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Sample records for anterior ankle arthroscopy

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

    Chamseddin, Khalil H; Kirkwood, Melissa L

    2016-07-01

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

  3. Ankle arthroscopy

    Science.gov (United States)

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

  4. Removal of osteoblastoma of the talar neck using standard anterior ankle Arthroscopy:A case report

    OpenAIRE

    Duan, Xiao-jun; Yang, Liu

    2016-01-01

    Highlights • We present the first, to our knowledge, case of osteoblastoma of the talar that was excised using standard anterior ankle arthroscopy. • Osteoblastoma of the talar is rare. • We present the first case, to our knowledge, that was excised using standard anterior ankle arthroscopy.

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

    Directory of Open Access Journals (Sweden)

    B. Voicu

    2010-02-01

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

  6. Update on anterior ankle impingement

    OpenAIRE

    Vaseenon, Tanawat; Amendola, Annunziato

    2012-01-01

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

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

    Science.gov (United States)

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

    2014-09-01

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

  8. Driving ability after right-sided ankle arthroscopy-A prospective Study

    DEFF Research Database (Denmark)

    Liebensteiner, Michael C; Braito, Matthias; Giesinger, Johannes M;

    2016-01-01

    INTRODUCTION: Due to the current lack of evidence the aim of this study was to investigate the driving ability after right-sided ankle arthroscopy. MATERIALS AND METHODS: Nineteen patients underwent right-sided ankle arthroscopy. Brake response time (BRT) was assessed preoperatively, 2 days, 2......, the 'time-by-driving interaction' was significant (p=0.018), which means the BRT-peak on the second day was much lower in low-frequency drivers. CONCLUSIONS: From the findings made in the current study we conclude that a driving abstinence of two weeks is necessary following right-sided ankle...

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

    OpenAIRE

    B. Voicu; R. Opriş

    2010-01-01

    This paper wants to demonstrate the value of the arthroscopy in the diagnosis and treatment of the ankle sprain and cronic ankle instability. Between January 2005 and March 2009, there were studied 25 patients, to whom there was made ankle arthroscopy with the purpose to diagnose and the treatment. The mean age was 26 years, with a range from 19 to 42 years, 19 from them were men and 6 women. The final evaluation was made to 23 patient, with a medium six month follow-up. The functional resul...

  10. Editorial Commentary: Big Data Suggest That Because of a Significant Increased Risk of Postoperative Infection, Steroid Injection Is Not Recommended After Ankle Arthroscopy.

    Science.gov (United States)

    Brand, Jefferson C

    2016-02-01

    A recent study addressing infection rate after intra-articular steroid injection during ankle arthroscopy gives pause to this practice, with an odds ratio of 2.2 in the entire population that was injected with a steroid simultaneously with ankle arthroscopy compared with patients who did not receive an ankle injection. Big data, used in the study upon which the Editor comments here, suggest that because of a significant increased risk of postoperative infection, steroid injection is not recommended after ankle arthroscopy.

  11. Chronic instability of the anterior tibiofibular syndesmosis of the ankle. Arthroscopic findings and results of anatomical reconstruction

    Directory of Open Access Journals (Sweden)

    Swierstra Bart A

    2011-09-01

    Full Text Available Abstract Background The arthroscopic findings in patients with chronic anterior syndesmotic instability that need reconstructive surgery have never been described extensively. Methods In 12 patients the clinical suspicion of chronic instability of the syndesmosis was confirmed during arthroscopy of the ankle. All findings during the arthroscopy were scored. Anatomical reconstruction of the anterior tibiofibular syndesmosis was performed in all patients. The AOFAS score was assessed to evaluate the result of the reconstruction. At an average of 43 months after the reconstruction all patients were seen for follow-up. Results The syndesmosis being easily accessible for the 3 mm transverse end of probe which could be rotated around its longitudinal axis in all cases during arthroscopy of the ankle joint, confirmed the diagnosis. Cartilage damage was seen in 8 ankles, of which in 7 patients the damage was situated at the medial side of the ankle joint. The intraarticular part of anterior tibiofibular ligament was visibly damaged in 5 patients. Synovitis was seen in all but one ankle joint. After surgical reconstruction the AOFAS score improved from an average of 72 pre-operatively to 92 post-operatively. Conclusions To confirm the clinical suspicion, the final diagnosis of chronic instability of the anterior syndesmosis can be made during arthroscopy of the ankle. Cartilage damage to the medial side of the tibiotalar joint is often seen and might be the result of syndesmotic instability. Good results are achieved by anatomic reconstruction of the anterior syndesmosis, and all patients in this study would undergo the surgery again if necessary.

