthritis, recent studies have shown that patients who undergo total ankle replacement have equivalent pain relief and improved functi...

  16. Conservative treatment of an anterior-lateral ankle dislocation without an associated fracture in a diabetic patient: a case report

    Directory of Open Access Journals (Sweden)

    Panagiotis K. Karampinas

    2012-06-01

    Full Text Available Anterior or anterior-lateral dislocation of the ankle is a rare condition that can be treated conservatively as well as any other similar types of ankle dislocations without associated fractures. We present a case report of an anterior-lateral ankle dislocation with a concomitant avulsion injury of the ankle's anterior capsule in a diabetic patient that was treated conservatively. At the patient's visit 12 months after the initial injury, he was asymptomatic with full range of motion of the ankle joint. To our knowledge, we could not identify this type of an injury in a diabetic patient that was treated successfully with conservative treatment in the existing literature.

  17. Predicting functional recovery after acute ankle sprain.

    Directory of Open Access Journals (Sweden)

    Sean R O'Connor

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

  18. Total ankle replacement – surgical treatment and rehabilitation

    Science.gov (United States)

    Krogulec, Zbigniew; Turski, Piotr; Przepiórski, Emil; Małdyk, Paweł; Księżopolska-Orłowska, Krystyna

    2015-01-01

    Functions of the ankle joint are closely connected with the gait and ability to maintain an upright position. Degenerative lesions of the joint directly contribute to postural disorders and greatly restrict propulsion of the foot, thus leading to abnormal gait. Development of total ankle replacement is connected with the use of the method as an efficient treatment of joint injuries and continuation of achievements in hip and knee surgery. The total ankle replacement technique was introduced as an alternative to arthrodesis, i.e. surgical fixation, which made it possible to preserve joint mobility and to improve gait. Total ankle replacement is indicated in post-traumatic degenerative joint disease and joint destruction secondary to rheumatoid arthritis. In this paper, total ankle replacement and various types of currently used endoprostheses are discussed. The authors also describe principles of early postoperative rehabilitation as well as rehabilitation in the outpatient setting. PMID:27407223

  19. 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

  20. The effects of ankle Kinesio taping on ankle stiffness and dynamic balance.

    Science.gov (United States)

    Fayson, Shirleeah D; Needle, Alan R; Kaminski, Thomas W

    2013-01-01

    The purpose of this study was to determine the effects of Kinesio® taping on static restraint and dynamic postural control of the ankle joint. Thirty female subjects with no history of ankle injury participated in this study. Subjects were tested for passive ankle laxity and stiffness, and time to stabilization following forward, backward, medial, and lateral hops. Subjects were tested prior to tape application, immediately following application, and following 24 hours of use. Differences between taping conditions were investigated using analyses of variance and pairwise comparisons. Stiffness increased following initial application and 24 hours of Kinesio® tape use (F = 6.99, p = .003), despite no observed changes in ankle laxity (F = 0.77, p = .49); however, no changes were observed in time-to-stabilization (F = 0.03, p = .97). Our results suggest that Kinesio® tape may improve static restraint in the ankle joint without altering peak motion or dynamic postural control. A future investigation into Kinesio® tape efficacy in injury prevention or rehabilitation is warranted.

  1. An examination of ankle, knee, and hip torque production in individuals with chronic ankle instability.

    Science.gov (United States)

    Gribble, Phillip A; Robinson, Richard H

    2009-03-01

    There is some debate in the literature as to whether strength deficits exist at the ankle in individuals with chronic ankle instability (CAI). Additionally, there is evidence to suggest that knee and hip performance is altered in those with CAI. Therefore, the purpose of this study was to determine whether CAI is associated with deficits in ankle, knee, and hip torque. Fifteen subjects with unilateral CAI and fifteen subjects with healthy ankles participated. Subjects reported to the laboratory for one session during which the torque production of ankle plantar flexion/dorsiflexion, knee flexion/extension, and hip flexion/extension were measured with an isokinetic device. Subjects performed 5 maximum-effort repetitions of a concentric/concentric protocol at 60 degrees .s for both extremities. Average peak torque (APT) values were calculated. The subjects with CAI demonstrated significantly less APT production for knee flexion (F1,28 = 5.40; p = 0.03) and extension (F1,28 = 5.34; p = 0.03). Subjects with CAI exhibited significantly less APT for ankle plantar flexion in the injured limb compared with their noninjured limb (F1,28 = 6.51; p = 0.02). No significant difference in ankle dorsiflexion or hip flexion/extension APT production existed between the 2 groups. Individuals with CAI, in addition to deficits in ankle plantar flexion torque, had deficits in knee flexor and extensor torque, suggesting that distal joint instability may lead to knee joint neuromuscular adaptations. There were no similar deficits at the hip. Future research should determine what implications this has for prevention and rehabilitation of lower-extremity injury. Clinicians may need to consider including rehabilitation efforts to address these deficits when rehabilitating patients with CAI.

  2. 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

  3. 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.

  4. Internal Fixation of Open Ankle Fracture. Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Yaniel Truffin Rodríguez

    2014-10-01

    Full Text Available Open ankle fracture is sporadically seen in the orthopedic practice. Its clinical course is subject to multiple factors, showing a propensity to cause ankle osteoarthritis over the years. Two cases treated at the Dr. Gustavo Aldereguía Lima University General Hospital in Cienfuegos are presented. The patients underwent emergency surgical treatment consisting of surgical cleaning of the open wound, reduction of the dislocation and internal fixation of the fracture. These cases are presented due to the infrequency of this type of ankle injury and its importance for the medical staff, especially orthopedic doctors.

  5. Modified Evans peroneus brevis lateral ankle stabilization for balancing varus ankle contracture during total ankle replacement.

    Science.gov (United States)

    Roukis, Thomas S

    2013-01-01

    Lateral ankle instability is frequently encountered when performing total ankle replacement and remains a challenge. In the present techniques report, I have described a modification of the Evans peroneus brevis tendon lateral ankle stabilization harvested through limited incisions using simple topographic anatomic landmarks. The harvested peroneus brevis is then transferred either to the anterior distal tibia concomitantly with total ankle replacement or through the tibia when performed after total ankle replacement and secured with plate and screw fixation. This modified Evans peroneus brevis tendon is useful in providing lateral ankle stability during or after primary and revision total ankle replacement.

  6. 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...

  7. 静态平衡训练系统对踝关节损伤术后本体感觉的影响%Effects in Sensory Static Balance Training System on Postoperative Proprioception of Ankle Injury

    Institute of Scientific and Technical Information of China (English)

    陈汴生; 蒋拥军; 李克军; 胡敏杰; 陈佳旭

    2013-01-01

    Objective:To investigate the effects of sensory static balance training system on postoperative proprioception of ankle injury. Methods:66 patients were randomly divided into observation group and control group, control group with pace movement training, balance board training and elastic belt training, observation group received equilibrium, proprioception, skiing training mode of static balance training system based on the treat-ment of control group, balance function was measured before and after the training with the balance function assessment system. Results:Coverage of 90%ellipse area with eyes closed and LFS index of two groups after training were both less than those before (P<0.05), and those of observation group were lower than control group (P<0.05). Conclusion:There are obvious enhancing effects of static balance training system on efferent ability of postoperative proprioception of ankle injury.%目的:探讨静态平衡训练系统对踝关节损伤术后本体感觉的影响。方法:将66例患者随机分为观察组和对照组,对照组采用步伐移动训练、平衡板训练、弹力带训练,观察组在对照组治疗的基础上进行静态平衡训练系统中的平衡、本体感觉、滑雪运动模式训练,在训练前后均采用平衡功能评定系统进行平衡功能测定。结果:两组患者训练后在闭眼状态下的覆盖90%椭圆区域面积、LFS指数均小于训练前(P<0.05),而观察组均小于对照组(P<0.05)。结论:静态平衡训练系统中的训练模式对踝关节损伤术后本体感觉的传出能力有明显的提高作用。

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

    LENUS (Irish Health Repository)

    O'Driscoll, Jeremiah

    2011-06-09

    Abstract Background Ankle joint sprain and the subsequent development of chronic ankle instability (CAI) are commonly encountered by clinicians involved in the treatment and rehabilitation of musculoskeletal injuries. It has recently been advocated that ankle joint post-sprain rehabilitation protocols should incorporate dynamic neuromuscular training to enhance ankle joint sensorimotor capabilities. To date no studies have reported on the effects of dynamic neuromuscular training on ankle joint positioning during landing from a jump, which has been reported as one of the primary injury mechanisms for ankle joint sprain. This case report details the effects of a 6-week dynamic neuromuscular training programme on ankle joint function in an athlete with CAI. Methods The athlete took part in a progressive 6-week dynamic neuromuscular training programme which incorporated postural stability, strengthening, plyometric, and speed\\/agility drills. The outcome measures chosen to assess for interventional efficacy were: 1 Cumberland Ankle Instability Tool (CAIT) scores, 2 Star Excursion Balance Test (SEBT) reach distances, 3 ankle joint plantar flexion during drop landing and drop vertical jumping, and 4 ground reaction forces (GRFs) during walking. Results CAIT and SEBT scores improved following participation in the programme. The angle of ankle joint plantar flexion decreased at the point of initial contact during the drop landing and drop vertical jumping tasks, indicating that the ankle joint was in a less vulnerable position upon landing following participation in the programme. Furthermore, GRFs were reduced whilst walking post-intervention. Conclusions The 6-week dynamic neuromuscular training programme improved parameters of ankle joint sensorimotor control in an athlete with CAI. Further research is now required in a larger cohort of subjects to determine the effects of neuromuscular training on ankle joint injury risk factors.

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

    Directory of Open Access Journals (Sweden)

    O'Driscoll Jeremiah

    2011-06-01

    Full Text Available Abstract Background Ankle joint sprain and the subsequent development of chronic ankle instability (CAI are commonly encountered by clinicians involved in the treatment and rehabilitation of musculoskeletal injuries. It has recently been advocated that ankle joint post-sprain rehabilitation protocols should incorporate dynamic neuromuscular training to enhance ankle joint sensorimotor capabilities. To date no studies have reported on the effects of dynamic neuromuscular training on ankle joint positioning during landing from a jump, which has been reported as one of the primary injury mechanisms for ankle joint sprain. This case report details the effects of a 6-week dynamic neuromuscular training programme on ankle joint function in an athlete with CAI. Methods The athlete took part in a progressive 6-week dynamic neuromuscular training programme which incorporated postural stability, strengthening, plyometric, and speed/agility drills. The outcome measures chosen to assess for interventional efficacy were: 1 Cumberland Ankle Instability Tool (CAIT scores, 2 Star Excursion Balance Test (SEBT reach distances, 3 ankle joint plantar flexion during drop landing and drop vertical jumping, and 4 ground reaction forces (GRFs during walking. Results CAIT and SEBT scores improved following participation in the programme. The angle of ankle joint plantar flexion decreased at the point of initial contact during the drop landing and drop vertical jumping tasks, indicating that the ankle joint was in a less vulnerable position upon landing following participation in the programme. Furthermore, GRFs were reduced whilst walking post-intervention. Conclusions The 6-week dynamic neuromuscular training programme improved parameters of ankle joint sensorimotor control in an athlete with CAI. Further research is now required in a larger cohort of subjects to determine the effects of neuromuscular training on ankle joint injury risk factors.

  10. 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? ...

  11. Stresses in the ankle joint and total ankle replacement design.

    Science.gov (United States)

    Kakkar, Rahul; Siddique, M S

    2011-06-01

    The ankle is a highly congruent joint with a surface area of 11-13 cm(2). Total ankle replacements have been attempted since the early 1970s and design has continually evolved as the early designs were a failure. This was because the stresses involved and the mutiaxial motion of the ankle has not been understood until recently. It has been shown that the talus slides as well as rolls during the ankle arc of motion from plantarflexion to dorsiflexion. Furthermore, the articular surfaces and the calcaneofibular and tibiocalcaneal ligaments have been shown to form a four bar linkage dictating ankle motion. A new design ankle replacement has been suggested recently which allows multiaxial motion at the ankle while maintaining congruency throughout the arc of motion. The early results of this ankle replacement have been encouraging without any reported failures due to mechanical loosening.

  12. The effectiveness of balance training programs on reducing the incidence of ankle sprains in adolescent athletes.

    Science.gov (United States)

    Valovich McLeod, Tamara C

    2008-08-01

    Ankle sprains are one of the most common sport-related injuries treated by rehabilitation professionals. These injuries often result in lost participation and can lead to subsequent injury episodes. Therefore, it is important to determine appropriate means of preventing these injuries. There has recently been an increase in the popularity of balance training programs for the prevention of knee anterior cruciate ligament (ACL) injury, with some thought that starting these programs in younger athletes may be most beneficial. However, there is the potential that these types of training programs may also be beneficial for decreasing the risk of other lower extremity injuries, including ankle sprains in the adolescent athlete.

  13. X-Ray Exam: Ankle

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old X-Ray Exam: Ankle KidsHealth > For Parents > X-Ray Exam: Ankle A A A What's in ... español Radiografía: tobillo What It Is An ankle X-ray is a safe and painless test that ...

  14. Tourniquet use during ankle surgery leads to increased postoperative opioid use

    DEFF Research Database (Denmark)

    Kruse, Heidi; Christensen, Kristian P; Møller, Ann M;

    2015-01-01

    STUDY OBJECTIVE: Ankle surgery is often done using a tourniquet. Ischemia/reperfusion injury caused by the tourniquet may increase postoperative pain. The study objective was to investigate the amount of opioids given to patients after ankle surgery with and without tourniquet. DESIGN: We did a c...

  15. Acute paediatric ankle trauma: MRI versus plain radiography

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-09-01

    Objective: To evaluate the diagnosis of acute physeal ankle fractures on plain radiographs using MRI as the gold standard. Methods: Sixty consecutive children, 29 with a clinical diagnosis of lateral ligament injury and 31 with physeal ankle fractures, were examined using both radiographs and MRI in the acute period. The imaging data were reviewed by three ''masked'' radiologists. The fracture diagnosis and Slater-Harris classification of radiographs were compared with findings on MRI. Results: Plain radiography produced five of 28 (18%) false negative and 12 of 92 (13%) false positive fracture diagnoses compared with MRI. Six of the 12 false positive fractures were due to a misclassification of lateral ligament disruption as SH1 fractures. Altogether a difference was found in 21% of cases in either the diagnosis or the classification of the fractures according to Salter- Harris. All bone bruises in the distal tibia and fibula and 64% of bone bruises in the talus were seen in association with lateral ligament injuries. Talar bone bruises in association with fractures occurred on the same side as the malleolar fracture; talar bone bruises in association with lateral ligament disruption were seen in different locations. The errors identified on radiographs by MRI did not affect the management of the injury. Conclusions: The incidence of false negative ankle fractures in plain radiographs was small and no complex ankle fractures were missed on radiographs. The total extent of complex fractures was, however, not always obvious on radiographs. In an unselected series of relatively mild ankle injuries, we were unable to show a single case where the treatment or prognosis based on plain radiography should have been significantly altered after having done a routine MRI examination. Plain radiography is still the diagnostic cornerstone of paediatric ankle injuries. (orig.)

  16. 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.

  17. Septic arthritis of the adult ankle joint secondary to Salmonella enteritidis: a case report.

    LENUS (Irish Health Repository)

    Munigangaiah, Sudarshan

    2011-09-01

    Salmonella septic arthritis in healthy individuals is a rare phenomenon. However, septic arthritis of the native adult ankle joint in healthy patients has not been previously described in the published data. This is a case report of a 70-year-old farmer who presented with a 2-week history of a painful, swollen right ankle and an inability to bear weight. He had no history of ankle injury or any predisposing conditions. Joint aspirations were positive for Salmonella enteritidis that was successfully treated with right ankle arthrotomy and washout, along with a 6-week course of intravenous antibiotic therapy.

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

    Directory of Open Access Journals (Sweden)

    Brendan Wilson

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

  19. 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).

  20. Factors Affecting Ankle Support Device Usage in Young Basketball Players

    Directory of Open Access Journals (Sweden)

    Michael D. Cusimano

    2013-05-01

    Full Text Available This cross-sectional study explores factors affecting the decision of basketball players to wear ankle support devices (ASDs. A questionnaire regarding attitudes towards ASD usage was developed based on the Health Belief Model (HBM. The questionnaire assessed HBM perceptions (susceptibility, severity, benefits, and barriers and modifying factors (demographic, personal history of ankle injury, influence of coach to preventive action that may affect an athlete’s decision to wear ASDs. One hundred forty basketball players competing at the recreational, high school, or university levels completed the questionnaire, with the questionnaires being completed at the basketball gymnasium or at home. It was found that athletes whose coaches enforced ASD use were significantly more likely to wear them (OR: 35.71; 95% CI: 10.01, 127.36, as were athletes who perceived ankle injuries to be severe (OR: 2.77; 95% CI: 1.04, 7.37. Previous injury did not significantly increase the odds of using an ASD. The combined influence of coach enforcement and previous injury had the greatest effect on increasing ASD use. The largest barrier to ASD use was a lack of aesthetic appeal. Strategies aimed at increasing players’ willingness to wear ankle protection should be emphasized among coaches and parents as this may increase use of ASDs.

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

    Directory of Open Access Journals (Sweden)

    Alireza Manafi Rasi

    2013-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Alireza Manafi Rasi

    2013-12-01

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

  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.

  4. [Long-term results of active-passive ligament repair of the external lateral ligament of the ankle].

    Science.gov (United States)

    Farizon, F; Paris, D; Azoulai, J J; Bousquet, G

    1996-03-01

    We reviewed 95 ankles at an average of 9 years after an "activo-passive" operation performed for chronic lateral instability. All the patients had suffered recurrent ankle sprain or instability, with pain in 67 patients. Ten ankles showed a subtalar injury at operation. Degenerative changes were noted in 11 ankle joints. On review, 81 ankles (85%) were stable. The 14 cases with persistent instability had developed the problem one to five years after operation. Two cases presented with limitation in mobility. Osteoarthritis, found in 15 ankles, was severe in only two, and had been present on preoperative films. We found no correlation between functional results (talar tilt, anterior-drawer test) and radiological evaluation. The "activo-passive" operation provides long-term stabilization with preservation of the ankle and of subtalar mobility without severe osteoarthritis.

  5. A Survey of Parachute Ankle Brace Breakages

    Science.gov (United States)

    2008-01-10

    reduced since it was subject to abrasion from the concrete in the harness shed, asphalt on the loading ramp, and dirt on the drop zone. b. DJ...strap was also directly under the heel and subject to abrasion from concrete in the harness shed, asphalt on the loading ramp, and dirt on the drop...airborne injuries), airborne students who did not wear the brace were 1.90 times more likely to experience an ankle sprain, 1.47 times more likely to

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

    Science.gov (United States)

    Wilson, Brendan; Bialocerkowski, Andrea

    2015-01-01

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

  7. Functional bandage for ankle sprains. Recommendations for nursing

    Directory of Open Access Journals (Sweden)

    Mª Isabel Arcos Cirauqui

    2011-11-01

    Full Text Available Three quarters of ankle injuries are diagnosed as sprains. For the most part sprains are caused by a forced inversion movement with involvement of the lateral collateral ligament (LCL. One of the recommended guidelines is immobilization by taping. The aim of this article is to unify the recommendations for nursing, on taping in the treatment of ankle sprains. The methodology used was a literature review, analyzing the information found in books and journals in hospital libraries and nursing databases on the Internet. The main results are a set of guidelines for the most accurate and therapeutic taping.

  8. Effects of different surgical mananement of the three-column injury of ankle on the peak contact pressure in the tibiotalar joint%不同手术方式治疗踝关节韧带复合体损伤的生物力学评价

    Institute of Scientific and Technical Information of China (English)

    董伟强; 余斌; 白波

    2015-01-01

    Objective To study the effects of different surgical procedures of clinical treatment of the three-column injury of ankle on the peak contact pressure in the tibiotalarjoint. Methods Six fresh cadaveric adult ankles were used for creation of 3 models of different surgical proceduresof treatment for the three-column injury of ankle. In model A, the medial and lateral ligaments of ankle joint were intact(repaired), the broken inferior tibiofibular ligament were not fixed. In model B, the medial and lateral ligaments of ankle joint were intact(repaired),the broken inferior tibiofibular ligament was fixed by a screw. In model C, lateral ligaments of ankle joint were intact(repaired), the broken inferior tibiofibular ligament was fixed by a screw, but the broken medial ligaments were not repaired. The three groups were tested in order A、B、C. The 3 models were tested with an electronic pressure sensor in a BOSE material testing machine, respectively, in 5 positions. The peak values of the compressive stresses of the 3 models in 5 positions were recorded. All data were collected and analyzed using SPSS22.0. Results Model B exhibited the smallest average stress in all 5 positions, followed by model C and model A, with significant differences between B and A groups (P<0.05).There were significant differences between B and C groups (P<0.05)at 10° dorsal extension and 10° valgus position. Conclusion The surgical management of the three-column injury of ankle where the medial and lateral ligaments are intact or repaired, and the tibiofibular syndesmosisis effectively fixed can reduce the peak contact pressure in the tibiotalar joint.%目的:研究不同手术方式治疗踝关节3个韧带复合体同时损伤的生物力学特征。方法选用6例成年新鲜正常踝关节,建立3组模型:A组:模拟内、外侧韧带损伤后予以形态和张力完全修复,下胫腓联合不固定。B组:模拟内、外侧韧带损伤后予以形态和张力完全修

  9. Effect of knee ankle foot orthosis in the rehabilitation of patients with complete spinal cord injury%膝踝足矫形器对完全性脊髓损伤患者的康复作用

    Institute of Scientific and Technical Information of China (English)

    林志伟; 练振坚; 符俏

    2013-01-01

    Objective To investigate effect of knee ankle foot orthosis (KAFO) in the rehabilitation of patients with complete spinal cord injury. Methods Seventeen patients (11 males and 6 females) with spinal cord injury of L1 or under L1 were enrolled in the study, aged from 19 to 42 years old (34.7 in average), of which 9 cases were L1 level, 5 cases were L2 level, 3 cases were L3 level. Several rehabilitation therapies were needed before assembly of KAFO, including muscle strength, cardiopulmonary function, wheelchair transfer, the activities daily living (ADL), bladder training. After assembly of KAFO, intensive gait training was performed, with walking function tests (including 6 min walking test and 10 m walking time evaluation) before orthosis assembly and before discharge. The gait analysis and the modified Barthel index (MBI) were evaluated. Results All patients could not walk independently without orthosis conditions. After the orthosis assembly and training, the 10 m walking time was (76.35±32.45) s, the average 6 min walking distance was (67.48±24.35) m, and the average step size was 37.9 cm. Conclusion The KAFO combined with systematic rehabilitation treatment can improve the walking ability and the activities of daily living in patients with complete spinal cord injury.%目的 探讨膝踝足矫形器(KAFO)对完全性脊髓损伤患者的康复作用.方法 L1及以下脊髓损伤患者17 例,其中男性11 例,女性6 例;损伤节段:L1损伤9 例,L2损伤5 例,L3损伤3 例;年龄19~42 岁,平均34.7岁.在装配膝踝足矫形器前需进行多项康复治疗,包括肌肉力量、心肺功能、轮椅转移、日常活动能力(ADL)、膀胱训练等,装配矫形器后加强步态训练;分别于矫形器装配前及出院前进行限时的步行功能检查(包括6 min 步行评测和10 m步行时间评测)、步态分析及改良Barthel 指数(MBI)作为指标进行评定.结果 17 例患者在不使用矫形器的情况下均不能独立行

  10. Sway as predictor of injuries in children

    DEFF Research Database (Denmark)

    Runge, Lisbeth; Kristensen, Peter Lund; Junge, Tina;

    ). Outcome measures Primary outcome was overuse and traumatic injuries, with special emphasis on ankle and knee sprains. Complaints were registered by SMS-track on a weekly basis, and after a telephone interview, clinicians examined and diagnosed the children with complaints. Injuries were diagnosed using...... ICD-10. Results Injuries: 2276, traumatic injuries: 714, ankle sprains: 164, knee sprains: 42 Preliminary multivariate analysis taking into account competing risk showed significant odds ratios (OR) at test 1; A) 1.003 per cm increase of sway; B) overall traumatic injury OR=3.0, ankle sprain OR=5...

  11. Injuries in orienteering.

    Science.gov (United States)

    Linde, F

    1986-09-01

    In a one-year prospective study of 42 elite orienteers, 73 recent injuries (1.7 per runner per year) were found. Acute injuries totalled 52% and 48% were due to overuse. Ankle sprains made up 37% of acute injuries while the remaining were mainly contusions caused by falls or bumps against branches or rocks. Medial shin pain, Achilles peritendinitis, peroneal tenosynovitis and iliotibial band friction syndrome were the most frequent overuse injuries. All overuse injuries were located in the lower extremity while 18% of acute injuries was located elsewhere. Acute injuries were most frequent in the competitive season while overuse injuries occurred most often during the continuous training period.

  12. Reverse Evans peroneus brevis medial ankle stabilization for balancing valgus ankle contracture during total ankle replacement.

    Science.gov (United States)

    Roukis, Thomas S; Prissel, Mark A

    2014-01-01

    Medial ankle instability secondary to deltoid ligament insufficiency is frequently encountered when performing total ankle replacement and remains a challenge. In the present techniques report, we describe a "reverse" Evans peroneus brevis tendon nonanatomic deltoid ligament reconstruction for medial ankle stabilization harvested through limited incisions using simple topographic anatomic landmarks. The harvested peroneus brevis tendon is brought through a drill hole in the talus from laterally to medially, aiming for the junction of the talar neck and body plantar to the midline. The tendon is the brought superiorly and obliquely to the anterior medial aspect of the distal tibia where it is secured under a plate and screw construct. This modified Evans peroneus brevis tendon nonanatomic deltoid ligament reconstruction is useful in providing medial ankle stability during or after primary and revision total ankle replacement.

  13. Total ankle replacement or ankle fusion in painful advanced hemophilic arthropathy of the ankle.

    Science.gov (United States)

    Rodriguez-Merchan, E Carlos

    2015-12-01

    In advanced painful hemophilic arthropathy of the ankle, the last resort is surgical treatment (ankle arthrodesis [AA] or total ankle replacement [TAR]). There is a controversy in the literature on which of the two procedures is more appropriate. A review of the literature was performed to clarify such a controversy. The first search engine was MedLine (keywords: total ankle replacement, ankle arthrodesis). Seventy articles were found in MedLine. Of these, only 16 were selected and reviewed because they were strictly focused on the topic of this article. The second search engine was the Cochrane Library, where only nine systematic reviews were found on the role of TAR and AA in non-hemophilia patients. TAR and AA provide pain relief and patient satisfaction in hemophilia patients in the short term. The available non-hemophilia literature is insufficient to conclude which treatment is superior. My current view is that AA may be preferable in most hemophilia patients.

  14. US and MR imaging of the extensor compartment of the ankle.

    Science.gov (United States)

    Ng, Joshua M; Rosenberg, Zehava Sadka; Bencardino, Jenny T; Restrepo-Velez, Zoraida; Ciavarra, Gina A; Adler, Ronald Steven

    2013-01-01

    Injuries to the extensor compartment of the ankle are uncommon and often are overlooked or misinterpreted at clinical presentation. Ultrasonography (US) and magnetic resonance (MR) imaging play a critical role in the diagnosis and evaluation of these injuries. US is a dynamic, quick, cost-effective imaging method for assessing ankle extensor compartment injuries as an alternative or adjunct to MR imaging. MR imaging provides multiplanar cross-sectional delineation of regional anatomic structures and also can be used to assess the predisposing cause, estimate the extent of injury, and aid in preoperative planning for requisite surgical repair. The spectrum of pathologic conditions affecting the ankle extensor compartment ranges from tendinosis secondary to degenerative, inflammatory, or depositional disease to traumatic tendon or retinacular rupture and entrapment neuropathy. Major components of the ankle extensor compartment at risk for injury include the anterior tibial, extensor hallucis longus, and extensor digitorum longus tendons; the extensor retinacular mechanism; and the anterior tarsal tunnel. Familiarity with the normal anatomic appearance and pathologic features of the ankle extensor compartment at US and MR imaging as well as potential imaging pitfalls is critical for accurate injury evaluation.

  15. 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…

  16. Treatment of Unstable Ankle Fractures

    Directory of Open Access Journals (Sweden)

    Yaniel Truffín Rodríguez

    2015-11-01

    Full Text Available Patients with unstable ankle fractures frequently attend the emergency rooms. It is estimated that there are 122 ankle fractures per 100 000 people a year. Surgical treatment of those that are unstable is inevitable since they can not be corrected in a conservative way. Several surgical procedures for repair of such lesions have been described and all of them constitute important tools for the orthopedic surgeon. Therefore, we conducted a literature review to discuss the current management of unstable ankle fractures based on the analysis of the published literature and the experiences in the Dr. Gustavo Aldereguía Lima University General Hospital of Cienfuegos.

  17. Recent developments on models and inclusion criteria for chronic ankle instability

    Institute of Scientific and Technical Information of China (English)

    Songning; Zhang

    2012-01-01

    <正>In the most recent report of injury data on 15 sports from the U.S.National Collegiate Athletic Association(NCAA) Injury Surveillance System over a span of 16 years (1988-2004),ankle ligament sprains were the most common injury.Residual symptoms such as recurrent sprains,pain, instability,and giving way are common after an initial,acute ligament sprain.Chronic ankle instability(CAI) is one of these common problems,and has enjoyed increased interest in the recent literature.However,CAI remains a poorly-defined and understood condition.

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    to characterize different balance exercises based on level of difficulty and sensori-motor training stimulus. PURPOSE: The purpose of this study was to investigate frontal-plane ankle kinematics and associated peroneal muscle activity during single-legged balance on stable surface (floor) and three commonly used...... balance devices (Airex®, BOSU® Ball and wobble board). DESIGN: Descriptive exploratory laboratory study. METHODS: Nineteen healthy subjects performed single-legged balance with eyes open on an Airex® mat, BOSU® Ball, wobble board, and floor (reference condition). Ankle kinematics were measured using......BACKGROUND: A lateral ankle sprain is the most prevalent musculoskeletal injury in sports. Exercises that aim to improve balance are a standard part of the ankle rehabilitation process. In an optimal progression model for ankle rehabilitation and prevention of future ankle sprains, it is important...

  19. Effects of Ankle Braces Upon Agility Course Performance in High School Athletes

    OpenAIRE

    Beriau, Mark R.; Cox, William B.; Manning, James

    1994-01-01

    The purpose of this study was to compare the effects of wearing the AircastTM Sports Stirrup, AircastTM Training brace, Swede-OTM brace, and DonJoyTM Ankle Ligament Protector while running an agility course. Eighty-five high school athletes with no history of ankle injury and no experience in wearing any ankle support served as subjects. Each subject participated in four separate testing sessions. During sessions 1 and 4, subjects ran the agility course under the control (unbraced) conditions...

  20. Mobility of the ankle joint: recording of rotatory movements in the talocrural joint in vitro with and without the lateral collateral ligaments of the ankle.

    Science.gov (United States)

    Rasmussen, O; Tovborg-Jensen, I

    1982-02-01

    A method for graphic recording of rotatory movements in osteoligamentous ankle preparations is described. By this method it is possible to record characteristic mobility patterns in two planes at the same time. The ankle is affected by a known torque, so that the individual mobility patterns are reproducible with unchanged condition of the ligaments. Six amputated legs were investigated in the sagittal and horizontal planes and another six in the sagittal and frontal planes. Mobility patterns were recorded with intact ligaments and after successive cutting of the lateral collateral ligaments of the ankle in the anteroposterior direction. In the sagittal plane increased dorsiflexion was observed after total cutting of the lateral ligaments, while plantar flexion remained unchanged. In the horizontal plane the internal rotation of the talus increased in step with increasing injury to the ligament, particularly when the ankle was plantar flexed. When all collateral ligaments had been cut, an increase in external rotation occurred, especially in dorsiflexion. In the frontal plane the talar tilt increased gradually with increasing injury to the ligaments. Talar tilt was at a maximum in the neutral position of the ankle or in plantar flexion. After total severing of the collateral ligaments, however, talar tilt was most marked in dorsiflexion of the ankle.

  1. 军事跳伞着陆踝关节损伤危险因素及生物力学研究进展%Risk factors of causing military parachutist' s ankle joints injury during landing and biomechanical research progress

    Institute of Scientific and Technical Information of China (English)

    崔松超; 伍骥; 郑超; 黄蓉蓉; 文偃伍

    2012-01-01

    Objective To comprehensively analyze risk factors of causing parachutist's ankle joints injury during landing and review the progress on the biomechanical research.Literature resource and selection Original research papers and reviews in fields of aviation medicine and medical information.Literature quotation Twenty-eight research articles and reviews published at home and abroad were cited.Literature synthesis With the development of biomechanics,many researchers have emerged into the mechanism of parachutist' s ankle joints injury and risk factors during parachute landing all over the world,and the protection measures have gradually progressed.Conclusion There are many factors affecting the biomechanical characteristics of ankle joints in parachutist's landing.Although traditional biomechanical research method can reflect the basic strain condition of ankle joint bone and anadesma,but internal stress transfer mechanism of ankle joint bone and soft tissue can't be discovered under the circumstance of different strain afforded in military parachutist's landing.Therefore,it is significant to apply digital technology and finite element analysis on the biomechanical research of ankle and foot in the future.%目的 通过文献综合分析军事跳伞踝关节着陆损伤的危险因素及相关生物力学的研究进展. 资料来源与选择 国内外该领域的相关文献. 资料引用 引用国内外公开发表的文献28篇. 资料综合 随着生物力学技术的发展,国内外对军事跳伞踝关节着陆损伤的机制和相关的危险因素也有了更好的理解,相应的损伤防护措施也不断进步. 结论 影响军事跳伞中踝关节生物力学特性的因素很多,传统的生物力学研究方法虽然可以反映踝关节骨与韧带的基本受力情况,但是无法发现军事跳伞中不同受力情况下的踝关节骨骼、软组织等内部的应力传递机制,借助数字化技术及运用有限元法模拟足踝部生物力学

  2. Effects of ankle balance taping with kinesiology tape for a patient with chronic ankle instability

    Science.gov (United States)

    Kim, Byeong-Jo; Lee, Jung-Hoon; Kim, Chang-Tae; Lee, Sun-Min

    2015-01-01

    [Purpose] To report the effects of ankle balance taping for a patient with chronic ankle instability (CAI). [Subject] A 33-year-old man with a 10 year history of chronic ankle stability. [Methods] ABT with kinesiology tape was performed for 2 months (average, 16 h/day) around the right ankle. [Results] At the end of two months, no ankle instability was noted when ascending and descending the stairs, jumping, turning, operating the pedals while driving, and lifting heavy objects. [Conclusion] The repeated use of kinesiology tape in ankle balance taping may be an effective treatment for recovering the ankle stability of patients with chronic ankle instability. PMID:26311206

  3. Can an Ankle-Foot Orthosis Change Hearts and Minds?

    Science.gov (United States)

    2011-01-01

    ities. The most common fracture of the lower extremity is to the tibia and fibula . As opposed to prior military From 1Orthopaedic Surgery Service...patients, demonstrates that 26% of patients with extremity wounds have fractures , 82% of which are open, divided evenly between the upper and lower extrem...sustained a severe open ankle fracture and underwent irrigation and debridement with splint immobilization in theater on the day of injury. Thereafter he

  4. Surgical efficacy of the ankle tourniquet for forefoot surgery.

    Science.gov (United States)

    Roberts, Rachel K; Cleave, Elizabeth S; Rambani, Rohit

    2014-12-01

    For precise, safe and proficient procedures haemostasis is critical. For forefoot surgery, the customary thigh tourniquet is commonly accepted for this role as the additional muscle mass and minimal bony prominences in the thigh avert neuromuscular and skin injury. However, for patients with pathophysiological issues that may be exacerbated by a thigh tourniquet, application of an ankle tourniquet may decrease the risks and increase cuff tolerance as the volume of ischaemic tissue is reduced.

  5. Total ankle replacement. Design evolution and results.

    Science.gov (United States)

    van den Heuvel, Alexander; Van Bouwel, Saskia; Dereymaeker, Greta

    2010-04-01

    The ankle joint has unique anatomical, biomechanical and cartilaginous structural characteristics that allow the joint to withstand the very high mechanical stresses and strains over years. Any minor changes to any of these features predispose the joint to osteoarthritis. Total ankle replacement (TAR) is evolving as an alternative to ankle arthrodesis for the treatment of end-stage ankle osteoarthritis. Initial implant designs from the early 1970s had unacceptably high failure and complication rates. As a result many orthopaedic surgeons have restricted the use of TAR in favour of ankle arthrodesis. Long term follow-up studies following ankle arthrodesis show risks of developing adjacent joint osteoarthritis. Therefore research towards a successful ankle replacement continues. Newer designs and longer-term outcome studies have renewed the interest in ankle joint replacement. We present an overview of the evolution, results and current concepts of total ankle replacement.

  6. Two-hole plate and suture complex for trimalleolar ankle fractures combined with distal tibioifbular syndesmosis injuries%二孔钢板缝线装置治疗三踝骨折合并下胫腓联合损伤

    Institute of Scientific and Technical Information of China (English)

    王玥; 方伟; 闫红旗; 李志高; 李力

    2015-01-01

    目的:探讨二孔钢板缝线装置治疗三踝骨折合并的下胫腓联合损伤的手术方式及手术临床效果。方法2010年9月至2012年9月,对利用二孔钢板缝线装置固定的三踝骨折合并的下胫腓联合损伤的11例进行连续随访观察,术后第2天即嘱患者踝关节伸屈功能锻炼,术后6周开始部分负重功能锻炼,术后12周行完全负重功能锻炼。所有患者平均随访1年,随访内容包括临床及 X 线检查,对踝关节功能行 AOFAS ( american orthopedic foot and ankle society )评分。通过术后 X 线片和标准的踝足功能评分,评估其临床效果并探讨该装置的临床应用前景。结果患者均在术后6周开始部分负重功能锻炼,术后多次的 X 线片表明,所有患者下胫腓间距在术后8周和更长时间的随访中均能保持稳定,距骨在踝穴中也无外侧位移现象,术后3个月11例 AOFAS 评分平均达60分;术后半年7例随访,平均达85分;术后1年11例随访,得分95分(满分100分)。X 线片未发现内固定失效。所有患者术后1年取出内固定装置。所有患者取出内固定时均未发现钢板切割致缝线断裂,取出内固定装置后未有不适症状复诊。结论二孔钢板缝线装置治疗下腓联合损伤具有技术简单、手术时间短、内固定器物理特性符合踝关节正常解剖、固定强度足够、避免内固定物断裂、费用较低等多项优势。%Objective To investigate the operative method in the treatment of trimalleolar ankle fractures combined with distal tibiofibular syndesmosis injuries by using 2-hole plate and suture complex, and to evaluate clinical results.Methods Eleven patients with trimalleolar ankle fractures combined with distal tibiofibular syndesmosis injuries were treated by 2-hole plate and suture complex from September 2010 to September 2012, and then were followed up. The patients were encouraged to perform active ankle

  7. Telemark skiing injuries: an 11-year study.

    Science.gov (United States)

    Made, C; Borg, H; Thelander, D; Elmqvist, L G

    2001-11-01

    This study evaluated telemark injuries in a Swedish ski area in terms of injury ratio, location, and causes over time. During the seasons of 1989-2000 all injured telemark skiers ( n=94) who attended the medical center in Tärnaby, Sweden, within 48 h after the accident were registered and asked to fill in an injury form. A control group of noninjured telemark skiers were interviewed in the season of 1999-2000. The most common cause of injury was fall (70%) and the injury ratio was 1.2. There was a higher proportion of beginners in the injured population, and they had a fall/run ratio of 0.7, compared with 0.3 for average and advanced skiers. Ankle/foot injuries were most common (28% of injuries) followed by knee (20%) and head/neck (17%). The ankle/foot injuries decreased from 35% to 22% in the seasons 1989-1995 to 1995-2000. Beginners had more ankle/foot injuries than skilled participants. The severity of ankle/foot injuries classified as the Abbreviated Injury Scale group 2 or higher decreased from 33% to 21% during the study period. Twenty-seven percent used plastic and 73% leather boots. We found no association between boot material and ankle/foot injuries. The proportion of high boots with two or more buckles was 51%. High boots appeared to be protective against ankle/foot injuries. The proportion of high boots increased from 24% to 67% during the study period. Thus ankle/foot injuries were the most common injury location, but have decreased over time. The severity of these injuries has also decreased. A possible explanation could be the increased use of high boots.

  8. 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

  9. 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

  10. Flexor Digitorum Accessorius Longus: Importance of Posterior Ankle Endoscopy

    Science.gov (United States)

    Batista, Jorge Pablo; del Vecchio, Jorge Javier; Golanó, Pau; Vega, Jordi

    2015-01-01

    Endoscopy for the posterior region of the ankle through two portals is becoming more widespread for the treatment of a large number of conditions which used to be treated with open surgery years ago. The tendon of the flexor hallucis longus (FHL) travels along an osteofibrous tunnel between the posterolateral and posteromedial tubercles of the talus. Chronic inflammation of this tendon may lead to painful stenosing tenosynovitis. The aim of this report is to describe two cases depicting an accessory tendon which is an anatomical variation of the flexor hallucis longus in patients with posterior friction syndrome due to posterior ankle impingement and associated with a posteromedial osteochondral lesion of the talus. The anatomical variation (FDAL) described was a finding during an endoscopy of the posterior region of the ankle, and we have spared it by sectioning the superior flexor retinaculum only. The accessory flexor digitorum longus is an anatomical variation and should be taken into account when performing an arthroscopy of the posterior region of the ankle. We recommend this treatment on this type of injury although we admit this does not make a definite conclusion. PMID:26060592

  11. Flexor Digitorum Accessorius Longus: Importance of Posterior Ankle Endoscopy

    Directory of Open Access Journals (Sweden)

    Jorge Pablo Batista

    2015-01-01

    Full Text Available Endoscopy for the posterior region of the ankle through two portals is becoming more widespread for the treatment of a large number of conditions which used to be treated with open surgery years ago. The tendon of the flexor hallucis longus (FHL travels along an osteofibrous tunnel between the posterolateral and posteromedial tubercles of the talus. Chronic inflammation of this tendon may lead to painful stenosing tenosynovitis. The aim of this report is to describe two cases depicting an accessory tendon which is an anatomical variation of the flexor hallucis longus in patients with posterior friction syndrome due to posterior ankle impingement and associated with a posteromedial osteochondral lesion of the talus. The anatomical variation (FDAL described was a finding during an endoscopy of the posterior region of the ankle, and we have spared it by sectioning the superior flexor retinaculum only. The accessory flexor digitorum longus is an anatomical variation and should be taken into account when performing an arthroscopy of the posterior region of the ankle. We recommend this treatment on this type of injury although we admit this does not make a definite conclusion.

  12. Lisfranc Joint Injuries

    Institute of Scientific and Technical Information of China (English)

    Lisa Chinn

    2009-01-01

    @@ The ankle and foot are the most common sites for athletic injuries.[1]Midfoot,or Lisfranc,injuries are the second most common foot injury and have a high in cidence in particular sports.They account for 4% of all football injuries per year,occurring frequently in linemen.[2]They are also common in equestrians,surfers,and windsurfers.[2]Lisfranc injuries are often misdiagnosed and if not treated properly can have lingering symptoms.It is estimated that Lisfranc joint injuries occur in 1 in every 55,000 persons every year.[3,4

  13. Operative versus non-operative treatments of acute injury to the lateral ankle ligaments: a systematic review%急性踝关节外侧副韧带损伤手术与非手术治疗的Meta分析

    Institute of Scientific and Technical Information of China (English)

    吴显奎; 孙永建; 金丹

    2012-01-01

    Objective To systematically compare the operative and non-operative treatments of acute injury to the lateral ankle ligaments in terms of efficacy and complications.Methods The databases of MEDLINE (From January 1966 to October 2011 ),EMBASE (From January 1988 to October 2011 ),CBMdisc (From January 1978 to October 2011) and CNKI (From January 1980 to October 2011 ) were researched for eligible randomized-controlled trials (RCTs),controlled clinical trials,quasi randomized controlled trials and cohort study which compared operative and non-operative treatments for acute injury to the lateral ankle ligaments.The methodological quality of the eligible studies collected was evaluated.The data of the studies included were extracted for a Meta analysis to compare the motional recovery,functional stability,re-injury,residual pain and post-treatment complications of the ankle between operative and non-operative treatments.RevMan 5.0 software was used for statistical analysis.Results In all the eligible 13 studies included,713 patients were treated operatively and 817 patients non-operatively.The functional stability of the ankle was significantly better in the operative treatment group than in the non-operative treatment group [ OR =0.72,95% CI,(0.52,0.99),P < 0.05].The incidence of ankle arthrocleisis in the operative treatment group was significantly higher than in the non-operative treatment group [ OR =3.41,95% CI (1.56,7.44),P =0.002].There were no statistical differences in the motional recovery [ OR =1.14,95% CI (0.58,2.21),P> 0.05],incidence ofre-injury [OR=0.68,95% CI (0.35,1.31),P>0.05],residual pain [ OR =0.81,95% CI(0.56,1.16),P> 0.05],or ankle dyskinesia [ OR =2.38,95% CI (0.91,6.25),P> 0.05]between the 2 groups.The incidences,scar tenderness [01R=7.46,95%CI(1.32,42.08),P <0.05]and sensory nerve loss [OR=12.16,95% CI(2.24,66.02),P <0.05]were significantly higher in the operative treatment group than in the non-operative treatment

  14. 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 ...

  15. ANKLE TAPING DOES NOT IMPAIR PERFORMANCE IN JUMP OR BALANCE TESTS

    Directory of Open Access Journals (Sweden)

    Javier Abián-Vicén

    2008-09-01

    Full Text Available This study aimed to investigate the influence of prophylactic ankle taping on two balance tests (static and dynamic balance and one jump test, in the push off and the landing phase. Fifteen active young subjects (age: 21.0 ± 4.4 years without previous ankle injuries volunteered for the study. Each participant performed three tests in two different situations: with taping and without taping. The tests were a counter movement jump, static balance, and a dynamic posturography test. The tests and conditions were randomly performed. The path of the center of pressures was measured in the balance tests, and the vertical ground reaction forces were recorded during the push-off and landing phases of the counter movement jump. Ankle taping had no influence on balance performance or in the push off phase of the jump. However, the second peak vertical force value during the landing phase of the jump was 12% greater with ankle taping (0.66 BW, 95% CI -0.64 to 1.96. The use of prophylactic ankle taping had no influence on the balance or jump performance of healthy young subjects. In contrast, the taped ankle increased the second peak vertical force value, which could be related to a greater risk of injury produced by the accumulation of repeated impacts in sports where jumps are frequently performed

  16. 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.

  17. EFFICIENCY OF SENSORY-MOTOR REHABILITATION OF ANKLE SPRAIN IN FEMALE HANDBALL PLAYERS

    Directory of Open Access Journals (Sweden)

    Rață Marinela

    2015-12-01

    Full Text Available This paper presents the concept of sensory-motor rehabilitation, the scientific fundamentation of the method and the results of its application on female handball players suffering from an ankle sprain. Being one of the most frequently encountered injuries in handball, the sprained ankle is often treated superficially and can have multiple consequences for the athlete reaching up to serious functional deficits that lead to a decreased efficiency of the player and even to seizing the sports activity. Due to the need to treat and prevent ankle sprain consequences, we assumed that the intervention on the sensory-motor system can have beneficial effects on the functionality of the ankle. After applying the specific assessment tests, as well as the rehabilitation exercises, we have managed to identify sensory-motor problems and intervene objectively by chiropractic means.

  18. Immediate Weight-Bearing after Ankle Fracture Fixation

    Directory of Open Access Journals (Sweden)

    Reza Firoozabadi

    2015-01-01

    Full Text Available We believe that a certain subset of surgical ankle fracture patients can be made weight-bearing as tolerated immediately following surgery. Immediate weight-bearing as tolerated (IWBAT allows patients to return to ambulation and activities of daily living faster and may facilitate rehabilitation. A prospectively gathered orthopaedic trauma database at a Level 1 trauma center was reviewed retrospectively to identify patients who had ORIF after unstable ankle injuries treated by the senior author. Patients were excluded if they were not IWBAT based on specific criteria or if they did meet followup requirement. Only 1/26 patients was noted to have loss of fixation. This was found at the 6-week followup and was attributed to a missed syndesmotic injury. At 2-week followup, 2 patients had peri-incisional erythema that resolved with a short course of oral antibiotics. At 6-week followup, 20 patients were wearing normal shoes and 6 patients continued to wear the CAM Boot for comfort. To conclude, IWBAT in a certain subset of patients with stable osteosynthesis following an ankle fracture could potentially be a safe alternative to a period of protected weight-bearing.

  19. Ankles back in randomized controlled trial (ABrCt: braces versus neuromuscular exercises for the secondary prevention of ankle sprains. Design of a randomised controlled trial

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    Verhagen Evert ALM

    2011-09-01

    Full Text Available Abstract Background Ankle sprains are the most common sports and physical activity related injury. There is extensive evidence that there is a twofold increased risk for injury recurrence for at least one year post injury. In up to 50% of all cases recurrences result in disability and lead to chronic pain or instability, requiring prolonged medical care. Therefore ankle sprain recurrence prevention in athletes is essential. This RCT evaluates the effect of the combined use of braces and neuromuscular training (e.g. proprioceptive training/sensorimotor training/balance training against the individual use of either braces or neuromuscular training alone on ankle sprain recurrences, when applied to individual athletes after usual care. Methods/Design This study was designed as three way randomized controlled trial with one year follow-up. Healthy individuals between 12 and 70 years of age, who were actively participating in sports and who had sustained a lateral ankle sprain in the two months prior to inclusion, were eligible for inclusion. After subjects had finished ankle sprain treatment by means of usual care, they were randomised to any of the three study groups. Subjects in group 1 received an eight week neuromuscular training program, subjects in group 2 received a sports brace to be worn during all sports activities for the duration of one year, and group 3 received a combination of the neuromuscular training program and a sports brace to be worn during all sports activities for the duration of eight weeks. Outcomes were assessed at baseline and every month for 12 months therafter. The primary outcome measure was incidence of ankle sprain recurrences. Secondary outcome measures included the direct and indirect costs of recurrent injury, the severity of recurrent injury, and the residual complaints during and after the intervention. Discussion The ABrCt is the first randomized controlled trial to directly compare the secondary preventive

  20. Life impact of ankle fractures: Qualitative analysis of patient and clinician experiences

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    McPhail Steven M

    2012-11-01

    Full Text Available Abstract Background Ankle fractures are one of the more commonly occurring forms of trauma managed by orthopaedic teams worldwide. The impacts of these injuries are not restricted to pain and disability caused at the time of the incident, but may also result in long term physical, psychological, and social consequences. There are currently no ankle fracture specific patient-reported outcome measures with a robust content foundation. This investigation aimed to develop a thematic conceptual framework of life impacts following ankle fracture from the experiences of people who have suffered ankle fractures as well as the health professionals who treat them. Methods A qualitative investigation was undertaken using in-depth semi-structured interviews with people (n=12 who had previously sustained an ankle fracture (patients and health professionals (n=6 that treat people with ankle fractures. Interviews were audio-recorded and transcribed. Each phrase was individually coded and grouped in categories and aligned under emerging themes by two independent researchers. Results Saturation occurred after 10 in-depth patient interviews. Time since injury for patients ranged from 6 weeks to more than 2 years. Experience of health professionals ranged from 1 year to 16 years working with people with ankle fractures. Health professionals included an Orthopaedic surgeon (1, physiotherapists (3, a podiatrist (1 and an occupational therapist (1. The emerging framework derived from patient data included eight themes (Physical, Psychological, Daily Living, Social, Occupational and Domestic, Financial, Aesthetic and Medication Taking. Health professional responses did not reveal any additional themes, but tended to focus on physical and occupational themes. Conclusions The nature of life impact following ankle fractures can extend beyond short term pain and discomfort into many areas of life. The findings from this research have provided an empirically derived

  1. American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score: a study protocol for the translation and validation of the Dutch language version

    Science.gov (United States)

    Van Lieshout, Esther M M; De Boer, A Siebe; Meuffels, Duncan E; Den Hoed, P Ted; Van der Vlies, Cornelis H; Tuinebreijer, Wim E; Verhofstad, Michael H J

    2017-01-01

    Introduction The American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score is among the most commonly used instruments for measuring the outcome of treatment in patients who sustained a complex ankle or hindfoot injury. It combines a clinician-reported and a patient-reported part. A valid Dutch version of this instrument is currently not available. Such a translated and validated instrument would allow objective comparison across hospitals or between patient groups, and with shown validity and reliability it may become a quality of care indicator in future. The main aims of this study are to translate and culturally adapt the AOFAS Ankle-Hindfoot Score questionnaire into Dutch according to international guidelines, and to evaluate the measurement properties of the AOFAS Ankle-Hindfoot Score-Dutch language version (DLV) in patients with a unilateral ankle or hindfoot fracture. Methods and analysis The design of the study will be a multicentre prospective observational study (case series) in patients who presented to the emergency department with a unilateral ankle or hindfoot fracture or (fracture) dislocation. A research physician or research assistant will complete the AOFAS Ankle-Hindfoot Score-DLV based on interview for the subjective part and a physical examination for the objective part. In addition, patients will be asked to complete the Foot Function Index (FFI) and the Short Form-36 (SF-36). Descriptive statistics (including floor and ceiling effects), internal consistency, construct validity, reproducibility (ie, test–retest reliability, agreement and smallest detectable change) and responsiveness will be assessed for the AOFAS DLV. Ethics and dissemination This study has been exempted by the Medical Research Ethics Committee (MREC) Erasmus MC (Rotterdam, the Netherlands). Each participant will provide written consent to participate and remain anonymised during the study. The results of the study are planned to be published in an

  2. Strategies for the prevention of volleyball related injuries.

    Science.gov (United States)

    Reeser, J C; Verhagen, E; Briner, W W; Askeland, T I; Bahr, R

    2006-07-01

    Although the overall injury rate in volleyball and beach volleyball is relatively low compared with other team sports, injuries do occur in a discipline specific pattern. Epidemiological research has revealed that volleyball athletes are, in general, at greatest risk of acute ankle injuries and overuse conditions of the knee and shoulder. This structured review discusses both the known and suspected risk factors and potential strategies for preventing the most common volleyball related injuries: ankle sprains, patellar tendinopathy, and shoulder overuse.

  3. Outcome and quality of life after surgically treated ankle fractures in patients 65 years or older

    Directory of Open Access Journals (Sweden)

    Ekdahl Charlotte

    2007-12-01

    Full Text Available Abstract Background Despite high incidence of ankle fractures in the elderly, studies evaluating outcome and impact of quality of life in this age group specifically are sparse. The aim of this study was to evaluate outcome and quality of life 6 and 12 months after injury in patients 65 years or older who had been operated on due to an ankle fracture. Methods Sixty patients 65 years or older were invited to participate in the study. 6 and 12 months after the injury a questionnaire including inquiry to participate, the Olerud-Molander Ankle Score (OMAS, Short-Form 36 (SF-36, Linear Analogue Scale (LAS, Self-rated Ankle Function and some supplementary questions was sent home to the patients. The supplementary questions concerned subjective experience of ankle instability, sporting and physical activity level before injury and recaptured activity level at follow-ups, need of walking aid before injury, state of living before injury and at follow-ups and co-morbidities. After the 12-month follow-up the patients were also called for a radiological examination. Results Fifty patients (83% answered the questionnaire at 6-month and 46 (77% at the 12-month follow-up. Although, 45 (90% fractures were low-energy trauma 44 (88% were bi- or trimalleolar and post-operative reduction results were complete in 23 (46% ankles. The median OMAS improved from 60 (Interquartile range (IQR 36 at 6-month to 70 (IQR 35 at 12-month (p = 0.002, but at 12-month still sixty percent or more of the patients reported pain, swelling, problems when stair-climbing and reduced activities of daily life. Twenty (40% rated their ankle function as 'good' or 'very good' at 6-month and 30 (60% at 12-month. Forty-one (82% were physically active before injury but still one year after only 18/41 had returned to their pre-injury physical activity level. According to SF-36 four dimensions differed from the age- and gender matched normative data of the Swedish population, 'physical function

  4. Anterior Approach Total Ankle Arthroplasty: Superficial Peroneal Nerve Branches at Risk.

    Science.gov (United States)

    McAlister, Jeffrey E; DeMill, Shyler L; Hyer, Christopher F; Berlet, Gregory C

    2016-01-01

    In ankle arthroplasty, little attention has been given to intraoperative nerve injury and its postoperative sequelae. The aim of the present anatomic study was to determine the relationship of the superficial peroneal nerve to the standard anterior approach for total ankle arthroplasty. The superficial peroneal nerve was dissected in 10 below-the-knee cadaver specimens. The medial and intermediate dorsal cutaneous branches were identified. A needle was placed at the ankle joint. The following measurements were recorded: bifurcation into the medial and intermediate dorsal cutaneous branches, reference needle to the branches of the medial and intermediate superficial peroneal nerve, and the crossing branches of the medial dorsal cutaneous nerve. Two specimens (20%) had a medial dorsal cutaneous branch cross from medially to laterally. Eight specimens (80%) had a crossing branch of the medial dorsal cutaneous branch within 5 cm of the incision. No intermediate dorsal cutaneous branches were within the incision. The results from the present cadaver study suggest that during an anterior ankle approach, aberrant branches of the superficial peroneal nerve could require transection in 20% of patients at the joint level and ≤80% of patients with distal extension >35 mm from the ankle joint. The risk of injury to branches of the superficial peroneal nerve is substantial. The risk of nerve injury can be decreased with meticulous operative technique, smaller incisions, and the avoidance of aggressive retraction.

  5. Development of an efficient rehabilitation exercise program for functional recovery in chronic ankle instability.

    Science.gov (United States)

    Kim, Kewwan; Jeon, Kyoungkyu

    2016-05-01

    [Purpose] The aim of the present study was to construct an integrated rehabilitation exercise program to prevent chronic pain and improve motor ability in cases of ankle injury and re-injury. [Subjects and Methods] Twenty-six male soccer players who required functional strength exercises due to repeated ankle injury were the subjects. A 12-week rehabilitation exercise program was constructed with the aim of improving muscle strength in the ankle and dynamic coordination of the lower limb. Muscle strength and dynamic coordination were evaluated using the Y Balance Test, and isokinetic muscle strength of ankle dorsiflexion, plantarflexion, inversion, and eversion were measured before and after the 12-week program. [Results] Following 12 weeks of rehabilitation exercise, there were statistically significant improvements in the ratios of dorsiflexor strength to plantarflexor strength, eversion strength, and inversion strength on the left side. The other variables showed no significant changes. [Conclusion] The rehabilitation exercise program for chronic ankle instability helped to reduce pain, and to restore normal joint range of motion, muscle strength and endurance, and functional ability. Active protocols to improve complex functions need to be developed to complement these results.

  6. Ankle Arthritis: You Can't Always Replace It.

    Science.gov (United States)

    Hayes, Brandon J; Gonzalez, Tyler; Smith, Jeremy T; Chiodo, Christopher P; Bluman, Eric M

    2016-02-01

    End-stage arthritis of the tibiotalar joint is disabling and causes substantial functional impairment. Most often it is the residual effect of a previous traumatic injury. Nonsurgical treatment of end-stage arthritis of the ankle includes bracing, shoe-wear modifications, and selective joint injections. For patients who fail to respond to nonsurgical modalities, the two primary treatment options are arthroplasty and arthrodesis. Each has its proponents. Although no ideal treatment of ankle arthritis exists, high-quality studies can help guide treatment in patients of varying demographics. Inherent risks are linked with each treatment option, but those of greatest concern are early implant loosening that requires revision following arthroplasty and the acceleration of adjacent joint degeneration associated with arthrodesis.

  7. 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

    2016-05-06

    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.

  8. The Scandinavian Total Ankle Replacement and the ideal biomechanical requirements of ankle replacements.

    Science.gov (United States)

    Robati, Shibby; Salih, Alan; Ghosh, Koushik; Vinayakam, Parthiban

    2016-03-01

    The complex anatomy of the articular bone surfaces, ligaments, tendon attachments and muscles makes the ankle joint difficult to replicate in prosthetic replacements. Ever since the early 1970s, which saw the dawn of the first total ankle replacements, there have been numerous other attempts at replicating the joint, often with poor clinical outcomes. The anatomy of the ankle is discussed, followed by evidence of the normal ankle biomechanics and the ideal requirements of an ankle replacement. We focus on the Scandinavian Total Ankle Replacement and evaluate whether these requirements have been met.

  9. PERONEUS LONGUS ACTIVITY IN DIFFERENT TYPES OF TAPING: ATHLETES WITH ANKLE INSTABILITY

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    Muhammad Rahmani Jaffar

    Full Text Available ABSTRACT Introduction: Participation in sport among university athletes in Malaysia has progressed right up to Olympic level. However, some of these athletes are prevented from competing due to injuries. Ankle injuries, in particular, are among the common types of injury. Even so, there is still lack of local data and research describing the incidence of ankle injuries. Objectives: To determine peroneus longus muscle activity in different taped ankles and positions among subjects with functional ankle instability (FAI. Methods: Twenty-three subjects with ankle instability (AJFAT score > 26 volunteered to take part in the study. The subjects were tested under three conditions; 1 no tape (NT, 2 Kinesio(r tape (KT, and 3 rigid tape (RT. The subjects completed two postural stability tests, followed by a sudden inversion perturbation test with EMG, recording throughout the procedures. The EMG data were analyzed, filtered, full-wave rectified and normalized. The data were analyzed by analysis of variance (Independent T-test and ANOVA to evaluate differences in peak muscle activation (mV and peroneal latency (ms. Results: Peak muscle activation of the peroneus was activated more in the RT group during both the Static and Dynamic Stability Tests. Apart from that, there were no statistically significant differences. During sudden inversion perturbation, the RT group was the one that was most activated (p=0.001. Peroneal latency was even delayed in KT and RT during the three tests, and shorter in the NT group. There were significant differences during the Dynamic Stability Test, between the NT and KT groups (p=0.001 and between the NT, RT and KT groups (p=0.001. Conclusion: RT tape may enhance the peroneus longus response by maintaining a higher level of muscle activation, especially during dynamic movements and sudden inversion of the ankle, and may selectively benefit individuals with FAI. The KT ankle did not show superior effect to the NT ankle, and

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

    NARCIS (Netherlands)

    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 p

  11. The effect of strapping on the motor performance of the ankle and wrist joints.

    Science.gov (United States)

    Kauranen, K; Siira, P; Vanharanta, H

    1997-08-01

    The purpose of this study was to examine the effect of strapping on different components of motor performance of wrist and ankle joints. The subjects were 14 healthy volunteers (12 females, two males), aged 21-33 years, with no known previous injuries of the ankle and wrist joints. The measurements were made with the HPM/BEP system and Isokinetic Lido Active Multi-joint system. First, the subjects performed the test without strapping and then, on the following day, with strapped right wrist and ankle joints. The strapping of the wrist increased the simple reaction time by 9%, choice reaction time by 9% and decreased the wrist tapping speed by 21%. Wrist strength decreased in flexion (180 degrees/s) by 14% and ulnar deviation (180 degrees/s) by 8%. The strapping of the ankle increased the simple reaction time by 12%, choice reaction time by 9% and decreased foot tapping speed by 14%. Ankle strength in plantar flexion decreased in 60 degrees/s by 22% and 180 degrees/s by 14% and in inversion in 60 degrees/s by 28% and 180 degrees/s by 15%. These results suggest the strapping of ankle and wrist joints reduces motor performance in the above-mentioned directions as measured by the following parameters: simple reaction time, choice reaction time, tapping speed, and muscle strength.

  12. Annular lipoatrophy of the ankles.

    Science.gov (United States)

    Dimson, Otobia G; Esterly, Nancy B

    2006-02-01

    Lipoatrophic panniculitis likely represents a group of disorders characterized by an inflammatory panniculitis followed by lipoatrophy. It occurs locally in a variety of settings and has been reported in the literature under various terms, including annular atrophic connective tissue panniculitis of the ankles, annular and semicircular lipoatrophy, abdominal lipoatrophy, and connective tissue panniculitis. Herein, a case of annular lipoatrophy of the ankles is described in a 6-year-old girl with autoimmune thyroid disease. Histologically, a mixed lobular panniculitis with lipophages was present. This pattern resembles that seen in lipoatrophic panniculitis. After a single, acute episode of an inflammatory process with subsequent lipoatrophy, her skin lesions have stabilized for 2 years requiring no treatment.

  13. Diclofenac epolamine topical patch relieves pain associated with ankle sprain

    Directory of Open Access Journals (Sweden)

    David R Lionberger

    2011-03-01

    Full Text Available David R Lionberger1, Eric Joussellin2, Arturo Lanzarotti3, Jillmarie Yanchick4, Merrell Magelli5 1Southwest Orthopedic Group, LLP, Houston, Texas, USA; 2Institut National du Sport, Paris, France; 3Institut Biochimique SA, Pambionoranco, Switzerland; 4Alpharma Pharmaceuticals LLC, a wholly owned subsidiary of King Pharmaceuticals®, Inc, Piscataway, New Jersey, USA; 5GTx, Inc, Memphis, Tennessee, USABackground: Sports-related injuries, such as sprains and strains, commonly occur during exercise and athletic events. Current therapy includes nonsteroidal anti-inflammatory drugs (NSAIDs, which have a high incidence of upper gastrointestinal side effects. The present study assessed the efficacy and safety of the diclofenac epolamine topical patch (DETP, 1.3%, a topical NSAID for the treatment of acute minor sprains and strains.Methods: This multicenter, randomized, placebo-controlled clinical study enrolled adult patients (n = 134 with acute ankle pain (due to a minor sprain occurring less than 48 hours prior to entering the study. Patients were treated with either the DETP or a placebo topical patch daily for seven days. Pain intensity was evaluated during the first six hours after application of the patch, and on treatment days 1, 2, 3, and 7.Results: Patients treated with the DETP experienced a significantly greater reduction in pain associated with their ankle injury compared with placebo, beginning four hours after the first patch application (P = 0.02. The DETP was well tolerated and was comparable with placebo in terms of safety.Conclusion: Overall, the results of this study demonstrate that the DETP is an effective analgesic for local treatment of pain in mild acute ankle sprain.Keywords: soft tissue injury, acute pain, visual analog scale, efficacy, tolerability 

  14. Total Ankle Arthroplasty: A Brief Review

    Directory of Open Access Journals (Sweden)

    Roger A. Mann

    2012-12-01

    Full Text Available Ankle fusion has long been the standard of treatment for end-stage ankle arthritis, and a successful arthroplasty has been a long sought alternative. It is a motion sparing procedure and may greatly reduce the potential for adjacent level degeneration as seen with arthrodesis. The typical candidate for arthroplasty is a healthy low demand patient, although the indications are widening as the success of the procedure has increased. Nevertheless, it is not fail-safe, technical expertise and experience are necessary to achieve a successful result. We have been treating ankle arthritis with the Scandinavian Total Ankle Replacement (STAR ankle replacement prosthesis for over ten years. We believe that arthroplasty will surpass arthrodesis as the standard of care for severe ankle arthritis.

  15. Effects of ankle braces upon agility course performance in high school athletes.

    Science.gov (United States)

    Beriau, M R; Cox, W B; Manning, J

    1994-09-01

    The purpose of this study was to compare the effects of wearing the Aircast(TM) Sports Stirrup, Aircast(TM) Training brace, Swede-O(TM) brace, and DonJoy(TM) Ankle Ligament Protector while running an agility course. Eighty-five high school athletes with no history of ankle injury and no experience in wearing any ankle support served as subjects. Each subject participated in four separate testing sessions. During sessions 1 and 4, subjects ran the agility course under the control (unbraced) conditions. Sessions 2 and 3 consisted of randomly wearing the ankle braces while running the agility course. A questionnaire concerning support, comfort, and restriction was completed by each subject after wearing each of the braces. An analysis of variance (ANOVA) with repeated measures revealed that a significant difference existed between the agility times. Tukey's post hoc test indicated that a significant difference existed between each ankle brace and the control 2 agility times as well as a control 1 and control 2 time difference. The control time difference was attributed to a learning effect. An ANOVA with repeated measures of only the four braces revealed that a significant difference existed between the agility times. Tukey's post hoc test showed the only difference was between the DonJoy Ankle Ligament Protector and the Aircast Training brace. We concluded: 1) there is limited practical performance effect upon agility while wearing an ankle brace; and 2) an athlete's perceived comfort, support, and performance restriction are contributing factors that may directly influence the effectiveness of ankle bracing.

  16. Effects of Acupuncture-moxibustion Intervention on Proprioception in Athletes with Lateral Collateral Ligament Injury of Ankle Joint%针灸对踝关节外侧韧带损伤后期本体感觉恢复的影响

    Institute of Scientific and Technical Information of China (English)

    唐文江; 蒋垂刚; 陈丽容; 庞勇; 李杰; 黄昀

    2013-01-01

    Objective To compare the efficacy differences between acupuncture-moxibustion and physiotherapy interventions in improving proprioception of athletes with lateral collateral ligament injury of the ankle joint.Methods Thirty patients with injured lateral collateral ligament of ankle joint were randomly divided into acupuncture group (n =15) and physiotherapy group (n =15).Patients of the acupuncture group were treated by acupuncture and moxibustion stimulation of Qiuxu(GB 40),Kunlun(BL 60),Shenmai (BL 62),Jiexi (ST 41),and Ashi-points,etc.,and those of the physiotherapy group treated with TDP irradiation of the regional lateral malleolus.The treatment of the two groups was conducted once the other day,3 times each week,continuously for 8 weeks.Before and after the treatment,the ankle-joint's active and passive repositioning error angles were measured by using a joint angle ruler.Results The average error angle values of active and passive reposition tests of the injured ankle-joint were 4.98 ± 1.11 and 4.78± 1.13 before the treatment,and 3.67± 0.58 and 3.51 ± 0.64 after the treatment,respectively in the acupuncture group,being reduced significantly after the treatment (both P<0.01).No significant changes of the average error angle values of both active and passive reposition tests of the ankle-joint were found after the treatment in the physiotherapy group (P>0.05).Comparison between two groups showed that the average error angle,average active and passive reposition angles of the injured ankle in the acupuncture group were evidently lower than those in the physiotherapy group (P<0.01).Conclusion Acupuncture and moxibustion can effectively improve the proprioception of the injured lateral collateral ligament of the ankle joint in athletes,which is superior to conventional physiotherapy in the therapeutic effect.%目的:观察针灸与常规理疗对踝关节外侧韧带损伤后本体感觉恢复影响的差异.方法:30例踝关节外侧韧带损伤后

  17. Fusion following failed total ankle replacement.

    Science.gov (United States)

    Wünschel, Markus; Leichtle, Ulf G; Leichtle, Carmen I; Walter, Christian; Mittag, Falk; Arlt, Eva; Suckel, Andreas

    2013-04-01

    Although mid- to long-term results after total ankle replacement have improved because of available second- and third-generation devices, failure of total ankle replacement is still more common compared with total hip replacement and total knee replacement. The portfolio of available total ankle replacement revision component options is small. Furthermore, the bone stock of the tibiotalar region is scarce making it difficult and in some situations impossible to perform revision total ankle replacement. In these cases tibiotalar and tibiotalocalcaneal fusions are valuable options. This article describes which surgical procedures should be performed depending on the initial situation and gives detailed advice on surgical technique, postoperative care, and clinical results.

  18. Total Ankle Arthroplasty: An Imaging Overview.

    Science.gov (United States)

    Kim, Da-Rae; Choi, Yun Sun; 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.

  19. Total ankle arthroplasty: An imaging overview

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Da Rae; Choi, Yun Sun; Chun, Ka Young; Jung, Yoon Young; Kim, Jin Su; Young, Ki Won [Eulji Hospital, Eulji University, Seoul (Korea, Republic of); Potter, Hollis G.; Li, Angela E. [Dept. of Radiology and Imaging, Hospital for Special Surgery, New York (United States)

    2016-06-15

    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.

  20. Prevention of Lower Extremity Injuries in Basketball

    OpenAIRE

    2015-01-01

    Context: Lower extremity injuries are common in basketball, yet it is unclear how prophylactic interventions affect lower extremity injury incidence rates. Objective: To analyze the effectiveness of current lower extremity injury prevention programs in basketball athletes, focusing on injury rates of (1) general lower extremity injuries, (2) ankle sprains, and (3) anterior cruciate ligament (ACL) tears. Data Sources: PubMed, MEDLINE, CINAHL, SPORTDiscus, and the Cochrane Register of Controlle...

  1. Haemophilic arthropathy of the ankle treated by total ankle replacement: a case series.

    Science.gov (United States)

    Barg, A; Elsner, A; Hefti, D; Hintermann, B

    2010-07-01

    The standard treatment for end-stage osteoarthritis of the ankle joint in haemophilic patients has been fusion of the ankle joint. Total ankle replacement is still controversial as a treatment option. The objective of this prospective study was to evaluate the mid-term outcome in patients treated with total ankle replacement using an unconstrained three-component ankle implant. Ten haemophilic ankles in eight patients (mean age: 43.2 years, range 26.7-57.5) treated with total ankle replacement were followed up for a minimum of 2.7 years (mean: 5.6, range 2.7-7.6). The outcome was measured with clinical and radiological evaluations. There were no intra- or peri-operative complications. The AOFAS-hindfoot-score increased from 38 (range 8-57) preoperatively to 81 (range 69-95) postoperatively. All patients were satisfied with the results. Four patients became pain free; in the whole patient cohort pain level decreased from 7.1 (range 4-9) preoperatively to 0.8 (range 0-3) postoperatively. All categories of SF-36 score showed significant improvements in quality of life. In one patient, open ankle arthrolysis was performed because of painful arthrofibrosis. For patients with haemophilic osteoarthritis of the ankle joint, total ankle replacement is a valuable alternative treatment to ankle fusion.

  2. 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

    Full Text Available OBJETIVO: Identificar o perfil epidemiológico dos pacientes que procuram tratamento ortopédico das complicações nos pés e tornozelos relacionadas ao diabetes, além de correlacionar à sequência de eventos que culminam na amputação da extremidade. MÉTODO: analisamos os dados de prontuário de 300 pacientes no período compreendido entre março de 1997 a julho de 2006. RESULTADOS: A média de idade foi 61 anos, destes, duzentos e setenta e três pacientes (91% apresentavam diagnóstico de diabetes do tipo II, onde somente 49 (16,3% faziam controle regular da glicemia. Quatrocentos e cinco extremidades apresentavam problemas afetando a função do pé ou tornozelo, detacando-se: 102 extremidades (34% com lesões osteoarticulares relacionadas a neuroartropatia de Charcot; 181 extremidades (60,4% com ulceração crônica e 97 extremidades (32,4% com infecção. Após tempo médio de seguimento 14 pacientes (4,6% foram a óbito. CONCLUSÃO: A ulceração na planta dos pés foi a complicação mais frequente na nossa série de pacientes que, estavam na sétima década de vida, apresentavam diabetes do tipo II, faziam uso irregular de insulina e não realizavam controle adequado da glicemia. A perda da sensibilidade protetora nos pés, em associação com deformidade pré-existente, foi identificada como a principal causa das infecções secundárias culminando com a amputação da extremidade.OBJECTIVE: To identify the epidemiological profile of patients undergoing orthopedic treatment for complications of the feet and ankles due to diabetes, and to try to establish the sequence of events that led to amputation of the limb. METHOD: The medical records of 300 diabetic patients treated from March, 1997 to July, 2006 were systematically reviewed. RESULTS: The mean age of the patients was 61 years. Of these, two hundred and seventy three (91% were diagnosed with type II diabetes, but only 49 (16.3% had proper medical supervision and control of

  3. Osteochondral defects in the ankle: why painful?

    NARCIS (Netherlands)

    van Dijk, C.N.; Reilingh, M.L.; Zengerink, M.; van Bergen, C.J.A.

    2010-01-01

    Osteochondral defects of the ankle can either heal and remain asymptomatic or progress to deep ankle pain on weight bearing and formation of subchondral bone cysts. The development of a symptomatic OD depends on various factors, including the damage and insufficient repair of the subchondral bone pl

  4. Radiological aspects of sprained ankle syndrome

    NARCIS (Netherlands)

    Sijbrandij, E.S.

    2002-01-01

    This thesis addresses several problems related to sprained ankle syndrome. The purpose of this thesis is to evaluate the imaging features of sprained ankles, found on new radiological modalities, and to assess the additional diagnostic understanding and treatment planning of helical CT as well as M

  5. Management of syndesmosis injuries in the elite athlete.

    Science.gov (United States)

    Mak, May Fong; Gartner, Louise; Pearce, Christopher J

    2013-06-01

    This article reviews the basics and evidence base thus far on syndesmosis injuries, focusing on its management in the elite sporting population. A syndesmosis injury or "high ankle sprain" is a significant injury, especially in the elite athlete. Among all ankle sprains, the syndesmotic injury is most predictive of persistent symptoms in the athletic population. Late diagnosis of unstable syndesmosis injuries leads to a poor outcome and delayed return to sports. A high index of suspicion and an understanding of the mechanism of injury is required to ensure an early diagnosis. Incomplete/inaccurate reduction leads to a poor outcome.

  6. Simulation of an ankle rehabilitation system based on scotch- yoke mechanism

    Science.gov (United States)

    Racu (Cazacu, C. M.; Doroftei, I.; Plesu, Ghe; Doroftei, I. A.

    2016-08-01

    Due to injuries that occur on the ankle joint, everyday all around the world, more and more rehabilitation devices have been developed in recent years. The prices for ankle rehabilitation systems are still high, thus we developed a new device that we indented to be low cost and easy to manufacture. A model of an ankle rehabilitation device is presented in this paper. The device has two degrees of freedom, for flexion-extension and inversion-eversion move, and will ensure functionality with minimum dimensions. For the 3D model that we design, the dimensions are taken so that the proposed system will ensure functionality but also have a small dimensions and low mass, considering the physiological dimensions of the foot and lower leg.

  7. Treatment of chronic lateral ankle instability: a modified broström technique using three suture anchors

    Directory of Open Access Journals (Sweden)

    Busconi Brian D

    2009-12-01

    Full Text Available Abstract Ankle sprains are very common injuries seen in the athletic and young population. Majority of patients will improve with a course of rest and physical therapy. However, with conservative management about twenty percent of all patients will go on to develop chronic lateral ankle instability. This manuscript describes our detailed surgical technique of a modification to the original Broström procedure using three suture anchors to anatomically reconstruct the lateral ankle ligaments to treat high demand patients who have developed chronic lateral ankle instability. The rationale for this modification along with patient selection and workup are discussed. Both the functional outcomes at the two year follow up along with the complications and the detailed postoperative rehabilitation protocol for the high demand athletes are also presented. This modified Broström procedure is shown in both illustrative format and intra-operative photos.

  8. The Split Second Effect: The Mechanism of How Equinus Damages the Human Foot and Ankle

    Directory of Open Access Journals (Sweden)

    James Amis

    2016-07-01

    Full Text Available We are currently in the process of discovering that many, if not the majority, of non-traumatic acquired adult foot and ankle problems are caused by a singular etiology: 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 each individual resulting specific pathology 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 orthopaedic 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.

  9. 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

  10. Effects of ankle joint cooling on peroneal short latency response.

    Science.gov (United States)

    Hopkins, J Ty; Hunter, Iain; McLoda, Todd

    2006-01-01

    While cryotherapy has direct physiological effects on contractile tissues, the extent to which joint cooling affects the neuromuscular system is not well understood. The purpose of the study was to detect changes in ankle dynamic restraint (peroneal short latency response and muscle activity amplitude) during inversion perturbation following ankle joint cryotherapy. A 2x3 factorial design was used to compare reaction time and EMG amplitude data of treatment conditions (cryotherapy and control) across time (pre-treatment, post-treatment, and 30 min post-treatment). Thirteen healthy volunteers (age 23 ± 4 yrs, ht 1.76 ± 0.09 m, mass 78.8 ± 16.6 kg), with no history of lower extremity joint injury participated in this study. Surface EMG was collected from the peroneus longus (PL) of the dominant leg during an ankle inversion perturbation triggered while walking. Subjects walked the length of a 6.1 m runway 30 times. A trap door mechanism, inducing inversion perturbation, was released at heel contact during six randomly selected trials for each leg. Following baseline measurements, a 1.5 L bag of crushed ice was applied to the lateral ankle of subjects in the treatment group with an elastic wrap. A bag similar in weight and consistency was applied to the lateral ankle of subjects in the control group. A repeated measures ANOVA was used to compare treatment conditions across time (p 0.05) for PL reaction time. Average RMS EMG, normalized to an isometric reference position, increased in the cryotherapy group at the 30 min post-treatment interval relative to the control group (p movement is unknown.Short latency response should be measured during functional movement instead of during stance to take into consideration alterations in motor drive.Joint cooling has no effect on peroneal short latency response, and joint cooling may result in increased short term peroneal activation.Joint cooling has no effect on the peroneus longus as a dynamic stabilizer during walking.

  11. Effects of immobilization and remobilization on the ankle joint in Wistar rats

    Energy Technology Data Exchange (ETDEWEB)

    Kunz, R.I. [Laboratório de Biologia Estrutural e Funcional, Universidade Estadual do Oeste do Paraná, Cascavel, PR (Brazil); Coradini, J.G.; Silva, L.I.; Bertolini, G.R.F. [Laboratório do Estudo das Lesões e Recursos Fisioterapêuticos, Universidade Estadual do Oeste do Paraná, Cascavel, PR (Brazil); Brancalhão, R.M.C.; Ribeiro, L.F.C. [Laboratório de Biologia Estrutural e Funcional, Universidade Estadual do Oeste do Paraná, Cascavel, PR (Brazil)

    2014-08-15

    A sprained ankle is a common musculoskeletal sports injury and it is often treated by immobilization of the joint. Despite the beneficial effects of this therapeutic measure, the high prevalence of residual symptoms affects the quality of life, and remobilization of the joint can reverse this situation. The aim of this study was to analyze the effects of immobilization and remobilization on the ankle joint of Wistar rats. Eighteen male rats had their right hindlimb immobilized for 15 days, and were divided into the following groups: G1, immobilized; G2, remobilized freely for 14 days; and G3, remobilized by swimming and jumping in water for 14 days, performed on alternate days, with progression of time and a series of exercises. The contralateral limb was the control. After the experimental period, the ankle joints were processed for microscopic analysis. Histomorphometry did not show any significant differences between the control and immobilized/remobilized groups and members, in terms of number of chondrocytes and thickness of the articular cartilage of the tibia and talus. Morphological analysis of animals from G1 showed significant degenerative lesions in the talus, such as exposure of the subchondral bone, flocculation, and cracks between the anterior and mid-regions of the articular cartilage and the synovial membrane. Remobilization by therapeutic exercise in water led to recovery in the articular cartilage and synovial membrane of the ankle joint when compared with free remobilization, and it was shown to be an effective therapeutic measure in the recovery of the ankle joint.

  12. Revision of the aseptic and septic total ankle replacement.

    Science.gov (United States)

    Espinosa, Norman; Wirth, Stephan Hermann

    2013-04-01

    Total ankle replacement has become a popular treatment of symptomatic end-stage ankle osteoarthritis. Contemporary total ankle replacement systems provide more anatomic and biomechanically sound function. However, longevity is still limited and long-term results of modern total ankle replacement designs are not available. In the case of failure, conversion into arthrodesis has remained the treatment of choice but at the cost of hindfoot function and potential degeneration of the adjacent joints. Thus, revision total ankle replacement by exchange of the prosthetic components represents an attractive solution. This article focuses on revision total ankle replacement and conversion to ankle arthrodesis.

  13. [Biomechanics of the ankle joint].

    Science.gov (United States)

    Zwipp, H

    1989-03-01

    According to Fick, the tree-dimensional patterns of foot motion are best characterized as jawlike movement. Anatomically and biomechanically, this process represents conjoined, synchronous motion within the three mobile segments of the hindfoot: the ankle joint, the posterior subtalar joint, and the anterior subtalar joint. Foot kinematics can be described more completely if the anterior subtalar joint is defined not only as the talocalcaneal navicular joint, but as including the calcaneocuboid joint, thus representing the transverse joint of the tarsus, i.e., the Chopart joint. The axes of these three joints can be defined precisely. In some parts they represent a screwlike motion, clockwise or counter-clockwise, around the central ligamentous structures (fibulotibial ligament, talocalcaneal interosseous ligament, bifurcate ligament). The individual anatomy and structure of these ligaments provide variations in the degree and direction of foot motion. A precise knowledge of foot kinematics is important in surgical ligament and joint reconstruction and in selective foot arthrodeses.

  14. Biomechanics of the ankle joint and clinical outcomes of total ankle replacement.

    Science.gov (United States)

    Michael, Junitha M; Golshani, Ashkahn; Gargac, Shawn; Goswami, Tarun

    2008-10-01

    Until the 1970s ankle arthrodesis was considered to be the "gold-standard" to treat arthritis. But the low fusion rate of ankle arthrodeses along with the inability to achieve normal range of motion led to the growing interest in the development of total ankle replacements. Though the short-term outcomes were good, their long-term outcomes were not as promising. To date, most models do not exactly mimic the anatomical functionality of a natural ankle joint. Therefore, research is being conducted worldwide to either enhance the existing models or develop new models while understanding the intricacies of the joint more precisely. This paper reviews the anatomical and biomechanical aspects of the ankle joint. Also, the evolution and comparison of clinical outcomes of various total ankle replacements are presented.

  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.

  16. FATIGUE DEVICE FOR TESTING ANKLE JOINT ENDOPROSTHESES

    Directory of Open Access Journals (Sweden)

    Cristian TOADER-PASTI

    2012-05-01

    Full Text Available The paper proposes a model of a fatigue device for testing dedicated to ankle prostheses. The concept of the testing device relies on two aspects: almost any type of ankle prosthesis can be tested on it and it has to work on INSTRON axial-torsion testing machine. Starting from these requirements, a 3D functional assembly that reproduces the real movement of the ankle joint during gait cycle has been designed. The device is based on a cam-follower mechanism.

  17. Transfibular ankle arthrodesis: A novel method for ankle fusion - A short term retrospective study

    Directory of Open Access Journals (Sweden)

    S Muthukumar Balaji

    2017-01-01

    Full Text Available Background: Ankle arthrodesis has long been the traditional operative treatment for posttraumatic arthritis, rheumatoid arthritis, infection, neuromuscular conditions, and salvage of failed ankle arthroplasty. It remains the treatment of choice for patients in whom heavy and prolonged activity is anticipated. We present our short term followup study of functional outcome of patients who underwent transfibular ankle arthrodesis for arthritis of ankle due to various indications. Materials and Methods: 29 transfibular ankle arthrodesis in 29 patients performed between April 2009 and April 2014 were included in this study. The mean age was 50 years (range 22-75 years. The outcome analysis with a minimum of 1-year postoperative followup were included. All the patients were assessed with the American Orthopaedic Foot and Ankle Society (AOFAS Hindfoot scale. Results: All cases of ankle fusions (100% progressed to solid union in a mean postoperative duration of 3.8 months (range 3-6 months. All patients had sound arthrodesis. The mean followup period was 32.52 months (standard deviation ± 10.34. The mean AOFAS score was 74 (pain score = 32, functional score = 42. We found that twenty patients (68.96% out of 29, had excellent results, 7 (24.13% had good, and 2 (6.89% showed fair results. Conclusion: Transfibular ankle arthrodesis is a simple and effective procedure for ankle arthritis. It achieves a high rate of union and good functional outcome on midterm followup.