  12. FUNCTIONAL OUTCOME OF ARTHROSCOPY ASSISTED ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION USING BONE PATELLAR TENDON BONE AUTOGRAFT

    Directory of Open Access Journals (Sweden)

    Vinod Kumar

    2015-04-01

    Full Text Available INTRODUCTION: The anterior cruciate ligament (ACL is one of the most frequently injured ligaments in the human body. 1 The Anterior Cruciate ligament (ACL is the primary stabilizer of the knee and prevents the knee against anterior translation. 2 It is also important in counteracting rotational and valgus stress. 1 The middle third of the patellar tendon autograft for ACL reconstruction can be readily procured and firmly fixed. 3 It can tolerate the loads produced by an intensive rehabilitation programme. 3 Fixation of bone plugs using interference screws provides sufficient stability to meet the demand of a vigorous postoperative protocol. 3 It remains the gold standard for ACL reconstruction. 3 This study is to assess the functional outcome of arthroscopy assisted anterior cruciate ligament reconstruction using bone patellar tendon bone autograft. METHODS: This study was conducted in Kempegowda Institute of Medical Sciences Hospital from November 2012 to April 2014. During this period 20 cases of adult patients with ACL deficient patients were selected according to the inclusion criteria. Study aims to assess the functional outcome of arthroscopy assisted anterior cruciate ligament reconstruction using bone - patellar tendon - bone autograft in terms of range of motion, postoperative knee stability, graft site morbidity and subjective knee functions. RESULTS: Results of our study showed that arthroscopy assisted anterior cruciate ligament reconstruction with bone - patellar tendon - bone autograft could effectively improve knee stability and functions after surgery without any complication. CONCLUSION : Arthroscopy assisted anterior cruciate l igament reconstruction with bone - patellar tendon - bone autograft is an excellent treatment option for anterior cruciate ligament deficient knees. It provides a stable knee and reduces postoperative morbidity and enables early rehabilitation. The functional outcome of arthroscopy assisted anterior

  13. Anterior cruciate ligament tears: MRI versus arthroscopy. Vordere Kreuzbandruptur: MRT versus Arthroskopie

    Energy Technology Data Exchange (ETDEWEB)

    Tosch, U.; Felix, R. (Strahlenklinik und Poliklinik, Universitaetsklinik Rudolf Virchow, Berlin (Germany)); Schauwecker, W.; Dreithaler, B. (Chirurgische Klinik und Poliklinik, Universitaetsklinik Rudolf Virchow, Berlin (Germany))

    1992-05-01

    Because of suspected rupture of the anterior cruciate ligament sixteen acute traumatised patients were investigated by MR and arthroscopy. The MR diagnosis of a lesion of the anterior cruciate ligament proved to be correct by arthroscopy in fifteen of sixteen cases. Diagnostic criteria for lesions of the anterior cruciate ligament were: increased signal intensity in T[sub 1]- and T[sub 2] weighted images, increased volume and discontinuity of ligamentous structures. Additional MR findings of meniscal tears were correct in three of four cases laterally and in four of four cases medially. Femoral cartilage lesions were correctly identified by MR in three cases. MR normal findings proved to be correct by arthroscopy in another five cases. (orig.).

  14. Examination of the sprained ankle: Anterior drawer test or arthrography?

    International Nuclear Information System (INIS)

    The accuracy of the anterior drawer test for the diagnosis of recent lateral ligament tears in the ankle was evaluated in a series of 192 patients using surgical or arthrographic findings for reference. Considerable overlapping of results was obtained in ankles with and without ligament tear. Twenty-eight per cent of the anterior talofibular ligament tears, and 38% of the combined anterior talofibular and calcaneofibular tears were not detected, and single and combined tears could not be differentiated. It is concluded that the anterior drawer test is too unreliable as a basis for any decision regarding surgical treatment of a recent sprain. Therefore, arthrography is recommended as the method of choice in such cases of recent ankle sprain, where the need of surgery has to be supported by X-ray analysis. (orig.)