  18. Transfibular ankle arthrodesis: A novel method for ankle fusion – A short term retrospective study

    Science.gov (United States)

    Balaji, S Muthukumar; Selvaraj, V; Devadoss, Sathish; Devadoss, Annamalai

    2017-01-01

    Background: Ankle arthrodesis has long been the traditional operative treatment for posttraumatic arthritis, rheumatoid arthritis, infection, neuromuscular conditions, and salvage of failed ankle arthroplasty. It remains the treatment of choice for patients in whom heavy and prolonged activity is anticipated. We present our short term followup study of functional outcome of patients who underwent transfibular ankle arthrodesis for arthritis of ankle due to various indications. Materials and Methods: 29 transfibular ankle arthrodesis in 29 patients performed between April 2009 and April 2014 were included in this study. The mean age was 50 years (range 22-75 years). The outcome analysis with a minimum of 1-year postoperative followup were included. All the patients were assessed with the American Orthopaedic Foot and Ankle Society (AOFAS) Hindfoot scale. Results: All cases of ankle fusions (100%) progressed to solid union in a mean postoperative duration of 3.8 months (range 3–6 months). All patients had sound arthrodesis. The mean followup period was 32.52 months (standard deviation ± 10.34). The mean AOFAS score was 74 (pain score = 32, functional score = 42). We found that twenty patients (68.96%) out of 29, had excellent results, 7 (24.13%) had good, and 2 (6.89%) showed fair results. Conclusion: Transfibular ankle arthrodesis is a simple and effective procedure for ankle arthritis. It achieves a high rate of union and good functional outcome on midterm followup. PMID:28216754

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

    LENUS (Irish Health Repository)

    Thomason, Katherine

    2014-07-01

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

  20. Lichen simplex chronicus on the ankle (image)

    Science.gov (United States)

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

  1. American College of Foot and Ankle Surgeons

    Science.gov (United States)

    ... Practice Management Education Opportunities Practice Management e-Learning e-Learning CME Transcripts Corporate Relations Faculty Application Research & Publications Journal of Foot and Ankle Surgery ACFAS Update Read ...

  2. Ankle Fractures Often Not Diagnosed

    Science.gov (United States)

    ... injuries. Telltale signs of a fracture include bruising, blisters, significant swelling or bone protruding through the skin. ... for stability. She also advises buying from small shoe stores that have certified orthotists who work with ...

  3. Ankle Joint Angle and Lower Leg Musculotendinous Unit Responses to Cryotherapy.

    Science.gov (United States)

    Akehi, Kazuma; Long, Blaine C; Warren, Aric J; Goad, Carla L

    2016-09-01

    Akehi, K, Long, BC, Warren, AJ, and Goad, CL. Ankle joint angle and lower leg musculotendinous unit responses to cryotherapy. J Strength Cond Res 30(9): 2482-2492, 2016-The use of cold application has been debated for its influence on joint range of motion (ROM) and stiffness. The purpose of this study was to determine whether a 30-minute ice bag application to the plantarflexor muscles or ankle influences passive ankle dorsiflexion ROM and lower leg musculotendinous stiffness (MTS). Thirty-five recreationally active college-aged individuals with no history of lower leg injury 6 months before data collection volunteered. On each testing day, we measured maximum passive ankle dorsiflexion ROM (°) and plantarflexor torque (N·m) on an isokinetic dynamometer to calculate the passive plantarflexor MTS (N·m per degree) at 4 joint angles before, during, and after a treatment. Surface electromyography amplitudes (μV), and skin surface and ambient air temperature (°C) were also measured. Subjects received an ice bag to the posterior lower leg, ankle joint, or nothing for 30 minutes in different days. Ice bag application to the lower leg and ankle did not influence passive ROM (F(12,396) = 0.67, p = 0.78). Passive torque increased after ice bag application to the lower leg (F(12,396) = 2.21, p = 0.011). Passive MTS at the initial joint angle increased after ice bag application to the lower leg (F(12,396) = 2.14, p = 0.014) but not at the other joint angles (p > 0.05). Surface electromyography amplitudes for gastrocnemius and soleus muscles increased after ice application to the lower leg (F(2,66) = 5.61, p = 0.006; F(12,396) = 3.60, p < 0.001). Ice bag application to the lower leg and ankle joint does not alter passive dorsiflexion ROM but increases passive ankle plantarflexor torque in addition to passive ankle plantarflexor MTS at the initial joint angle.

  4. Total Ankle Arthroplasty: A Brief Review

    OpenAIRE

    Mann, Roger A.; Harrison, Matthew J.

    2012-01-01

    Ankle fusion has long been the standard of treatment for end-stage ankle arthritis, and a successful arthroplasty has been a long sought alternative. It is a motion sparing procedure and may greatly reduce the potential for adjacent level degeneration as seen with arthrodesis. The typical candidate for arthroplasty is a healthy low demand patient, although the indications are widening as the success of the procedure has increased. Nevertheless, it is not fail-safe, technical expertise and exp...

  5. Salvage arthrodesis for failed total ankle arthroplasty

    Science.gov (United States)

    Zürcher, Arthur W

    2010-01-01

    Background and purpose Total ankle arthroplasty (TAA) has gained popularity in recent years. If it fails, however, salvage arthrodesis must be reliable as a rescue procedure. We therefore investigated the clinical, radiographic, and subjective outcome after salvage arthrodesis in a consecutive group of patients, and concentrated on the influence of the method of fixation on union rate and on salvage in inflammatory joint disease. Patients and methods Between 1994 and 2005, salvage arthrodesis was performed on 18 ankles (18 patients). Diagnosis was inflammatory joint disease (IJD) in 15 cases and osteoarthritis (OA) in 3. Tibio-talar fusion was performed in 7 ankles, and tibio-talocalcaneal fusion in 11. Serial radiographs were studied for time to union. Clinical outcome at latest follow-up was measured by the AOFAS score, the foot function index (FFI) and by VAS scores for pain, function, and satisfaction. Results Blade plates were used in 7 ankles (4 IJD, 3 OA); all united. Nonunion developed in 7 of the 11 rheumatic ankles stabilized by other methods. 11 patients (8 fused ankles, 3 nonunions) were available for clinical evaluation. Their mean AOFAS score was 62 and mean overall FFI was 70. VAS score for pain was 20, for function 64, and for satisfaction 74. The scores were similar in united and non-united ankles. Interpretation Blade plate fixation is successful in salvage arthrodesis for failed TAA. A high nonunion rate was found after salvage ankle arthrodesis in IJD with other methods of fixation. Clinical results were fair to good. PMID:20175648

  6. 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.

  7. TOTAL ANKLE REPLACEMENT: WHY, WHEN AND HOW?

    Science.gov (United States)

    Bonasia, Davide Edoardo; Dettoni, Federico; Femino, John E; Phisitkul, Phinit; Germano, Margherita; Amendola, Annunziato

    2010-01-01

    Total ankle replacement (TAR) was first attempted in the 1970s, but poor results led to its being considered inferior to ankle fusion until the late 1980s and early 1990s. By that time, newer designs which more closely replicated the natural anatomy of the ankle, showed improved clinical outcomes.1 Currently, even though controversy still exists about the effectiveness of TAR compared to ankle fusion, TAR has shown promising mid-term results and should no longer be considered an experimental procedure. Factors related to improved TAR outcomes include: 1) better patient selection, 2) more precise knowledge and replication of ankle biomechanics, 3) the introduction of less-constrained designs with reduced bone resection and no need for cementation, and 4) greater awareness of soft-tissue balance and component alignment. When TAR is performed, a thorough knowledge of ankle anatomy, pathologic anatomy and biomechanics is needed along with a careful pre-operative plan. These are fundamental in obtaining durable and predictable outcomes. The aim of this paper is to outline these aspects through a literature review. PMID:21045984

  8. Salvage of a Failed Agility Total Ankle Replacement System Associated with Acute Traumatic Periprosthetic Midfoot Fractures.

    Science.gov (United States)

    Roukis, Thomas S

    2015-10-01

    This article presents a rare case involving combined revision of a failed Agility Total Ankle Replacement System (DePuy Orthopaedics, Warsaw, Indiana) and open reduction with internal fixation of periprosthetic midfoot fractures secondary to acute traumatic injury. The rationale for these procedures, the operative sequence of events, and recovery course are presented in detail. Causes for concern regarding subsequent revision, should this be required, are raised.

  9. A pneumatic power harvesting ankle-foot orthosis to prevent foot-drop

    Directory of Open Access Journals (Sweden)

    Chin Robin

    2009-06-01

    Full Text Available Abstract Background A self-contained, self-controlled, pneumatic power harvesting ankle-foot orthosis (PhAFO to manage foot-drop was developed and tested. Foot-drop is due to a disruption of the motor control pathway and may occur in numerous pathologies such as stroke, spinal cord injury, multiple sclerosis, and cerebral palsy. The objectives for the prototype PhAFO are to provide toe clearance during swing, permit free ankle motion during stance, and harvest the needed power with an underfoot bellow pump pressurized during the stance phase of walking. Methods The PhAFO was constructed from a two-part (tibia and foot carbon composite structure with an articulating ankle joint. Ankle motion control was accomplished through a cam-follower locking mechanism actuated via a pneumatic circuit connected to the bellow pump and embedded in the foam sole. Biomechanical performance of the prototype orthosis was assessed during multiple trials of treadmill walking of an able-bodied control subject (n = 1. Motion capture and pressure measurements were used to investigate the effect of the PhAFO on lower limb joint behavior and the capacity of the bellow pump to repeatedly generate the required pneumatic pressure for toe clearance. Results Toe clearance during swing was successfully achieved during all trials; average clearance 44 ± 5 mm. Free ankle motion was observed during stance and plantarflexion was blocked during swing. In addition, the bellow component repeatedly generated an average of 169 kPa per step of pressure during ten minutes of walking. Conclusion This study demonstrated that fluid power could be harvested with a pneumatic circuit built into an AFO, and used to operate an actuated cam-lock mechanism that controls ankle-foot motion at specific periods of the gait cycle.

  10. PEAK AND END RANGE ECCENTRIC EVERTOR/CONCENTRIC INVERTOR MUSCLE STRENGTH RATIOS IN CHRONICALLY UNSTABLE ANKLES: COMPARISON WITH HEALTHY INDIVIDUALS

    Directory of Open Access Journals (Sweden)

    Mahmut Komurcu

    2003-09-01

    Full Text Available The aim of this study was to evaluate the alterations in eccentric evertor/concentric invertor strength ratio and their importance in the chronically unstable ankle. Eight patients with chronic ankle instability (CAI and nine healthy individuals participated in this study. Isokinetic concentric and eccentric invertor and evertor muscle strength measurement was carried out at an angular velocity of 120°·sec-1 by measuring maximal force moments (torque during isokinetic ankle inversion and eversion movements. Functionally, evertor/invertor muscle strength ratios (E/I strength ratio were calculated separately based on peak moment and angle-specific moments obtained at 0°, 5°, 10°, 15°, 20° ankle joint angles. Peak and angle-specific eccentric evertor strength values at 0°, 5°, 10°, 15°, 20° were significantly lower in the chronic ankle instability (CAI group. In spite of this, no differences were obtained for peak and angle-specific concentric invertor torque values. Eccentric evertor/concentric invertor strength (Eecc/Icon ratios were also significantly lower in the CAI group, but only at 15° and 20°. Eccentric evertor muscle torque and end range (15°-20° Eecc/Icon strength ratio for the chronically unstable ankle were significantly different from those for the healthy ankle. For this reason, measurements of end range eccentric/concentric strength ratios are more valuable in monitoring chronic ankle injuries and rehabilitation should include not only concentric muscle strengthening but also eccentric muscle strengthening, particularly for the evertor muscles

  11. [Revision arthroplasty of the ankle joint].

    Science.gov (United States)

    Hintermann, B; Barg, A; Knupp, M

    2011-11-01

    In the last 20 years total ankle replacement has become a viable alternative to arthrodesis for end-stage osteoarthritis of the ankle. Numerous ankle prosthesis designs have appeared on the market in the past and attracted by the encouraging intermediate results reported in the literature, many surgeons have started to perform this procedure. With increased availability on the market the indications for total ankle replacement have also increased in recent years. In particular, total ankle replacement may now be considered even in younger patients. Therefore, despite progress in total ankle arthroplasty the number of failures may increase. Up to now, arthrodesis was considered to be the gold standard for salvage of failed ankle prostheses. Because of extensive bone loss on the talar side, in most instances tibiocalcaneal fusion is the only reliable solution. An alternative to such extended hindfoot fusions would be revision arthroplasty. To date, however, there are no reported results of revision arthroplasty for salvage of a failed ankle replacement.Based on our experience prosthetic components with a flat undersurface are most likely to be able to find solid support on remaining bone stock. The first 83 cases (79 patients, 46 males, 33 females, average age 58.9 years, range 30.6-80.7 years) with a average follow-up of 5.4 years (range 2-11 years) showed excellent to good results in 69 cases (83%), a satisfactory result in 12 cases (15%) and a fair result in 2 cases (2%) and 47 patients (56%) were pain free. Primary loosening was noted in three cases and of these two cases were successfully revised by another total ankle replacement and in one case with arthrodesis. Another case with hematogenous infection was also revised by arthrodesis. At the last follow-up control two components were considered to be loose and the overall loosening rate was thus 6%.This series has proven that revision arthroplasty can be a promising option for patients with failed total

  12. Do Ankle Orthoses Improve Ankle Proprioceptive Thresholds or Unipedal Balance in Older Persons with Peripheral Neuropathy?

    Science.gov (United States)

    Son, Jaebum; Ashton-Miller, James A.; Richardson, James K.

    2010-01-01

    Objective To determine whether ankle orthoses that provide medial and lateral support, and have been found to decrease gait variability in older persons with peripheral neuropathy, decrease (improve) frontal plane ankle proprioceptive thresholds or increase unipedal stance time in that same population. Design Observational study in which unipedal stance time was determined with a stopwatch, and frontal plane ankle (inversion and eversion) proprioceptive thresholds were quantified during bipedal stance with and without the ankle orthoses, in 11 older diabetic subjects with peripheral neuropathy (8 men; age 72 ± 7.1 years) using a foot cradle system which presented a series of 100 rotational stimuli. Results The subjects demonstrated no change in combined frontal plane (inversion + eversion) proprioceptive thresholds or unipedal stance time with versus without the orthoses (1.06 ± 0.56 versus 1.13 ± 0.39 degrees, respectively; p = 0.955 and 6.1 ± 6.5 versus 6.2 ± 5.4 seconds, respectively; p = 0.922). Conclusion Ankle orthoses which provide medial-lateral support do not appear to change ankle inversion/eversion proprioceptive thresholds or unipedal stance time in older persons with diabetic peripheral neuropathy. Previously identified improvements in gait variability using orthoses in this population are therefore likely related to an orthotically-induced stiffening of the ankle rather than a change in ankle afferent function. PMID:20407302

  13. Sesamoid Injuries in the Foot

    Science.gov (United States)

    ... the shoe may be prescribed for long-term treatment of sesamoiditis to balance the pressure placed on the ball of the foot. When Is Surgery Needed? When sesamoid injuries fail to respond to nonsurgical treatment, surgery may be required. The foot and ankle ...

  14. Treatment of a Fracture-dislocation of the Ankle Using RALCA® External Fixator

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    Yaniel Truffin Rodriguez

    2016-06-01

    Full Text Available The association of ankle fractures with a dislocation modifies their therapeutic management since the joint must not remain in such abnormal position for more than six hours and therefore, urgent surgical treatment is needed. The case of a 30-year-old woman treated at the Dr. Gustavo Aldereguía Lima Hospital in Cienfuegos is presented. The patient presented with a severe fracture-dislocation of the right ankle with a supra-syndesmotic fibular fracture, a syndesmotic injury, a deltoid ligament injury and a tibial plafond fracture resulting from a bicycle fall. The fracture-dislocation was stabilized by using a RALCA® external mini-fixator. Full recovery was achieved five months after surgery. In our service, we may not have the devices most commonly used for fixation of ankle injuries at a given moment; therefore, external fixation becomes a viable option to correct this type of fractures. For this reason, we decided to present this case that demonstrates the effectiveness of the RALCA® external fixator.

  15. Can ankle imbalance be a risk factor for tensor fascia lata muscle weakness?

    Science.gov (United States)

    Zampagni, Maria L; Corazza, I; Molgora, A Paladini; Marcacci, M

    2009-08-01

    Risk factors that can determine knee and ankle injuries have been investigated and causes are probably multifactorial. A possible explanation could be related by the temporary inhibition of muscular control following an alteration of proprioceptive regulation due to the ankle imbalance pathology. The purpose of our study was to validate a new experimental set up to quantify two kinesiologic procedures (Shock Absorber Test (SAT) and Kendall and Kendall's Procedure (KKP)) to verify if a subtalus stimulus in an ankle with imbalance can induce a non-appropriate response of controlateral tensor fascia lata muscle (TFL). Fifteen male soccer players with ankle imbalance (AIG) and 14 healthy (CG) were tested after (TEST) before (NO-TEST) a manual percussion in subtalus joint (SAT). A new tailor-made device equipped with a load cell was used to quantify TFL's strength activation in standardized positions. Two trials for each subject were performed, separated by at least one 4-min resting interval. In NO-TEST conditions both AIG and CG showed a progressive adaptation of the subject to the force imposed by operator. No reduction in mean force, mean peak force, and muscle force duration (p>0.5). AIG presented significant differences (mean difference 0.92+/-0.46 s; p=0.000) in muscle force duration in TEST conditions. Our results indicated that "wrong" proprioceptive stimuli coming from the subtalus joint in AIG might induce inhibition in terms of duration of TFL muscle altering the knee stability. This kinesiological evaluation might be useful to prevent ankle and knee injuries.

  16. Injuries and Injury Prevention in the US Army Band

    Science.gov (United States)

    2006-12-30

    team members served roles as questioner, note taker, timer, and taper (tape recorder operator). The questioner asked the structured interview...allotted for a particular topic. The taper assured the functionality of a tape recorder and was responsible for downloading the tapes at conclusion of the...28, 2000. 164. McKay GD, Goldie PA, and Oakes BW. Ankle injuries in basketball : injury rate and risk factors. Br J Sports Med 35, 2001. 165. Milgrom C

  17. Epidemiology of Injury in Gaelic Handball.

    Science.gov (United States)

    O'Connor, S; Downey, M; Moran, K

    2016-03-10

    The initial step in developing injury prevention strategies is to establish the epidemiology of injury. However there has been no published research on injury in Gaelic handball. This study describes the epidemiology of injury in 75 Gaelic handball players utilising a retrospective questionnaire. 88% of participants reported one or more injuries. Injuries to the upper limb were prevalent (52.9%), followed by the lower limb (30.3%). The shoulder (17.6%), finger (10.5%) and ankle (9.8%) were the primary sites of injury. Injuries occurred most frequently in December (9.7%), January (9.7%), February (9.7%) and November (8.7%). Injuries predominantly occurred during games (82.4%). Injuries were primarily severe (54.7%), with 14.6% of participants admitted to hospital due to injury. Given that this is the only study on Gaelic handball to date, prospective epidemiological studies and further research on injury prevention strategies are necessary.

  18. Incidence, aetiology and prevention of musculoskeletal injuries in volleyball: A systematic review of the literature.

    Science.gov (United States)

    Kilic, O; Maas, M; Verhagen, E; Zwerver, J; Gouttebarge, V

    2017-04-09

    Currently, there is no overview of the incidence and (volleyball-specific) risk factors of musculoskeletal injuries among volleyball players, nor any insight into the effect of preventive measures on the incidence of injuries in volleyball. This study aimed to review systematically the scientific evidence on the incidence, prevalence, aetiology and preventive measures of volleyball injuries. To this end, a highly sensitive search strategy was built based on two groups of keywords (and their synonyms). Two electronic databases were searched, namely Medline (biomedical literature) via Pubmed, and SPORTDiscus (sports and sports medicine literature) via EBSCOhost. The results showed that ankle, knee and shoulder injuries are the most common injuries sustained while playing volleyball. Results are presented separately for acute and overuse injuries, as well as for contact and non-contact injuries. Measures to prevent musculoskeletal injuries, anterior knee injuries and ankle injuries were identified in the scientific literature. These preventive measures were found to have a significant effect on decreasing the occurrence of volleyball injuries (for instance on ankle injuries with a reduction from 0.9 to 0.5 injuries per 1000 player hours). Our systematic review showed that musculoskeletal injuries are common among volleyball players, while effective preventive measures remain scarce. Further epidemiological studies should focus on other specific injuries besides knee and ankle injuries, and should also report their prevalence and not only the incidence. Additionally, high-quality studies on the aetiology and prevention of shoulder injuries are lacking and should be a focus of future studies.

  19. The results of ankle arthrodesis with screws for end stage ankle arthrosis.

    Science.gov (United States)

    Torudom, Yingyong

    2010-02-01

    Aim of this study was to evaluate the results of ankle arthrodesis with screws in patients with ankle arthrosis. The author studied 19 patients (20 feet) who had been treated by ankle arthrodesis with screws from 2003 to 2008. Ten patients were men (11 feet) and nine (9 feet) were women. Their mean age was 56 years (30 to 65), and the average duration of follow-up was four years (2 to 6). Two compression screws were used in all feet. Union was achieved in 19 of the 20 feet (95%). Average scores for pain and clinical condition are increase after operation. One re-operation was performed for nonunion. Author conclude that ankle arthrodesis with screws was effective treatment for ankle arthrosis.

  20. Arthroscopic Management of Complications Following Total Ankle Replacement.

    Science.gov (United States)

    Lui, Tun Hing; Roukis, Thomas S

    2015-10-01

    There is great potential of managing the complications of total ankle replacement arthroscopically and endoscopically, and these procedures can be summarized into 3 groups. Group 1 includes procedures of the ankle joint proper with close proximity to the articular components of the total ankle replacement. Group 2 includes procedures of the tibia and talus with close proximity to the nonarticular parts of the total ankle replacement. Group 3 includes procedures that are away from the total ankle replacement. However, these remain master arthroscopist procedures and should be performed by foot and ankle surgeons who perform them with regularity.

  1. TO COMPARE THE EFFECTIVENESS OF CRYOTHERAPY WITH EXERCISES VERSUS TAPING WITH EXERCISES IN TREATING ACUTE LATERAL ANKLE SPRAIN

    Directory of Open Access Journals (Sweden)

    Suresh

    2014-12-01

    Full Text Available BACKGROUND: Ankle sprain is a common form of sport injuries and it is a leading cause of pain and disability in common man and sportsman worldwide. Rate of this injury is 1 per 10, 000 persons in common man whereas lateral ligament injuries account for 15 to 25% of all sports injuries. Lateral ankle sprains are one of the most common injuries sustained in sports and exercise activities. It is one of the most common soft tissue injury encountered in clinical practice. Complications such as prolonged ankle pain, a high recurrence rate, and chronic laxity underline the importance of careful diagnosis and treatment of ankle sprain. Physical therapy such as cryotherapy and taping technique are frequently used and have been cited that use of cryotherapy and taping technique have shown significant improvement in relieving pain and improving functional ability. OBJECTIVES: This study is intended to find and compare the effectiveness of Cryotherapy and exercises versus taping and exercises in acute lateral ankle sprain. DESIGN: A comparative study. SETTING: Kempegowda department of Orthopaedics and Rehabilitation unit-Kempegowda institute of physiotherapy. SUBJECTS: 40 patients (20 in each group. INTERVENTION: Forty males and female patients with lateral ankle sprain belonging to an age group of 15-35 years were selected for the study who fulfilled the inclusion and exclusion criteria and were divided into two groups. Group A was treated with Cryotherapy and exercises and group B was treated with taping and exercises with a frequency of 7 sittings for one week. Treatment outcomes were assessed using VAS, ROM, and LEFS for pain and functional ability. OUTCOME MEASURES: VAS to measure pain intensity, ROM for stiffness and Lower extremity functional scale for functional ability. RESULT: In comparison with VAS, ROM and LEFS, Group B shows significant improvement of all the parameters than Group A. INTERPRETATION & CONCLUSION: Study findings concluded that

  2. MORPHOMETRIC STUDY OF MEDIAL COLLATERAL LIGAMENTS OF ANKLE

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    Neelu Prasad

    2016-06-01

    Full Text Available BACKGROUND The ankle joint is one of the most frequently injured joint. A sprained ankle results due to tear of anterior talofibular and calcaneofibular ligaments when the foot is twisted in lateral direction. In forcible eversion of the foot, the deltoid ligament may be torn. At times, the deltoid ligament pulls the medial malleolus thereby causing avulsion fracture of the malleolus. The strong eversion pull on the deltoid ligament causes transverse fracture of medial malleolus. If the tibia is carried anteriorly, the posterior margin of the distal end of the tibia is also broken by the talus producing a trimalleolar fracture. The talocrural joint is a major weight bearing joint of the body. The weight of the body is transmitted from the tibia and fibula to the talus which distributes the weight anteriorly and posteriorly within the foot. One sixth of the static load of the leg is carried by the fibula at the tibiofibular joint. These require a high degree of stability which is determined by the passive and dynamic factors. A sprained ankle results due to tear of anterior talofibular and calcaneofibular ligaments when the foot is twisted in lateral direction. In forcible eversion of the foot, the deltoid ligament may be torn. At times, the deltoid ligament pulls the medial malleolus thereby causing avulsion fracture of the malleolus. The strong eversion pull on the deltoid ligament causes transverse fracture of medial malleolus. If the tibia is carried anteriorly, the posterior margin of the distal end of the tibia is also broken by the talus producing a trimalleolar fracture. Conventionally, X-ray techniques have been used to diagnose ligament injuries. Magnetic resonance (MR imaging has opened new horizons in the diagnosis and treatment of many musculoskeletal diseases of the ankle and foot. It demonstrates abnormalities in the bones and soft tissues before they become evident at other imaging modalities. The anatomy of the deltoid ligament

  3. Management of Open Fracture-Dislocation of the Ankle. A Case Report

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    Yaniel Truffin Rodriguez

    2014-12-01

    Full Text Available An open fracture-dislocation of the ankle is a rare injury. The case of a 57-year-old patient without a history of previous diseases who attended the emergency department of the Dr. Gustavo Aldereguía Lima University General Hospital in Cienfuegos after suffering a work-related accident is presented. To repair this serious injury, the surgical cleaning of the joint with antiseptic solutions was performed urgently, the fracture-dislocation was reduced and an osteosynthesis was carried out. Twelve weeks after surgery the patient returned to his previous work.

  4. 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.

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

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    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

  6. Stress fractures of the ankle malleoli diagnosed by ultrasound: a report of 6 cases

    Energy Technology Data Exchange (ETDEWEB)

    Bianchi, Stefano [CIM SA, Cabinet Imagerie Medicale, Geneve (Switzerland); Luong, Dien Hung [CIM SA, Cabinet Imagerie Medicale, Geneve (Switzerland); University of Montreal, Department of Physical Medicine and Rehabilitation, Montreal (Canada)

    2014-06-15

    To present the ultrasound appearance of stress fractures (SF) of the ankle malleoli. We present a retrospective review of 6 patients (4 women and 2 men, with an age range of 24-52 years, mean age of 39 years) in which ultrasound diagnosed, together with the clinical findings, an SF of the ankle malleoli. For all of these patients ultrasound was the first imaging technique applied because of a clinical suspicion of soft tissue injuries following excessive exertion. Patients were subsequently examined using standard radiographs and/or MRI. At ultrasound patients showed thickening of the periosteum in all patients, calcified bone callus was evident in 3 out of 6 patients. Cortical irregularities and subcutaneous oedema were found in all but one patient. Colour Doppler showed local hypervascular changes in all patients. Local compression with the transducers during real-time scanning increased pain in all cases. Ultrasound, together with the clinical findings, can diagnose an SF of the ankle malleoli. We suggest that sonologists should include malleolar SF in their differential diagnosis, particularly in the case of perimalleolar pain from over-solicitation. They must also include, as part of every ultrasound examination of the ankle, the evaluation of both malleoli and should be aware of the ultrasound appearance of malleolar SF. If the diagnosis remains uncertain, an MRI should be prescribed. (orig.)

  7. Bilateral ankle edema with bilateral iritis.

    Science.gov (United States)

    Kumar, Sunil

    2007-07-01

    I report two patient presented to me with bilateral symmetrical ankle edema and bilateral acute iritis. A 42-year-old female of Indian origin and 30-year-old female from Somalia both presented with bilateral acute iritis. In the first patient, bilateral ankle edema preceded the onset of bilateral acute iritis. Bilateral ankle edema developed during the course of disease after onset of ocular symptoms in the second patient. Both patients did not suffer any significant ocular problem in the past, and on systemic examination, all clinical parameters were within normal limit. Lacrimal gland and conjunctival nodule biopsy established the final diagnosis of sarcoidosis in both cases, although the chest x-rays were normal.

  8. 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.

  9. The 2BFit study: is an unsupervised proprioceptive balance board training programme, given in addition to usual care, effective in preventing ankle sprain recurrences? Design of a Randomized Controlled Trial

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    van Mechelen Willem

    2008-05-01

    Full Text Available Abstract Background There is strong evidence that athletes have a twofold risk for re-injury after a previous ankle sprain, especially during the first year post-injury. These ankle sprain recurrences could result in disability and lead to chronic pain or instability in 20 to 50% of these cases. When looking at the high rate of ankle sprain recurrences and the associated chronic results, ankle sprain recurrence prevention is important. Objective To evaluate the effect of a proprioceptive balance board training programme on ankle sprain recurrences, that was applied to individual athletes after rehabilitation and treatment by usual care. Methods/Design This study was designed as a randomized controlled trial with a follow-up of one year. Healthy individuals between 12 and 70 years of age, who were actively participating in sports and who had sustained a lateral ankle sprain up to two months prior to inclusion, were eligible for inclusion in the study. The intervention programme was compared to usual care. The intervention programme consisted of an eight-week proprioceptive training, which started after finishing usual care and from the moment that sports participation was again possible. Outcomes were assessed at baseline and every month for 12 months. The primary outcome of this study was the incidence of recurrent ankle injuries in both groups within one year after the initial sprain. Secondary outcomes were severity and etiology of re-injury and medical care. Cost-effectiveness was evaluated from a societal perspective. A process evaluation was conducted for the intervention programme. Discussion The 2BFit trial is the first randomized controlled trial to study the effect of a non-supervised home-based proprioceptive balance board training programme in addition to usual care, on the recurrence of ankle sprains in sports. Results of this study could possibly lead to changes in practical guidelines on the treatment of ankle sprains. Results will

  10. Management of Osseous and Soft-Tissue Ankle Equinus During Total Ankle Replacement.

    Science.gov (United States)

    Roukis, Thomas S; Simonson, Devin C

    2015-10-01

    Obtaining functional alignment of a total ankle replacement, including physiologic sagittal plane range of motion, is paramount for a successful outcome. This article reviews the literature on techniques available for correction of osseous and soft-tissue equinus at the time of index total ankle replacement. These techniques include anterior tibiotalar joint cheilectomy, posterior superficial muscle compartment lengthening, posterior ankle capsule release, and release of the posterior portions of the medial and lateral collateral ligament complexes. The rationale for these procedures and the operative sequence of events for these procedures are presented.

  11. Characterization of ankle function during stair ambulation

    OpenAIRE

    Gates, Deanna H.; Lelas, Jennifer L.; Della Croce, Ugo; Herr, Hugh; Bonato, Paolo

    2004-01-01

    The aim of this study was to examine the ankle joint during level walking, stair ascent, and stair descent to determine models for use in the design of prosthetic and orthotic systems. Ten healthy subjects were asked to walk (1) across a level walkway, (2) up, and (3) down an instrumented stairway. Sagittal plane kinematic and kinetic data were analyzed to obtain ankle biomechanics during the stance phase of each task. Each stance phase was broken down into sub-phases based on the power traje...

  12. Ankle fusion using a 2-incision, 3-screw technique

    NARCIS (Netherlands)

    R.P.M. Hendrickx; G.M.M.J. Kerkhoffs; S.A.S. Stufkens; C.N. van Dijk; R.K. Marti

    2011-01-01

    Reliable fusion and optimal correction of the alignment of the ankle joint using a 2-incision, 3-screw technique. Symptomatic osteoarthritis of the ankle joint after insufficient other treatment, severe deformity of the osteoarthritic ankle joint, or salvation procedure after failed arthroplasty. Ac

  13. Classification of fractures in the area of the ankle joint for practical surgical concerns

    Energy Technology Data Exchange (ETDEWEB)

    Gay, B.

    1983-09-01

    For practical surgical concerns we require radiological diagnosis of all injuries, indication for conservative or operative therapy and prognostic evidence in order to classify fractures of the ankle joint. Due to the fact that joint stability is ensured by the fibula and syndesmosis, we prefer classification according to Weber. Fracture types A, B and C are classified according to radiological findings, the pertinent concomitant injuries introduced and differentiated from the special forms of the ''interligamentary fracture'' and ''flake fractures''. Due to the frequency of injury in children of the distal, tibial epiphyseal cartilage we select classification according to Aitken for practical purposes, which differentiates basically between separation and fracture of the epiphysis and makes for prognosis about disturbances in growth. Delimited from ''crush injury'' the Aitken classification is compared to other conventional forms of classification in tabular form.

  14. Supination external rotation ankle fractures A simpler pattern with better outcomes

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    Nirmal C Tejwani

    2015-01-01

    Full Text Available Background: Rotational injuries are the most common and usually classified as per the Lauge Hansen classification; with the most common subgroup being the supination external rotation (SER mechanism. Isolated fractures of the distal fibula (SE2 without associated ligamentous injury are usually treated with a splint or brace and the patient may be allowed to weight bear as tolerated. This study reports the functional outcomes following a stable, low energy, rotational ankle fracture supination external rotation (SER2 when compared to unstable SER4 fractures treated operatively. Materials and Methods: 64 patients who were diagnosed and treated nonoperatively for a stable SER2 ankle fracture were followed prospectively. In the comparison group, 93 operatively treated fibular fractures were extracted from a prospectively collected database and evaluated comparison. Baseline characteristics obtained by trained interviewers at the time of injury included: Patient demographics, short form-36, short musculoskeletal functional assessment (SMFA and American Orthopedic Foot and Ankle Society (AOFAS questionnaires. Patients were followed at 3, 6 and 12 months postsurgery. Additional information obtained at each followup point included any complications or evidence on fracture healing. Data were analyzed by the Student′s t-test and theFisher′s Exact Test to compare demographic and functional outcomes between the two cohorts. P < 0.05 was considered to be significant. Results: The average of patients′ age in the stable fracture cohort was 43 versus 45 in the SER4 group. Nearly 64% of the patient population was female when compared with 37% in the operative group. In the SER2 by 6 months all patients had returned to baseline functional status. There were 18 delayed unions (all healed by 6 months. Based on the functional outcome scores all patients had returned to preoperative level. In comparison, SE4 patients had less functional recovery at 3 and 6

  15. EFFICACY OF A SPORTS SPECIFIC BALANCE TRAINING PROGRAMME ON THE INCIDENCE OF ANKLE SPRAINS IN BASKETBALL

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    Elke Cumps

    2007-06-01

    Full Text Available The purpose of the study was to determine the efficacy of a 22- week prescribed sports specific balance training programme on the incidence of lateral ankle sprains in basketball players. A controlled clinical trial was set up. In total 54 subjects of six teams participated and were assigned to either an intervention (IG or a control group (CG. The IG performed a prescribed balance training programme on top of their normal training routine, using balance semi-globes. The programme consisted of 4 basketball skills each session and its difficulty was progressively thought-out. The intervention lasted 22 weeks and was performed 3 times a week for 5 to 10 minutes. Efficacy of the intervention on the incidence of lateral ankle sprains was determined by calculating Relative Risks (RR, including their 95% Confidence Intervals or CI and incidence rates expressed per 1000h. RR (95% CI showed a significantly lower incidence of lateral ankle sprains in the IG compared to the CG for the total sample (RR= 0.30 [95% CI: 0.11-0.84] and in men (RR= 0.29 [95% CI: 0.09-0.93]. The difference in RR was not confirmed when examining the incidence rates and their 95%CI's, which overlapped. The risk for new or recurrent ankle sprains was slightly lower in the IG (new: RR= 0.76 [95% CI: 0.17-3.40]; re-injury: RR= 0.21 [95% CI: 0.03-1.44]. Based on these pilot results, the use of balance training is recommended as a routine during basketball activities for the prevention of ankle sprains

  16. Pulmonary embolism following ankle fractures treated without an operation - an analysis using National Health Service data.

    Science.gov (United States)

    Jameson, Simon S; Rankin, Kenneth S; Desira, Nicola L; James, Philip; Muller, Scott D; Reed, Mike R; Rangan, Amar

    2014-08-01

    The majority of ankle fractures are stable and can be treated without an operation, most commonly with cast immobilisation. Based on concerns regarding the risk of a venous thromboembolic event (VTE) while immobilised, there is currently debate as to whether these patients should receive VTE prophylaxis for the duration of treatment. Rates of pulmonary embolism (PE) in this patient group are unknown. This retrospective cohort study was designed to identify patients treated without an operation for ankle fracture and determine the occurrence of PE and inpatient mortality within 90 days of injury using the English National Health Service administrative databases. Logistic regression models were used to assess the influence of age, gender and Charlson co-morbidity score on these outcomes. We identified 14777 adult patients over a 54-month period (April 2007-September 2011) that met our linkage and inclusion criteria (isolated, unilateral closed ankle fracture that did not require hospitalisation). Mean age was 46.4 years (range 18-99) and the majority had a Charlson 0 score (97.7%). There were 32 (0.22%) PEs within 90 days of the fracture (including in one patient who subsequently died). After adjustment, Charlson score of ≥1 was associated with a greater risk of PE (Odds ratio = 11.97, p < 0.001) compared to Charlson 0. Risk for these patients was 2.08%. In total, fifteen patients (0.11%) died in hospital within 90 days. Pulmonary embolism is rare following ankle fractures treated without an operation. Patients with multiple co-morbidities are at a higher risk. Based on this evidence, an ankle fracture treated without an operation does not appear to be an indication for routine VTE prophylaxis.

  17. Effects of immobilization and remobilization on the ankle joint in Wistar rats

    Directory of Open Access Journals (Sweden)

    R.I. Kunz

    2014-10-01

    Full Text Available A sprained ankle is a common musculoskeletal sports injury and it is often treated by immobilization of the joint. Despite the beneficial effects of this therapeutic measure, the high prevalence of residual symptoms affects the quality of life, and remobilization of the joint can reverse this situation. The aim of this study was to analyze the effects of immobilization and remobilization on the ankle joint of Wistar rats. Eighteen male rats had their right hindlimb immobilized for 15 days, and were divided into the following groups: G1, immobilized; G2, remobilized freely for 14 days; and G3, remobilized by swimming and jumping in water for 14 days, performed on alternate days, with progression of time and a series of exercises. The contralateral limb was the control. After the experimental period, the ankle joints were processed for microscopic analysis. Histomorphometry did not show any significant differences between the control and immobilized/remobilized groups and members, in terms of number of chondrocytes and thickness of the articular cartilage of the tibia and talus. Morphological analysis of animals from G1 showed significant degenerative lesions in the talus, such as exposure of the subchondral bone, flocculation, and cracks between the anterior and mid-regions of the articular cartilage and the synovial membrane. Remobilization by therapeutic exercise in water led to recovery in the articular cartilage and synovial membrane of the ankle joint when compared with free remobilization, and it was shown to be an effective therapeutic measure in the recovery of the ankle joint.

  18. 慢性踝关节不稳的研究进展%Research Progress of Chronic Ankle Instability

    Institute of Scientific and Technical Information of China (English)

    刘欣; 黄真

    2015-01-01

    Ankle sprain is the most common injury of lower limbs. Without proper treatment,it is likely to develop chronic ankle instability. This paper summarized possible pathogenesis of chronic ankle instability, illustrated from the perspectives of proprioceptive disorder,dysfunction of neuromuscular and postural control and weakness of muscles around ankle joint,pointed out the rehabilitation programs which were often used,and provided suggestions for the clinical rehabilitation training of chronic ankle instability.%踝关节扭伤是下肢最常见的损伤,如未得到合理的处理很容易发展成为慢性踝关节不稳。本文归纳了慢性踝关节不稳可能的发病机制,从本体感觉障碍、神经肌肉控制不全、姿势控制功能不全及周围肌群肌力减退等方面进行了阐述,指出了目前常采用的康复训练方法及效果,为慢性踝关节不稳的临床康复训练提供建议。

  19. Acute traumatic open posterolateral dislocation of the ankle without tearing of the tibiofibular syndesmosis ligaments: a case report.

    Science.gov (United States)

    Demiralp, Bahtiyar; Komurcu, Mahmut; Ozturk, Cagatay; Ozturan, Kutay; Tasatan, Ersin; Erler, Kaan

    2008-01-01

    Pure open dislocation of the ankle, or dislocation not accompanied by rupture of the tibiofibular syndesmosis ligaments or fractures of the malleoli or of the posterior border of the tibia, is an extremely rare injury. A 62-year-old man injured his right ankle in a motor vehicle accident. Besides posterolateral ankle dislocation, there was a 7-cm transverse skin cut on the medial malleolus, and the distal end of the tibia was exposed. After reduction, we made a 2- to 2.5-cm longitudinal incision on the lateral malleolus; the distal fibular fracture was exposed. Two Kirschner wires were placed intramedullary in a retrograde manner, and the fracture was stabilized. The deltoid ligament and the medial capsule were repaired. The tibiofibular syndesmosis ligaments were intact. At the end of postoperative year 1, right ankle joint range of motion had a limit of approximately 5 degrees in dorsiflexion, 10 degrees in plantarflexion, 5 degrees in inversion, and 0 degrees in eversion. The joint appeared normal on radiographs, with no signs of osteoarthritis or calcification. The best result can be obtained with early reduction, debridement, medial capsule and deltoid ligament restoration, and early rehabilitation. Clinical and radiographic features at long-term follow-up also confirm good mobility of the ankle without degenerative change or mechanical instability.

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

    Directory of Open Access Journals (Sweden)

    Anindo Roy, PhD

    2011-05-01

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

  1. Malignant melanoma of the foot and ankle.

    Science.gov (United States)

    John, K J; Hayes, D W; Green, D R; Dickerson, J

    2000-04-01

    Malignant melanoma is a serious and devastating skin disease that podiatrists may be called upon to treat. It is pertinent that delays in diagnosis and treatment of malignant melanoma be avoided. Some of the topics discussed in this article are causes, clinical features, classification, and treatment of malignant melanoma, focusing on the foot and ankle.

  2. SPARKy-Spring Ankle with Regenerative Kinematics

    Science.gov (United States)

    2011-09-01

    89-93215-02-1 98560/10/$15 ©ICROS 142 1 BIONIC RUNNING FOR UNILATERAL TRANSTIBIAL MILITARY AMPUTEES Joseph Hitt, James Merlo, and Jonathan...ankle joint, and n optical switch embedded at the heel provides the necessary ensor feedback. Advantech’s 650MHZ PC-104 with 512MB on oard memory is

  3. Cutaneous mechanisms of isometric ankle force control.

    Science.gov (United States)

    Choi, Julia T; Lundbye-Jensen, Jesper; Leukel, Christian; Nielsen, Jens Bo

    2013-07-01

    The sense of force is critical in the control of movement and posture. Multiple factors influence our perception of exerted force, including inputs from cutaneous afferents, muscle afferents and central commands. Here, we studied the influence of cutaneous feedback on the control of ankle force output. We used repetitive electrical stimulation of the superficial peroneal (foot dorsum) and medial plantar nerves (foot sole) to disrupt cutaneous afferent input in 8 healthy subjects. We measured the effects of repetitive nerve stimulation on (1) tactile thresholds, (2) performance in an ankle force-matching and (3) an ankle position-matching task. Additional force-matching experiments were done to compare the effects of transient versus continuous stimulation in 6 subjects and to determine the effects of foot anesthesia using lidocaine in another 6 subjects. The results showed that stimulation decreased cutaneous sensory function as evidenced by increased touch threshold. Absolute dorsiflexion force error increased without visual feedback during peroneal nerve stimulation. This was not a general effect of stimulation because force error did not increase during plantar nerve stimulation. The effects of transient stimulation on force error were greater when compared to continuous stimulation and lidocaine injection. Position-matching performance was unaffected by peroneal nerve or plantar nerve stimulation. Our results show that cutaneous feedback plays a role in the control of force output at the ankle joint. Understanding how the nervous system normally uses cutaneous feedback in motor control will help us identify which functional aspects are impaired in aging and neurological diseases.

  4. Osteoarthritis of the Foot and Ankle

    Science.gov (United States)

    ... that creates an increased risk of arthritis. Symptoms People with osteoarthritis in the foot or ankle experience, in varying degrees, one or more of the following: Pain and stiffness in the joint Swelling in or near the joint Difficulty walking or bending the joint Some patients with osteoarthritis ...

  5. Injuries in racket sports among Slovenian players.

    Science.gov (United States)

    Kondric, Miran; Matković, Branka R; Furjan-Mandić, Gordana; Hadzić, Vedran; Dervisević, Edvin

    2011-06-01

    On the sample of 83 top Slovenian athletes we have studied the frequency of injuries among table tennis, tennis and badminton players, types of injuries and severity of injuries--the latter based on data of players absences from training and/or competition processes. The most liable parts to injuries are shoulder girdle (17.27%), spine (16.55%) and ankle (15.83%), while foot (10.07%) and wrist (12.23%) are slightly less liable to injuries. The most frequent injuries in racket sports pertain to muscle tissues. According to this data, the majority of injuries occur halfway through a training session or a competition event, mostly during a competition season. The injuries primarily pertain to muscle tissues; these are followed by joint and tendon injuries. There are no differences between male and female players. Compared to other racket sports players, table tennis players suffer from fewer injuries.

  6. 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.

  7. Arthroscopic anatomical reconstruction of the lateral ankle ligaments: A technical simplification.

    Science.gov (United States)

    Lopes, R; Decante, C; Geffroy, L; Brulefert, K; Noailles, T

    2016-12-01

    Anatomical reconstruction of the lateral ankle ligaments has become a pivotal component of the treatment strategy for chronic ankle instability. The recently described arthroscopic version of this procedure is indispensable to ensure that concomitant lesions are appropriately managed, yet remains technically demanding. Here, we describe a simplified variant involving percutaneous creation of the calcaneal tunnel for the distal attachment of the calcaneo-fibular ligament. The rationale for this technical stratagem was provided by a preliminary cadaver study that demonstrated a correlation between the lateral malleolus and the distal footprint of the calcaneo-fibular ligament. The main objectives are simplification of the operative technique and decreased injury to tissues whose function is crucial to the recovery of proprioception.

  8. Injuries in classical ballet

    Directory of Open Access Journals (Sweden)

    Adriana Coutinho de Azevedo Guimarães

    2008-06-01

    Full Text Available This study aimed to elucidate what injuries are most likely to occur due to classical ballet practice. The research used national and international bibliography. The bibliography analysis indicated that technical and esthetical demands lead to a practice of non-anatomical movements, causing the ballet dancer to suffer from a number of associated lesions. Most of the injuries are caused by technical mistakes and wrong training. Troubles in children are usually due to trying to force external rotation at hip level and to undue use of point ballet slippers. The commonest lesions are in feet and ankles, followed by knees and hips. The rarest ones are in the upper limbs. These injuries are caused by exercise excess, by repetitions always in the same side and by wrong and early use of point slippers. The study reached the conclusion that incorrect application of classical ballet technique predisposes the dancers to characteristic injuries.

  9. Total Ankle Arthroplasty: An Overview of the Canadian Experience.

    Science.gov (United States)

    Latham, Warren C W; Lau, Johnny T C

    2016-06-01

    Total ankle arthroplasty use has increased across Canada over the last two decades. Multiple implant designs are readily available and implanted across Canada. Although arthrodesis is a reliable procedure for treating end-stage ankle arthritis, ankle replacement is often the preferred surgical treatment by patients. A recent prospective study evaluated intermediate-term outcomes of ankle replacement and arthrodesis at multiple centers across Canada, with variability in prosthesis type, surgeon, and surgical technique. Intermediate-term clinical outcomes of total ankle replacement and ankle arthrodesis were comparable in a diverse cohort in which treatment was tailored to patient presentation; however, rates of reoperation and major complications were higher after ankle replacement.

  10. 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.

  11. Electrical stimulation as a treatment intervention to improve function, edema or pain following acute lateral ankle sprains: A systematic review.

    Science.gov (United States)

    Feger, Mark A; Goetschius, John; Love, Hailey; Saliba, Sue A; Hertel, Jay

    2015-11-01

    The purpose of this systematic review was to assess whether electrical stimulation (ES), when used in conjunction with a standard treatment, can reduce levels of functional impairment, edema, and pain compared to a standard treatment alone, in patients following a lateral ankle sprain. We searched PubMed, CINAHL, SportDiscus, and Medline (OVID) databases through June 2014 using the terms "ankle sprain or ankle sprains or ligament injury or ligamentous injury," and "electric stimulation or electric stimulation or electrotherapy." Our search identified four randomized control trials, of which, neuromuscular ES and high-voltage pulsed stimulation were the only two ES modalities utilized. Effect sizes and 95% confidence intervals (CI) were estimated using Cohen's d for comparison between treatment groups. Three of four effect sizes for function had 95% CI that crossed zero. Twenty-four of the thirty-two effect sizes for edema had 95% CI that crossed zero. All effect sizes for pain had 95% CI that crossed zero. Therefore, the use of ES is not recommended as a means to improve function, reduce edema, or decrease pain in the treatment of acute lateral ankle sprains.

  12. Accident reconstruction to analyze impact of injured drivers during the collision. Ankle fracture in the car-to-car offset frontal collision; Join no jusho jokyo ni kansuru jiko saigen. Joyosha doshi no offset zenmen shototsuji no ashi kansetsu kossetsu

    Energy Technology Data Exchange (ETDEWEB)

    Sakurai, M. [Japan Automobile Research Institute Inc., Tsukuba (Japan)

    1997-10-01

    An accident reconstruction test of car-to-car crash was conducted in order to analyze the impact on the driver in the offset head-on collision. The ankle fracture of the driver resulting from the accident was examined with the test results and the accident data. The test results of the car-to-car crashes indicated that the belted driver`s ankle would have fractured in the early stage of the crash. The detailed information from the accident data, especially the cars` interior deformation and the driver`s X-ray photographs, was also very important in analyzing injury mechanisms of the ankle/foot region. The above results suggested an injury mechanism that the ankle joint fracture was due to dorsiflexion and valgus resulting from the impact and intrusion of the toeboard in the early stage of the crash. 12 refs., 11 figs.

  13. 论普通高校排球项目踝关节力量训练的重要性%On the Importance of Ankle Joint Strength Training in General Colleges and Universities' Volleyball Courses

    Institute of Scientific and Technical Information of China (English)

    杨枝创

    2012-01-01

    This paper illustrates the importance of strength training in ankle joints by analyzing the technical characteristics of volleyball with the help of analyzing the physiological structure and the motion features of ankle joint, and the reason for ankle jonits athletic injury.%分析了排球运动的技术特征,借助踝关节生理结构、运动特征及踝关节运动损伤的机制及原因分析,论述踝关节力量训练的重要性。

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

    Science.gov (United States)

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

    2015-09-01

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

  15. Injuries in Irish dance.

    Science.gov (United States)

    Stein, Cynthia J; Tyson, Kesley D; Johnson, Victor M; Popoli, David M; d'Hemecourt, Pierre A; Micheli, Lyle J

    2013-12-01

    Irish dance is growing in popularity and competitiveness; however, very little research has focused specifically on this genre of dance. The purpose of this study was to analyze the types of dance injuries incurred by Irish dancers. A chart review was performed to identify all injuries associated with Irish dance seen in the sports medicine or orthopaedic clinics at the investigators' hospital over an 11-year period. "Injury" was defined as any dance-related pain or disorder that led to evaluation in the clinics. Survey data were also collected from study participants. Ultimately, 255 patients from over 30 different schools of dance were seen with injuries directly related (726 clinic visits) or partially related (199 visits) to Irish dance. Participants ranged in age from 4 to 47, with 95% (243/255) under the age of 19. These 255 patients received 437 diagnoses. Almost 80% of the injuries (348/437) were attributable to overuse, and 20.4% were acute and traumatic injuries (89/437). Ninety-five percent (95.9%) of injuries involved the hip or lower extremity. The most common sites were the foot (33.2%), ankle (22.7%), knee (19.7%), and hip (14.4%). Typical diagnoses were tendon injury (13.3%), apophysitis (11.4%), patellofemoral pain and instability (10.8%), stress injury (10.1%), and muscle injury (7.8%). The majority of traumatic injuries were seen in clinic within 3 weeks, but less than a quarter of overuse injuries were seen that quickly. The most common treatment, prescribed to 84.3% of patients, was physical therapy and home exercises, and the majority of dancers (64.3%) were able to return to full dance activity after injury.

  16. Diminished Foot and Ankle Muscle Volumes in Young Adults With Chronic Ankle Instability

    Science.gov (United States)

    Feger, Mark A.; Snell, Shannon; Handsfield, Geoffrey G.; Blemker, Silvia S.; Wombacher, Emily; Fry, Rachel; Hart, Joseph M.; Saliba, Susan A.; Park, Joseph S.; Hertel, Jay

    2016-01-01

    Background: Patients with chronic ankle instability (CAI) have demonstrated altered neuromuscular function and decreased muscle strength when compared with healthy counterparts without a history of ankle sprain. Up to this point, muscle volumes have not been analyzed in patients with CAI to determine whether deficits in muscle size are present following recurrent sprain. Purpose: To analyze intrinsic and extrinsic foot and ankle muscle volumes and 4-way ankle strength in young adults with and without CAI. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Five patients with CAI (mean age, 23.0 ± 4 years; 1 male, 4 females) and 5 healthy controls (mean age, 23.8 ± 4.5 years; 1 male, 4 females) volunteered for this study. Novel fast-acquisition magnetic resonance imaging (MRI) was used to scan from above the femoral condyles through the foot and ankle. The perimeter of each muscle was outlined on each axial slice and then the 2-dimensional area was multiplied by the slice thickness (5 mm) to calculate the muscle volume. Plantar flexion, dorsiflexion, inversion, and eversion isometric strength were measured using a handheld dynamometer. Patients with CAI were compared with healthy controls on all measures of muscle volume and strength. Extrinsic muscle volumes of patients with CAI were also compared with a normative database of healthy controls (n = 24) by calculating z scores for each muscle individually for each CAI subject. Results: The CAI group had smaller total shank, superficial posterior compartment, soleus, adductor hallucis obliqus, and flexor hallucis brevis muscle volumes compared with healthy controls as indicated by group means and associated 90% CIs that did not overlap. Cohen d effect sizes for the significant group differences were all large and ranged from 1.46 to 3.52, with 90% CIs that did not cross zero. The CAI group had lower eversion, dorsiflexion, and 4-way composite ankle strength, all with group means and associated 90

  17. Cutaneous mechanisms of isometric ankle force control

    DEFF Research Database (Denmark)

    Choi, Julia T; Jensen, Jesper Lundbye; Leukel, Christian

    2013-01-01

    The sense of force is critical in the control of movement and posture. Multiple factors influence our perception of exerted force, including inputs from cutaneous afferents, muscle afferents and central commands. Here, we studied the influence of cutaneous feedback on the control of ankle force...... of transient stimulation on force error were greater when compared to continuous stimulation and lidocaine injection. Position-matching performance was unaffected by peroneal nerve or plantar nerve stimulation. Our results show that cutaneous feedback plays a role in the control of force output at the ankle...... joint. Understanding how the nervous system normally uses cutaneous feedback in motor control will help us identify which functional aspects are impaired in aging and neurological diseases....

  18. [Ankle joint prosthesis for bone defects].

    Science.gov (United States)

    Lampert, C

    2011-11-01

    Large defects of the talus, i.e. due to tumors, large areas of osteolysis in total ankle replacement (TAR) and posttraumatic talus body necrosis are difficult to manage. The gold standard in these circumstances is still tibiocalcaneal arthrodesis with all the negative aspects of a completely rigid hindfoot. We started 10 years ago to replace the talus by a custom-made, all cobalt-chrome implant (laser sintering). The first patient with a giant cell tumor did very well but the following patients showed all subsidence of the metal talus into the tibia due to missing bony edges. Therefore, we constructed a custom-made talus (mirrored from the healthy side) and combined it with a well functioning total ankle prosthesis (Hintegra). So far we have implanted this custom-made implant into 3 patients: the first had a chondrosarcoma of the talus (1 year follow-up), the second had massive osteolysis/necrosis of unknown origin (6 months follow-up) and the third massive osteolysis following a correct TAR (2 months follow-up). The results are very encouraging as all of the patients are practically pain free and have a good range of movement (ROM): D-P flexion 15°-0-20° but less motion in the lower ankle joint: ROM P-S 5°-0-5°. No subsidence was detected in the tibia or the calcaneus. The custom-made talus combined with the Hintegra total ankle replacement will probably be an interesting alternative to a tibiocalcaneal arthrodesis in selected cases with massive defects of the talus.

  19. Charcot foot and ankle with osteomyelitis

    OpenAIRE

    Donegan, Ryan; Sumpio, Bauer; Peter A. Blume

    2013-01-01

    This paper presents a review of the current literature discussing topics of Charcot osteoarthropathy, osteomyelitis, diagnosing osteomyelitis, antibiotic management of osteomyelitis, and treatment strategies for management of Charcot osteoarthropathy with concurrent osteomyelitis.Keywords: Charcot foot; osteomyelitis; diabetes mellitus; infection; neuropathy(Published: 1 October 2013)Citation: Diabetic Foot & Ankle 2013, 4: 21361 - http://dx.doi.org/10.3402/dfa.v4i0.21361

  20. Effects of a powered ankle-foot prosthesis on kinetic loading of the unaffected leg during level-ground walking

    OpenAIRE

    Grabowski, Alena M.; D’Andrea, Susan

    2013-01-01

    Background People with a lower-extremity amputation that use conventional passive-elastic ankle-foot prostheses encounter a series of stress-related challenges during walking such as greater forces on their unaffected leg, and may thus be predisposed to secondary musculoskeletal injuries such as chronic joint disorders. Specifically, people with a unilateral transtibial amputation have an increased susceptibility to knee osteoarthritis, especially in their unaffected leg. Previous studies hav...

  1. 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.

  2. Control method for exoskeleton ankle with surface electromyography signals

    Institute of Scientific and Technical Information of China (English)

    ZHANG Zhen; WANG Zhen; JIANG Jia-xin; QIAN Jin-wu

    2009-01-01

    This paper is concerned with a control method for an exoskeleton ankle with clectromyography (EMG) signals.The EMG signals of human ankle and the exoskeleton ankle are introduced.Then a control method is proposed to control the exoskeleton ankle using the EMG signals.The feed-forward neural network model applied here is composed of four layers and uses the back-propagation training algorithm.The output signals from neural network are processed by the wavelet transform.Finally the control orders generated from the output signals are passed to the motor controller and drive the exoskeleton to move.Through experiments,the equality of neural network prediction of ankle movement is evaluated by giving the correlation coefficient.It is shown from the experimental results that the proposed method can accurately control the movement of ankle joint.

  3. Talar Osteochondroma Fracture Presenting as Posterior Ankle Impingement.

    Science.gov (United States)

    Ercin, Ersin; Bilgili, Mustafa Gokhan; Gamsizkan, Mehmet; Avsar, Serdar

    2016-05-01

    Osteochondromas are the most common benign bone tumors. They are usually asymptomatic and found incidentally. When symptomatic, the symptoms are usually due to its location and size. Fracture of an osteochondroma presenting as posterior ankle impingement is a rare condition. We describe a 22-year-old man with solitary exostosis who presented with a posterior ankle mass and posterior ankle impingement with 2 years of follow-up. Surgical intervention was the treatment of choice in this patient, and histologic examination revealed a benign osteochondroma. Osteochondromas found in the posterior aspect of the talus can be complicated by fracture due to persistent motion of the ankle. Talar osteochondroma should be included in the differential diagnosis of posterior ankle impingement causes. Posterior talar osteochondromas, especially when a stalk is present, should be treated surgically before it is more complicated by a fracture and posterior ankle impingement.

  4. Total ankle replacement. Early experiences with STAR prosthesis.

    Science.gov (United States)

    Murnaghan, J. M.; Warnock, D. S.; Henderson, S. A.

    2005-01-01

    Early designs of Total Ankle Replacement (TAR) had a high failure rate. More recent experience with the 3-piece, meniscal bearing, total ankle replacement has been more promising. We report a review of the early results of our first 22 prostheses in 20 patients undergoing Scandinavian Total Ankle Replacement (STAR) in Northern Ireland. There was a mean follow-up time of 26 months. Seventeen patients are pain-free at the ankle joint during normal daily activities. Two of the early cases have required revision surgery due to technical errors. Other complications have included malleolar fractures, poor wound healing and postoperative stiffness. These early results show high levels of patient satisfaction, and we are encouraged to continue with total ankle arthroplasty. There is a steep initial learning curve and use of TAR should be restricted to foot and ankle surgeons. Images Fig 1 Figs 2a and b Figs 2 c and d PMID:16022128

  5. Closed medial total subtalar joint dislocation without ankle fracture: a case report

    Science.gov (United States)

    2014-01-01

    Introduction Total subtalar dislocation without fracture of the ankle is a rare clinical entity; it is usually due to a traumatic high-energy mechanism. Standard treatment is successful closed reduction under general anesthesia followed by non-weight bearing and ankle immobilization with a below-knee cast for 6 weeks. Case presentation We present the case of a 30-year-old Moroccan woman who was involved in a road traffic accident. She subsequently received a radiological assessment that objectified a total subtalar dislocation without fracture of her ankle. She was immediately admitted to the operating theater where an immediate reduction was performed under sedation, and immobilization in a plaster boot was adopted for 8 weeks. The management of this traumatic lesion is discussed in the light of the literature. Conclusions Medial subtalar dislocation is a rare dislocation and is not commonly seen as a sports injury because it requires transfer of a large amount of kinetic energy. The weaker talocalcaneal and talonavicular ligaments often bear the brunt of the energy and are more commonly disrupted, compared to the relatively stronger calcaneonavicular ligament. Urgent reduction is important, and closed reduction under general anesthesia is usually successful, often facilitated by keeping the knee in flexion to relax the gastrocnemius muscle. Long-term sequelae include talar avascular necrosis and osteochondral fracture, as well as chronic instability and pain. PMID:25240955

  6. 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.)

  7. Ankle fusion with a retrograde locked intramedullary nail for sequela of lower extremity compartment syndrome

    Institute of Scientific and Technical Information of China (English)

    WANG Xu; MA Xin; ZHANG Chao; HUANG Jia-zhang; GU Xiang-jie; JIANG Jian-yuan

    2012-01-01

    the end of follow-up.Nail breakage happened in one patient and no other breakage or backing out of the nail was found.Conclusions:Lower extremity compartment syndrome and residual ankle deformity often extremely impact ambulation and are bard to deal with because several pathologic phenomena might exist in these patients,for instance,poor skin conditions due to repeated preexisting surgery;poor perfusion in distal limbs following blood vascular injury;reflux limitation and long-term limb swelling due to muscle strength disturbance; osteoporosis as a result of long-term immobilization or limb disuse.Ankle fusion with a retrograde locked intramedullary nail is an optimal protocol to solve these clinical symptoms and rather ensures a definite fusion and firm fixation to these patients with simple manipulation and few complications.

  8. Comparison of total ankle replacement and ankle arthrodesis in patients with haemophilia using gait analysis: two case reports

    OpenAIRE

    Dauty, Marc; Gross, Raphael; Leboeuf, Fabien; Trossaert, Marc

    2015-01-01

    Background Severe hemophilia is an inherited, lifelong bleeding disorder characterized by spontaneous bleeding, which results in painful joint deformities. Currently two surgical treatments are available to treat haemophilia-related ankle joint destruction: ankle arthrodesis and total ankle replacement. The aim of the present study was to compare these two surgical procedures in haemophiliac subjects. Case presentation Kinematic and dynamic parameters were quantified using a three-dimensional...

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

    OpenAIRE

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

    2014-01-01

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

  10. Effect of medial arch-heel support in inserts on reducing ankle eversion: a biomechanics study

    Directory of Open Access Journals (Sweden)

    Yung Patrick SH

    2008-02-01

    Full Text Available Abstract Background Excessive pronation (or eversion at ankle joint in heel-toe running correlated with lower extremity overuse injuries. Orthotics and inserts are often prescribed to limit the pronation range to tackle the problem. Previous studies revealed that the effect is product-specific. This study investigated the effect of medial arch-heel support in inserts on reducing ankle eversion in standing, walking and running. Methods Thirteen pronators and 13 normal subjects participated in standing, walking and running trials in each of the following conditions: (1 barefoot, and shod condition with insert with (2 no, (3 low, (4 medium, and (5 high medial arch-heel support. Motions were captured and processed by an eight-camera motion capture system. Maximum ankle eversion was calculated by incorporating the raw coordinates of 15 anatomical positions to a self-compiled Matlab program with kinematics equations. Analysis of variance with repeated measures with post-hoc Tukey pairwise comparisons was performed on the data among the five walking conditions and the five running conditions separately. Results Results showed that the inserts with medial arch-heel support were effective in dynamics trials but not static trials. In walking, they successfully reduced the maximum eversion by 2.1 degrees in normal subjects and by 2.5–3.0 degrees in pronators. In running, the insert with low medial arch support significantly reduced maximum eversion angle by 3.6 and 3.1 degrees in normal subjects and pronators respectively. Conclusion Medial arch-heel support in inserts is effective in reducing ankle eversion in walking and running, but not in standing. In walking, there is a trend to bring the over-pronated feet of the pronators back to the normal eversion range. In running, it shows an effect to restore normal eversion range in 84% of the pronators.

  11. Injury profile in junior tennis players: a prospective two year study.

    Science.gov (United States)

    Hjelm, Nina; Werner, Suzanne; Renstrom, Per

    2010-06-01

    The aim of this study was to prospectively make a survey of injuries in junior players from a Swedish local tennis club during a 2-year period in relation to gender, anatomic location, month of the year when injured, injury type and injury severity. All 12-18 years old members in a tennis club playing more than twice weekly were asked to participate. Fifty-five junior tennis players, 35 boys and 20 girls accepted to participate. All tennis-related injuries were prospectively registered and evaluated. Time of exposure for playing tennis was recorded. Thirty-nine players sustained 100 injuries, 73 in boys and 27 in girls. Injury incidence for boys was 1.7 injuries/1000 h of tennis playing time and for girls 0.6 injuries/1000 h. Ankle sprains, low back pain and knee injuries were the most common ones. Sixty-five percent were new injuries, and the majority of these injuries were located at the knee joint followed by the ankle joint, while most of the recurrent injuries were found in the lumbar spine. Boys suffered mainly from low back pain and ankle injuries and girls from low back pain and knee injuries. Forty-three percent of the injuries caused absence from tennis for more than 4 weeks and 31% more than 1 week.

  12. Total ankle prostheses in rheumatoid arthropathy

    Science.gov (United States)

    Schutte, Bernard; Louwerens, Jan Willem K; van den Hoogen, Frank H J; de Waal Malefijt, Maarten C

    2009-01-01

    Background and purpose The first generations of total ankle replacements (TARs) showed a high rate of early failure. In the last decades, much progress has been made in the development of TARs, with the newer generation showing better results. We evaluated TARs implanted with rheumatoid arthritis (RA) or juvenile inflammatory arthritis (JIA) as indication. Patients and methods 58 total ankle prostheses (Buechel-Pappas and STAR type) were implanted in patients with RA (n = 53) or JIA (n = 5) in 54 patients (4 bilateral). After a mean follow-up of 2.7 (1–9) years, all patients were reviewed by two orthopedic surgeons who were not the surgeons who performed the operation. Standard AP and lateral radiographs were taken and a Kofoed ankle score was obtained; this is a clinical score ranging from 0–100 and consists of sub-scores for pain, disability, and range of motion. Results 2 patients died of unrelated causes. Of the 52 patients who were alive (56 prostheses), 51 implants were still in place and showed no signs of loosening on the most recent radiographs. The mean Kofoed score at follow-up was 73 points (SD 16, range 21–92). 4 patients showed a poor result (score < 50) with persistent pain for which no obvious reason could be found. 5 implants were removed, 4 because of infection and 1 because of aseptic loosening. Interpretation Medium-term results of the STAR and BP types of TAR in RA were satisfactory. The main reason for failure of the implant was infection. PMID:19634020

  13. 10-year survival of total ankle arthroplasties

    Science.gov (United States)

    2011-01-01

    Background and purpose There is an ongoing need to review large series of total ankle replacements (TARs) for monitoring of changes in practice and their outcome. 4 national registries, including the Swedish Ankle Register, have previously reported their 5-year results. We now present an extended series with a longer follow-up, and with a 10-year survival analysis. Patients and methods Records of uncemented 3-component TARs were retrospectively reviewed, determining risk factors such as age, sex, and diagnosis. Prosthetic survival rates were calculated with exchange or removal of components as endpoint—excluding incidental exchange of the polyethylene meniscus. Results Of the 780 prostheses implanted since 1993, 168 (22%) had been revised by June 15, 2010. The overall survival rate fell from 0.81 (95% CI: 0.79–0.83) at 5 years to 0.69 (95% CI: 0.67–0.71) at 10 years. The survival rate was higher, although not statistically significantly so, during the latter part of the period investigated. Excluding the STAR prosthesis, the survival rate for all the remaining designs was 0.78 at 10 years. Women below the age of 60 with osteoarthritis were at a higher risk of revision, but age did not influence the outcome in men or women with rheumatoid arthritis. Revisions due to technical mistakes at the index surgery and instability were undertaken earlier than revisions for other reasons. Interpretation The results have slowly improved during the 18-year period investigated. However, we do not believe that the survival rates of ankle replacements in the near future will approach those of hip and knee replacements—even though improved instrumentation and design of the prostheses, together with better patient selection, will presumably give better results. PMID:22066551

  14. Clinical measurement of mechanical ankle instability.

    Science.gov (United States)

    Parasher, Raju K; Nagy, Dawn R; Em, April L; Phillips, Howard J; Mc Donough, Andrew L

    2012-10-01

    Clinicians commonly use the anterior draw test (ligament laxity) and distal fibular position (lateral malleolus displacement), to measure ankle instability. The purpose of this study was to establish intra-rater and inter-rater reliability for the anterior draw test and distal fibular position in a clinical setting. The anterior draw test (AD) was measured with a plastic Goniometer, and was defined as the linear displacement of the foot as it is drawn anteriorly with the ankle held in 20 degrees of plantar-flexion. Distal fibular position (DFP) was measured in standing using a digital vernier caliper and was the relative linear distance between the lateral and the medial malleoli. 20 participants aged 21-28 volunteered for the study and were measured on both ankles. It was found that Intra-tester reliability (ICC) ranged from 0.88 to 0.97 for AD and DFP; while inter-tester reliability (ICC) was 0.6 for AD and 0.77 for DFP. In addition for measures across trials, the standard error of the measurement (SEM) was, on average 0.66 mm for AD and 1.7 mm for DFP. While the limits of agreement (LOA) was ±0.17 mm for AD and ±4.03 mm for DFP. However, the SEM and LOA between testers was 2.27 mm and ±2.27 mm respectively for AD; and for 3.1 mm and ±10.4 mm for DFP. Overall the results suggest that both measures, as defined in this study exhibit moderate to good reliability and low standard error of measurement, suggesting a high degree of repeatability across trials.

  15. Robotic Ankle for Omnidirectional Rock Anchors

    Science.gov (United States)

    Parness, Aaron; Frost, Matthew; Thatte, Nitish

    2013-01-01

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

  16. Mechanically induced ankle inversion during human walking and jumping.

    NARCIS (Netherlands)

    Nieuwenhuijzen, P.H.J.A.; Grüneberg, C.; Duysens, J.E.J.

    2002-01-01

    A new method to study sudden ankle inversions during human walking and jumping is presented. Ankle inversions of 25 degrees were elicited using a box containing a trap door. During the gait task, subjects walked at a speed of 4 km/h. At a pre-programmed delay after left heel strike, an electromagnet

  17. Medium- to long-term outcome of ankle arthrodesis

    NARCIS (Netherlands)

    R.P.M. Hendrickx; S.A.S. Stufkens; E.E. de Bruijn; I.N. Sierevelt; C.N. van Dijk; G.M.M.J. Kerkhoffs

    2011-01-01

    Despite improvement in outcome after ankle arthroplasty, fusion of the ankle joint is still considered the gold standard. A matter of concern is deterioration of clinical outcome as a result of loss of motion and advancing degeneration of adjacent joints. We performed a long-term study to address th

  18. Dislocated ankle fracture complicated by near total distal ischaemia

    Science.gov (United States)

    Duygun, Fatih; Sertkaya, Omer; Aldemir, Cengiz; Dogan, Ali

    2013-01-01

    Total arterial ischaemia is rarely seen following a dislocated ankle fracture but if it does and intervention is not made, it can lead to serious morbidity. We present a 39-year-old woman with almost total occlusion in the arteria tibialis and arteria dorsalis pedis following a dislocated ankle fracture as a result of a bicycle fall. PMID:24248319

  19. Simultaneous bilateral total ankle replacement using a 3-component prosthesis

    Science.gov (United States)

    2011-01-01

    Background and purpose Total ankle replacement is an established surgical procedure in patients with end-stage ankle osteoarthritis. We analyzed complications and medium-term results in patients with simultaneous bilateral total ankle replacement. Patients and methods 10 women and 16 men, mean age 60 (SD 13) years, were followed for a median of 5 (2–10) years. Results There were no intraoperative or perioperative complications, with the exception of 1 patient with prolonged wound healing. Major revision surgery was necessary in 6 of the 52 ankles, including 4 revisions of prosthetic components. The average pain score decreased from 6.9 (4−10) to 1.8 (0−4) points. The American Orthopaedic Foot and Ankle Society hindfoot score increased from 32 (SD 14) points preoperatively to 74 (SD 12) points postoperatively. The average range of motion increased from 28° (SD 12) preoperatively to 38° (SD 9) postoperatively. All 8 categories of SF-36 score improved. Interpretation Simultaneous bilateral total ankle replacement is a suitable method for restoration of function and attainment of pain relief in patients with bilateral end-stage ankle osteoarthritis. The results of this procedure, including complication rates, revision rates, and functional outcome, are comparable to those reported in patients with unilateral total ankle replacement. PMID:21999622

  20. Hindfoot endoscopy for posterior ankle impingement. Surgical technique

    NARCIS (Netherlands)

    van Dijk, C.N.; de Leeuw, P.A.J.; Scholten, P.E.

    2009-01-01

    BACKGROUND: The surgical treatment of posterior ankle impingement is associated with a high rate of complications and a substantial time to recover. An endoscopic approach to the posterior ankle (hindfoot endoscopy) may lack these disadvantages. We hypothesized that hindfoot endoscopy causes less mo

  1. Recycling energy to restore impaired ankle function during human walking.

    Directory of Open Access Journals (Sweden)

    Steven H Collins

    Full Text Available BACKGROUND: Humans normally dissipate significant energy during walking, largely at the transitions between steps. The ankle then acts to restore energy during push-off, which may be the reason that ankle impairment nearly always leads to poorer walking economy. The replacement of lost energy is necessary for steady gait, in which mechanical energy is constant on average, external dissipation is negligible, and no net work is performed over a stride. However, dissipation and replacement by muscles might not be necessary if energy were instead captured and reused by an assistive device. METHODOLOGY/PRINCIPAL FINDINGS: We developed a microprocessor-controlled artificial foot that captures some of the energy that is normally dissipated by the leg and "recycles" it as positive ankle work. In tests on subjects walking with an artificially-impaired ankle, a conventional prosthesis reduced ankle push-off work and increased net metabolic energy expenditure by 23% compared to normal walking. Energy recycling restored ankle push-off to normal and reduced the net metabolic energy penalty to 14%. CONCLUSIONS/SIGNIFICANCE: These results suggest that reduced ankle push-off contributes to the increased metabolic energy expenditure accompanying ankle impairments, and demonstrate that energy recycling can be used to reduce such cost.

  2. Recycling Energy to Restore Impaired Ankle Function during Human Walking

    NARCIS (Netherlands)

    Collins, S.H.; Kuo, A.D.

    2010-01-01

    Background: Humans normally dissipate significant energy during walking, largely at the transitions between steps. The ankle then acts to restore energy during push-off, which may be the reason that ankle impairment nearly always leads to poorer walking economy. The replacement of lost energy is nec

  3. PREVALENCE AND TYPES OF SPORTS INJURIES PRESENTING TO EMERGENCY DEPARTMENT SUEZ CANAL UNIVERSITY HOSPITAL

    Directory of Open Access Journals (Sweden)

    Adel Hamed Elbaih

    2016-10-01

    Full Text Available Inroduction: regular physical activity is essential for the prevention of various diseases and reduces the risk of premature mortality in general and coronary heart disease, hypertension, colon cancer, obesity and diabetes mellitus in particular. Aim of this study was to assess the most common sports causing injuries and to assess the types and mechanisms of these injuries. Patients and methods: The researcher examined 250 patients attending emergency departmentl. Results: The study showed that the most common type of sports involved in injury was football .The ankle was the most common affected part in the whole body . Chest contusion and back contusion were the most common types of sports injuries in head, neck and trunk. Fracture scaphoid and fissure radius were the most common sport injuries. Ankle sprain was the most common injury. The study showed that (62.7% of the studied patients who were playing football had injuries in the lower limbs. Ankle sprain was the most common sport injury that was associated with wearing football shoes . Conclusion: Ankle sprain was the most common sport injury associated with artificial grass court . Wrist sprain was the common sport injury in the upper limbs associated with artificial grass court .

  4. Technique of Arthroscopic Treatment of Impingement After Total Ankle Arthroplasty.

    Science.gov (United States)

    Gross, Christopher E; Neumann, Julie A; Godin, Jonathan A; DeOrio, James K

    2016-04-01

    Rates of medial and/or lateral gutter impingement after total ankle replacement are not insignificant. If impingement should occur, it typically arises an average of 17 months after total ankle replacement. Our patient underwent treatment for right ankle medial gutter bony impingement with arthroscopic debridement 5 years after her initial total ankle replacement. Standard anteromedial and anterolateral portals and a 30° 2.7-mm-diameter arthroscope were used. An aggressive soft-tissue and bony resection was performed using a combination of curettes, a 3.5-mm shaver, a 5.5-mm unsheathed burr, a drill, and a radiofrequency ablator. This case shows that arthroscopic treatment is an effective and potentially advantageous alternative to open treatment of impingement after total ankle replacement. In addition, symptoms of impingement often improve in a short amount of time after arthroscopic debridement of the medial and/or lateral gutter.

  5. Finite element analysis of a composite artificial ankle

    Science.gov (United States)

    Perkins, Leigh Ann; Johnston, Lawrence; Denniston, Charles; Czekalski, Blaise E.

    1993-01-01

    Ultra-light carbon fiber composite materials are being utilized in artificial limbs with increasing frequency in recent years. Dr. Arthur Copes, an orthotist from Baton Rouge, Louisiana, has developed a graphite expoxy composite material artificial ankle (Copes/Bionic Ankle) that is intended to be used by amputees who require the most advanced above-and-below-the-knee prosthetic devices. The Copes/Bionic Ankle is designed to reproduce the function of the natural ankle joint by allowing the composite material to act as a spring mechanism without the use of metal mechanical parts. NASA Marshall Space Flight Center has agreed to participate in the design effort by providing the structural analysis of the artificial ankle design.

  6. Analysis of the Stress and Displacement Distribution of Inferior Tibiofibular Syndesmosis Injuries Repaired with Screw Fixation: A Finite Element Study

    OpenAIRE

    Qinghua Liu; Kun Zhang; Yan Zhuang; Zhong Li; Bin Yu; Guoxian Pei

    2013-01-01

    BACKGROUND: Studies of syndesmosis injuries have concentrated on cadaver models. However, they are unable to obtain exact data regarding the stress and displacement distribution of various tissues, and it is difficult to compare models. We investigated the biomechanical effects of inferior tibiofibular syndesmosis injuries (ITSIs) and screw fixation on the ankle using the finite element (FE) method. METHODOLOGY/PRINCIPAL FINDINGS: A three-dimensional model of a healthy ankle complex was devel...

  7. Effects of changing speed on knee and ankle joint load during walking and running.

    Science.gov (United States)

    de David, Ana Cristina; Carpes, Felipe Pivetta; Stefanyshyn, Darren

    2015-01-01

    Joint moments can be used as an indicator of joint loading and have potential application for sports performance and injury prevention. The effects of changing walking and running speeds on joint moments for the different planes of motion still are debatable. Here, we compared knee and ankle moments during walking and running at different speeds. Data were collected from 11 recreational male runners to determine knee and ankle joint moments during different conditions. Conditions include walking at a comfortable speed (self-selected pacing), fast walking (fastest speed possible), slow running (speed corresponding to 30% slower than running) and running (at 4 m · s(-1) ± 10%). A different joint moment pattern was observed between walking and running. We observed a general increase in joint load for sagittal and frontal planes as speed increased, while the effects of speed were not clear in the transverse plane moments. Although differences tend to be more pronounced when gait changed from walking to running, the peak moments, in general, increased when speed increased from comfortable walking to fast walking and from slow running to running mainly in the sagittal and frontal planes. Knee flexion moment was higher in walking than in running due to larger knee extension. Results suggest caution when recommending walking over running in an attempt to reduce knee joint loading. The different effects of speed increments during walking and running should be considered with regard to the prevention of injuries and for rehabilitation purposes.

  8. THE EFFECT OF CRYOTHERAPY ON THREE DIMENSIONAL ANKLE KINEMATICS DURING A SIDESTEP CUTTING MANEUVER

    Directory of Open Access Journals (Sweden)

    Jean L. McCrory

    2004-06-01

    Full Text Available Although cryotherapy is commonly used in the treatment of acute and chronic athletic injuries, the deleterious effects of limb cooling, such as decreased nerve and muscle function, slowed sensation and inhibition of normal relaxes, may put an athlete at increased risk of additional injury. The purpose of this study was to determine the effects of cryotherapy on subtalar and ankle joint kinematics of healthy athletes performing a sidestep 45° cut. We hypothesized that greater joint displacements and velocities would be seen after icing. Twenty one subjects performed a 45° sidestep cut prior to and after limb cooling. Retroreflective markers were placed on the subject's shank and foot while 6 high-speed cameras were used to collect the kinematic data. In this test-retest controlled laboratory study, a repeated measures ANOVA was performed on the PRE and POST icing data for the minimum and maximum joint displacements and velocities. No statistical differences were noted between the PRE and POST icing conditions. The results indicate that a 10-minute icing treatment did not have an effect on either the movement patterns or angular velocities. Our results do not support any change in practice of icing injured ankles for ten minutes during halftime of athletic events

  9. Musculoskeletal injuries and pain in dancers: a systematic review update.

    Science.gov (United States)

    Jacobs, Craig L; Hincapié, Cesar A; Cassidy, J David

    2012-01-01

    The objective of this study was to assemble and synthesize the best available literature from 2004 to 2008 on musculoskeletal injury and pain in dancers. MEDLINE and CINAHL were the primary sources of data. Indexed terms such as dance, dancer, dancing, athletic injuries, occupational injuries, sprains and strains, musculoskeletal diseases, bone density, menstruation disturbances, and eating disorders were used to search the databases. Citations were screened for relevance using a priori criteria, and relevant studies were critically reviewed for scientific merit by the best-evidence synthesis method. After screening, 19 articles were found to be scientifically admissible. Data from accepted studies were abstracted into evidence tables relating to: prevalence and associated factors; incidence and risk factors; intervention; and injury characteristics and prognosis of musculoskeletal injury and pain in dancers. Principal findings included: a high prevalence and incidence of lower extremity, hip and back injuries; preliminary evidence that psychosocial and psychological issues such as stress and coping strategies affect injury frequency and duration; history of a previous lateral ankle sprain is associated with an increased risk of ankle sprain in the contralateral ankle in dance students; fatigue may play a role in ACL injury in dancers; acute hamstring strains in dancers affect tendon more than muscle tissue, often resulting in prolonged absence from dance. It is concluded that, while there are positive developments in the literature on the epidemiology, diagnosis, prognosis, treatment, and prevention of MSK injuries and pain in dancers, much room for improvement remains. Suggestions for future research are offered.

  10. Injury risk management plan for volleyball athletes.

    Science.gov (United States)

    James, Lachlan P; Kelly, Vincent G; Beckman, Emma M

    2014-09-01

    Volleyball is an increasingly popular team sport. As with any competitive sport, there is an inherent risk of injury that must be recognized and collaboratively managed. This article provides a practical approach to the management of volleyball injuries within a team or organization. A brief review of the epidemiological data is presented which establishes (i) ankle sprain, (ii) shoulder overuse injury, (iii) patella tendinopathy, and (iv) anterior cruciate ligament injury as the primary injuries to address amongst these athletes. The interaction of modifiable and non-modifiable risk factors for these injuries are used to classify athletes into high-, medium- and low-risk groups. Targeted training interventions are suggested, based upon the risk level of the athlete, to minimize the occurrence of these injuries. Practical methods for integrating these activities into a training plan are also discussed.

  11. EFFICACY OF WEIGHT BEARING DISTAL TIBIOFIBULAR JOINT MOBILIZATION WITH MOVEMENT (MWM IN IMPROVING PAIN, DORSIFLEXION RANGE AND FUNCTION IN PATIENTS WITH POSTACUTE LATERAL ANKLE SPRAIN

    Directory of Open Access Journals (Sweden)

    Kumari Nisha

    2014-06-01

    Full Text Available Background: Various treatments in physiotherapy are available for ankle sprain with no consensus like taping, bracing, splinting, cryotherapy, electrotherapy modality like ultrasound, laser therapy, interferential therapy and HVGS, joint mobilization. Mulligan’s mobilizations-with movement (MWM have been proposed as novel manual therapy technique to improve joint ROM by combining physiological and accessory joint movements. He developed a suite of treatment techniques on the basis of his theory of positional faults and altered joint kinematics following injuries affecting spinal and peripheral joints. Objective: To find out the efficacy of distal tibiofibular joint MWM in conjunction with conventional treatment over conventional treatment alone for improving pain , dorsiflexion range and lower extremity function in patients with post acute lateral ankle sprain. Subject and methods: 30 lateral ankle sprain subjects were randomized into 2 groups:- Group 1(n=15 were received distal tibiofibular joint MWM along with conventional treatment and Group 2 (n=15 subjects were received conventional treatment only. Treatment consist of 3 sessions spread over 1 week, each session 48 hours apart and data is recorded at beginning and end of treatment regimen. Results: Independent t-test showed statistical significant improvement in only weight bearing lunge measure for dorsiflexion (p=0.008 in group 1 over group 2 and paired t-test was used for within group analysis which showed significant improvement in both the groups in all the outcome variables (p=0.000 Discussion and conclusion: Both the groups demonstrated significant improvement in pain, range and lower extremity function in lateral ankle sprain and distal tibiofibular joint mobilization with movement in conjunction with conventional treatment will be significantly more effective than conventional treatment alone in improving weight bearing ankle dorsiflexion range (Weight bearing lunge measure in

  12. Effects of a training program after surgically treated ankle fracture: a prospective randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Ekdahl Charlotte S

    2009-09-01

    Full Text Available Abstract Background Despite conflicting results after surgically treated ankle fractures few studies have evaluated the effects of different types of training programs performed after plaster removal. The aim of this study was to evaluate the effects of a 12-week standardised but individually suited training program (training group versus usual care (control group after plaster removal in adults with surgically treated ankle fractures. Methods In total, 110 men and women, 18-64 years of age, with surgically treated ankle fracture were included and randomised to either a 12-week training program or to a control group. Six and twelve months after the injury the subjects were examined by the same physiotherapist who was blinded to the treatment group. The main outcome measure was the Olerud-Molander Ankle Score (OMAS which rates symptoms and subjectively scored function. Secondary outcome measures were: quality of life (SF-36, timed walking tests, ankle mobility tests, muscle strength tests and radiological status. Results 52 patients were randomised to the training group and 58 to the control group. Five patients dropped out before the six-month follow-up resulting in 50 patients in the training group and 55 in the control group. Nine patients dropped out between the six- and twelve-month follow-up resulting in 48 patients in both groups. When analysing the results in a mixed model analysis on repeated measures including interaction between age-group and treatment effect the training group demonstrated significantly improved results compared to the control group in subjects younger than 40 years of age regarding OMAS (p = 0.028, muscle strength in the plantar flexors (p = 0.029 and dorsiflexors (p = 0.030. Conclusion The results of this study suggest that when adjusting for interaction between age-group and treatment effect the training model employed in this study was superior to usual care in patients under the age of 40. However, as only three

  13. Mobile-bearing total ankle arthroplasty : a fundamental assessment of the clinical, radiographic and functional outcomes

    NARCIS (Netherlands)

    Doets, Hendrik Cornelis

    2009-01-01

    Ankle arthritis often leads to significant impairments for the patient. As total ankle arthroplasty (TAA) with use of fixed-bearing (2-component) total ankle prostheses has a high rate of early failures, fusion of the ankle joint is, until today, considered to be the standard surgical treatment for

  14. Influence of distal tibiofibular synostosis on ankle function

    Institute of Scientific and Technical Information of China (English)

    HOU Zhen-hai; ZHOU Ji-hong; YE Hong; SHI Jian-guo; ZHENG Long-bao; YAO Jun; NI Zhi-ming

    2009-01-01

    Objective: To study the influence distal tibiofibular synostosis on ankle function.Methods: From October 1998 to October 2004,a total of 281 consecutive patients underwent operations because of ankle fractures or distal fractures of the tibia and fibula.Distal tibiofibular synostosis occurred after operation in 8 Patients.The duration of follow-up averaged 20.6 months (14-44 months).The ankle function was assessed on the basis of functional rating system described by Mazur.1Results: According to Mazur's ankle evaluation system,4 patients achieved an excellent result,2 a good result and 2 a fair result.The dorsiflexion of the synostosis ankle reduced by 8.26 degrees as compared with that of the contralateral ankle.and there was little influence on the plantar flexion.All the Patients had a normal gait.Conclusion: The distal tibiofibular synostosis after the operation of ankle fractures or distal fractures of the tibia and fibula usually gives rise to few symptoms and needs no specific treatment.

  15. Summary of Human Ankle Mechanical Impedance During Walking

    Science.gov (United States)

    Rouse, Elliott J.; Krebs, Hermano Igo

    2016-01-01

    The human ankle joint plays a critical role during walking and understanding the biomechanical factors that govern ankle behavior and provides fundamental insight into normal and pathologically altered gait. Previous researchers have comprehensively studied ankle joint kinetics and kinematics during many biomechanical tasks, including locomotion; however, only recently have researchers been able to quantify how the mechanical impedance of the ankle varies during walking. The mechanical impedance describes the dynamic relationship between the joint position and the joint torque during perturbation, and is often represented in terms of stiffness, damping, and inertia. The purpose of this short communication is to unify the results of the first two studies measuring ankle mechanical impedance in the sagittal plane during walking, where each study investigated differing regions of the gait cycle. Rouse et al. measured ankle impedance from late loading response to terminal stance, where Lee et al. quantified ankle impedance from pre-swing to early loading response. While stiffness component of impedance increases significantly as the stance phase of walking progressed, the change in damping during the gait cycle is much less than the changes observed in stiffness. In addition, both stiffness and damping remained low during the swing phase of walking. Future work will focus on quantifying impedance during the “push off” region of stance phase, as well as measurement of these properties in the coronal plane. PMID:27766187

  16. Sports injuries in adolescents' ball games: soccer, handball and basketball.

    OpenAIRE

    Yde, J; Nielsen, A.B.

    1990-01-01

    In a prospective study of 302 adolescent players in three ball games (soccer, handball and basketball), 119 incurred injuries. The injury incidence (number of injuries per 1000 playing hours) was 5.6 in soccer, 4.1 in handball and 3.0 in basketball. Ankle sprains accounted for 25 per cent of the injuries, finger sprains 32 per cent, strains in the thigh and leg 10 per cent, and tendinitis/apophysitis 12 per cent. The most serious injuries were four fractures, one anterior cruciate ligament ru...

  17. Balance in single-limb stance after surgically treated ankle fractures: a 14-month follow-up

    Directory of Open Access Journals (Sweden)

    Ageberg Eva

    2006-04-01

    Full Text Available Abstract Background The maintenance of postural control is fundamental for different types of physical activity. This can be measured by having subjects stand on one leg on a force plate. Many studies assessing standing balance have previously been carried out in patients with ankle ligament injuries but not in patients with ankle fractures. The aim of this study was to evaluate whether patients operated on because of an ankle fracture had impaired postural control compared to an uninjured age- and gender-matched control group. Methods Fifty-four individuals (patients operated on because of an ankle fracture were examined 14 months postoperatively. Muscle strength, ankle mobility, and single-limb stance on a force-platform were measured. Average speed of centre of pressure movements and number of movements exceeding 10 mm from the mean value of centre of pressure were registered in the frontal and sagittal planes on a force-platform. Fifty-four age- and gender-matched uninjured individuals (controls were examined in the single-limb stance test only. The paired Student t-test was used for comparisons between patients' injured and uninjured legs and between side-matched legs within the controls. The independent Student t-test was used for comparisons between patients and controls. The Chi-square test, and when applicable, Fisher's exact test were used for comparisons between groups. Multiple logistic regression was performed to identify factors associated with belonging to the group unable to complete the single-limb stance test on the force-platform. Results Fourteen of the 54 patients (26% did not manage to complete the single-limb stance test on the force-platform, whereas all controls managed this (p Conclusion One in four patients operated on because of an ankle fracture had impaired postural control compared to an age- and gender-matched control group. Age over 45 years and decreased strength in the ankle plantar flexors and dorsiflexors

  18. Registry data trends of total ankle replacement use.

    Science.gov (United States)

    Roukis, Thomas S; Prissel, Mark A

    2013-01-01

    Joint arthroplasty registry data are meaningful when evaluating the outcomes of total joint replacement, because they provide unbiased objective information regarding survivorship and incidence of use. Critical evaluation of the registry data information will benefit the surgeon, patient, and industry. However, the implementation and acceptance of registry data for total ankle replacement has lagged behind that of hip and knee implant arthroplasty. Currently, several countries have national joint arthroplasty registries, with only some procuring information for total ankle replacement. We performed an electronic search to identify publications and worldwide registry databanks with pertinent information specific to total ankle replacement to determine the type of prostheses used and usage trends over time. We identified worldwide registry data from 33 countries, with details pertinent to total ankle replacement identified in only 6 countries. The obtained information was arbitrarily stratified into 3 distinct periods: 2000 to 2006, 2007 to 2010, and 2011. Within these study periods, the data from 13 total ankle replacement systems involving 3,980 ankles were identified. The vast majority (97%) of the reported ankle replacements were 3-component, mobile-bearing, uncemented prostheses. Three usage trends were identified: initial robust embracement followed by abrupt disuse, minimal use, and initial embracement followed by sustained growth in implantation. Before the widespread acceptance of new total ankle replacements, the United States should scrutinize and learn from the international registry data and develop its own national joint registry that would include total ankle replacement. Caution against the adoption of newly released prostheses, especially those without readily available revision components, is recommended.

  19. Preoperative gait characterization of patients with ankle arthrosis.

    Science.gov (United States)

    Khazzam, Michael; Long, Jason T; Marks, Richard M; Harris, Gerald F

    2006-08-01

    The purpose of this study was to evaluate the kinematic changes that occur about the foot and ankle during gait in patients with degenerative joint disease (DJD). By comparing a normal adult population with what was found in the DJD population we determined how the motion of theses groups differed, thereby characterizing how this pathology affects foot and ankle motion. A 15-camera Vicon Motion Analysis System was used in conjunction with weight bearing radiographs to obtain three-dimensional motion of the foot and ankle during ambulation. The study was comprised of 34 patients and 35 ankles diagnosed with DJD (19 men and 15 women) of the ankle and 25 patients with normal ankles (13 men and 12 women). Dynamic foot and ankle motion was analyzed using the four-segment Milwaukee Foot Model (MFM). The data from this model resulted in three-dimensional (3D) kinematic parameters in the sagittal, coronal, and transverse planes as well as spatial-temporal parameters. Patient health status was evaluated using the SF-36 Health Survey and American Orthopaedics Foot and Ankle Society (AOFAS) hindfoot scores. The DJD group showed significant differences (pgait. This decreased range of motion may be related to several factors including bony deformity, muscle weakness, and attempts to decrease the pain associated with weight bearing. To date there has not been a study which describes the effect of this disease process on motion of the foot and ankle. These findings may prove to be useful in the pre-operative assessment of these patients.

  20. Agility to INBONE: anterior and posterior approaches to the difficult revision total ankle replacement.

    Science.gov (United States)

    DeVries, J George; Scott, Ryan T; Berlet, Gregory C; Hyer, Christopher F; Lee, Thomas H; DeOrio, James K

    2013-01-01

    Total ankle replacement is now acknowledged as a viable alternative to ankle arthrodesis for end-stage ankle arthritis. The authors present a series of 14 patients who were converted from the Agility total ankle replacement to an INBONE total ankle replacement. This report is unique in that anterior and posterior approaches are discussed and detailed. Although the authors present successful conversion of the Agility total ankle replacement to an INBONE total ankle replacement, the difficulty of this procedure is demonstrated by the high complication rate and 2 early failures.

  1. Outcome of unilateral ankle arthrodesis and total ankle replacement in terms of bilateral gait mechanics.

    Science.gov (United States)

    Chopra, Swati; Rouhani, Hossein; Assal, Mathieu; Aminian, Kamiar; Crevoisier, Xavier

    2014-03-01

    Previous studies assessed the outcome of ankle arthrodesis (AA) and total ankle replacement (TAR) surgeries; however, the extent of postoperative recovery towards bilateral gait mechanics (BGM) is unknown. We evaluated the outcome of the two surgeries at least 2 years post rehabilitation, focusing on BGM. 36 participants, including 12 AA patients, 12 TAR patients, and 12 controls were included. Gait assessment over 50 m distance was performed utilizing pressure insoles and 3D inertial sensors, following which an intraindividual comparison was performed. Most spatiotemporal and kinematic parameters in the TAR group were indicative of good gait symmetry, while the AA group presented significant differences. Plantar pressure symmetry among the AA group was also significantly distorted. Abnormality in biomechanical behavior of the AA unoperated, contralateral foot was observed. In summary, our results indicate an altered BGM in AA patients, whereas a relatively fully recovered BGM is observed in TAR patients, despite the quantitative differences in several parameters when compared to a healthy population. Our study supports a biomechanical assessment and rehabilitation of both operated and unoperated sides after major surgeries for ankle osteoarthrosis.

  2. Use of a trabecular metal implant in ankle arthrodesis after failed total ankle replacement

    Science.gov (United States)

    2010-01-01

    Background and purpose Arthrodesis after failed total ankle replacement is complicated and delayed union, nonunion, and shortening of the leg often occur—especially with large bone defects. We investigated the use of a trabecular metal implant and a retrograde intramedullary nail to obtain fusion. Patients and methods 13 patients with a migrated or loose total ankle implant underwent arthrodesis with the use of a retrograde intramedullary nail through a trabecular metal Tibial Cone. The mean follow-up time was 1.4 (0.6–3.4) years. Results At the last examination, 7 patients were pain-free, while 5 had some residual pain but were satisfied with the procedure. 1 patient was dissatisfied and experienced pain and swelling when walking. The implant-bone interfaces showed no radiographic zones or gaps in any patient, indicating union. Interpretation The method is a new way of simplifying and overcoming some of the problems of performing arthrodesis after failed total ankle replacement. PMID:21067435

  3. Strategies for Revision Total Ankle Replacement

    Directory of Open Access Journals (Sweden)

    Thomas S. Roukis, DPM, PhD, FACFAS

    2014-12-01

    Full Text Available As the frequency of primary total ankle replacement (TAR continues to build, revision will become more commonplace. At present there are no “standard principles” associated with revision TAR. What is clear is that the current approaches are technically complex, fraught with complications and no one approach represents the only answer. Exchange of TAR metallic components to the same system standard or dedicated revision components are viable options with limited occurrence of complications. Explantation and conversion to custom-design long stemmed components has limited availability. Explantation and conversion to another TAR system is high-risk and has strong potential for complications. The use of metal reinforced polymethylmethacrylate cement augmentation of failed TAR systems and tibio-talo-calcaneal arthrodesis should be reserved for very select situations where other options are not possible. There is a real need for long-term survivorship following revision TAR and future efforts ought to be directed in this area.

  4. Early intra-articular complement activation in ankle fractures

    DEFF Research Database (Denmark)

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

    2014-01-01

    osteochondritis dissecans (OCD) of the ankle. All fractures needed external fixation during which joint effusions were collected. Fluid analysis was done by ELISA measuring aggrecan, bFGF, IL-1 β, IGF-1, and the complement components C3a, C5a, and C5b-9. The time periods between occurrence of fracture...... and OCD patients, bFGF, IGF-1, and all complement components were significantly higher concentrated in ankle joints with fractures (P Complement activation and inflammatory cell infiltration characterize the joint biology following acute ankle fractures....

  5. 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.

  6. Seasonality of Ankle Swelling: Population Symptom Reporting Using Google Trends.

    Science.gov (United States)

    Liu, Fangwei; Allan, G Michael; Korownyk, Christina; Kolber, Michael; Flook, Nigel; Sternberg, Harvey; Garrison, Scott

    2016-07-01

    In our experience, complaints of ankle swelling are more common in summer, typically from patients with no obvious cardiovascular disease. Surprisingly, this observation has never been reported. To objectively establish this phenomenon, we sought evidence of seasonality in the public's Internet searches for ankle swelling. Our data, obtained from Google Trends, consisted of all related Google searches in the United States from January 4, 2004, to January 26, 2016. Consistent with our expectations and confirmed by similar data for Australia, Internet searches for information on ankle swelling are highly seasonal (highest in midsummer), with seasonality explaining 86% of search volume variability.

  7. Diabetic charcot neuroarthropathy of the foot and ankle with osteomyelitis.

    Science.gov (United States)

    Ramanujam, Crystal L; Stapleton, John J; Zgonis, Thomas

    2014-10-01

    One of the most devastating foot and/or ankle complications in the diabetic population with peripheral neuropathy is the presence of Charcot neuroarthropathy (CN). In recent years, diabetic limb salvage has been attempted more frequently as opposed to major lower extremity amputation for CN of the foot and ankle with ulceration and/or deep infection. Treatment strategies for osteomyelitis in the diabetic population have evolved. This article reviews some of the most common surgical strategies recommended for the diabetic patient with CN of the foot and/or ankle and concomitant osteomyelitis.

  8. Effects of hip and head position on ankle range of motion, ankle passive torque, and passive gastrocnemius tension.

    Science.gov (United States)

    Andrade, R J; Lacourpaille, L; Freitas, S R; McNair, P J; Nordez, A

    2016-01-01

    Ankle joint range of motion (ROM) is notably influenced by the position of the hip joint. However, this result remains unexplained. Thus, the aim of this study was to test if the ankle passive torque and gastrocnemius muscle tension are affected by the hip and the head positions. The torque and the muscle shear elastic modulus (measured by elastography to estimate muscle tension) were collected in nine participants during passive ankle dorsiflexions performed in four conditions (by combining hip flexion at 90 or 150°, and head flexed or neutral). Ankle maximum dorsiflexion angle significantly decreased by flexing the hip from 150 to 90° (P  0.05). Maximal passive torque and shear elastic modulus were higher with the hip flexed at 90° (P  0.05) were found for both torque and shear elastic modulus at a given common ankle angle among conditions. Shifts in maximal ankle angle due to hip angle manipulation are not related neither to changes in passive torque nor tension of the gastrocnemius. Further studies should be addressed to better understand the functional role of peripheral nerves and fasciae in the ankle ROM limits.

  9. Effect of anterior translation of the talus on outcomes of three-component total ankle arthroplasty

    Science.gov (United States)

    2013-01-01

    Background Ankle osteoarthritis commonly involves sagittal malalignment with anterior translation of the talus relative to the tibia. Total ankle arthroplasty has become an increasingly popular treatment for patients with symptomatic ankle osteoarthritis. However, no comprehensive study has been conducted on the outcomes of total ankle arthroplasty for osteoarthritis with preoperative sagittal malalignment. The purpose of this study was to evaluate the effect of anterior translation of the talus on outcomes of three-component total ankle arthroplasty. Methods One hundred and four osteoarthritic ankles in 104 patients who underwent three-component total ankle arthroplasty were included in this study. The 104 ankles were divided into 2 groups: ankles with anteriorly translated talus (50 ankles), and ankles with non-translated talus (54 ankles). Clinical and radiographic outcomes were assessed in both groups. The mean follow-up duration was 42.8 ± 17.9 months (range, 24 to 95 months). Results Forty-six (92%) of 50 ankles with anterior translation of the talus showed relocation of the talus within the mortise at 6 months, and 48 (96%) ankles were relocated at 12 months after total ankle arthroplasty. But, 2 (4%) ankles were not relocated until the final follow-up. The AOFAS scores, ankle range of motion, and radiographic outcomes showed no significant difference between the two groups at the final follow-up (p > 0.05 for each). Conclusions In majority of cases, the anteriorly translated talus in osteoarthritic ankles was restored to an anatomical position within 6 months after successful three-component total ankle arthroplasty. The clinical and radiographic outcomes in the osteoarthritic ankles with anteriorly translated talus group were comparable with those in non-translated talus group. PMID:24007555

  10. Analysis of 3-dimensional finite element after reconstruction of impaired ankle deltoid ligament

    OpenAIRE

    Ji, Yunhan; Tang, Xianzhong; Li, Yifan; Xu, Wei; Qiu, Wenjun

    2016-01-01

    We compared four repair techniques for impaired ankle ligament deltoideum, namely Wiltberger, Deland, Kitaoka and Hintermann using a 3-dimensional finite element. We built an ankle ligament deltoideum model, including six pieces of bone structures, gristles and main ligaments around the ankle. After testing the model, we built an impaired ligament deltoideum model plus four reconstruction models. Subsequently, different levels of force on ankles with different flexion were imposed and ankle b...

  11. Treatment of Isolated Ankle Osteoarthritis with Arthrodesis or the Total Ankle Replacement: A Comparison of Early Outcomes

    Science.gov (United States)

    Saltzman, Charles L.; Kadoko, Robert G.

    2010-01-01

    Background Ankle arthrodesis and replacement are two common surgical treatment options for end-stage ankle osteoarthritis. However, the relative value of these alternative procedures is not well defined. This study compared the clinical and radiographic outcomes as well as the early perioperative complications of the two procedures. Methods Between January 2, 1998 and May 31, 2002, 138 patients were treated with ankle fusion or replacements. Seventy one patients had isolated posttraumatic or primary ankle arthritis. However, patients with inflammatory arthritis, neuropathic arthritis, concomitant hind foot fusion, revision procedures and two component system ankle replacement were excluded. Among them, one group of 42 patients had a total ankle replacement (TAR), whereas the other group of 29 patients underwent ankle fusion. A complete follow-up could be performed on 89% (37/42) and 73% (23/29) of the TAR and ankle fusion group, respectively. The mean follow-up period was 4.2 years (range, 2.2 to 5.9 years). Results The outcomes of both groups were compared using a student's t-test. Only the short form heath survery mental component summary score and Ankle Osteoarthritis Scale pain scale showed significantly better outcomes in the TAR group (p < 0.05). In the radiographic evaluation, there was no significant difference in preoperative and postoperative osteoarthritis between the TAR and fusion groups. Conclusions The clinical results of TAR are similar to those of fusion at an average follow-up of 4 years. However, the arthroplasty group showed better pain relief and more postoperative complications that required surgery. PMID:20190994

  12. Analysis of injuries in taekwondo athletes.

    Science.gov (United States)

    Ji, MinJoon

    2016-01-01

    [Purpose] The present study aims to provide fundamental information on injuries in taekwondo by investigating the categories of injuries that occur in taekwondo and determining the locations of these injuries. [Subjects and Methods] The data of 512 taekwondo athletes were collected. The sampling method was convenience sampling along with non-probability sampling extraction methods. Questionnaire forms were used to obtain the data. [Results] The foot, knee, ankle, thigh, and head were most frequently injured while practicing taekwondo, and contusions, strains, and sprains were the main injuries diagnosed. [Conclusion] It is desirable to decrease the possibility of injuries to the lower extremities for extending participation in taekwondo. Other than the lower extremities, injuries of other specific body parts including the head or neck could be important factors limiting the duration of participation. Therefore, it is necessary to cope with these problems before practicing taekwondo.

  13. Find an Orthopaedic Foot and Ankle MD/DO

    Science.gov (United States)

    ... AAOS). Selecting a Medical Provider When selecting a medical provider to care for your feet and ankles, be sure to ask him/her about: Medical school education Accredited residency training Areas of practice ...

  14. 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.

  15. Ultrasound-guided intervention in the ankle and foot

    Science.gov (United States)

    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

  16. Multivariable dynamic ankle mechanical impedance with relaxed muscles.

    Science.gov (United States)

    Lee, Hyunglae; Krebs, Hermano Igo; Hogan, Neville

    2014-11-01

    Neurological or biomechanical disorders may distort ankle mechanical impedance and thereby impair locomotor function. This paper presents a quantitative characterization of multivariable ankle mechanical impedance of young healthy subjects when their muscles were relaxed, to serve as a baseline to compare with pathophysiological ankle properties of biomechanically and/or neurologically impaired patients. Measurements using a highly backdrivable wearable ankle robot combined with multi-input multi-output stochastic system identification methods enabled reliable characterization of ankle mechanical impedance in two degrees-of-freedom (DOFs) simultaneously, the sagittal and frontal planes. The characterization included important ankle properties unavailable from single DOF studies: coupling between DOFs and anisotropy as a function of frequency. Ankle impedance in joint coordinates showed responses largely consistent with a second-order system consisting of inertia, viscosity, and stiffness in both seated (knee flexed) and standing (knee straightened) postures. Stiffness in the sagittal plane was greater than in the frontal plane and furthermore, was greater when standing than when seated, most likely due to the stretch of bi-articular muscles (medial and lateral gastrocnemius). Very low off-diagonal partial coherences implied negligible coupling between dorsiflexion-plantarflexion and inversion-eversion. The directions of principal axes were tilted slightly counterclockwise from the original joint coordinates. The directional variation (anisotropy) of ankle impedance in the 2-D space formed by rotations in the sagittal and frontal planes exhibited a characteristic "peanut" shape, weak in inversion-eversion over a wide range of frequencies from the stiffness dominated region up to the inertia dominated region. Implications for the assessment of neurological and biomechanical impairments are discussed.

  17. Supramalleolar osteotomy for realignment of the ankle joint.

    Science.gov (United States)

    Siddiqui, Noman A; Herzenberg, John E; Lamm, Bradley M

    2012-10-01

    Ankle replacement systems have not been as reliable as hip replacements in providing long-term relief of pain, increased motion, and return to full activity. Supramalleolar Osteotomy is an extraarticular procedure that realigns the mechanical axis, thereby restoring ankle function. The literature discussing knee arthritis has shown that realignment osteotomies of the tibia improve function and prolong total knee replacement surgery. The success of the procedure is predicated on understanding the patient's clinical and radiographic presentation and proper preoperative assessment and planning.

  18. The trAPP-study: Cost-effectiveness of an unsupervised e-health supported neuromuscular training program for the treatment of acute ankle sprains in general practice: Design of a randomized controlled trial

    NARCIS (Netherlands)

    A.K.E. Mailuhu (Adinda); E.A.L.M. Verhagen (Evert); J.M. van Ochten (John); P.J.E. Bindels (Patrick); S.M. Bierma-Zeinstra (Sita); M. van Middelkoop (Marienke)

    2015-01-01

    textabstractBackground: Ankle sprains are one of the most frequent injuries of the musculoskeletal system, with yearly around 680.000 new sprains in the Netherlands. Of these, about 130.000 people will visit the general practitioner (GP) each year. In addition, patients have an increased risk of a r

  19. Flap surgery in treatment of patients with pathology of ankle

    Directory of Open Access Journals (Sweden)

    D. I. Kutyanov

    2013-01-01

    Full Text Available Objective: to determine the capabilities and perspectives of flap surgery in treatment of patients with traumas and diseases of ankle joint region. Material and methods. The results of surgical treatment of 88 such patients. All the patients were treated in the Vreden Russian Research Institute of Traumatology and Orthopedics within the period from 2000 to 2011. All the patients had pedicled flap transfer (46 cases or free tissue transfer (45 cases. 11 patients had additional need in other open orthopedic operations of ankle joint. Besides this, scientific works dealing with the studied problem have been analyzed. Results and conclusions. It has been stated that flap surgery is predominantly used as the only and exhaustive method of treatment of such patients (87,5%. In these situations pedicled flap transfer and free tissue transfer tend to be used in comparatively equal quantities. Flap surgery is now seldom used as a component of complex surgical treatment. It is used only in some cases of bone reconstruction of distal tibia by Ilizarov bone transport, in some cases of tumors of ankle joint as well as in some cases of local infectious complications after internal fixation and total ankle arthroplasty. Patients with the pathology of this kind have a high need in free tissue transfer (from 66,7% to 83,3%. Progressing technology of total ankle arthroplasty will contribute to the frequency of use of flap surgery for patients with pathology of ankle joint.

  20. Kinesio-Taping Application and Corticospinal Excitability at the Ankle Joint

    Science.gov (United States)

    Tremblay, Francois; Karam, Siobhan

    2015-01-01

    Context Physiotherapists and athletic trainers often use Kinesio Taping (KT) to prevent and treat musculoskeletal injuries in athletes, yet evidence about its effects on neuromuscular performance is conflicting. Objective To investigate the influence of a KT application directed at the ankle joint on measures of corticospinal excitability with transcranial magnetic stimulation. Design Controlled laboratory study. Setting Research laboratory. Patients or Other Participants Twelve healthy young women (age = 23.1 ± 1.9 years; range, 19–26 years). Intervention(s) Participants were tested under no-tape and KT conditions according to a random sequence order. The KT was applied to the skin overlying the dorsiflexor and plantar-flexor muscles of the ankle. Main Outcome Measure(s) We assessed changes in the amplitude of motor-evoked potentials elicited at rest and during movement and changes in the silent period and background muscle activity during movement. Results Taping conditions had no effect on motor-evoked potential amplitude at rest or during movement or on the silent-period duration and background muscle activity. Conclusions Our results concur with other recent reports, showing KT applications have little influence at the neuromuscular level. Alterations in sensory feedback ascribed to elastic taping are likely insufficient to modulate corticospinal excitability in a functionally meaningful manner. PMID:26090708

  1. Simulations of foot stability during gait characteristic of ankle dorsiflexor weakness in the elderly.

    Science.gov (United States)

    Gefen, A

    2001-12-01

    Falls are common among the elderly and often cause injuries. They most frequently occut during walking and are associated with the chronic deterioration in neuromuscular and sensory systems, as well as with ankle dorsiflexor muscular weakness and lowered endurance of these muscles to fatigue. In the present study, a three-dimensional (3-D) finite element model of the structure of the foot was utilized to determine the effects of ankle dorsiflexor muscle weakness on the structural stability of the foot and, consequently, on the risk of falls during gait. The medial-lateral tendency of instability of the foot during gait in such conditions of weakness was analyzed by means of this model to identify the most important muscles used in controlling foot stability in affected individuals. The values of the eccentricity of the center of pressure under the heel during foot placement were used to indicate the degree of foot stability. The computational analysis indicated that it is the tibialis anterior muscle's weakness that dramatically decreases foot stability. Clinical investigation is now needed to correlate the significance of tibialis anterior muscle weakness with other known risk factors affecting the tendency to falls among the elderly, e.g., deterioration of sensory abilities. Rehabilitation practitioners and physical therapists may apply the present analytic approach to evaluate the stability of a foot before treatment and compare the predicted with the actual therapeutic results in terms of optimization of foot-ground pressure.

  2. Management of syndesmotic injuries: What is the evidence?

    Science.gov (United States)

    Schnetzke, Marc; Vetter, Sven Y; Beisemann, Nils; Swartman, Benedict; Grützner, Paul A; Franke, Jochen

    2016-01-01

    Ankle fractures are accompanied by a syndesmotic injury in about 10% of operatively treated ankle fractures. Usually, the total rupture of the syndesmotic ligaments with an external rotation force is associated with a Weber type B or C fracture or a Maisonneuve fracture. The clinical assessment should consist of a comprehensive history including mechanism of injury followed by a specific physical examination. Radiographs, and if in doubt magnetic resonance imaging, are needed to ascertain the syndesmotic injury. In the case of operative treatment the method of fixation, the height and number of screws and the need for hardware removal are still under discussion. Furthermore, intraoperative assessment of the accuracy of reduction of the fibula in the incisura using fluoroscopy is difficult. A possible solution might be the assessment with intraoperative three-dimensional imaging. The aim of this article is to provide a current concepts review of the clinical presentation, diagnosis and treatment of syndesmotic injuries. PMID:27900268

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

    Science.gov (United States)

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

    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, 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.

  4. 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.

  5. The mid-term outcome of total ankle arthroplasty and ankle fusion in rheumatoid arthritis: a systematic review

    Science.gov (United States)

    2013-01-01

    Background While arthrodesis is the standard treatment of a severely arthritic ankle joint, total ankle arthroplasty has become a popular alternative. This review provides clinical outcomes and complications of both interventions in patients with rheumatoid arthritis. Methods Studies were obtained from Pubmed, Embase and Web of Science (January 1980 – June 2011) and additional manual search. Inclusion criteria: original clinical study, > 5 rheumatoid arthritis (population), internal fixation arthrodesis or three-component mobile bearing prosthesis (intervention), ankle scoring system (outcome). The clinical outcome score, complication- and failure rates were extracted and the methodological quality of the studies was analysed. Results 17 observational studies of 868 citations were included. The effect size concerning total ankle arthroplasty ranged between 1.9 and 6.0, for arthrodesis the effect sizes were 4.0 and 4.7. Reoperation due to implant failure or reoperation due to non-union, was 11% and 12% for respectively total ankle arthroplasty and arthrodesis. The methodological quality of the studies was low (mean 6.4 out of a maximum of 14 points) and was lower for arthrodesis (mean 4.8) as compared to arthroplasty (mean 7.8) (p = 0.04). Conclusions 17 observational and no (randomized) controlled clinical trials are published on the effectiveness of arthroplasty or arthrodesis of the ankle in rheumatoid arthritis. Regardless of the methodological limitations it can be concluded that both interventions show clinical improvement and in line with current literature neither procedure is superior to the other. PMID:24161014

  6. Anthropometric measurements of ankle mortise for evaluating mortise fracture reductions with an aim to develop contoured implants

    Directory of Open Access Journals (Sweden)

    M.S. Patil

    2012-10-01

    Full Text Available Background: Ankle injuries are unique as they are not only intra-articular of weight bearing joint, but also caused by a variety of mechanism, each resulting in different pattern with ankle fractures. The primary concern is residual instability of the joint as malalignment or residual displacement can adversely affect the biomechanical behaviour of ankle and resulting loss of function, due to non restoration of normal anatomy. Therefore essential of proper anatomical parameters for assessment of reduction and improved designs of implants used to get good results. Objectives: Measuring various radiological and Anatomical normal parameters of the ankle mortise. Material and Methods: Cadaveric 20 fibula and 27 tibia. Anteroposterior and 15○ internal rotation radiographs, of both Ankles in 20 adult individuals formed the material. Following parameters measured- a Tibiofibular clearspace b Tibiofibular overlap c Talocrural angle d Length of medial and lateral malleoli e Angles sustained on medial surface of medial malleoli and lateral surface of lateral malleoli. Results: a Tibiofibular clear space on Anteroposterior 2.4mm (±1.3mm in 15○ rotation 4.5mm (±1.2mm. b Tibiofibular overlap in Anteroposterior 11.2mm (±4.4mm in 15○ rotation 4.2mm (±1.7mm. c Talocrural angle in Anteroposterior 77.7mm (±3.2mm in 15○ rotation 79.9mm (±2.9mm. d Length of medial malleolus in Anteroposterior 15.3mm (±1.01mm in 15○ rotation 15.3mm (±0.8mm. e Length of lateral malleolus in Anteroposterior 27.35mm (±3.8mm in 15○ rotation 26.5mm (±5.1mm. Angles- Lateral bend of lateral malleolus was ranging 8○-21○ average being 16.2○. Medial bend of medial malleolus was ranging 10○-34○, average 19.5○. Conclusion: The unique measurement of angles on both surface of malleoli and other parameters definitely contribute for assessment of reduction and prognostic evaluations of ankle fracture, Designing, moulding and manufacturing of prebent plates for use

  7. Clinical benefits of early cold therapy in accident and emergency following ankle sprain.

    Science.gov (United States)

    Sloan, J P; Hain, R; Pownall, R

    1989-03-01

    One hundred and forty-three patients presenting with ankle sprains within 24 h of injury were entered into a double blind study. Treatment consisted of a standardized regime of high dose non-steroidal anti-inflammatory medication and an elastic support for all patients, who were then randomly allocated to two groups. One group received immediate cold therapy, the other received simulated therapy. Assessments made at 7 days showed a trend in favour of the group receiving cold therapy, although this did not reach significance. It is concluded that cold therapy together with compression may have a beneficial effect but that a single application in the accident and emergency department is not justified when a background therapy of non-steroidal anti-inflammatory medication is given.

  8. Overuse injuries in classical ballet.

    Science.gov (United States)

    Khan, K; Brown, J; Way, S; Vass, N; Crichton, K; Alexander, R; Baxter, A; Butler, M; Wark, J

    1995-05-01

    Successful management of classical ballet dancers with overuse injuries requires an understanding of the art form, precise knowledge of anatomy and awareness of certain conditions. Turnout is the single most fundamental physical attribute in classical ballet and 'forcing turnout' frequently contributes to overuse injuries. Common presenting conditions arising from the foot and ankle include problems at the first metatarsophalangeal joint, second metatarsal stress fractures, flexor hallucis longus tendinitis and anterior and posterior ankle impingement syndromes. Persistent shin pain in dancers is often due to chronic compartment syndrome, stress fracture of the posteromedial or anterior tibia. Knee pain can arise from patellofemoral syndrome, patellar tendon insertional pathologies, or a combination of both. Hip and back problems are also prevalent in dancers. To speed injury recovery of dancers, it is important for the sports medicine team to cooperate fully. This permits the dancer to benefit from accurate diagnosis, technique correction where necessary, the full range of manual therapies to joint and soft tissue, appropriate strengthening programmes and maintenance of dance fitness during any time out of class with Pilates-based exercises and nutrition advice. Most overuse ballet conditions respond well to a combination of conservative therapies. Those dancers that do require surgical management still depend heavily on ballet-specific rehabilitation for a complete recovery.

  9. Incidence of injury in kickboxing participation.

    Science.gov (United States)

    Romaine, Linda J; Davis, Shala E; Casebolt, Kevin; Harrison, Kelly A

    2003-08-01

    Cardio kickboxing classes have become a popular form of exercise to enhance fitness. This study surveyed kickboxing participants and instructors to ascertain the severity, type, and incidence of injuries sustained while performing cardio kickboxing exercise. The respondents consisted of 77.4% instructors and 29.3% participants with a mean age of 32.29 years (+/-8.98 years). Injury from kickboxing exercise was reported by 29.3% of the respondents, 31% of the instructors, and 15.5% of the participants. The most common site of injury for instructors was the back, followed by the knee, hip, and shoulder. The most common site of injury for participants was the back, knee, and ankle. Strains were the most common type of injury reported, followed by sprains and tendinitis. More than half of the injuries reported were new injuries (64%), with almost 59% of the total injuries reported causing a disruption of the normal exercise routine or an alteration of normal daily activities. Instructors who reported using music speeds greater than 140 beats per minute had a higher incidence of injury, compared with instructors who used music between 125 and 139 beats per minute. The wrist and elbow had the highest percentage of new injuries reported. This study suggests that kickboxing exercise can be a safe form of exercise for fitness purposes. Keeping music speeds below 140 beats per minute and limiting the number of kickboxing sessions per week may help to reduce injury rates.

  10. Total ankle replacement--evolution of the technology and future applications.

    Science.gov (United States)

    Yu, John J; Sheskier, Steven

    2014-01-01

    Total ankle arthroplasty was developed to reduce pain and retain motion of the ankle joint in patients with osteoarthritis much like its total hip and knee counterparts. Orthopaedic surgeons are well equipped to evaluate and treat patients with end-stage hip or knee arthritis; however, the management of patients with ankle arthritis represents a challenge to both general orthopaedic surgeons and to the foot and ankle surgeons to whom these patients are often referred. Although techniques for both hip and knee arthroplasty have evolved to provide long-term pain relief and functional improvement, neither ankle arthrodesis nor arthroplasty has demonstrated comparably favorable outcomes in long-term follow-up studies. Early ankle arthroplasty designs with highly constrained cemented components were abandoned due to unacceptably high failure rates and complications. While arthrodesis is still considered the "gold standard" for treatment of end-stage ankle arthritis, progression of adjacent joint arthrosis and diminished gait efficiency has led to a resurgence of interest in ankle arthroplasty. Long-term outcome studies for total ankle replacement found excellent or good results in 82% of patients who received a newer generation ankle device compared with 72% if undergoing ankle fusion. Continued long-term follow-up studies are necessary, but total ankle arthroplasty has become a viable option for surgical treatment of ankle arthritis.

  11. The Eccentric Torque Production Capacity of the Ankle, Knee, and Hip Muscle Groups in Patients with Unilateral Chronic Ankle Instability

    Science.gov (United States)

    Negahban, Hossein; Moradi-Bousari, Aida; Naghibi, Saeed; Sarrafzadeh, Javad; Shaterzadeh-Yazdi, Mohammad-Jafar; Goharpey, Shahin; Etemadi, Malihe; Mazaheri, Masood; Feizi, Awat

    2013-01-01

    Purpose The aim of this study was to investigate eccentric torque production capacity of the ankle, knee and hip muscle groups in patients with unilateral chronic ankle instability (CAI) as compared to healthy matched controls. Methods In this case-control study, 40 participants (20 with CAI and 20 controls) were recruited based on convenient non-probability sampling. The average peak torque to body weight (APT/BW) ratio of reciprocal eccentric contraction of ankle dorsi flexor/plantar flexor, ankle evertor/invertor, knee flexor/extensor, hip flexor/extensor and hip abductor/adductor was determined using an isokinetic dynamometer. All subjects participated in two separate sessions with a rest interval of 48 to 72 hours. In each testing session, the torque production capacity of the ankle, knee, and hip muscle groups of only one lower limb was measured. At first, 3 repetitions of maximal eccentric-eccentric contraction were performed for the reciprocal muscles of a joint in a given movement direction. Then, the same procedure of practice and testing trials was repeated for the next randomly-ordered muscle group or joint of the same limb. Results There was no significant interaction of group (CAI and healthy controls) by limb (injured and non-injured) for any muscle groups. Main effect of limb was not significant. Main effect of group was only significant for eccentric torque production capacity of ankle dorsi flexor and hip flexor muscle groups. The APT/BW ratio of these muscles was significantly lower in the CAI group than the healthy controls (P<0.05). Conclusion CAI is associated with eccentric strength deficit of ankle dorsi flexor and hip flexor muscles as indicated by reduction in torque production capacity of these muscles compared to healthy controls. This strength deficit appeared to exist in both the injured and non-injured limbs of the patients. PMID:23802057

  12. FIBULAR MOTOR NERVE CONDUCTION STUDIES AND ANKLE SENSORIMOTOR CAPACITIES*

    Science.gov (United States)

    Richardson, James K.; Allet, Lara; Kim, Hogene; Ashton-Miller, James A.

    2012-01-01

    Introduction Nerve conduction studies provide information regarding the status of the peripheral nerve, but relationships with sensorimotor capacities that influence mobility have not been defined. Methods A secondary analysis was conducted of data from 41 older subjects (20 women, age 69.1 ± 8.3 years), 25 with diabetic neuropathy of varying severity, and 16 without diabetes or neuropathy. Measurements included routine fibular motor nerve conduction studies and laboratory-based determination of ankle inversion/eversion proprioceptive thresholds and ankle inversion/eversion motor function. Results Independent of age, fibular amplitude correlated robustly with ankle inversion/eversion proprioceptive thresholds (R2 = .591, p < .001), moderately with ankle inversion and eversion rates of torque generation (R2 = .216; p = .004 and R2 = .200; p = .006, respectively), and more strongly when fibular motor amplitude was normalized for body mass index (R2 = .350; p < .001 and R2 = .275; p = .001). Discussion Fibular motor amplitude was strongly associated with ankle sensorimotor capacities that influence lateral balance and recovery from perturbations during gait. The results suggest that nerve conduction study measures have potential for an expanded clinical role in evaluating mobility function in the population studied. PMID:23225524

  13. Adaptation to walking with an exoskeleton that assists ankle extension.

    Science.gov (United States)

    Galle, S; Malcolm, P; Derave, W; De Clercq, D

    2013-07-01

    The goal of this study was to investigate adaptation to walking with bilateral ankle-foot exoskeletons with kinematic control that assisted ankle extension during push-off. We hypothesized that subjects would show a neuromotor and metabolic adaptation during a 24min walking trial with a powered exoskeleton. Nine female subjects walked on a treadmill at 1.36±0.04ms(-1) during 24min with a powered exoskeleton and 4min with an unpowered exoskeleton. Subjects showed a metabolic adaptation after 18.5±5.0min, followed by an adapted period. Metabolic cost, electromyography and kinematics were compared between the unpowered condition, the beginning of the adaptation and the adapted period. In the beginning of the adaptation (4min), a reduction in metabolic cost of 9% was found compared to the unpowered condition. This reduction was accompanied by reduced muscular activity in the plantarflexor muscles, as the powered exoskeleton delivered part of the necessary ankle extension moment. During the adaptation this metabolic reduction further increased to 16%, notwithstanding a constant exoskeleton assistance. This increased reduction is the result of a neuromotor adaptation in which subjects adapt to walking with the exoskeleton, thereby reducing muscular activity in all leg muscles. Because of the fast adaptation and the significant reductions in metabolic cost we want to highlight the potential of an ankle-foot exoskeleton with kinematic control that assists ankle extension during push-off.

  14. [Arthrodesis versus total joint replacement of the ankle].

    Science.gov (United States)

    Mittlmeier, T

    2013-06-01

    In general, for the treatment of end-stage osteoarthritis of the ankle joint arthrodesis is considered to be the gold standard based on its versatility and eligibility for numerous indications. Nowadays, total ankle arthroplasty represents a viable alternative to ankle arthrodesis taking into account distinct premises as both procedures provide a calculable reduction of the preoperative pain level and a comparable functional gain. Furthermore, current 10-year-survival rates of total ankle replacement are reported to range between 76 % and 89 %. Revision rates of up to 10 % for both techniques have been reported with manifest differences within the respective spectrum of complications. Due to the fact that more than two thirds of patients suffer from post-traumatic osteoarthritis with a relatively low average of age concomitant malalignment, soft tissue damage or instability may frequently occur. A restoration of anatomic axes and an adequate centering of the talus under the tibia appear to be crucial for the outcome as well as an adequate soft tissue balancing, in particular in total ankle replacement. Thus, the selection of the correct indication and the right choice of treatment on the basis of complete preoperative diagnostics considering necessary additive surgical measures are of paramount importance for the final outcome.

  15. Early Intra-Articular Complement Activation in Ankle Fractures

    Directory of Open Access Journals (Sweden)

    Hagen Schmal

    2014-01-01

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

  16. [Pattern of injuries and prophylaxis in paragliding].

    Science.gov (United States)

    Schulze, W; Hesse, B; Blatter, G; Schmidtler, B; Muhr, G

    2000-06-01

    This study will present trends and recommendations to increase active and passive safety in paragliding on the basis of current state-of-the-art equipment and typical patterns of injury. This German-Swiss teamwork presents data of 55 male and 9 female patients treated after paragliding accidents between 1994 to 1998 respectively 1996 to 1998. 43.7% of the pilots presented with multiple injuries, 62.5% suffered spinal fractures and 18.8% pelvic fractures. 28.4% of the injured pilots were admitted with injuries of the lower extremities mainly affecting the tarsus or the ankle joint. Only three patients with single injuries could be treated in an ambulatory setting. 54.0% of the injuries left the patients with lasting functional residues and complaints. Main causes of accidents were either pilot error in handling the paraglider or general lack of awareness about potential risk factors. 46.0% of injuries occurred during landing, 42.9% of injuries during the flight and another 11.1% of injuries during starting procedures. With noticeable enhanced performance sails of the beginners and intermediate level are increasingly popular. Protective helmets and sturdy footwear reaching above the ankle joint are indispensable pieces of equipment. The use of protective gloves is highly recommended. Back protection devices of the new generation provide the best passive prophylaxis for the pilot against pelvic and spinal cord injuries. This area hold the most promise for increasing safety and reducing risk of injury in future, apart from using beginners and intermediate wings. After acquisition of the pilot license performance and security training provide the best preparing to master unforeseeable situations.

  17. 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.

  18. 78 FR 34708 - Proposed Information Collection (Ankle Conditions Disability Benefits Questionnaire) Activity...

    Science.gov (United States)

    2013-06-10

    ... AFFAIRS Proposed Information Collection (Ankle Conditions Disability Benefits Questionnaire) Activity... Control No. 2900--NEW (Ankle Conditions Disability Benefits Questionnaire)'' in any correspondence. During... Conditions Disability Benefits Questionnaire, VA Form 21-0960M-2. OMB Control Number: 2900--NEW...

  19. 78 FR 68908 - Agency Information Collection (Ankle Conditions Disability Benefits Questionnaire) Under OMB Review

    Science.gov (United States)

    2013-11-15

    ... AFFAIRS Agency Information Collection (Ankle Conditions Disability Benefits Questionnaire) Under OMB... Questionnaire)'' in any correspondence. FOR FURTHER INFORMATION CONTACT: Crystal Rennie, Enterprise Records... Disability Benefits Questionnaire)''. SUPPLEMENTARY INFORMATION: Title: Ankle Conditions Disability...

  20. The Effects of Anesthetic Technique on Postoperative Opioid Consumption in Ankle Fracture Surgery

    DEFF Research Database (Denmark)

    Christensen, Kristian P; Møller, Ann M; Nielsen, Jesper Kjær;

    2015-01-01

    OBJECTIVES: To investigate the impact of common anesthetic techniques on postoperative opioid consumption in ankle fracture surgery. MATERIALS AND METHODS: We performed a retrospective cohort study on 622 patients with isolated ankle fractures undergoing primary reconstructive surgery. Patients...

  1. Assessment of AK (Above Knee) Prosthesis with Different Ankle Assembly Using GRF Pattern in Stance Phase

    Science.gov (United States)

    Kim, Sung-Min; Kim, Sung-Jae; Bae, Ha-Suk

    In this study, ground reaction force (GRF), absolute symmetry index (ASI) and coefficient of variation (CV) of fixed, single-axis and multi-axis prosthetic ankle assemblies were investigated by biomechanical evaluation of above knee amputees. In the experiments, 37 normal male volunteers, two male and two female Above Knee (AK) amputees GRF data were tested with fixed, single-axis and multi-axis prosthetic ankle assembly. A gait analysis was carried out to derive the ratio of GRF to weight as the percentage of total stance phase for ten points. The results showed that fixed-axis ankle assembly was superior to other two ankle assemblies for forwarding and braking forces. Multi-axis ankle was relatively superior to other two ankle assemblies for gait balancing and movement of the mass center. Single-axis ankle was relatively superior to the other two ankle assemblies for CV and ASI of GRF.

  2. Study Casts Doubt on Need for Physical Therapy After Ankle Sprain

    Science.gov (United States)

    ... 162090.html Study Casts Doubt on Need for Physical Therapy After Ankle Sprain Rates of 'excellent recovery' similar ... a sprained ankle often involves some kind of physical therapy, but a new study questions the usefulness of ...

  3. Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults

    Science.gov (United States)

    ... Force Recommendations Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults ... on Screening for Peripheral Artery Disease (PAD) and Cardiovascular Disease (CVD) Risk Assessment with Ankle Brachial Index (ABI) ...

  4. Modeling and stress analyses of a normal foot-ankle and a prosthetic foot-ankle complex.

    Science.gov (United States)

    Ozen, Mustafa; Sayman, Onur; Havitcioglu, Hasan

    2013-01-01

    Total ankle replacement (TAR) is a relatively new concept and is becoming more popular for treatment of ankle arthritis and fractures. Because of the high costs and difficulties of experimental studies, the developments of TAR prostheses are progressing very slowly. For this reason, the medical imaging techniques such as CT, and MR have become more and more useful. The finite element method (FEM) is a widely used technique to estimate the mechanical behaviors of materials and structures in engineering applications. FEM has also been increasingly applied to biomechanical analyses of human bones, tissues and organs, thanks to the development of both the computing capabilities and the medical imaging techniques. 3-D finite element models of the human foot and ankle from reconstruction of MR and CT images have been investigated by some authors. In this study, data of geometries (used in modeling) of a normal and a prosthetic foot and ankle were obtained from a 3D reconstruction of CT images. The segmentation software, MIMICS was used to generate the 3D images of the bony structures, soft tissues and components of prosthesis of normal and prosthetic ankle-foot complex. Except the spaces between the adjacent surface of the phalanges fused, metatarsals, cuneiforms, cuboid, navicular, talus and calcaneus bones, soft tissues and components of prosthesis were independently developed to form foot and ankle complex. SOLIDWORKS program was used to form the boundary surfaces of all model components and then the solid models were obtained from these boundary surfaces. Finite element analyses software, ABAQUS was used to perform the numerical stress analyses of these models for balanced standing position. Plantar pressure and von Mises stress distributions of the normal and prosthetic ankles were compared with each other. There was a peak pressure increase at the 4th metatarsal, first metatarsal and talus bones and a decrease at the intermediate cuneiform and calcaneus bones, in

  5. A MULTIDISCIPLINARY APPROACH TO THE REHABILITATION OF A COLLEGIATE FOOTBALL PLAYER FOLLOWING ANKLE FRACTURE: A CASE REPORT

    Science.gov (United States)

    Kaplan, Lee D.; Musto, Tony; Gaunaurd, Ignacio A.; Gailey, Robert S.; Kelley, William P.; Alemi, Timothy J.; Espinosa, Braulio; Mandler, Eli; Scavo, Vincent A.; West, Dustin C.

    2016-01-01

    ABSTRACT Background and Purpose Multiple rehabilitation factors including overall wellness need to be considered when an athlete returns to sport after an injury. The purpose of this case report is to describe a multidisciplinary approach for return to sport of a Division I collegiate football player following a traumatic ankle fracture requiring surgical repair. The assessment and treatment approach included the use of a performance-based physical therapy outcome measure, self-reported functional abilities, body composition assessments, and nutritional counseling. Case Description A 21 year-old running back fractured his lateral malleolus due to a mechanism of injury of excessive eversion with external rotation of the ankle. Surgical intervention included an open reduction internal fixation (ORIF) of the fibula and syndesmosis. In addition to six months of rehabilitation, the patient received consultations from the team sports nutritionist specialist to provide dietary counseling and body composition testing. The Comprehensive High-level Activity Mobility Predictor-Sport (CHAMP-S), a performance-based outcome measure, self-report on the Foot and Ankle Disability Index (FADI-ADL, FADI-S), and body composition testing using whole body densitometry (BOD POD®), were administered throughout rehabilitation. Outcomes The subject was successfully rehabilitated, returned to his starting role, and subsequently was drafted by a National Football League (NFL) franchise. High-level mobility returned to above pre-injury values, achieving 105% of his preseason CHAMP-S score at discharge. Self-reported function on the FADI-ADL and FADI-Sport improved to 100% at discharge. Body fat percentages decreased (13.3% to 11.9%) and fat mass decreased (12.0 kg to 11.0kg). Lean body mass (78.1 kg to 81.5 kg) and lbm/in increased (1.14 kg/in to 1.19 kg/in). His BMI changed from 29.8 kg/m2 to 30.6 kg/m2. Discussion This case report illustrates the positive effects of a

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

    Directory of Open Access Journals (Sweden)

    Robert W. Jordan

    2014-01-01

    Full Text Available Introduction. End-stage ankle osteoarthritis is a debilitating condition. Traditionally, ankle arthrodesis (AA has been the surgical intervention of choice but the emergence of total ankle replacement (TAR has challenged this concept. This systematic review aims to address whether TAR or AA is optimal in terms of functional outcomes. Methods. We conducted a systematic review according to PRISMA checklist using the online databases Medline and EMBASE after January 1, 2005. Participants must be skeletally mature and suffering from ankle arthrosis of any cause. The intervention had to be an uncemented TAR comprising two or three modular components. The comparative group could include any type of ankle arthrodesis, either open or arthroscopic, using any implant for fixation. The study must have reported at least one functional outcome measure. Results. Of the four studies included, two reported some significant improvement in functional outcome in favour of TAR. The complication rate was higher in the TAR group. However, the quality of studies reviewed was poor and the methodological weaknesses limited any definitive conclusions being drawn. Conclusion. The available literature is insufficient to conclude which treatment is superior. Further research is indicated and should be in the form of an adequately powered randomised controlled trial.

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

    Science.gov (United States)

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

    2014-01-01

    Introduction. End-stage ankle osteoarthritis is a debilitating condition. Traditionally, ankle arthrodesis (AA) has been the surgical intervention of choice but the emergence of total ankle replacement (TAR) has challenged this concept. This systematic review aims to address whether TAR or AA is optimal in terms of functional outcomes. Methods. We conducted a systematic review according to PRISMA checklist using the online databases Medline and EMBASE after January 1, 2005. Participants must be skeletally mature and suffering from ankle arthrosis of any cause. The intervention had to be an uncemented TAR comprising two or three modular components. The comparative group could include any type of ankle arthrodesis, either open or arthroscopic, using any implant for fixation. The study must have reported at least one functional outcome measure. Results. Of the four studies included, two reported some significant improvement in functional outcome in favour of TAR. The complication rate was higher in the TAR group. However, the quality of studies reviewed was poor and the methodological weaknesses limited any definitive conclusions being drawn. Conclusion. The available literature is insufficient to conclude which treatment is superior. Further research is indicated and should be in the form of an adequately powered randomised controlled trial. PMID:25215242

  8. Salto Talaris fixed-bearing total ankle replacement system.

    Science.gov (United States)

    Rush, Shannon M; Todd, Nicholas

    2013-01-01

    The Salto Talaris total ankle replacement is an anatomically designed fixed bearing prosthesis available in the United States based on the successful design of the mobile-bearing Salto prosthesis available outside the United States. The original mobile-bearing design was modified and the mobile-bearing was transferred to the precision instrumentation at the trial phase evaluation. Instrumentation and technique allow the surgeon to determine the functional joint axis before final implantation. The Salto Talaris total ankle replacement design blends minimal bone resection and optimizes surface area, cortical contact, and ultra-high molecular weight polyethylene conformity. The authors present an overview of the Salto Talaris total ankle replacement surgical technique and pearls for successful application.

  9. Back Injuries

    Science.gov (United States)

    ... extending from your neck to your pelvis. Back injuries can result from sports injuries, work around the house or in the garden, ... back is the most common site of back injuries and back pain. Common back injuries include Sprains ...

  10. Intraoperative Radiation Exposure During Revision Total Ankle Replacement.

    Science.gov (United States)

    Roukis, Thomas S; Iceman, Kelli; Elliott, Andrew D

    2016-01-01

    Intraoperative C-arm image intensification is required for primary total ankle replacement implantation. Significant radiation exposure has been linked to these procedures; however, the radiation exposure during revision total ankle replacement remains unknown. Therefore, we sought to evaluate the radiation exposure encountered during revision total ankle replacement. The data from 41 patients were retrospectively analyzed from a prospective database: 19 Agility(™) to Agility(™); 4 Agility(™) to Custom Agility(™); 9 Agility(™) to INBONE(®) II; 5 Agility(™) to Salto Talaris(®) XT; 2 Scandinavian Total Ankle Replacement Prosthesis to Salto Talaris(®) XT; and 2 INBONE(®) I to INBONE(®) II revision total ankle replacements were performed. Two broad categories were identified: partial revision (Agility(™) to Agility(™), Agility(™) to Custom Agility(™), INBONE(®) I to INBONE(®) II) and complete conversion (Agility(™) to INBONE(®) II, Agility(™) to Salto Talaris(®) XT, Scandinavian Total Ankle Replacement Prosthesis to Salto Talaris(®) XT). The mean radiation exposure per case was significant at 3.49 ± 2.21 mGy. Complete conversions, specifically Agility(™) to INBONE(®) II, exhibited the greatest radiation exposure and C-arm time. Revision implant selection and revision type (complete or partial) directly contributed to radiation exposure. Accordingly, revision systems requiring less radiation exposure are preferable. Surgeons should strive to minimize intraoperative complications and limit additional procedures to those necessary, because both lead to additional radiation exposure.

  11. Motion Simulation of a New Ankle Rehabilitation Device

    Directory of Open Access Journals (Sweden)

    Cristina Racu (Cazacu

    2016-06-01

    Full Text Available The ankle structure holds one of the most important role in the human biomechanics. Due to complexity of everyday activities this joint is the most prone to be injured part of the lower limb. For a complete recovery of the locomotion function, recovery exercises are mandatory. The introduction of robotic physical recovery systems represents a modern alternative to traditional recovery. Based on the 3D virtual model and a previous dimensional synthesis of a new ankle rehabilitation device, its motion simulation is presented in this paper, to prove that it may fully recover the range of motion required for this joint.

  12. Triceps surae contracture: implications for foot and ankle surgery.

    Science.gov (United States)

    Abdulmassih, Sami; Phisitkul, Phinit; Femino, John E; Amendola, Annunziato

    2013-07-01

    Restricted ankle dorsiflexion secondary to contracture of the gastrocnemius-soleus complex is frequently encountered in patients with foot and ankle pain and is well documented in the literature. During gait, decreased dorsiflexion shifts weight-bearing pressures from the heel to the forefoot, which may result in or exacerbate one of several pathologic conditions. Modest success has been achieved with nonsurgical management of triceps surae contracture, including splinting and stretching exercises. Surgical lengthening of the gastrocnemius-soleus complex at multiple levels has been described, and early clinical results have been promising. Additional research is required to further elucidate the long-term outcomes of various lengthening techniques.

  13. 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

  14. The effect of ankle foot orthosis stiffness on the energy cost of walking: A simulation study

    NARCIS (Netherlands)

    Bregman, D.J.J.; Van der Krogt, M.M.; De Groot, V.; Harlaar, J.; Wisse, M.; Collins, S.H.

    2011-01-01

    Background In stroke and multiple sclerosis patients, gait is frequently hampered by a reduced ability to push-off with the ankle caused by weakness of the plantar-flexor muscles. To enhance ankle push-off and to decrease the high energy cost of walking, spring-like carbon-composite Ankle Foot Ortho

  15. The feasibility of total ankle prosthesis for severe arthropathy in haemophilia and prothrombin deficiency.

    NARCIS (Netherlands)

    Heide, H.J. van der; Nováková, I.R.O.; Waal Malefijt, M.C. de

    2006-01-01

    The standard treatment for end-stage arthropathy of the ankle joint in haemophilia has been fusion of the ankle joint. Total ankle replacement is used in osteoarthritis and especially in rheumatoid arthritis with good medium-term results. In this case series three patients are being described, in wh

  16. Use of an acrylic mold for mortise view improvement in ankle fractures: a feasibility study

    NARCIS (Netherlands)

    Donken, C.C.; Verhofstad, M.H.J.; Edwards, M.J.R.; Schoemaker, M.C.; Laarhoven, C.J.H.M. van

    2011-01-01

    We investigated an acrylic mold for use in obtaining ankle radiographs in 31 consecutive patients with ankle fracture. The radiologic examination consisted of routine lateral and mortise views, with the same views procured with the use of the acrylic mold to position the ankle. Radiographic evidence

  17. Congenital Pseudoarthrosis of Medial Malleolus in A Young Soccer Player – Diagnosis in Clinical setting of Ankle Sprain

    Directory of Open Access Journals (Sweden)

    Giuliano Cerulli

    2014-01-01

    Full Text Available Introduction: We report a case of a young female soccer player affected by congenital medial bilateral malleolus pseudoarthrosis and os subfibulare. Congenital pseudoarthrosis is the failure of the bones to fuse prior or at birth. The etiology is still unknown, although frequency is high in subjects affected by neurofibromatosis or correlated syndromes, so it has been suggested that these congenital disorders may be the cause of congenital pseudoarthrosis. Case Report: Our patient, a 16-year-old female, high level soccer player, was referred to us following a right ankle sprain during a match. She reported no medical history of tibia-tarsus joint injuries or disease. Pain, swelling and functional impairment were noted immediately after the accident. Standard radiographs in the emergency department revealed a displaced fracture of the medial malleolus and the presence of os subfibularis. The patient was transferred to our Traumatology and Orthopaedic Department to undergo malleolus ostheosynthesis. Before surgery swelling, functional impairment and intense pain at the medial malleolus level were confirmed. However, there was no radiological opening of ankle, instability or pronation pain; furthermore the flexion-extension was preserved with slight pain. Twenty-four hours later a considerable remission of symptoms was evident with increased range of motion and reduction in the swelling and post-traumatic edema. A radiograph on the left ankle to compare with that of the right ankle was necessary to overcome the discrepancy between the radiological diagnosis and the clinical examination. The radiographic results of both medial malleoli were comparable although on the left the os subfibularis was absent. Since the diagnosis of fracture by the association between the radiographs and the symptomatology was doubtful, a bilateral CT was performed. The scan revealed a medial bilateral malleolus pseudoarthrosis and an accessory right subfibularis nucleus

  18. Effects of Two Football Stud Types on Knee and Ankle Kinetics of Single-Leg Land-Cut and 180° Cut Movements on Infilled Synthetic Turf.

    Science.gov (United States)

    Bennett, Hunter J; Brock, Elizabeth; Brosnan, James T; Sorochan, John C; Zhang, Songning

    2015-10-01

    Higher ACL injury rates have been recorded in cleats with higher torsional resistance in American football, which warrants better understanding of shoe/stud-dependent joint kinetics. The purpose of this study was to determine differences in knee and ankle kinetics during single-leg land cuts and 180° cuts on synthetic infilled turf while wearing 3 types of shoes. Fourteen recreational football players performed single-leg land cuts and 180° cuts in nonstudded running shoes (RS) and in football shoes with natural (NTS) and synthetic turf studs (STS). Knee and ankle kinetic variables were analyzed with a 3 × 2 (shoe × movement) repeated-measures ANOVA (P < .05). A significant shoe-by-movement interaction was found in loading response peak knee adduction moments, with NTS producing smaller moments compared with both STS and RS only in 180° cuts. Reduced peak negative plantar flexor powers were also found in NTS compared with STS. The single-leg land cut produced greater loading response and push-off peak knee extensor moments, as well as peak negative and positive extensor and plantar flexor powers, but smaller loading peak knee adduction moments and push-off peak ankle eversion moments than 180° cuts. Overall, the STS and 180° cuts resulted in greater frontal plane knee loading and should be monitored for possible increased ACL injury risks.

  19. A comparison of the injuries sustained by female basketball and netball players.

    Science.gov (United States)

    McKay, G D; Payne, W R; Goldie, P A; Oakes, B W; Stanley, J J

    1996-03-01

    A prospective and reliable method of injury surveillance was implemented to document a comprehensive injury profile in female basketball and netball. The study further aimed to compare the injury profiles of the two sports. Trained observers viewed basketball and netball games, noting the occurrence of injuries. Injuries were confirmed by questioning all players on site after the game. Injured players completed a questionnaire and the progress of their injury was monitored by telephone interview. A total of 16,162 player participations were observed; 6,972 for basketball and 9,190 for netball. Comparable injury rates were observed for female basketball and netball players; 18.22 and 17.30 injuries per 1,000 participations, respectively. The ankle, hand and knee were the body parts injured most frequently in both sports, whilst head and neck injuries were prevalent in basketball only. Netball players sustained severe injuries at a rate 3.3 times that of female basketball players. The major and severe injuries occurred at an average of one injury in 625 games in female basketball and one in 250 games in netball. The ankle, knee and calf/shin were the body parts most frequently involved in the more serious injuries.

  20. Injury prevalence of netball players in South Africa: The need for in jury prevention

    Directory of Open Access Journals (Sweden)

    T. Pillay

    2012-12-01

    Full Text Available This study aimed to establish baseline data for injury prevalence,mechanism of injury, injury severity and management of injuries in netball playersin South Africa. A cross sectional descriptive design was employed to collect databy means of a questionnaire in 2010. Participants consisted of 254 netball playerswho participated in a netball tournament. Permission was obtained from all therelevant organizations and informed consent obtained from the participants. Thegeneral injury rate was 61.8% with an injury rate of 1.9 injuries per player forthe past season. The most commonly injured structures were the ankle 37.5 % andthe knee 28.6% with the most common mechanism of injury being landing, 19% and 29% respectively. Of those whosustained injuries, 86 (44% of the injured athletes’ sustained severe injuries, 31(16% sustained moderate injuriesand 78 (40% sustained mild injuries. 67% of players reported they were able to continue with the game and 33%received medical assistance losing game and training time. The most common form of management accessed wasphysiotherapy, which accounted for 31%. It is evident that the ankle and knee injury rates amongst South Africannetball players are high in comparison to other netball playing nations. Injury surveillance is an integral part ofdeveloping preventative measures. The article lays a platform for developing these strategies against the backdrop ofits findings and comparison with other authors.

  1. Motor Performance as Risk Factor for Lower Extremity Injuries in Children

    DEFF Research Database (Denmark)

    Runge, Lisbeth; Kristensen, Peter Lund; Junge, Tina

    2016-01-01

    for distance, core stability tests, vertical jump, shuttle run, and a cardiorespiratory fitness test. Lower extremity injuries were registered by clinicians by weekly questionnaires and classified according to the ICD-10 system. RESULTS: Poor balance increased risk for traumatic injury in the foot region (IRR...... for overuse injuries in the foot region (IRR=1.65), as did good performance in core stability tests and shuttle run, especially for knee injuries (IRR=1.07-1.18). CONCLUSIONS: Poor balance (sway) performance was a consistent predictor of traumatic injuries, in particular for traumatic ankle injuries. Good...... motor performance (core stability, vertical jump, shuttle run) was positively associated with traumatic and overuse injuries, and negatively (single leg hop) associated with traumatic injuries, indicating different influence on injury risk. Previous injury was a confounder affecting the effect size...

  2. International Foot and Ankle Biomechanics Community (i-FAB: past, present and beyond

    Directory of Open Access Journals (Sweden)

    Rosenbaum Dieter

    2009-06-01

    Full Text Available Abstract The International Foot and Ankle Biomechanics Community (i-FAB is an international collaborative activity which will have an important impact on the foot and ankle biomechanics community. It was launched on July 2nd 2007 at the foot and ankle session of the International Society of Biomechanics (ISB meeting in Taipei, Taiwan. i-FAB is driven by the desire to improve our understanding of foot and ankle biomechanics as it applies to health, disease, and the design, development and evaluation of foot and ankle surgery, and interventions such as footwear, insoles and surfaces.

  3. Analysis and simulation of fully ankle actuated planar bipedal robots

    NARCIS (Netherlands)

    Franken, Michel; Oort, van Gijs; Stramigioli, Stefano

    2008-01-01

    This paper deals with the analysis of planar bipedal robots, based on passive dynamic walkers, which are actuated only by actuation of the ankle joints. An overview of the major design characteristics of such robots and their influence on the feasibility of a stable limit cycle is presented. It is s

  4. Dorsiflexion deficit during jogging with chronic ankle instability.

    Science.gov (United States)

    Drewes, Lindsay K; McKeon, Patrick O; Kerrigan, D Casey; Hertel, Jay

    2009-11-01

    The purpose of the study was to determine whether individuals with chronic ankle instability (CAI) demonstrate altered dorsiflexion/plantar flexion range of motion (ROM) compared to controls during jogging. The case control study took place in a university motion analysis laboratory. Fourteen volunteers participated in the study, seven suffered from CAI (age 25+/-4.2 years, height 173+/-9.4 cm, mass 71+/-8.1kg) and seven were healthy, matched controls (age 25+/-4.5 years, height 168+/-5.9 cm, mass 67+/-9.8kg). All subjects jogged on an instrumented treadmill while a ten-camera motion analysis system collected three-dimensional kinematics of the lower extremities. The main outcome measure was sagittal plane (dorsiflexion/plantar flexion) range of motion of the ankle throughout the gait cycle. CAI subjects had significantly less dorsiflexion compared to the control group from 9% to 25% during jogging (4.83+/-0.55 degrees ). CAI subjects demonstrated limited ankle dorsiflexion ROM during the time of maximal dorsiflexion during jogging. Limited dorsiflexion ROM during gait among individuals with CAI may be a risk factor for recurrent ankle sprains. These deficits should be treated appropriately by rehabilitation clinicians.

  5. A controlled-release ergometer for the human ankle

    NARCIS (Netherlands)

    Hof, AL

    1997-01-01

    A hydraulic ergometer for the human foot is described that can apply ankle rotations up to 1 rad at a constant high speed of 10-20 rad/s against moments up to 200 N m. The initial acceleration is damped, so as not to exceed a preset value. With the presented set-up the series elasticity of the intac

  6. Genetic determinants of the ankle-brachial index

    DEFF Research Database (Denmark)

    Wassel, Christina L; Lamina, Claudia; Nambi, Vijay

    2012-01-01

    Candidate gene association studies for peripheral artery disease (PAD), including subclinical disease assessed with the ankle-brachial index (ABI), have been limited by the modest number of genes examined. We conducted a two stage meta-analysis of ∼50,000 SNPs across ∼2100 candidate genes to iden...... to identify genetic variants for ABI....

  7. Gait Training and Ankle Dorsiflexors in Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2015-03-01

    Full Text Available Investigators at University of Copenhagen, Denmark, evaluated whether 4 weeks of 30 min daily treadmill training with an incline may facilitate corticospinal transmission and improve control of the ankle joint in 16 children, aged 5-14 years, with cerebral palsy.

  8. 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.

  9. 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.

  10. New ankle actuation mechanism for a humanoid robot

    NARCIS (Netherlands)

    Oort, van Gijs; Reinink, Roelof; Stramigioli, Stefano

    2011-01-01

    In this article we discuss the design of a new ankle actuation mechanism for the humanoid robot TUlip. The new mechanism consists of two coupled series-elastic systems. We discuss the choice of actuators according to calculations for maximum achievable walking speed. Some control issues, MIMO and no

  11. Robot-Aided Neurorehabilitation: A Pediatric Robot for Ankle Rehabilitation.

    Science.gov (United States)

    Michmizos, Konstantinos P; Rossi, Stefano; Castelli, Enrico; Cappa, Paolo; Krebs, Hermano Igo

    2015-11-01

    This paper presents the pediAnklebot, an impedance-controlled low-friction, backdriveable robotic device developed at the Massachusetts Institute of Technology that trains the ankle of neurologically impaired children of ages 6-10 years old. The design attempts to overcome the known limitations of the lower extremity robotics and the unknown difficulties of what constitutes an appropriate therapeutic interaction with children. The robot's pilot clinical evaluation is on-going and it incorporates our recent findings on the ankle sensorimotor control in neurologically intact subjects, namely the speed-accuracy tradeoff, the deviation from an ideally smooth ankle trajectory, and the reaction time. We used these concepts to develop the kinematic and kinetic performance metrics that guided the ankle therapy in a similar fashion that we have done for our upper extremity devices. Here we report on the use of the device in at least nine training sessions for three neurologically impaired children. Results demonstrated a statistically significant improvement in the performance metrics assessing explicit and implicit motor learning. Based on these initial results, we are confident that the device will become an effective tool that harnesses plasticity to guide habilitation during childhood.

  12. Wear prediction on total ankle replacement effect of design parameters

    CERN Document Server

    Saad, Amir Putra Bin Md; Harun, Muhamad Noor; Kadir, Mohammed Rafiq Abdul

    2016-01-01

    This book develops and analyses computational wear simulations of the total ankle replacement for the stance phase of gait cycle. The emphasis is put on the relevant design parameters. The book presents a model consisting of three components; tibial, bearing and talar representing their physiological functions.

  13. Normal values of patellar and ankle tendon reflex latencies

    NARCIS (Netherlands)

    Frijns, CJM; Laman, DM; vanDuijn, MAJ; vanDuijn, H

    1997-01-01

    The clinical value of latency measurement of tendon reflexes in neurological patients has been reported by several authors. However, normal values are not readily comparable. In the present study, latencies and amplitudes of patellar (PTR) and ankle tendon reflexes (ATR) were measured at rest and af

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

    Science.gov (United States)

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

    2010-01-01

    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 University of São Paulo (USP). The ten patients (six women and four men, aged between 29 and 66 years), underwent a surgical procedure consisting of Hintermann's technique, between January and June 2005. They were evaluated at prearranged intervals, and the data were subjected to statistical analysis. The surgery led to a significant improvement in ankle mobility. Radiological evaluation showed no signs of loosening or failure in the prosthetic components in any of the patients studied. Although the complication rate in our sample was high, it was equivalent to the rates found by other authors, and directly represents the learning curve associate with this kind of procedure. Four years after the procedure, it was found that the patients pain levels had significantly decreased, and that their functional patterns had significantly improved, with AOFAS and Hintermann scores indicating results that were excellent for 20%, good for 70% and poor for 10%. Treatment of ankle arthritis by means of total arthroplasty using the HINTEGRA prosthesis was capable of providing good results over an average observation period of four years.

  15. Sports injuries in physical education teacher education students.

    Science.gov (United States)

    Goossens, L; Verrelst, R; Cardon, G; De Clercq, D

    2014-08-01

    Sports injuries could be highly detrimental to the career of a physical education teacher education (PETE) student. To enable the development of future sports injury prevention programs, sports injuries in 128 first-year academic bachelor PETE students were registered prospectively during one academic year. Common risk factors for sports injuries, taken from the literature, were also evaluated by means of logistic regression analysis. We found an incidence rate of 1.91 and an injury risk of 0.85, which is higher than generally found in a sports-active population. Most injuries involved the lower extremities, were acute, newly occurring injuries, and took place in non-contact situations. More than half of all injuries lead to an inactivity period of 1 week or more and over 80% of all injuries required medical attention. A major part of these injuries happened during the intracurricular sports classes. Few differences were seen between women and men. A history of injury was a significant risk factor (P = 0.018) for the occurrence of injuries, and performance of cooling-down exercises was significantly related to a lower occurrence of ankle injuries (P = 0.031). These data can inform future programs for the prevention of sports injuries in PETE students.

  16. The importance of early arthroscopy in athletes with painful cartilage lesions of the ankle: a prospective study of 61 consecutive cases

    Directory of Open Access Journals (Sweden)

    Riyami Masoud

    2006-09-01

    Full Text Available Abstract Background Ankle sprains are common in sports and can sometimes result in a persistent pain condition. Purpose Primarily to evaluate clinical symptoms, signs, diagnostics and outcomes of surgery for symptomatic chondral injuries of the talo crural joint in athletes. Secondly, in applicable cases, to evaluate the accuracy of MRI in detecting these injuries. Type of study: Prospective consecutive series. Methods Over around 4 years we studied 61 consecutive athletes with symptomatic chondral lesions to the talocrural joint causing persistent exertion ankle pain. Results 43% were professional full time athletes and 67% were semi-professional, elite or amateur athletes, main sports being soccer (49% and rugby (14%. The main subjective complaint was exertion ankle pain (93%. Effusion (75% and joint line tenderness on palpation (92% were the most common clinical findings. The duration from injury to arthroscopy for 58/61 cases was 7 months (5.7–7.9. 3/61 cases were referred within 3 weeks from injury. There were in total 75 cartilage lesions. Of these, 52 were located on the Talus dome, 17 on the medial malleolus and 6 on the Tibia plafond. Of the Talus dome injuries 18 were anteromedial, 14 anterolateral, 9 posteromedial, 3 posterolateral and 8 affecting mid talus. 50% were grade 4 lesions, 13.3% grade 3, 16.7% grade 2 and 20% grade 1. MRI had been performed pre operatively in 26/61 (39% and 59% of these had been interpreted as normal. Detection rate of cartilage lesions was only 19%, but subchondral oedema was present in 55%. At clinical follow up average 24 months after surgery (10–48 months, 73% were playing at pre-injury level. The average return to that level of sports after surgery was 16 weeks (3–32 weeks. However 43% still suffered minor symptoms. Conclusion Arthroscopy should be considered early when an athlete presents with exertion ankle pain, effusion and joint line tenderness on palpation after a previous sprain

  17. Combined total ankle replacement and modified bridle tendon transfer for end-stage ankle joint arthrosis with paralytic dropfoot: report of an unusual case.

    Science.gov (United States)

    Bibbo, Christopher; Baronofsky, Hyim J; Jaffe, Leland

    2011-01-01

    In recent years, total ankle replacement has become a reasonable option for many patients with end-stage ankle arthrosis. In order to be successful, total ankle replacement requires a relatively balanced alignment of the foot in relation to the leg. Such alignment is traditionally achieved surgically by means of stabilization of the hindfoot in conjunction with relocation osteotomy of the calcaneus and/or tibia. In this report, we describe the unconventional combination of total ankle replacement in an adult patient with concomitant paralysis that was addressed by means of tendon transfer.

  18. [Arthrodesis and endoprostheses of the ankle joint: indications, techniques and pitfalls].

    Science.gov (United States)

    Wirth, S H; Klammer, G; Espinosa, N

    2013-09-01

    If adequate conservative measures for the treatment of end-stage ankle osteoarthritis have failed, surgery may be taken into consideration. After exorbitant failure rates in the beginning of total ankle replacement, nowadays this kind of treatment has regained lot of interest and has become a viable alternative to ankle fusion. The correct indication and a precise explanation of the surgical procedure, outcomes and potential complications provide a solid base for future success.Currently, there is no doubt that total ankle replacement has become an important player in the treatment of symptomatic and debilitating end-stage ankle arthritis. With increasing number of patients who undergo total ankle replacement the experience with this kind of procedure increases too. As a consequence several surgeons have started to stretch indications favoring total ankle replacement. However, it must be mentioned here, despite progress in terms of improved anatomical and biomechanical understanding of the hindfoot and improved surgical techniques and instruments, total ankle replacement and ankle fusion remain challenging and difficult procedures. We provide a review article including an overview of the relevant techniques. This article should serve as rough guide for surgeons and help in decision-making regarding total ankle replacement and ankle fusion.

  19. Using an electrohydraulic ankle foot orthosis to study modifications in feedforward control during locomotor adaptation to force fields applied in stance

    Directory of Open Access Journals (Sweden)

    Bouyer Laurent J

    2009-06-01

    Full Text Available Abstract Background Adapting to external forces during walking has been proposed as a tool to improve locomotion after central nervous system injury. However, sensorimotor integration during walking varies according to the timing in the gait cycle, suggesting that adaptation may also depend on gait phases. In this study, an ElectroHydraulic AFO (EHO was used to apply forces specifically during mid-stance and push-off to evaluate if feedforward movement control can be adapted in these 2 gait phases. Methods Eleven healthy subjects walked on a treadmill before (3 min, during (5 min and after (5 min exposure to 2 force fields applied by the EHO (mid-stance/push-off; ~10 Nm, towards dorsiflexion. To evaluate modifications in feedforward control, strides with no force field ('catch strides' were unexpectedly inserted during the force field walking period. Results When initially exposed to a mid-stance force field (FF20%, subjects showed a significant increase in ankle dorsiflexion velocity. Catches applied early into the FF20% were similar to baseline (P > 0.99. Subjects gradually adapted by returning ankle velocity to baseline over ~50 strides. Catches applied thereafter showed decreased ankle velocity where the force field was normally applied, indicating the presence of feedforward adaptation. When initially exposed to a push-off force field (FF50%, plantarflexion velocity was reduced in the zone of force field application. No adaptation occurred over the 5 min exposure. Catch strides kinematics remained similar to control at all times, suggesting no feedforward adaptation. As a control, force fields assisting plantarflexion (-3.5 to -9.5 Nm were applied and increased ankle plantarflexion during push-off, confirming that the lack of kinematic changes during FF50% catch strides were not simply due to a large ankle impedance. Conclusion Together these results show that ankle exoskeletons such as the EHO can be used to study phase-specific adaptive

  20. Activation of brain areas following ankle dorsiflexion versus plantar flexion Functional magnetic resonance imaging verification

    Institute of Scientific and Technical Information of China (English)

    Tianyu Jiang; Weiping Wu; Xinglin Wang; Changshui Weng; Qiuhua Wang; Yanmei Guo

    2012-01-01

    Changes in activated areas of the brain during ankle active dorsiflexion and ankle active plantar flexion were observed in six healthy subjects using functional magnetic resonance imaging.Excited areas of ankle active dorsiflexion involved the bilateral primary motor area and the primary somatosensory area, as well as the bilateral supplementary sensory area, the primary visual area, the right second visual area, and the vermis of cerebellum.Excited areas of ankle active plantar flexion included the ipsilateral supplementary motor area, the limbic system, and the contralateral corpus striatum.Fine movements of the cerebral cortex control the function of the ankle dorsiflexion to a larger extent than ankle plate flexion, and the function of ankle plate flexion is more controlled by the subcortical area.

  1. Evaluation of flexibility of the ankle in elementary students with mental retardation

    Directory of Open Access Journals (Sweden)

    Stavrou V.

    2011-01-01

    Full Text Available Aim: This study aims to measure and evaluate the flexibility of the legs, namely the ankle by measuring the maximum values in flexion and extension of both legs. Method: The study included twelve students with mental retardation. Measured and recorded values of ankle-bending extent of both legs and assign the average of each test. Calculated and measurement the temperature of space and time. The measurement flexion and extension of the ankle was a plastic protractor. Results: The flexion presents decrease at the right ankle relationship with the left ankle by 1.86. The extension presents decrease at the left ankle relationship with the right ankle by 11.43. Conclusions: The results found that the normal range of motion of joints has a significant role in improving efficiency and thus on quality of life of persons with mental retardation. The flexibility is a determinant of performance and therefore should be evaluated at regular intervals.

  2. The postoperative COFAS end-stage ankle arthritis classification system: interobserver and intraobserver reliability.

    Science.gov (United States)

    Krause, Fabian G; Di Silvestro, Matthew; Penner, Murray J; Wing, Kevin J; Glazebrook, Mark A; Daniels, Timothy R; Lau, Johnny T C; Younger, Alastair S E

    2012-02-01

    End-stage ankle arthritis is operatively treated with numerous designs of total ankle replacement and different techniques for ankle fusion. For superior comparison of these procedures, outcome research requires a classification system to stratify patients appropriately. A postoperative 4-type classification system was designed by 6 fellowship-trained foot and ankle surgeons. Four surgeons reviewed blinded patient profiles and radiographs on 2 occasions to determine the interobserver and intraobserver reliability of the classification. Excellent interobserver reliability (κ = .89) and intraobserver reproducibility (κ = .87) were demonstrated for the postoperative classification system. In conclusion, the postoperative Canadian Orthopaedic Foot and Ankle Society (COFAS) end-stage ankle arthritis classification system appears to be a valid tool to evaluate the outcome of patients operated for end-stage ankle arthritis.

  3. Ankle tenosynovitis in rheumatoid arthritis: clinical and ultrasonographic evaluation

    Directory of Open Access Journals (Sweden)

    Ana Luiza Naves Pereira

    2016-11-01

    Full Text Available Objective: To investigate ankle tenosynovitis in rheumatoid arthritis patients, regarding its presence, the kind of tendon involved and the concordance between clinical and ultrasound findings. Methods: Twenty patients with rheumatoid arthritis and pain or swollen ankle joint were evaluated. Tendon involvement was evaluated with ultrasound imaging. The Health Assessment Questionnaire (HAQ was performed for disability evaluation. Age, sex, disease duration, and vocational activity levels were also obtained. The statistical analysis included Fisher’s exact test. The significance level was 0.05. Results: Tenosynovitis was found in 13 of 20 (65.0% patients in 19 joints, in which 6 were bilaterally (46.1% and unilateral in 7 (53.8%. Tibialis posterior tenosynovitis was seen in nine (45.0% patients, Achilles tenosynovitis in seven (35.0%, tibialis anterior tenosynovitis in three (15.0%, and peroneal tenosynovitis in three (15.0% patients. We found concordance between symptomatic ankle and ultrasonographic findings in 92.3% of the patients with tenosynovitis. Association between severe HAQ with tendon involvement was not found (p>0.05. Disease duration was not associated with tenosynovitis. Patients were predominantly older, female, with mean age around 50.8 years. The long disease duration of patients presented a mean of 11.4 years and, most of them, with no vocational activity (65.0%. Conclusions: The results indicate that ankle tenosynovitis is very common in rheumatoid arthritis patients, both unilateral and bilateral. Tibialis posterior was the most common tendon involvement found. Finally, we found concordance between the clinical and ultrasound findings in almost all rheumatoid arthritis patients with ankle tenosynovitis.

  4. Ankle and hip postural strategies defined by joint torques

    Science.gov (United States)

    Runge, C. F.; Shupert, C. L.; Horak, F. B.; Zajac, F. E.; Peterson, B. W. (Principal Investigator)

    1999-01-01

    Previous studies have identified two discrete strategies for the control of posture in the sagittal plane based on EMG activations, body kinematics, and ground reaction forces. The ankle strategy was characterized by body sway resembling a single-segment-inverted pendulum and was elicited on flat support surfaces. In contrast, the hip strategy was characterized by body sway resembling a double-segment inverted pendulum divided at the hip and was elicited on short or compliant support surfaces. However, biomechanical optimization models have suggested that hip strategy should be observed in response to fast translations on a flat surface also, provided the feet are constrained to remain in contact with the floor and the knee is constrained to remain straight. The purpose of this study was to examine the experimental evidence for hip strategy in postural responses to backward translations of a flat support surface and to determine whether analyses of joint torques would provide evidence for two separate postural strategies. Normal subjects standing on a flat support surface were translated backward with a range of velocities from fast (55 cm/s) to slow (5 cm/s). EMG activations and joint kinematics showed pattern changes consistent with previous experimental descriptions of mixed hip and ankle strategy with increasing platform velocity. Joint torque analyses revealed the addition of a hip flexor torque to the ankle plantarflexor torque during fast translations. This finding indicates the addition of hip strategy to ankle strategy to produce a continuum of postural responses. Hip torque without accompanying ankle torque (pure hip strategy) was not observed. Although postural control strategies have previously been defined by how the body moves, we conclude that joint torques, which indicate how body movements are produced, are useful in defining postural control strategies. These results also illustrate how the biomechanics of the body can transform discrete control

  5. Staged bilateral ankle arthroplasty for the treatment of patient with severe defect of the talus (case report

    Directory of Open Access Journals (Sweden)

    K. S. Mikhaylov

    2013-01-01

    Full Text Available Ankle arthroplasty is known to become more successful procedure versus ankle fusion in patients with ankle osteoarthritis. This article represents a clinical case of performing three-staged bilateral ankle arthroplasty by means of HINTEGRA and Mobility implants in a patient with severe defect of the talus. The patient was followed up for 2 years for right ankle and 4 years - for left ankle. The correct treatment strategy gave the patient a new lease of life. He resumed sports activities, being pain-free in both the ankle joints.

  6. [Dance, art and top performance sport with specific injuries].

    Science.gov (United States)

    Rietveld, Boni; van de Wiel, Albert

    2011-01-01

    Professional theatre dance has high and specific physical demands, comparable to top sport. Dance injuries are often caused by faulty technique due to compensation for physical limitations. Knowledge of these limitations and professional teaching can prevent many problems. Dance injuries mostly involve the lower limbs, especially the ankles and knees. Dance injuries require that the medical professional has knowledge of dance technique and respects the passion of the dancer. The advice to stop dancing has hardly ever to be given. Scientific, prospective dance medical research is recommended.

  7. Study on Fuzzy Stochastic Damage Mathematic Model on Lateral Ligament of the Ankle%踝关节外侧韧带模糊随机损伤数学模型研究

    Institute of Scientific and Technical Information of China (English)

    孟庆华; 鲍春雨

    2012-01-01

    踝关节是人体重要的负重关节,踝关节外侧韧带损伤是常见的运动损伤之一,严重影响人们日常生活质量,早期预防具有重要意义.踝关节外侧韧带损伤的概念和存在的描述是不确定的,这种不确定性一表现在损伤概念与定义中被忽略的模糊性,二表现在描述损伤存在与发生时被忽略的随机性.分析了损伤变量的模糊性和随机性二者在[0,1]区间上的一致性,基于损伤变量的广义非确定性提出了模糊随机损伤模型.%The ankle jiont is the important loading joint for human, the injury of lateral ligament of the ankle is one of the most ordinary injuries, which affects our quality of daily life, it's dubious to describe the concept and existence of injury of ankle lateral ligament, firstly, the fuzziness is neglected in the concept and definition of injury, secondly, the randomicity is neglected to describe existence and happening of injury. The author analyzed the coherence about injury variable fuzziness and randomicity in [0,1], the fuzzy stochastic injury model was established based on injury variable generalized uncertainness.

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    walking robot RunBot, controlled by an reflexive neural network, uses only few sensors for generating its stable gait. The results show that at feet and compliant ankles extend RunBot's parameter range especially to more leaning back postures. They also allow the robot to stably walk over obstacles...

  9. Three-dimensional computer graphics-based ankle morphometry with computerized tomography for total ankle replacement design and positioning.

    Science.gov (United States)

    Kuo, Chien-Chung; Lu, Hsuan-Lun; Leardini, Alberto; Lu, Tung-Wu; Kuo, Mei-Ying; Hsu, Horng-Chaung

    2014-05-01

    Morphometry of the bones of the ankle joint is important for the design of joint replacements and their surgical implantations. However, very little three-dimensional (3D) data are available and not a single study has addressed the Chinese population. Fifty-eight fresh frozen Chinese cadaveric ankle specimens, 26 females, and 32 males, were CT-scanned in the neutral position and their 3D computer graphics-based models were reconstructed. The 3D morphology of the distal tibia/fibula segment and the full talus was analyzed by measuring 31 parameters, defining the relevant dimensions, areas, and volumes from the models. The measurements were compared statistically between sexes and with previously reported data from Caucasian subjects. The results showed that, within a general similarity of ankle morphology between the current Chinese and previous Caucasian subjects groups, there were significant differences in 9 out of the 31 parameters analyzed. From a quantitative comparison with available prostheses designed for the Caucasian population, few of these designs have both tibial and talar components suitable in dimension for the Chinese population. The current data will be helpful for the sizing, design, and surgical positioning of ankle replacements and for surgical instruments, especially for the Chinese population.

  10. Multi-segment foot kinematics after total ankle replacement and ankle arthrodesis during relatively long-distance gait.

    Science.gov (United States)

    Rouhani, H; Favre, J; Aminian, K; Crevoisier, X

    2012-07-01

    This study aimed to investigate the influence of ankle osteoarthritis (AOA) treatments, i.e., ankle arthrodesis (AA) and total ankle replacement (TAR), on the kinematics of multi-segment foot and ankle complex during relatively long-distance gait. Forty-five subjects in four groups (AOA, AA, TAR, and control) were equipped with a wearable system consisting of inertial sensors installed on the tibia, calcaneus, and medial metatarsals. The subjects walked 50-m twice while the system measured the kinematic parameters of their multi-segment foot: the range of motion of joints between tibia, calcaneus, and medial metatarsals in three anatomical planes, and the peaks of angular velocity of these segments in the sagittal plane. These parameters were then compared among the four groups. It was observed that the range of motion and peak of angular velocities generally improved after TAR and were similar to the control subjects. However, unlike AOA and TAR, AA imposed impairments in the range of motion in the coronal plane for both the tibia-calcaneus and tibia-metatarsals joints. In general, the kinematic parameters showed significant correlation with established clinical scales (FFI and AOFAS), which shows their convergent validity. Based on the kinematic parameters of multi-segment foot during 50-m gait, this study showed significant improvements in foot mobility after TAR, but several significant impairments remained after AA.

  11. Targeted computerised tomography scanning of the ankle syndesmosis with low dose radiation exposure

    Energy Technology Data Exchange (ETDEWEB)

    Kotwal, Rahul [Princess of Wales Hospital, Bridgend (United Kingdom); Rath, Narendra [Royal Gwent Hospital, Newport (United Kingdom); Paringe, Vishal; Hemmadi, Sandeep; Thomas, Rhys; Lyons, Kath [University Hospital of Wales, Cardiff (United Kingdom)

    2016-03-15

    To devise a new protocol for targeted CT scanning of the distal tibiofibular syndesmosis with minimal radiation exposure to patients. We also aimed to correlate the reduction of the syndesmosis as seen on CT scans with the functional outcome of patients. Prospective study. Forty adults undergoing surgical stabilisation of an acute distal tibiofibular syndesmosis injury were recruited. A targeted five-cut computerised tomography scan protocol was developed. The radiation exposure to the patient with this protocol was only 0.002 mSv. Scans were performed 12 weeks after surgery. The contralateral ankle of every patient was used as a control to determine the accuracy of the reduction of the syndesmosis for that individual patient. American Orthopaedic Foot and Ankle Society (AOFAS) scores were obtained at a minimum of 1 year after surgery. After considering the exclusions, 36 patients formed the study group. A wide variation was observed in the anatomy of the normal syndesmosis. If we considered a difference of more than 2 mm between the normal and injured syndesmosis relationship as significant, 15 (41.6 %) of our patients had a significant difference between the injured and normal sides. AOFAS scores were available for 13 of these patients and were good to excellent in 11(84.6 %). Our study describes a reliable new CT scanning technique for the distal tibiofibular syndesmosis using only five cuts and a low-radiation-dose protocol. Clinical correlation of the findings on the scan with functional outcomes suggests that routine post-operative CT of the syndesmosis is probably not justified. (orig.)

  12. MR arthrography of the ankle joint; MR-Arthrographie des Sprunggelenkes

    Energy Technology Data Exchange (ETDEWEB)

    Trattnig, S.; Rand, T.; Breitenseher, M.; Ba-Ssalamah, A.; Schick, S.; Imhof, H. [Universitaetsklinik fuer Radiodiagnostik, AKH-Wien (Austria)

    1999-01-01

    Due to its superior soft tissue contrast conventional MRI is the imaging method of choice in the evaluation of ankle joint disorders. Conventional MR imaging can accurately demonstrate normal or acutely injured ligaments; however, in subacute and chronic injury joint fluid necessary for delineation of injured ligaments is absent and MR arthrography should be performed. MR arthrography uses the intraarticular injection of contrast material to distend the joint, yielding improved discrimination of intraarticular structures. This joint distension with MR arthrography is also helpful in the staging of osteochondritis dissecans, since in cases of unstable lesions tracking of contrast material into the interface can be more easily demonstrated. Finally, high contrast and joint distension by MR arthrography improves the detection of intraarticular loose bodies, which often require surgery. MR artrography, although invasive, may provide additional information in various ankle joint disorders. (orig.) [Deutsch] Aufgrund des ausgezeichneten Weichteilkontrastes ist die konventionelle MRT die bildgebende Methode der Wahl in der Beurteilung von Sprunggelenkserkrankungen. Die konventionelle MRT kann zuverlaessig normale und akut verletzte Ligamente darstellen. Im subakuten und chronischen Stadium der Verletzung fehlt jedoch oft die Gelenksfluessigkeit die fuer eine exakte Abgrenzung der verletzten Ligamente notwendig ist. Die MR-Arthrographie sollte in diesen Faellen durchgefuehrt werden, da die intraartikulaere KM-Applikation den Gelenksraum distendiert mit verbesserter Unterscheidbarkeit intraartikulaerer Strukturen. Diese Gelenksdistension mit der MR-Arthrographie ist auch in der Stadiumbeurteilung der Osteochondritis dissecans hilfreich, da in Faellen von instabilen Laesionen eine KM-Umspuelung des Dissekats leichter dargestellt werden kann. Schliesslich verbessert die MR-Arthrographie aufgrund des hohen Kontrastes und der Gelenksdistension auch den Nachweis von

  13. Foot and ankle reconstruction: an experience on the use of 14 different flaps in 226 cases.

    Science.gov (United States)

    Zhu, Yue-Liang; Wang, Yi; He, Xiao-Qing; Zhu, Min; Li, Fu-Bin; Xu, Yong-Qing

    2013-11-01

    The aim of this report was to present our experience on the use of different flaps for soft tissue reconstruction of the foot and ankle. From 2007 to 2012, the soft tissue defects of traumatic injuries of the foot and ankle were reconstructed using 14 different flaps in 226 cases (162 male and 64 female). There were 62 pedicled flaps and 164 free flaps used in reconstruction. The pedicled flaps included sural flap, saphenous flap, dorsal pedal neurocutaneous flap, pedicled peroneal artery perforator flap, pedicled tibial artery perforator flap, and medial plantar flap. The free flaps were latissimus musculocutaneous flap, anterolateral thigh musculocutaneous flap, groin flap, lateral arm flap, anterolateral thigh perforator flap, peroneal artery perforator flap, thoracdorsal artery perforator flap, medial arm perforator flap. The sensory nerve coaptation was not performed for all of flaps. One hundred and ninety-four cases were combined with open fractures. One hundred and sixty-two cases had tendon. Among 164 free flaps, 8 flaps were completely lost, in which the defects were managed by the secondary procedures. Among the 57 flaps for plantar foot coverage (25 pedicled flaps and 32 free flaps), ulcers were developed in 5 pedicled flaps and 6 free flaps after weight bearing, and infection was found in 14 flaps. The donor site complications were seen in 3 cases with the free anterolateral thigh perforator flap transfer. All of limbs were preserved and the patients regained walking and daily activities. All of patients except for one regained protective sensation from 3 to 12 months postoperatively. Our experience showed that the sural flap and saphenous flap could be good options for the coverage of the defects at malleolus, dorsal hindfoot and midfoot. Plantar foot, forefoot and large size defects could be reconstructed with free anterolateral thigh perforator flap. For the infected wounds with dead spce, the free latissimus dorsi musculocutaneous flap remained to

  14. Analysis of the stress and displacement distribution of inferior tibiofibular syndesmosis injuries repaired with screw fixation: a finite element study.

    Directory of Open Access Journals (Sweden)

    Qinghua Liu

    Full Text Available BACKGROUND: Studies of syndesmosis injuries have concentrated on cadaver models. However, they are unable to obtain exact data regarding the stress and displacement distribution of various tissues, and it is difficult to compare models. We investigated the biomechanical effects of inferior tibiofibular syndesmosis injuries (ITSIs and screw fixation on the ankle using the finite element (FE method. METHODOLOGY/PRINCIPAL FINDINGS: A three-dimensional model of a healthy ankle complex was developed using computed tomography (CT images. We established models of an ITSI and of screw fixation at the plane 2.5 cm above and parallel to the tibiotalar joint surface of the injured syndesmosis. Simulated loads were applied under three conditions: neutral position with single-foot standing and internal and external rotation of the ankle. ITSI reduced contact forces between the talus and fibula, helped periarticular ankle ligaments withstand more load-resisting movement, and increased the magnitude of displacement at the lower extreme of the tibia and fibula. ITSI fixation with a syndesmotic screw reduced contact forces in all joints, decreased the magnitude of displacement at the lower extreme of the tibia and fibula, and increased crural interosseous membrane stress. CONCLUSIONS/SIGNIFICANCE: Severe syndesmosis injuries cause stress and displacement distribution of the ankle to change multidirectional ankle instability and should be treated by internal fixation. Though the transverse syndesmotic screw effectively stabilizes syndesmotic diastasis, it also changes stress distribution around the ankle and decreases the joint's range of motion (ROM. Therefore, fixation should not be performed for a long period of time because it is not physiologically suitable for the ankle joint.

  15. Sports injuries in floorball: a prospective one-year follow-up study.

    Science.gov (United States)

    Snellman, K; Parkkari, J; Kannus, P; Leppälä, J; Vuori, I; Järvinen, M

    2001-10-01

    Two hundred and ninety-five licensed floorball players from Finnish premier to fifth division were observed prospectively for one season to study the incidence, nature, causes and severity of floorball injuries. During the study period, 100 out of the 295 (34 %) players sustained 120 injuries. Thirty-seven percent (73/199) of the male players and 28 % (27/96) of the females suffered from an injury. The injury rate was 1.0 per 1000 practice hours for both sexes. The injury rates per 1000 game hours were 23.7 for men and 15.9 for women. One hundred injuries (83 %) were acute and the remaining 20 (17 %) were overuse injuries. Sprain was the most common type of injury in men while overuse injuries were the most frequent injury type in women. The lower extremity was involved in 62 %, spine or trunk in 19 % and upper extremity in 10 % of the injuries. The most commonly injured sites were the knee and ankle (22 % and 20 % of all injuries), followed by head and neck (8 %). In both sexes the majority of injuries were minor, level II, injuries. Ten of the knee injuries (38 %) were serious, level IV injuries, of which seven were ACL ruptures. In conclusion, the individual risk of injury in floorball is relatively low in game practice while rather high during the game itself. Before initiation of clinical trials on prevention of floorball injuries, an exact knowledge of the risk factors and mechanisms of floorball injuries are needed.

  16. Sports injury or trauma? Injuries of the competition off-road motorcyclist.

    Science.gov (United States)

    Colburn, Nona T; Meyer, Richard D

    2003-03-01

    A prospective analysis of the injuries of off-road competition motorcyclist at four International Six Day Enduro (ISDE) events was performed utilizing the injury severity score (ISS) and the abbreviated injury scale (AIS). Of the 1787 participants, approximately 10% received injuries that required attention from a medical response unit. The majority (85%) sustained a mild injury (mean ISS 3.9). Loss of control while jumping and striking immovable objects were important risk determinants for serious injury. Although seasoned in off-road experiences, mean 15.3 years, 54% of those injured were first year rookies to the ISDE event. Speeds were below 50 km/h in the majority of accidents (80%), and were not statistically correlated with severity. The most frequently injured anatomical regions were the extremities (57%). The most common types of injury were ligamentous (50%). Seventy-seven percent of all fractures were AIS grades 1 and 2. The most common fractures were those of the foot and ankle (36%). Multiple fractures involving different anatomical regions, or a combination of serious injuries was seen with only one rider. When compared to the injuries of the street motorcyclist, competition riders had lower AIS grades of head and limb trauma. Off-road motorcycle competition is a relatively safe sport with injury rates comparably less than those of contact sports such as American football and hockey.

  17. The association between body-built and injury occurrence in pre-professional ballet dancers – Separated analysis for the injured body-locations

    Directory of Open Access Journals (Sweden)

    Petra Zaletel

    2017-02-01

    Full Text Available Objectives: This study has aimed at identifying prevalence of injury-occurrence in 24 pre-professional-ballet-dancers (females, 16–18 years of age, and identifying the associations between the body-built and prevalence of injuries. Material and Methods: The sample of variables included: body mass, body height, and 3 somatotype characteristics (mesomorph, ectomorph and endomorph and data on injuries over the preceding year. Results: Dancers were mostly ectomorphic-mesomorph (endomorphy: 2.6±0.54, mesomorphy: 3.99±0.77, ectomorphy: 3.23±0.54. The most commonly injured locations were the foot (17% of all injuries and ankle (17%. Majority of the injuries occurred while practising but 37% of hip-injuries occurred while performing. Ankle-injuries resulted in longest absence from ballet. Endomorphy was related to ankle-injury (odds ratio (OR = 1.9, 95% confidence interval (CI: 1.4–2.3, ectomorphy to foot injury (OR = 1.7, 95% CI: 1.1–2.9, and body-mass to injury to the toes (OR = 1.7, 95% CI: 1.4–3.1. Conclusions: The results of this study allow for recognizing those dancers who are particularly vulnerable to injuries of certain body location. A more profound analysis of the possible mechanisms that lead to hip-injury during performance is needed. Int J Occup Med Environ Health 2017;30(1:151–159

  18. [Cold therapy of athletic injuries. Current literature review].

    Science.gov (United States)

    Thorsson, O

    2001-03-28

    Cryotherapy is often used in soft tissue sports injuries. The application of a cold pack reduces local muscular blood-flow by approximately 50% after 10 minutes. The duration of bleeding in a muscular injury is not known, but immediate application of external pressure is probably far superior in emergency treatment of an injury. Some studies have shown significant effect of cryotherapy in emergency treatment of ankle sprains, but external pressure is often applied simultaneously and the additive effect of cryotherapy is therefore uncertain. Cryotherapy reduces the metabolic rate in injured muscle and is often used several days after a soft tissue injury to reduce secondary hypoxic injury. Experimental studies, however, show no effect of cryotherapy on muscle regeneration, and no controlled clinical study has shown a significant effect in emergency treatment of soft tissue sports injuries.

  19. Sports Injuries

    Science.gov (United States)

    ... sometimes you can injure yourself when you play sports or exercise. Accidents, poor training practices, or improper ... can also lead to injuries. The most common sports injuries are Sprains and strains Knee injuries Swollen ...

  20. Eye Injuries

    Science.gov (United States)

    The structure of your face helps protect your eyes from injury. Still, injuries can damage your eye, sometimes severely enough that you could lose your vision. Most eye injuries are preventable. If you play sports or ...

  1. Characteristics and prevalence of musculoskeletal injury in professional and non-professional ballet dancers

    Science.gov (United States)

    Costa, Michelle S. S.; Ferreira, Arthur S.; Orsini, Marco; Silva, Elirez B.; Felicio, Lilian R.

    2016-01-01

    BACKGROUND: Ballet is a high-performance activity that requires an advanced level of technical skills. Ballet places great stress on tendons, muscles, bones, and joints and may act directly as a trigger of injury by overuse. OBJECTIVES: 1) to describe the main types of injuries and affected areas related to classical ballet and 2) to compare the frequency of musculoskeletal injuries among professional and non-professional ballet dancers, considering possible gender differences among the professional dancers. METHOD: A total of 110 questionnaires were answered by professional and non-professional dancers. The questionnaire contained items related to the presence of injury, the regions involved, and the mechanism of the injury. RESULTS: We observed a high frequency of musculoskeletal injuries, with ankle sprains accounting for 69.8% of injuries in professional dancers and 42.1% in non-professional dancers. Pirouettes were the most frequent mechanism of injury in professional dancers, accounting for 67.9% of injuries, whereas in the non-professional dancers, repetitive movement was the most common mechanism (28.1%). Ankle sprains occurred in 90% of the women's injuries, and muscle sprains occurred in 54.5% of the men's injuries. The most frequent injury location was the ankle joint in both sexes among the professional dancers, with 67.6% in women and 40.9% in men. CONCLUSIONS: The identification of the mechanism of injury and time of practice may contribute to better therapeutic action aimed at the proper function of the dancers' bodies and improved performance by these athletes. PMID:26786085

  2. Characteristics and prevalence of musculoskeletal injury in professional and non-professional ballet dancers

    Directory of Open Access Journals (Sweden)

    Michelle S. S. Costa

    2016-01-01

    Full Text Available BACKGROUND: Ballet is a high-performance activity that requires an advanced level of technical skills. Ballet places great stress on tendons, muscles, bones, and joints and may act directly as a trigger of injury by overuse. OBJECTIVES: 1 to describe the main types of injuries and affected areas related to classical ballet and 2 to compare the frequency of musculoskeletal injuries among professional and non-professional ballet dancers, considering possible gender differences among the professional dancers. METHOD: A total of 110 questionnaires were answered by professional and non-professional dancers. The questionnaire contained items related to the presence of injury, the regions involved, and the mechanism of the injury. RESULTS: We observed a high frequency of musculoskeletal injuries, with ankle sprains accounting for 69.8% of injuries in professional dancers and 42.1% in non-professional dancers. Pirouettes were the most frequent mechanism of injury in professional dancers, accounting for 67.9% of injuries, whereas in the non-professional dancers, repetitive movement was the most common mechanism (28.1%. Ankle sprains occurred in 90% of the women's injuries, and muscle sprains occurred in 54.5% of the men's injuries. The most frequent injury location was the ankle joint in both sexes among the professional dancers, with 67.6% in women and 40.9% in men. CONCLUSIONS: The identification of the mechanism of injury and time of practice may contribute to better therapeutic action aimed at the proper function of the dancers' bodies and improved performance by these athletes.

  3. 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.

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

    Science.gov (United States)

    Hintermann, Beat; Knupp, Markus; Zwicky, Lukas; Barg, Alexej

    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 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. PMID:22720158

  5. Effectiveness of joint mobilisation after cast immobilisation for ankle fracture: a protocol for a randomised controlled trial [ACTRN012605000143628

    Directory of Open Access Journals (Sweden)

    Haas Marion

    2006-05-01

    Full Text Available Abstract Background Passive joint mobilisation is a technique frequently used by physiotherapists to reduce pain, improve joint movement and facilitate a return to activities after injury, but its use after ankle fracture is currently based on limited evidence. The primary aim of this trial is to determine if adding joint mobilisation to a standard exercise programme is effective and cost-effective after cast immobilisation for ankle fracture in adults. Methods/Design Ninety participants will be recruited from the physiotherapy departments of three teaching hospitals and randomly allocated to treatment or control groups using a concealed procedure. All participants will perform an exercise programme. Participants in the treatment group will also receive joint mobilisation twice a week for four weeks. Blinded follow-up assessments will be conducted four, 12 and 24 weeks after randomisation. The primary outcome measures will be the Lower Extremity Functional Scale and the Assessment of Quality of Life. Secondary outcomes will include measures of impairments, activity limitation and participation. Data on the use of physiotherapy services and participants' out-of-pocket costs will be collected for the cost-effective and cost-utility analyses. To test the effects of treatment, between-group differences will be examined with analysis of covariance using a regression approach. The primary conclusions will be based on the four-week follow-up data. Discussion This trial incorporates features known to minimise bias. It uses a pragmatic design to reflect clinical practice and maximise generalisability. Results from this trial will contribute to an evidence-based approach for rehabilitation after ankle fracture.

  6. Posttraumatic severe infection of the ankle joint - long term results of the treatment with resection arthrodesis in 133 cases

    Directory of Open Access Journals (Sweden)

    Kienast B

    2010-02-01

    Full Text Available Abstract Although there is a clear trend toward internal fixation for ankle arthrodesis, there is general consensus that external fixation is required for cases of posttraumatic infection. We retrospectively evaluated the technique and clinical long term results of external fixation in a triangular frame for cases of posttraumatic infection of the ankle. From 1993 to 2006 a consecutive series of 155 patients with an infection of the ankle was included in our study. 133 cases of the advanced "Gächter" stage III and IV were treated with arthrodesis. We treated the patients with a two step treatment plan. After radical debridement and sequestrectomy the malleoli and the joint surfaces were resected. An AO fixator was applied with two Steinmann-nails inserted in the tibia and in the calcaneus and the gap was temporary filled with gentamicin beads as the first step. In the second step we performed an autologous bone graft after a period of four weeks. The case notes were evaluated regarding trauma history, medical complaints, further injuries and illnesses, walking and pain status and occupational issues. Mean age at the index procedure was 49.7 years (18-82, 104 patients were male (67,1%. Follow up examination after mean 4.5 years included a standardised questionnaire and a clinical examination including the criteria of the AO-FAS-Score and radiographs. 92,7% of the cases lead to a stable arthrodesis. In 5 patients the arthrodesis was found partly-stable. In six patients (4,5% the infection was not controllable during the treatment process. These patients had to be treated with a below knee amputation. The mean AOFAS score at follow up was 63,7 (53-92. Overall there is a high degree of remaining disability. The complication rate and the reduced patient comfort reserve this method mainly for infection. Joint salvage is possible in the majority of cases with an earlier stage I and II infection.

  7. Injury Statistics

    Science.gov (United States)

    ... Certification Import Safety International Recall Guidance Civil and Criminal Penalties Federal Court Orders & Decisions Research & Statistics Research & Statistics Technical Reports Injury Statistics NEISS Injury ...

  8. Injury risk in female floorball: a prospective one-season follow-up.

    Science.gov (United States)

    Pasanen, K; Parkkari, J; Kannus, P; Rossi, L; Palvanen, M; Natri, A; Järvinen, M

    2008-02-01

    The purpose of this prospective study was to examine the incidence, nature, causes, and severity of injuries in female floorball. Three hundred and seventy-four licensed female floorball players from Finnish top leagues were observed prospectively for one season (6 months). The practice and game hours of floorball were recorded on an exercise diary. All injuries were registered with a structured questionnaire and verified by a physician. During the study period, 133 out of the 374 (35%) players sustained 172 injuries. The injury incidence was 1.8 per 1000 practice hours and 40.3 per 1000 game hours. Of all injuries, 70% were traumatic and 30% were from overuse. The most common injury type was joint sprain (27%). The most commonly injured sites were the knee (27%) and ankle (22%). Twenty-one of the knee injuries (46%) were serious including 10 anterior cruciate ligament (ACL) ruptures. Eight of ACL ruptures occurred during floorball games, giving an ACL rupture incidence of 3.6 per 1000 game hours. Eleven injuries (6%) needed hospital admission. The study attested that injury rate in floorball game is very high. Injury prevention strategies in female floorball should be targeted at injuries occurring at the knee and ankle.

  9. Running with a powered knee and ankle prosthesis.

    Science.gov (United States)

    Shultz, Amanda H; Lawson, Brian E; Goldfarb, Michael

    2015-05-01

    This paper presents a running control architecture for a powered knee and ankle prosthesis that enables a transfemoral amputee to run with a biomechanically appropriate running gait and to intentionally transition between a walking and running gait. The control architecture consists firstly of a coordination level controller, which provides gait biomechanics representative of healthy running, and secondly of a gait selection controller that enables the user to intentionally transition between a running and walking gait. The running control architecture was implemented on a transfemoral prosthesis with powered knee and ankle joints, and the efficacy of the controller was assessed in a series of running trials with a transfemoral amputee subject. Specifically, treadmill trials were conducted to assess the extent to which the coordination controller provided a biomechanically appropriate running gait. Separate trials were conducted to assess the ability of the user to consistently and reliably transition between walking and running gaits.

  10. 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.

  11. 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.

  12. SIRT2 regulates nuclear envelope reassembly through ANKLE2 deacetylation

    Science.gov (United States)

    Kaufmann, Tanja; Kukolj, Eva; Brachner, Andreas; Beltzung, Etienne; Bruno, Melania; Kostrhon, Sebastian; Opravil, Susanne; Hudecz, Otto; Mechtler, Karl; Warren, Graham

    2016-01-01

    ABSTRACT Sirtuin 2 (SIRT2) is an NAD-dependent deacetylase known to regulate microtubule dynamics and cell cycle progression. SIRT2 has also been implicated in the pathology of cancer, neurodegenerative diseases and progeria. Here, we show that SIRT2 depletion or overexpression causes nuclear envelope reassembly defects. We link this phenotype to the recently identified regulator of nuclear envelope reassembly ANKLE2. ANKLE2 acetylation at K302 and phosphorylation at S662 are dynamically regulated throughout the cell cycle by SIRT2 and are essential for normal nuclear envelope reassembly. The function of SIRT2 therefore extends beyond the regulation of microtubules to include the regulation of nuclear envelope dynamics. PMID:27875273

  13. Total ankle replacement in 35 cases%人工全踝关节置换35例

    Institute of Scientific and Technical Information of China (English)

    廖翔; 高志增; 黄山虎; 杨述华

    2008-01-01

    treatments were performed in these patients. Postoperatively, injury of superficial peroneal nerve occurred in 1 patient, but this did not cause an obvious motor dysfunction, so no special treatment was given. In addition, infection of incisional wound appeared in 2 patients and late healed subsequent to another dressing. Thirty-three cases presented with primary healing of incision. Among 35 total ankle arthroplasties, 28 had detained 43.5-month follow up (range 3-80 months). The ankles were scored with Kofoed total scoring system. The average postoperative ankle score was 85.5 (range 58-95), pain degree score was 48.3 (range 35-50), joint function score was 20.7 (range 18-30), and range-of-motion score was 17.2 (range 16-20). There was significant difference in these scores as compared to preoperative scores (P < 0.01). None of prosthetic loosening and migration was found radiologically. All these indicated that standardized and normalized operative technique as well as operative tools closely matched to the prosthesis and used to prevent and treat postoperative infection, dislocation, and prosthetic loosening as well as histocompatibility between material and host are the essential conditions for enhancing the success rate of prosthetic replacement.

  14. Injuries associated with the 580 km university student grand voluntary road march: focus on foot injuries.

    Science.gov (United States)

    Choi, Sang-cheon; Min, Young-gi; Lee, In-Soo; Yoon, Gi-Ho; Kang, Bo-Ra; Jung, Yoon-Seok; Cho, Joon-Pil; Kim, Gi-Woon

    2013-12-01

    College student volunteers (n = 142) completed a 580 km road march for 21 consecutive days. Each volunteer carried a backpack that weighed 14.1 ± 1.4 kg on the average. We investigated the incidence and location of blisters associated with the road march using a foot map along with other injuries. Overall, 95.1% of the subjects (135 of 142) sustained one or more injuries. All injured subjects had foot blisters, and 18% had other foot injuries. The most common locations of blister development were the right 5th toe (61%) and the left 5th toe (57%). The little toes seem to have been subjected to the greatest friction and shearing forces. March-related injuries, excluding foot injuries, were ankle pain (12.7%), knee pain (12.7%) and Achilles tendon pain (7.7%). Six subjects (4.2%) needed extra medical treatment for more than 2 weeks prior to returning to their daily lives after completion of the march due to associated injuries. The present study observed a very high incidence rate of injuries (95.1%) associated with the 580 km university students grand road march. These injuries posed an obstacle against completion of the road march and against returning to daily life. Active preventive interventions such as physical therapy and customized reinforced shoes and education program are recommended for reducing incidence rate and severity of injuries.

  15. GENDER DIFFERENCES IN SPORT INJURY RISK AND TYPES OF INJU-RIES: A RETROSPECTIVE TWELVE-MONTH STUDY ON CROSS-COUNTRY SKIERS, SWIMMERS, LONG-DISTANCE RUNNERS AND SOCCER PLAYERS

    Directory of Open Access Journals (Sweden)

    Leena Ristolainen

    2009-09-01

    Full Text Available This twelve months survey compared injury risk and injury types by genders (312 females, 262 males in 15- to 35-year-old cross-country skiers, swimmers, long- distance runners and soccer players. More male than female athletes reported at least one acute injury (44% vs. 35%, p < 0.05, and more male than female runners reported at least one overuse injury (69% vs. 51%, p < 0.05. When the incidence of acute and overuse injuries both separately and combined was calculated per 1000 training hours, per 1000 competition hours and all exposure hours combined we found no gender differences in either of these comparisons. After adjustment for sport event males were at increased risk for posterior thigh overuse injuries compared to females (relative risk (RR 5.8, 95% confidence interval (CI 1.3 to 26.4, p < 0.05 while females were at increased risk for overuse injuries in the ankle compared to males (RR 3.1, 95% CI 1.0 to 9.3, p < 0.05. After adjustment for exposure time (injuries/1000 exposure hours significance of the difference between the sexes in overuse injury to the ankle persisted (female 0.11 vs. male 0.02 injuries/1000 exposure hours, p < 0.05. Six athletes had an anterior cruciate ligament (ACL injury, of whom four were female soccer players. After combining all reported acute and overuse ankle and knee injuries, the proportion of athletes with such injury was higher in the female compared to male soccer players (75% and 54% respectively; p < 0.05, but no difference was found in such injuries when calculated per 1000 exposure hours. In conclusion, we found some gender differences in sport-related injuries, but most of these differences seemed to be explained at least in part by differences in the amount of training

  16. 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.

  17. Celiac disease manifested by polyneuropathy and swollen ankles

    Institute of Scientific and Technical Information of China (English)

    Zlatko Djuric; Borislav Kamenov; Vuka Katic

    2007-01-01

    A 27-year-old male started to have his ankles swollen during his military service. He was examined at a military hospital where electromyoneurography showed the signs of distal sensory-motor polyneuropathy with axon demyelinization and weak myopathic changes,whereas histopathological examination of gastrocnemius muscle biopsy revealed some mild and nonspecific myopathy. Besides, he was found to have subcutaneous ankle tissue edemas and hypertransaminasemia. Due to these reasons, he was dismissed from the military service and examined at another hospital where bone osteodensitometry revealed low bone mineral density of the spine. However, his medical problems were not resolved and after the second discharge from hospital he was desperately seeing doctors from time to time. Finally, at our institution he was shown to have celiac disease (CD) by positive serology (antitissue transglutaminase and antiendomysial antibodies) and small bowel mucosal histopathological examination,which showed total small bowel villous atrophy. Three months after the initiation of gluten-free diet, his ankle edema disappeared, electromyoneurographic signs of polyneuropathy improved and liver aminotransferases normalized. Good knowledge of CD extraintestinal signs and serologic screening are essential for early CD recognition and therapy.

  18. 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.

  19. 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.

  20. Ultrasound of the ankle and foot in rheumatology.

    Science.gov (United States)

    Micu, Mihaela C; Nestorova, Rodina; Petranova, Tzvetanka; Porta, Francesco; Radunovic, Goran; Vlad, Violeta; Iagnocco, Annamaria

    2012-03-01

    In the last years musculoskeletal ultrasound (US) has become a very useful imaging tool for the evaluation of rheumatic patients and a natural extension of the clinical examination of the ankle and foot. Musculoskeletal US allows the evaluation of the symptomatic and asymptomatic ankle and foot with a detailed analysis of a wide range of elementary lesions at the level of different anatomical structures and their distribution in early or long standing disease. In inflammatory pathology, it helps in the assessment of the disease activity and severity at the joint, tendon or entheseal level and in the detection of subclinical pathological features in early disease or residual activity after therapy. Moreover, US guided procedures allow accurate diagnostic and therapeutic interventions. It is a valuable imaging method that can be also used in the follow up of the treated patients (systemic and/ or local therapies or surgical procedures), being a patient friendly, non-invasive, and quick to perform method. The aim of this paper is to review the US technique of scanning and the indications of US in the analysis of the ankle and foot in rheumatic diseases.

  1. Effect of ankle proprioceptive training on static body balance.

    Science.gov (United States)

    Karakaya, Mehmet Gürhan; Rutbİl, Hilal; Akpinar, Ercan; Yildirim, Alİ; Karakaya, İlkİm Çitak

    2015-10-01

    [Purpose] This study aimed to investigate the effect of ankle proprioceptive training on static body balance. [Subjects and Methods] In this randomized-controlled, single-blind study, 59 university students (35 females, 24 males) were randomized into study (n=29) and control (n=30) groups. The study group received a foot and ankle proprioceptive exercise program including stretching, strengthening (plantar and dorsi-flexors, invertor and evertor muscles), and balance board exercises, each with 10 repetitions per session, 5 days a week, for a total of 10 sessions. The control group did not receive any intervention. Static body balance was evaluated by a kinesthetic ability trainer, which showed the balance index scores under both single foot and both feet conditions. This evaluation was repeated at the end of two weeks for both groups. [Results] Outcome measures of the groups were similar at the baseline. Balance index scores of both groups improved at the end of two weeks, and the study group had significantly lower index scores than those of the control group, indicating better balance. [Conclusion] Ankle proprioceptive training had positive effects on static body balance parameters in healthy individuals, and it is worth investigating the effects of this type of training in patients with balance disorders.

  2. Jump Landing Characteristics Predicts Lower Extremity Injuries in Indoor Team Sports

    NARCIS (Netherlands)

    van der Does, H T D; Brink, M S; Benjaminse, A; Visscher, C; Lemmink, K A P M

    2015-01-01

    The aim of this study is to investigate the predictive value of landing stability and technique to gain insight into risk factors for ankle and knee injuries in indoor team sport players. Seventy-five male and female basketball, volleyball or korfball players were screened by measuring landing stabi

  3. Semi-rigid brace and taping decrease variability of the ankle joint position sense

    Directory of Open Access Journals (Sweden)

    Márcia Barbanera

    2014-12-01

    Full Text Available The present study investigated the effect of taping and the semi-rigid ankle brace on ankle joint position sense. Sixteen healthy women (20.8 ± 2.3 years old actively placed the ankle in a target position. The experimental conditions were: 1 wearing no orthosis device, 2 using semi-rigid brace, and 3 wearing ankle taping. Absolute error (AE and variable error (VE were calculated to obtain the joint position sense. We found an interaction effect between condition and target angle at 15o of plantar flexion for the variable VE, which showed smaller errors during the use of taping and semi-rigid brace. In conclusion, the use of ankle joint orthoses, whether taping or semi-rigid brace, decrease the variability of the position sense at 15o of plantar flexion, potentially decreasing ankle sprains occurrence.

  4. Three-dimensional Motion Analysis of the Ankle during Backward Walking.

    Science.gov (United States)

    Soda, Naoki; Ueki, Tsutomu; Aoki, Takaaki

    2013-06-01

    [Purpose] The purpose of this study was to perform kinematic and kinetic analyses of the ankle during both forward and backward walking using three-dimensional motion analysis. [Subjects] The subjects were 11 healthy adults. [Methods] Measurements of forward and backward walking motions were taken using a three-dimensional motion analysis device and 3 ground reaction force plates. The analysis segment was the standing phase and the items analyzed were walking time, maximum dorsal flexion of the ankle, maximum angle of plantar flexion, peak ankle power in the sagittal plane, workload of the ankle, and work rate. Statistical analysis consisted of comparisons using the t-test for each of the items measured during both forward and backward walking. [Results] The backward walking group had significantly lower ankle power, workload, and work rate. [Conclusion] The propulsive force in backward walking must come from some factor other than the ankle. The analysis of joint power is an important index for understanding the motion.

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

    OpenAIRE

    Brendan Wilson; Andrea Bialocerkowski

    2015-01-01

    Objective To identify, evaluate and synthesise evidence on the effect of kinesiotape applied to the lateral aspect of the ankle, through a systematic review of quantitative studies. Data Sources A search for quantitative studies was undertaken using key terms of “kinesiotape” and “ankle” in seven electronic databases, using the maximum date ranges. Databases included: the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Medline, Physiotherapy Evidence Database, Scop...

  6. Screening Characteristics of Ultrasonography in Detection of Ankle Fractures

    Directory of Open Access Journals (Sweden)

    Majid Shojaee

    2016-08-01

    Full Text Available Introduction: Ankle fracture is one of the most common joint fractures. X-ray and physical examination are itsmain methods of diagnosis. Recently, ultrasonography (US is considered as a simple and non-invasive methodof fracture diagnosis. This study evaluated the diagnostic accuracy of US in detection of ankle fracture in comparisonto plain radiography. Methods: In this diagnostic accuracy study, which was done in emergency departmentsof Imam Hossein and Shohadaye Tajrish hospitals, Tehran, Iran, during 2014, 141 patients with suspecteddiagnosis of distal leg or ankle fracture were examined by US and radiography (gold standard, independently.Screening performance characteristics of US in detection of distal leg fractures were calculated using SPSS version21. Results: 141 patients with the mean age of 34§11.52 years (range: 15–50 were evaluated (75.9% male.Radiography confirmed ankle fracture in 102 (72.3% patients. There was a significant correlation between theresults of US and radiography [Agreement: 95%; kappa: 0.88 (95% CI: 0.80–0.97; P Ç 0.001]. The screening performancecharacteristics of US in detection ankle fracture were as follows: sensitivity 98.9% (95% CI: 93.5% -99.9%, specificity 86.4% (95% CI: 71.9%–94.3%, PPV 94.1% (95% CI: 87.1%–97.6%, NPV 97.4% (95% CI: 84.9%–99.8%, PLR 16 (95% CI: 7.3–34.8, and NLR 0.02 (95% CI: 0.003 – 0.182. The area under the ROC curve of USin this regard was 95.8 (95% CI: 91.9§99.7. Conclusion: According to the results of this study, we can use USas an accurate and non-invasive method with high sensitivity and specificity in diagnosis ofmalleolus fractures.However, the inherent limitations of US such as operator dependency should be considered in this regard.

  7. Lower limb landmine injuries.

    Science.gov (United States)

    Necmioglu, S; Subasi, M; Kayikci, C; Young, D B

    2004-04-01

    The medical records of 186 patients seeking treatment for landmine injuries in the authors' region between 1993 and 2001 were evaluated. Of these patients 13 died of accompanying complications. Ten (10) patients with general body trauma and upper limb trauma were excluded from the study. Of 163 patients with lower-limb injuries included in the study, 21 with traumatic amputation underwent surgical amputation at different levels. Patients without traumatic amputation were divided into 2 groups. There were 41 patients (29%) in Group I who were treated by limb salvage procedures. Treatments used in Group I including wound debridement, tendon repair, skin approximation, minimal osteosynthesis, external fixation of long bones and secondary wound coverage. In Group II, there were 101 patients (71%) with primary amputation. Trans-tibial amputation was performed in 52 cases (51.4%), ankle disarticulation in 24 (23.7%), trans-femoral amputation in 9 (8.9%), partial foot amputation in 8 (7.9%), knee disarticulation in 7 (6.9%) and hip disarticulation in 1 case. In Group I, there was infection in 21 patients (51.2%), revision in 27 (65.8%), and amputation in 15 (36.5%). In Group II, there was infection in 28 patients (27.7%), revision in 17 (16.8%), and amputation at a higher level in 8 (7%). In crush injuries such as those resulting from landmines, soft tissue, vascular, and neurological assessment must be performed with utmost care. Even so, the desired success in interventions intended to save a limb is complicated by a high infection rate, soft tissue complications, and high revision amputation rates. Therefore, a decision to amputate in the early term based on an accurate preoperative assessment is crucial.

  8. Visceral injuries.

    Science.gov (United States)

    Wisner, D H; Blaisdell, F W

    1992-06-01

    Abdominal visceral injuries are encountered by every surgeon who deals with trauma. It is simple and useful to divide abdominal visceral injuries into those caused by penetrating mechanisms of injury and those due to blunt mechanisms. Determination of the need for operative intervention is generally easier after penetrating trauma. Gunshot wounds to the abdomen should be explored, as should stab wounds to the anterior abdomen that penetrate the fascia. A midline incision is the standard approach to abdominal visceral injuries because of its ease and versatility. Abdominal exploration should be consistent and systemic so as not to miss significant injuries. Hollow viscus injury is most common after penetrating injury, while blunt injury most often results in injury to solid viscera. Diagnostic and operative aspects of the treatment of specific visceral injuries are reviewed.

  9. Examination of Interventions to Prevent Common Lower-Limb Injuries in the New Zealand Defense Force

    Science.gov (United States)

    2009-01-01

    below the level of the knee.’ Fractures to the foot/toes comprised 42% of these lower-limb fractures , tibia/ fibula fractures comprised 37%, and ankle...knee sprain (16%), indicating that priority should be given to addressing these injuries. Fractures , although comprising only 6% of lower-limb injuries...stability con- trol will be reduced. Fractures All 62 lower-limb fractures identified in the epidemiologi- cal study of NZDF personnel were sustained at or

  10. One Hundred Ninety-five Cases of High-voltage Electric Injury

    Science.gov (United States)

    2005-08-01

    Cervical spine: 2 Thoraco–lumbar spine: 5 Upper extremity (including two scapular fractures ): 7 Rib: 1 Femur/ acetabulum : 1 Tibia/fibula/ankle/foot: 5 Soft...the most common were fractures in 22 patients, soft- tissue lesions in 14, lung injuries in 9, and head inju- ries in 8. In addition to the...aforementioned 14 patients Table 1. Associated trauma A total of 49 of 195 (25.1%) sustained the following associated acute injuries Fracture : 22 Skull: 4

  11. 应用 Lauge-Hansen分型手术治疗踝关节骨折%Application of Lauge-Hansen classification for surgical treatment of ankle fractures

    Institute of Scientific and Technical Information of China (English)

    赵广超; 薛双桃; 桂召柳; 吴天亮; 林志祥; 曹松松; 夏太保

    2016-01-01

    目的:探讨应用Lauge-Hansen分型手术治疗踝关节骨折的临床疗效。方法对30例踝关节骨折患者按Lauge-Hansen分型行手术治疗。术中按分型的损伤机制进行复位,根据骨折特征选择合适内固定。对踝关节术后疗效使用Baird-Jackson评分标准评价。结果术后X线片显示骨折复位良好,踝穴形态恢复正常,内固定位置满意。患者均获得随访,时间3~46个月。按踝关节Baird-Jackson评分标准评价:优20例,良7例,可2例,差1例,优良率90%。结论应用Lauge-Hansen分型手术治疗踝关节骨折,可指导术中骨折复位,选择合适内固定,判断下胫腓联合损伤情况,提高手术疗效。%Objective To evaluate the clinical efficacy of surgical treatment of ankle fracture by Lauge -Hansen classi-fication.Methods Thirty cases of ankle fractures underwent surgical treatment according to Lauge -Hansen classifi-cation.Intraoperative reduction according to fractural mechanism of damage , the internal fixation was selected accord-ing to the fracture characteristic .The ankle postoperative curative effect was evaluated by Baird-Jackson criteria .Re-sults The postoperative X-ray film showed good fracture reduction , the ankle mortise shape was recoved to normal , internal fixation position satisfaction .All patients were followed up for 3~46 months.According to ankle Baird-Jack-son score criteria, the result was excellent in 20 cases, good in 7, fair in 2, and poor in 1, with the excellent-good rate of 90%.Conclusions Surgical treatment of ankle fracture by Lauge-Hansen classification can guide fracture re-duction of operation , select the appropriate internal fixation , judge the joint injury of the lower tibia and fibula , and improve surgery efficacy .

  12. 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.

  13. The influence of a hydraulic prosthetic ankle on residual limb loading during sloped walking.

    Science.gov (United States)

    Koehler-McNicholas, Sara R; Nickel, Eric A; Medvec, Joseph; Barrons, Kyle; Mion, Spencer; Hansen, Andrew H

    2017-01-01

    In recent years, numerous prosthetic ankle-foot devices have been developed to address the demands of sloped walking for individuals with lower-limb amputation. The goal of this study was to compare the performance of a passive, hydraulic ankle-foot prosthesis to two related, non-hydraulic ankles based on their ability to minimize the socket reaction moments of individuals with transtibial amputation during a range of sloped walking tasks. After a two-week accommodation period, kinematic data were collected on seven subjects with a transtibial amputation walking on an instrumented treadmill set at various slopes. Overall, this study was unable to find significant differences in the torque at the distal end of the prosthetic socket between an ankle-foot prosthesis with a hydraulic range-of-motion and other related ankle-foot prosthesis designs (rigid ankle, multiaxial ankle) during the single-support phase of walking. In addition, socket comfort and perceived exertion were not significantly different for any of the ankle-foot prostheses tested in this study. These results suggest the need for further work to determine if more advanced designs (e.g., those with microprocessor control of hydraulic features, powered ankle-foot designs) can provide more biomimetic function to prosthesis users.

  14. Total ankle replacement using HINTEGRA, an unconstrained, three-component system: surgical technique and pitfalls.

    Science.gov (United States)

    Barg, Alexej; Knupp, Markus; Henninger, Heath B; Zwicky, Lukas; Hintermann, Beat

    2012-12-01

    Total ankle replacement (TAR) has become a valuable treatment option in patients with end-stage ankle osteoarthritis. One popular 3-component system, the HINTEGRA TAR, is an unconstrained system that provides inversion-eversion stability. More natural biomechanics of the replaced ankle may be expected when anatomic considerations drive prosthesis design. The HINTEGRA prosthesis includes 2 anatomically contoured metal components and a polyethylene insert, providing axial rotation and physiologic flexion-extension mobility. This article describes the HINTEGRA TAR design and surgical technique. Use of the prosthesis for complex hindfoot reconstruction in patients with an osteoarthritic, varus, or valgus ankle deformity is described.

  15. Techniques for managing varus and valgus malalignment during total ankle replacement.

    Science.gov (United States)

    Choi, Woo Jin; Yoon, Hang Seob; Lee, Jin Woo

    2013-01-01

    The ultimate goal of primary total ankle replacement is to provide a well-balanced soft-tissue envelope around a well-aligned, well-fixated implant. Some surgeons have emphasized that good outcomes in total ankle replacement are more dependent on ligament balancing, along with the procedure itself, than the extent of preoperative coronal deformity in the ankle. Thus, it is imperative that the surgeon be familiar with additional procedures to address the varus, valgus, and other associated deformities commonly encountered in primary total ankle replacement.

  16. Differences between measured and resultant joint moments during isometric contractions at the ankle joint.

    Science.gov (United States)

    Arampatzis, Adamantios; Morey-Klapsing, Gaspar; Karamanidis, Kiros; DeMonte, Gianpiero; Stafilidis, Savvas; Brüggemann, Gert-Peter

    2005-04-01

    The purpose of this study was to examine two hypotheses: (a) during voluntary and electrically induced isometric contractions the moments measured at the dynamometer are different from the resultant moments in the same plane around the ankle joint and (b) at a given resultant moment during electrically induced isometric contractions the ankle angle while loading is different from the ankle angle while unloading. Twenty-seven long distance runners participated in the study. All subjects performed isometric maximal voluntary contractions (MVC) and contractions induced by electrostimulation at four different ankle-knee angle combinations on a Biodex-dynamometer. The kinematics of the leg were recorded using the vicon 624 system with eight cameras operating at 120 Hz. The main findings were: (a) the resultant moment at the ankle joint and the moment measured by the Biodex-dynamometer during isometric contractions are different, (b) during a plantar flexion effort the ankle angle changes significantly, whereas the knee angle shows only small and in most cases not significant changes, and (c) at identical resultant ankle joint moments the ankle angles are different between the loading and the unloading phases. The observed differences may lead to erroneous conclusions concerning the following: (a) diagnostic of muscle architecture, (b) estimation of the moment-ankle angle relationship and (c) estimation of the strain and hysteresis of tendons and aponeuroses.

  17. Design and characterization of a biologically inspired quasi-passive prosthetic ankle-foot.

    Science.gov (United States)

    Mooney, Luke M; Lai, Cara H; Rouse, Elliott J

    2014-01-01

    By design, commonly worn energy storage and release (ESR) prosthetic feet cannot provide biologically realistic ankle joint torque and angle profiles during walking. Additionally, their anthropomorphic, cantilever architecture causes their mechanical stiffness to decrease throughout the stance phase of walking, opposing the known trend of the biological ankle. In this study, the design of a quasi-passive pneumatic ankle-foot prosthesis is detailed that is able to replicate the biological ankle's torque and angle profiles during walking. The prosthetic ankle is comprised of a pneumatic piston, bending spring and solenoid valve. The mechanical properties of the pneumatic ankle prosthesis are characterized using a materials testing machine and the properties are compared to those from a common, passive ESR prosthetic foot. The characterization spanned a range of ankle equilibrium pressures and testing locations beneath the foot, analogous to the location of center of pressure within the stance phase of walking. The pneumatic ankle prosthesis was shown to provide biologically appropriate trends and magnitudes of torque, angle and stiffness behavior, when compared to the passive ESR prosthetic foot. Future work will focus on the development of a control system for the quasi-passive device and clinical testing of the pneumatic ankle to demonstrate efficacy.

  18. The influence of a hydraulic prosthetic ankle on residual limb loading during sloped walking

    Science.gov (United States)

    Nickel, Eric A.; Medvec, Joseph; Barrons, Kyle; Mion, Spencer; Hansen, Andrew H.

    2017-01-01

    In recent years, numerous prosthetic ankle-foot devices have been developed to address the demands of sloped walking for individuals with lower-limb amputation. The goal of this study was to compare the performance of a passive, hydraulic ankle-foot prosthesis to two related, non-hydraulic ankles based on their ability to minimize the socket reaction moments of individuals with transtibial amputation during a range of sloped walking tasks. After a two-week accommodation period, kinematic data were collected on seven subjects with a transtibial amputation walking on an instrumented treadmill set at various slopes. Overall, this study was unable to find significant differences in the torque at the distal end of the prosthetic socket between an ankle-foot prosthesis with a hydraulic range-of-motion and other related ankle-foot prosthesis designs (rigid ankle, multiaxial ankle) during the single-support phase of walking. In addition, socket comfort and perceived exertion were not significantly different for any of the ankle-foot prostheses tested in this study. These results suggest the need for further work to determine if more advanced designs (e.g., those with microprocessor control of hydraulic features, powered ankle-foot designs) can provide more biomimetic function to prosthesis users. PMID:28278172

  19. 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

    , represented the basic anatomic structures and mechanical properties of the human foot and ankle. When a vertical load of 600 N was added on the upper section of the lower tibia at the simulated standing status of the ankle, the stresses on the ankle joint articular surface of the tibia was mainly distributed at the central and anterolateral aspects, with the maximum stress of 3.97 MPa, average contact stress of 1.52 MPa and contact area of 343.6 mm~2. Conclusion The 3D FE foot and ankle model can be constructed and reliably used in the study of foot and ankle injuries.

  20. Psychosocial Stress and Sport Injuries in Tennis Players

    Directory of Open Access Journals (Sweden)

    Amador Blas Redondo

    2011-09-01

    Full Text Available The purpose of this study was to assess the perceived social stress and its relation to sports injuries in tennis players. Sixty-three male tennis players, with a mean age of 31.62 years (SD = 8.93, Sports Clubs belonging to the Province of Alicante (Spain completed instruments of psychosocial stress and injuries sustained during the previous year the assessment. The results indicate that life events experienced was related to some of the injuries suffered by players. Relationships were found between the degree of psychological stress experienced and the negative evaluation of this strain, the type (lesions on wrists, ankles and sprains, and severity of injuries (minor injuries.

  1. Acupuncture as analgesia for low back pain, ankle sprain and migraine in emergency departments: Study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Cohen Marc

    2011-11-01

    Full Text Available Abstract Background Pain is the most common reason that patients present to an emergency department (ED and is often inadequately managed. Evidence suggests that acupuncture is effective for pain relief, yet it is rarely practiced in the ED. The current study aims to assess the efficacy of acupuncture for providing effective analgesia to patients presenting with acute low back pain, migraine and ankle sprain at the EDs of four hospitals in Melbourne, Australia. Method The study is a multi-site, randomized, assessor-blinded, controlled trial of acupuncture analgesia in patients who present to an ED with low back pain, migraine or ankle sprain. Patients will be block randomized to receive either acupuncture alone, acupuncture as an adjunct to pharmacotherapy or pharmacotherapy alone. Acupuncture will be applied according to Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA. Pain after one hour, measured using a visual analogue scale (VAS, is the primary outcome. Secondary outcomes measures include the following instruments; the Oswestry low back pain disability questionnaire, 24-hour Migraine Quality of Life questionnaire and Patient's Global Assessment of Ankle Injury Scale. These measures will be recorded at baseline, 1 hour after intervention, each hour until discharge and 48 ± 12 hours of ED discharge. Data will also be collected on the safety and acceptability of acupuncture and health resource utilization. Discussion The results of this study will determine if acupuncture, alone or as an adjunct to pharmacotherapy provides effective, safe and acceptable pain relief for patients presenting to EDs with acute back pain, migraine or ankle sprain. The results will also identify the impact that acupuncture treatment may have upon health resource utilisation in the ED setting. Trial registration Australia and New Zealand Clinical Trials Register (ANZCTR: ACTRN12609000989246

  2. Quadruple-component superficial circumflex iliac artery perforator (SCIP) flap: A chimeric SCIP flap for complex ankle reconstruction of an exposed artificial joint after total ankle arthroplasty.

    Science.gov (United States)

    Yamamoto, Takumi; Saito, Takafumi; Ishiura, Ryohei; Iida, Takuya

    2016-09-01

    Total ankle arthroplasty (TAA) is becoming popular in patients with rheumatoid arthritis (RA)-associated ankle joint degeneration. However, ankle wound complications can occur after TAA, which sometimes requires challenging reconstruction due to anatomical complexity of the ankle. Superficial circumflex iliac artery (SCIA) perforator (SCIP) flap has been reported to be useful for various reconstructions, but no case has been reported regarding a chimeric SCIP flap for complex ankle reconstruction. We report a case of complex ankle defect successfully reconstructed with a free quadruple-component chimeric SCIP flap. A 73-year-old female patient with RA underwent TAA, and suffered from an extensive ankle soft tissue defect (13 × 5 cm) with exposure of the implanted artificial joint and the extensor tendons. A chimeric SCIP flap was raised based on the deep branch and the superficial branch of the SCIA, which included chimeric portions of the sartorius muscle, the deep fascia, the inguinal lymph node (ILN), and the skin/fat. The flap was transferred to the recipient ankle. The sartorius muscle was used to cover the artificial joint, the deep fascia to reconstruct the extensor retinaculum, the ILN to prevent postoperative lymphedema, and the adiposal tissue to put around the extensor tendons for prevention of postoperative adhesion. Postoperatively, the patient could walk by herself without persistent leg edema or bowstringing of the extensor tendons, and was satisfied with the concealable donor scar. Although further studies are required to confirm efficacy, multicomponent chimeric SCIP has a potential to be a useful option for complex defects of the ankle.

  3. An epidemiologic and traumatologic study of injuries in handball.

    Science.gov (United States)

    Nielsen, A B; Yde, J

    1988-10-01

    To identify the risk factors of injuries in handball, 221 players were followed during one indoor season. The injury incidence was 4.6/1000 playing hours and 11.4/1000 game hours. The upper extremity was involved in 41% of the injuries including 21% finger sprains. Ankle sprains were the most common injury (33%), and overuse injuries accounted for 18%. The risk of reinjury was 32%. Contact with opponent players during running or shooting caused 31% of the injuries. Errors during grasping the ball were the reason for most of the finger injuries. Forty percent of the injuries was treated by the players themselves. After the injury 73% were absent from handball for more than 1 week. Forty-one percent of the injured players had complaints 6 months after the end of the season. The study shows that injuries in handball are serious and cause extensive consequences for the players. In most of the injuries both intrinsic and extrinsic factors were involved, and prophylactic intervention in these cases demands changes in more fields.

  4. 健美操训练对女大学生踝关节力觉影响的实验研究%Research on the Force Sense of the Ankle Joint on Female Aerobics Training

    Institute of Scientific and Technical Information of China (English)

    陈瑞琴; 林辉; 张秋霞

    2014-01-01

    Gymnastics is in the accompaniment of music, to exercise as the basic method, based on aerobic exercise, to promote health, sport and entertainment purposes shape. Aerobics is the most important technology of bounding techniques, is mainly caused by the ankle, knee, hip flexion and extension buffer, reduce the impact motion of the joint, thereby reducing the human body caused by injury. Increase the ankle proprioception, can improve the ability of the ankle joint control of peripheral nerve muscle, make the ankle joint to maintain coordination and stable body in move, jump landing, control the whole body posture, achieve beautification action, improve the ability of the movement technical level. In this study, the experimental study of Aerobics on female college students' Ankle haptic effects of training as the research object, aims to explore the aerobics every index of ankle joint force, which provides a theoretical basis for the ankle joint sports injury and aerobics teaching and training, competition.%健美操是在音乐的伴奏下,以身体练习为基本手段、以有氧运动为基础,达到增进健康、塑造形体和娱乐目的的一项体育运动。健美操最重要的技术是弹动技术,主要是依靠踝、膝、髋关节的屈伸缓冲而产生,减少运动对关节的冲力,从而减少对人体造成的损伤。踝关节本体感觉能力的增加,可提高踝关节周围神经肌肉控制能力,使踝关节在弹动、跳跃落地时保持身体的协调稳定,控制整个身体姿态,达到美化动作,提高运动技术水平的能力。本研究以健美操训练对女大学生踝关节力觉影响的实验研究为研究对象,旨在探讨健美操运动对踝关节的力觉各指标的影响,为减少踝关节运动损伤的发生和健美操的教学训练、比赛提供一定的理论依据。

  5. Noninvasive ankle distraction: relationship between force, magnitude of distraction, and nerve conduction abnormalities.

    Science.gov (United States)

    Dowdy, P A; Watson, B V; Amendola, A; Brown, J D

    1996-02-01

    Seven healthy volunteers (14 ankles; four males, 3 females) with no history of ankle or foot pathology were placed in a modified beach chair position on an operating table for ankle distraction using a noninvasive ankle distractor. In-line traction of 0 to 225 N (50 lb) in 22.5-N (5-lb) increments was applied to the ankle. A direct lateral radiograph was obtained at each distraction force. The joint space was measured on the lateral radiographs using electronic microcalipers. Surface recordings of the superficial peroneal, deep peroneal dorsal digital cutaneous, and sural nerves were obtained. The ankle joint space increased progressively from an average 3.1 mm with no force applied to an average 4.2 mm with 225 N (50 lb) distraction force applied. The maximum joint distraction averaged 1.3 mm (range, 0.35 to 2.35 mm). The sensory amplitudes were diminished or absent with increasing time and force of distraction. The decreased amplitudes were most marked after 1 hour of distraction with 135 N (30 lb) or greater distraction force. This correlated with symptoms of paresthesias. The superficial and deep peroneal cutaneous nerves were affected to a much greater extent than the sural nerve. The amplitudes quickly returned to normal values with the weight being released from the ankle. The noninvasive ankle distractor safely increased ankle joint space by more than 1 mm. Distraction with 135 N (30 lb) or more for 1 hour is associated with reversible nerve conduction changes. Based on these findings, we recommend using the noninvasive ankle distraction apparatus for ankle arthroscopy, with up to 135 N (30 lb) of traction applied to the foot for up to 1 hour. Greater force, applied for longer periods, is associated with increasing nerve conduction abnormalities.

  6. In vivo kinematics and articular surface congruency of total ankle arthroplasty during gait.

    Science.gov (United States)

    Yamaguchi, Satoshi; Tanaka, Yasuhito; Banks, Scott; Kosugi, Shinichi; Sasho, Takahisa; Takahashi, Kazuhisa; Takakura, Yoshinori

    2012-08-09

    Relatively high rates of loosening and implant failure have been reported after total ankle arthroplasty. Abnormal kinematics and incongruency of the articular surface may cause increased contact pressure and rotational torque applied to the implant, leading to loosening and implant failure. We measured in vivo kinematics of two-component total ankle arthroplasty (TNK ankle), and assessed congruency of the articular surface during the stance phase of gait. Eighteen ankles of 15 patients with a mean age of 75±6 years (mean±standard deviation) and follow-up of 44±38 months were enrolled. Lateral fluoroscopic images were taken during the stance phase of gait. 3D-2D model-image registration was performed using the fluoroscopic image and the implant models, and three-dimensional kinematics of the implant and incongruency of the articular surface were determined. The mean ranges of motion were 11.1±4.6°, 0.8±0.4°, and 2.6±1.5° for dorsi-/plantarflexion, inversion/eversion, and internal/external rotation, respectively. At least one type of incongruency of the articular surface occurred in eight of 18 ankles, including anterior hinging in one ankle, medial or lateral lift off in four ankles, and excessive axial rotation in five ankles. Among the four ankles in which lift off occurred during gait, only one ankle showed lift off in the static weightbearing radiograph. Our observations will provide useful data against which kinematics of other implant designs, such as three-component total ankle arthroplasty, can be compared. Our results also showed that evaluation of lift off in the standard weightbearing radiograph may not predict its occurrence during gait.

  7. Threatened limb from stingray injury.

    Science.gov (United States)

    Shiraev, Timothy P; Marucci, Damian; McMullin, Gabrielle

    2016-01-01

    We present the case of a 43-year-old female who suffered a stingray injury to her left ankle. The sting caused occlusion of the dorsalis pedis artery, causing dry gangrene of the medial forefoot. A below knee amputation was recommended but she was transferred for a second opinion. A Prostaglandin E1 infusion was commenced, resulting in alleviation of pain and improvement in perfusion. Amputation of great and second toes was performed, with the head of the first metatarsal preserved and covered via a cross-over skin flap raised from the contralateral leg. Achilles tendon lengthening was then performed to return the foot to a functional position. This case serves to highlight the utility of prostaglandin infusion, and the requirement for a multidisciplinary approach to critical limb ischemia in order to avoid major amputation.

  8. Can textured insoles improve ankle proprioception and performance in dancers?

    Science.gov (United States)

    Steinberg, Nili; Waddington, Gordon; Adams, Roger; Karin, Janet; Begg, Rezaul; Tirosh, Oren

    2016-08-01

    With the aim of determining both the acute and the chronic effects of textured insoles on the ankle discrimination and performance ability of dancers, 60 ballet dancers from the Australian Ballet School, aged 14-19 years, were divided into three groups (two intervention groups and a control group), age- and level-matched. In the first 5 weeks (weeks 1 to 5), the first intervention group (GRP1) was asked to wear textured insoles in their ballet shoes and the second intervention group (GRP2) was not given textured insoles to wear. In the next 5 weeks (weeks 6 to 10), GRP2 was asked to wear the same type of textured insoles and GRP1 did not wear the textured insoles. The control group (CTRL) did not wear textured insoles during the whole 10 weeks. All participants were tested preintervention, after 5 weeks and after 10 weeks for ankle discrimination score (AUC scores). Dance performance was assessed by 5-7 dance teachers. Pre-to-post change in AUC scores was significantly greater for the groups wearing insoles than for the controls (P = .046) and the size of pre-to-post changes did not differ between the two intervention groups (P = .834). Significant correlation was found between ankle discrimination score and performance scores, using the textured insoles (r = .412; P = .024). In conclusion, the stimulation to the proprioceptive system arising from textured insoles worn for five weeks was sufficient to improve the proprioceptive ability and performance ability of ballet dancers.

  9. Total ankle replacement through a lateral approach: surgical tips

    Science.gov (United States)

    Usuelli, Federico Giuseppe; Indino, Cristian; Maccario, Camilla; Manzi, Luigi; Salini, Vincenzo

    2016-01-01

    Purpose: Recently, the Zimmer Trabecular Metal Total Ankle Replacement (Zimmer TM TAR) was developed to be used through a lateral transfibular approach. The purpose of this paper is to describe the surgical technique and early outcomes of the TAR via the lateral approach using the Zimmer TM TARs. Methods: Sixty-seven patients underwent primary TAR using the Zimmer TM TAR between May 2013 and May 2015. Patients were clinically evaluated preoperatively and postoperatively at six and twelve months and annually using the American Orthopaedic Foot & Ankle Society (AOFAS) ankle and hindfoot scores, visual analogue scale (VAS) pain score, and the Short Form Health Survey (SF-12) questionnaire. The minimum follow-up was 12 months. Results: The mean AOFAS hindfoot score increased from 32.8 preoperatively to 85.0 at the latest follow-up (p-value < 0.001). The mean VAS pain score decreased from 8.0 to 2.0 at the latest follow-up (p-value < 0.001). The Physical and Mental Health Composite Scale scores (PCS and MCS) of the SF-12 passed from a mean value of 30.2 preoperatively to 43.1 (p-value < 0.001) and from a mean value of 44.6 to 53.5 at the latest follow-up (p-value < 0.001), respectively. Conclusions: We present our surgical tips and the early results of this prosthetic design which are encouraging. They could be useful as an adjunct to the manufacturer’s surgical technique guidance for surgeons who utilize these implants. PMID:27855774

  10. Total ankle replacement through a lateral approach: surgical tips

    Directory of Open Access Journals (Sweden)

    Usuelli Federico Giuseppe

    2016-01-01

    Full Text Available Purpose: Recently, the Zimmer Trabecular Metal Total Ankle Replacement (Zimmer TM TAR was developed to be used through a lateral transfibular approach. The purpose of this paper is to describe the surgical technique and early outcomes of the TAR via the lateral approach using the Zimmer TM TARs. Methods: Sixty-seven patients underwent primary TAR using the Zimmer TM TAR between May 2013 and May 2015. Patients were clinically evaluated preoperatively and postoperatively at six and twelve months and annually using the American Orthopaedic Foot & Ankle Society (AOFAS ankle and hindfoot scores, visual analogue scale (VAS pain score, and the Short Form Health Survey (SF-12 questionnaire. The minimum follow-up was 12 months. Results: The mean AOFAS hindfoot score increased from 32.8 preoperatively to 85.0 at the latest follow-up (p-value < 0.001. The mean VAS pain score decreased from 8.0 to 2.0 at the latest follow-up (p-value < 0.001. The Physical and Mental Health Composite Scale scores (PCS and MCS of the SF-12 passed from a mean value of 30.2 preoperatively to 43.1 (p-value < 0.001 and from a mean value of 44.6 to 53.5 at the latest follow-up (p-value < 0.001, respectively. Conclusions: We present our surgical tips and the early results of this prosthetic design which are encouraging. They could be useful as an adjunct to the manufacturer’s surgical technique guidance for surgeons who utilize these implants.

  11. Validating a new computed tomography atlas for grading ankle osteoarthritis.

    Science.gov (United States)

    Cohen, Michael M; Vela, Nathan D; Levine, Jason E; Barnoy, Eran A

    2015-01-01

    As the most common joint disease, osteoarthritis (OA) poses a significant source of pain and disability. It can be defined by classic radiographic findings, particular symptoms, or a combination of the 2. Although specific grading scales have been developed to evaluate OA in various joints, such as the shoulder, hip, and knee, no definitive classification system is available for grading OA in the ankle. The purpose of the present study was to create and validate a standardized atlas for grading (or staging) ankle osteoarthritis using computed tomography (CT) and "hallmark" findings noted on coronal, sagittal, and axial views extrapolated from the Kellgren-Lawrence radiographic scale. The CT scans of 226 patients at the Miami Veterans Affairs Medical Center were reviewed. An atlas was derived from a retrospective review of 30 remaining CT scans taken from July 2008 to November 2011. After this review, 3 orthogonal static CT images, obtained from 11 remaining patients, were chosen to represent the various stages on the OA scale and were used to test the validity of the atlas developed by 2 of us (M.M.C. and N.D.V.). A multispecialty panel of 9 examiners, excluding ourselves, independently rated the 11 CT scan subjects. The differences among examiners and specialties were calculated, including an intra-examiner agreement for 2 separate readings spaced 9 months apart. Although the small number of subspecialty examiners made the intraspecialty comparisons difficult to validate, the findings nevertheless indicated excellent agreement among all specialty groups, with good intra-investigational (intraclass correlation coefficient 0.962 and 1) inter-investigational (intraclass correlation coefficient 0.851) values. These results appeared to validate the CT ankle OA atlas, which we believe will be a valuable clinical and research tool, one that will likely be more beneficial than less relevant generalized OA grading scales in use today.

  12. [A very slow growing ankle swelling in a healthy male].

    Science.gov (United States)

    Merlo, Christoph; Merlo, Pierina; Holzinger, Fernando; Pranghofer, Sigrid; Pfeiffer, David; Nüesch, Reto

    2014-08-20

    We describe the case report of a 66-year-old man with a very slow growing ankle tumour caused by a subcutaneous fungal abscess. Phaeoacremonium inflatipes, a member of the Dematiaceae family, was identified by needle puncture and culture of the non-odorous creamy yellow brown fluid. The fungal pseudocyst was surgically removed in toto and no further fungicidal drug therapy was required. Human infections by dematiaceous fungi causes subcutaneous phaeohyphomycosis, a rare, deep fungal infection of the skin and subcutaneous tissues usually acquired through traumatic skin lesions. In addition, systemic infections are reported, predominantly in immunosuppressed individuals.

  13. Gait: the role of the ankle and foot in walking.

    Science.gov (United States)

    Dubin, Andrew

    2014-03-01

    Evaluation of gait and its associated deviations from normal requires an in-depth evaluation of the patient and an appreciation for the complexity of the task. Understanding gait starts with an appreciation of the basic determinants of gait. Foot drop is a common gait deviation. Functionally, a foot drop results in a long limb. This will result in alterations of the gait cycle during swing phase. The common compensations for a foot drop include steppage gait, circumduction, and a persistently abducted limb. Noninterventional options for management of common gait deviations secondary to ankle/foot dysfunction present challenges.

  14. Septic arthritis of the ankle due to Salmonella enteritidis.

    LENUS (Irish Health Repository)

    Dineen, Patrick F

    2011-06-01

    Salmonella septic arthritis in healthy, immunocompetent patients is extremely rare. We present the case of a 70-year-old man who presented with a one-day history of painful swelling of his ankle from which was aspirated pus which subsequently grew Salmonella enteritidis. There was no history of trauma or symptoms consistent with Salmonella enterocolitis. Our patient recovered fully after two weeks on intravenous ceftriaxone and six weeks on oral ciprofloxacin. Salmonella is a notifiable disease in the European Union and the United States of America, and is associated with outbreaks as a result of food contamination. The nature of Salmonella arthritis and its appropriate management are outlined.

  15. Isolated Hydatid Cyst of Ankle: A Case Report

    Directory of Open Access Journals (Sweden)

    Tuna Demirdal

    2015-11-01

    Full Text Available Hydatid cyst is a zoonotic infection usually caused by Echinococcus granulosus. Hydatid cysts are most often localized in the liver and lungs. Isolated cases of hydatid cyst in soft tissue is very rare. The incidance of isolated soft tissue hydatid cyst is 2.3% in endemic areas. Medical treatment is successful in 30-40% of cases. The first choice of treatment is surgery, especially in atypical localization of hydatid cyst. We aimed to present our patient with ankle hydatid cyst, a rare case in the literature.

  16. Osteomyelitis of the foot and ankle: diagnosis, epidemiology, and treatment.

    Science.gov (United States)

    Lindbloom, Benjamin J; James, Eric R; McGarvey, William C

    2014-09-01

    Osteomyelitis of the foot and ankle is a common, potentially devastating condition with diagnostic and treatment challenges. Understanding the epidemiology and pathogenesis of osteomyelitis can raise clinical suspicion and guide testing and treatments. History and physical examination, laboratory studies, vascular studies, histologic and microbiologic analyses, and various imaging modalities contribute to diagnosis and treatment. Treatment including empiric broad-spectrum antibiotics and surgery should take a multidisciplinary approach to optimize patient factors, ensure eradication of the infection, and restore function. Optimization of vascular status, soft tissues, limb biomechanics, and physiologic state of the patient must be considered to accelerate and ensure healing.

  17. Motion of the foot and ankle during the stance phase in rats

    NARCIS (Netherlands)

    Varejao, ASP; Cabrita, AM; Meek, MF; Bulas-Cruz, J; Gabriel, RC; Filipe, VM; Melo-Pinto, P; Winter, DA

    2002-01-01

    Computerized analysis of rat gait is becoming an invaluable technique used by some peripheral nerve investigators for the evaluation of function. In this article we describe the use of a biomechanical model of the foot and ankle that allows a quantitative assessment and description of the ankle angl

  18. 21 CFR 888.3100 - Ankle joint metal/composite semi-constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... cemented prosthesis. 888.3100 Section 888.3100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Ankle joint metal/composite semi-constrained cemented prosthesis. (a) Identification. An ankle joint metal/composite semi-constrained cemented prosthesis is a device intended to be implanted to replace...

  19. 21 CFR 888.3110 - Ankle joint metal/polymer semi-constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... cemented prosthesis. 888.3110 Section 888.3110 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Ankle joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. An ankle joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace an...

  20. 21 CFR 888.3120 - Ankle joint metal/polymer non-constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... prosthesis. 888.3120 Section 888.3120 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... metal/polymer non-constrained cemented prosthesis. (a) Identification. An ankle joint metal/polymer non-constrained cemented prosthesis is a device intended to be implanted to replace an ankle joint. The...

  1. Ankle proprioception is not targeted by exercises on an unstable surface

    NARCIS (Netherlands)

    Kiers, H.; Brumagne, S.; Dieen, J. van; Wees, P.J. van der; Vanhees, L.

    2012-01-01

    Laboratory study using a repeated measures design. The aim of this study was to determine if ankle proprioception is targeted in exercises on unstable surfaces. Lateral ankle sprain (LAS) has recurrence rates over 70%, which are believed to be due to a reduced accuracy of proprioceptive signals from

  2. Arthroscopic washout of the ankle for septic arthritis in a three-month-old boy

    Directory of Open Access Journals (Sweden)

    Hagino Tetsuo

    2011-10-01

    Full Text Available Abstract There is no report of athroscopic treatment for septic arthritis of the ankle in infants. We report a case of successful management of septic arthritis of the ankle in a three-month-old boy by arthroscopic washout. Arthroscopic washout may be a useful treatment for septic arthritis in young infants when performed early after onset.

  3. Ankle torque steadiness is related to muscle activation variability and coactivation in children with cerebral palsy

    DEFF Research Database (Denmark)

    Bandholm, Thomas; Rose, Martin Høyer; Sløk, Rikke;

    2009-01-01

    The aims of this study were to: (1) investigate the significance of muscle activation variability and coactivation for the ability to perform steady submaximal ankle torque (torque steadiness) in healthy children and those with cerebral palsy (CP), and (2) assess ankle function during isometric...

  4. Compensatory strategies during walking in response to excessive muscle co-contraction at the ankle joint.

    Science.gov (United States)

    Wang, Ruoli; Gutierrez-Farewik, Elena M

    2014-03-01

    Excessive co-contraction causes inefficient or abnormal movement in several neuromuscular pathologies. How synergistic muscles spanning the ankle, knee and hip adapt to co-contraction of ankle muscles is not well understood. This study aimed to identify the compensation strategies required to retain normal walking with excessive antagonistic ankle muscle co-contraction. Muscle-actuated simulations of normal walking were performed to quantify compensatory mechanisms of ankle and knee muscles during stance in the presence of normal, medium and high levels of co-contraction of antagonistic pairs gastrocnemius+tibialis anterior and soleus+tibialis anterior. The study showed that if co-contraction increases, the synergistic ankle muscles can compensate; with gastrocmemius+tibialis anterior co-contraction, the soleus will increase its contribution to ankle plantarflexion acceleration. At the knee, however, almost all muscles spanning the knee and hip are involved in compensation. We also found that ankle and knee muscles alone can provide sufficient compensation at the ankle joint, but hip muscles must be involved to generate sufficient knee moment. Our findings imply that subjects with a rather high level of dorsiflexor+plantarflexor co-contraction can still perform normal walking. This also suggests that capacity of other lower limb muscles to compensate is important to retain normal walking in co-contracted persons. The compensatory mechanisms can be useful in clinical interpretation of motion analyses, when secondary muscle co-contraction or other deficits may present simultaneously in subjects with motion disorders.

  5. Surgical versus conservative interventions for treating ankle fractures in adults (Review)

    NARCIS (Netherlands)

    Donken, C.C.M.A.; Al-Khateeb, H.; Verhofstad, M.H.J.; Laarhoven, C.J.H.M. van

    2012-01-01

    BACKGROUND: The annual incidence of ankle fractures is 122 per 100,000 people. They usually affect young men and older women. The question of whether surgery or conservative treatment should be used for ankle fractures remains controversial. OBJECTIVES: To assess the effects of surgical versus conse

  6. Foot and ankle history and clinical examination: A guide to everyday practice

    Science.gov (United States)

    Alazzawi, Sulaiman; Sukeik, Mohamed; King, Daniel; Vemulapalli, Krishna

    2017-01-01

    This review summarises the key points in taking a history and performing a comprehensive clinical examination for patients with foot and/or ankle problems. It is a useful guide for residents who are preparing for their specialty exams, as well as family doctors and any other doctor who has to deal with foot and ankle problems in adults. PMID:28144575

  7. Dynamic postural stability differences between male and female players with and without ankle sprain

    NARCIS (Netherlands)

    Dallinga, Joan M.; Does, van der Henrike T. D.; Benjaminse, Anne; Lemmink, Koen A. P. M.

    2016-01-01

    Objectives: To evaluate dynamic stability index (DSI) differences between males and females for different jump directions. To examine both preseason DSI differences between players with and without a history of ankle sprain, and between players with and without an ankle sprain during the subsequent

  8. Head Injuries

    Science.gov (United States)

    ... ATV) Safety Balance Disorders Knowing Your Child's Medical History First Aid: Falls First Aid: Head Injuries Preventing Children's Sports Injuries Getting Help: Know the Numbers Concussions Stay Safe: Baseball Concussions Concussions: Getting Better Sports and Concussions Dealing ...

  9. Ear Injury

    Science.gov (United States)

    ... Fundamentals Heart and Blood Vessel Disorders Hormonal and Metabolic Disorders Immune Disorders Infections Injuries and Poisoning Kidney and ... Fundamentals Heart and Blood Vessel Disorders Hormonal and Metabolic Disorders Immune Disorders Infections Injuries and Poisoning Kidney and ...

  10. Genital injury

    Science.gov (United States)

    ... each side of a bar, such as a monkey bar or the middle of a bicycle Symptoms ... Names Scrotal trauma; Straddle injury; Toilet seat injury Images Female reproductive anatomy Male reproductive anatomy Normal female ...

  11. Knee Injuries

    Science.gov (United States)

    ... bursitis . Symptoms of bursitis in the knee include warmth, tenderness, swelling, and pain on the front of ... injury without the aid of a television screen. Physical Therapy Depending on the type of knee injury ...

  12. Intra-articular Pressure Based Stress Analysis of the Distal Tibia Following Insertion of a Total Ankle Replacement

    OpenAIRE

    Soodmand, Ehsan; Natsakis, Tassos; Jonkers, Ilse; Vander Sloten, Jos

    2015-01-01

    The ankle joint plays an important role in transferring the human body weight to the ground. Given the associated loading, Osteoarthritis (OA) is one of the most common disorders in the ankle joint. The most common treatment of ankle OA is total ankle arthroplasty (TAA). However it is not known whether TAA influences the stress levels of the bone structures and specially the distal tibia. Clinical studies previously related the occurrence of tibia cysts to focal stress concentrations. In this...

  13. The concurrent validity and reliability of the Leg Motion system for measuring ankle dorsiflexion range of motion in older adults

    Science.gov (United States)

    2017-01-01

    Background New reliable devices for range of motion (ROM) measures in older adults are necessary to improve knowledge about the functional capability in this population. Dorsiflexion ROM limitation is associated with ankle injuries, foot pain, lower limb disorders, loss of balance, gait control disorders and fall risk in older adults. The aim of the present study was to assess the validity and reliability of the Leg Motion device for measuring ankle dorsiflexion ROM in older adults. Methods Adescriptive repeated-measures study was designed to test the reliability of Leg Motion in thirty-three healthy elderly patients older than 65 years. The subjects had to meet the following inclusion and exclusion criteria in their medical records: older than 65 years; no lower extremity injury for at least one year prior to evaluation (meniscopathy, or fractures) and any chronic injuries (e.g., osteoarthritis); no previous hip, knee or ankle surgery; no neuropathic alterations and no cognitive conditions (e.g., Alzheimer’s disease or dementia). Participants were recruited through the person responsible for the physiotherapist area from a nursing center. The subjects were evaluated in two different sessions at the same time of day, and there was a break of two weeks between sessions. To test the validity of the Leg Motion system, the participants were measured in a weight-bearing lunge position using a classic goniometer with 1° increments, a smartphone with an inclinometer standard app (iPhone 5S®) with 1° increments and a measuring tape that could measure 0.1 cm. All testing was performed while the patients were barefoot. The researcher had ten years of experience as a physiotherapist using goniometer, tape measure and inclinometer devices. Results Mean values and standard deviations were as follows: Leg Motion (right 5.15 ± 3.08; left 5.19 ± 2.98), tape measure (right 5.12 ± 3.08; left 5.12 ± 2.80), goniometer (right 45.87° ± 4.98; left 44.50° ± 5

  14. The concurrent validity and reliability of the Leg Motion system for measuring ankle dorsiflexion range of motion in older adults

    Directory of Open Access Journals (Sweden)

    Carlos Romero Morales

    2017-01-01

    Full Text Available Background New reliable devices for range of motion (ROM measures in older adults are necessary to improve knowledge about the functional capability in this population. Dorsiflexion ROM limitation is associated with ankle injuries, foot pain, lower limb disorders, loss of balance, gait control disorders and fall risk in older adults. The aim of the present study was to assess the validity and reliability of the Leg Motion device for measuring ankle dorsiflexion ROM in older adults. Methods Adescriptive repeated-measures study was designed to test the reliability of Leg Motion in thirty-three healthy elderly patients older than 65 years. The subjects had to meet the following inclusion and exclusion criteria in their medical records: older than 65 years; no lower extremity injury for at least one year prior to evaluation (meniscopathy, or fractures and any chronic injuries (e.g., osteoarthritis; no previous hip, knee or ankle surgery; no neuropathic alterations and no cognitive conditions (e.g., Alzheimer’s disease or dementia. Participants were recruited through the person responsible for the physiotherapist area from a nursing center. The subjects were evaluated in two different sessions at the same time of day, and there was a break of two weeks between sessions. To test the validity of the Leg Motion system, the participants were measured in a weight-bearing lunge position using a classic goniometer with 1° increments, a smartphone with an inclinometer standard app (iPhone 5S® with 1° increments and a measuring tape that could measure 0.1 cm. All testing was performed while the patients were barefoot. The researcher had ten years of experience as a physiotherapist using goniometer, tape measure and inclinometer devices. Results Mean values and standard deviations were as follows: Leg Motion (right 5.15 ± 3.08; left 5.19 ± 2.98, tape measure (right 5.12 ± 3.08; left 5.12 ± 2.80, goniometer (right 45.87° ± 4.98; left 44

  15. The effect of kinesiotape on dynamic balance following muscle fatigue in individuals with chronic ankle instability.

    Science.gov (United States)

    Kodesh, Einat; Dar, Gali

    2015-01-01

    This study aimed to evaluate the effect of kinesiotape (KT) on dynamic stability following ankle muscle fatigue among individuals with chronic ankle instability (CAI). Twenty participants with CAI participated in the study. Participants were tested under three conditions: KT, non-elastic tape, and no tape pre- and post-fatigue of the ankle muscles. Ankle muscles fatigue was induced using an isokinetic apparatus, activity of the fibularis muscle was recorded using one-channel vibromyography (VMG), and dynamic balance and neuromuscular control were assessed using the Y-Balance Test. Following fatigue exercises, the VMG signal significantly decreased in all groups (p < 0.01), without differences between groups. No significant difference in dynamic balance test scores was found between the pre- and post-fatigue condition for each group and between groups. Our results demonstrate that KT had no significant effects on dynamic balance and muscle activity following ankle muscle fatigue among individuals with CAI.

  16. Supramalleolar osteotomies for degenerative joint disease of the ankle joint: indication, technique and results.

    Science.gov (United States)

    Barg, Alexej; Pagenstert, Geert I; Horisberger, Monika; Paul, Jochen; Gloyer, Marcel; Henninger, Heath B; Valderrabano, Victor

    2013-09-01

    Patients with varus or valgus hindfoot deformities usually present with asymmetric ankle osteoarthritis. In-vitro biomechanical studies have shown that varus or valgus hindfoot deformity may lead to altered load distribution in the tibiotalar joint which may result in medial (varus) or lateral (valgus) tibiotalar joint degeneration in the short or medium term. The treatment of asymmetric ankle osteoarthritis remains challenging, because more than half of the tibiotalar joint surface is usually preserved. Therefore, joint-sacrificing procedures like total ankle replacement or ankle arthrodesis may not be the most appropriate treatment options. The shortand midterm results following realignment surgery, are very promising with substantial pain relief and functional improvement observed post-operatively. In this review article we describe the indications, surgical techniques, and results from of realignment surgery of the ankle joint in the current literature.

  17. Ankle arthritis predicts polyarticular disease course and unfavourable outcome in children with juvenile idiopathic arthritis

    DEFF Research Database (Denmark)

    Esbjörnsson, Anna-Clara; Aalto, Kristiina; Broström, Eva W;

    2015-01-01

    the first eight years of disease. Ankle arthritis was least common in the persistent oligoarticular category (25%) and most common in children with extended oligoarticular (83%) and polyarticular RF-negative (85%) JIA. Children who developed ankle arthritis during the first year of disease were younger......OBJECTIVES: To evaluate the occurrence, clinical characteristics and prognostic factors associated with ankle arthritis in children with juvenile idiopathic arthritis (JIA). METHODS: 440 children with JIA were followed for eight years in a prospective Nordic population-based cohort study. Data...... on remission was available for 427 of these children. Occurrence of clinically assessed ankle arthritis was analysed in relation to JIA category, clinical characteristics and remission data eight years after disease onset. RESULTS: In 440 children with JIA, 251 (57%) experienced ankle arthritis during...

  18. The top 10 things foot and ankle specialists wish every primary care physician knew.

    Science.gov (United States)

    Paige, Neil M; Nouvong, Aksone

    2006-06-01

    Foot and ankle problems are common complaints of patients presenting to primary care physicians. These problems range from minor disorders, such as ankle sprains, plantar fasciitis, bunions, and iIngrown toenails, to more serious conditions such as Charcot arthropathy and Achilles tendon rupture. Early recognition and treatment of foot and ankle problems are imperative to avoid associated morbidities. Primary care physicians can address many of these complaints successfully but should be cognizant of which patients should be referred to a foot and ankle specialist to prevent common short-term and long-term complications. This article provides evidence-based pearls to assist primary care physicians in providing optimal care for their patients with foot and ankle complaints.

  19. Orienteering injuries

    OpenAIRE

    Folan, Jean M.

    1982-01-01

    At the Irish National Orienteering Championships in 1981 a survey of the injuries occurring over the two days of competition was carried out. Of 285 individual competitors there was a percentage injury rate of 5.26%. The article discusses the injuries and aspects of safety in orienteering.

  20. Disentangling the contribution of the paretic and non-paretic ankle to balance control in stroke patients

    NARCIS (Netherlands)

    Asseldonk, van E.H.F.; Buurke, Jaap H.; Bloem, Bastiaan R.; Renzenbrink, Gerbert J.; Nene, Anand V.; Helm, van der Frans C.T.; Kooij, van der Herman

    2006-01-01

    During stroke recovery, restoration of the paretic ankle and compensation in the non-paretic ankle may contribute to improved balance maintenance. We examine a new approach to disentangle these recovery mechanisms by objectively quantifying the contribution of each ankle to balance maintenance. Eigh