  15. Examination of the sprained ankle: Anterior drawer test or arthrography

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    Laehde, S.; Putkonen, M.; Puranen, J.; Raatikainen, T.

    1988-11-01

    The accuracy of the anterior drawer test for the diagnosis of recent lateral ligament tears in the ankle was evaluated in a series of 192 patients using surgical or arthrographic findings for reference. Considerable overlapping of results was obtained in ankles with and without ligament tear. Twenty-eight per cent of the anterior talofibular ligament tears, and 38% of the combined anterior talofibular and calcaneofibular tears were not detected, and single and combined tears could not be differentiated. It is concluded that the anterior drawer test is too unreliable as a basis for any decision regarding surgical treatment of a recent sprain. Therefore, arthrography is recommended as the method of choice in such cases of recent ankle sprain, where the need of surgery has to be supported by X-ray analysis.

  16. Prospective clinical trial of patients who underwent ankle arthroscopy with articular diseases to match clinical and radiological scores with intra-articular cytokines

    DEFF Research Database (Denmark)

    Henkelmann, Ralf; Schmal, Hagen; Pilz, Ingo H;

    2015-01-01

    OBJECTIVE: There is still a lack of reliable data on cytokine concentrations in the ankle and their value for prognosis. METHODS: In a prospective clinical trial, lavage fluids were collected from 49 patients with an arthroscopy of the ankle. The fluids were investigated by ELISA for cytokine lev...

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-10-15

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

  19. Synovialisation of the torn anterior cruciate ligament of the knee: comparison between magnetic resonance and arthroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Higueras Guerrero, V.; Torregrosa Andres, A.; Marti-Bonmati, L.; Casillas, C. [Dept. of Radiology, Doctor Peset University Hospital, Valencia (Spain); Sanfeliu, M. [Dept. of Orthopedics, Doctor Peset University Hospital, Valencia (Spain)

    1999-07-01

    The aim of this study was to assess the accuracy of MR in the diagnosis of synovialisation of the anterior cruciate ligament (ACL) compared with arthroscopy. One hundred and forty-nine patients were examined with MR imaging and arthroscopy of the knee. The MR sign used to consider a synovialised ACL consisted of hypointense fibrillar tracts, disrupted and wavily, in its expected course. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV), comparison of proportions (McNemar test) and Kappa values for agreement between MR imaging and arthroscopy were calculated. Of the 133 (89.3 %) ligaments without synovialisation at arthroscopy, 130 accorded with the MR results. Of the 16 (10.7 %) synovialised ligaments, 13 accorded with the MR results. Three false-positive and three false-negative MR diagnoses were identified. The agreement between both techniques was excellent (Kappa = 0.79; p = 0.000), without differences (McNemar test; p = 1). Sensitivity was 0.81, specificity 0.98, PPV 0.98 and NPV 0.81. Magnetic resonance imaging is highly reliability for synovialisation diagnosis. The imaging sign used to diagnose synovialised ACL (hypointense comma-like tracts in its expected course) is reliable. As this reparative process can simulate an intact ligament, knowledge of this sign is important in diagnosing synovialisation of ACL tears so as not to confuse it with normal ACL. (orig.)

  20. Editorial Commentary: Does Early Arthroscopy of Subtle Instability in High Ankle Sprains Hasten Return to Play in Elite Athletes?

    Science.gov (United States)

    Feldman, Michael D

    2016-04-01

    Anterior inferior tibial fibular ligament tenderness to palpation, a positive squeeze test, and a positive external rotation test correlate well with syndesmosis instability after high ankle sprain. However, it is still unknown whether subtle unstable high ankle sprains (grade IIB) could heal satisfactorily with nonoperative treatment and whether their recovery would be prolonged compared with operative treatment. PMID:27039685

  1. Ankle Joint Fusion With an Anatomically Preshaped Anterior Locking Plate.

    Science.gov (United States)

    Wiewiorski, Martin; Barg, Alexej; Schlemmer, Thomas; Valderrabano, Victor

    2016-01-01

    We present a novel fixation plate for primary ankle joint fusion. A single anatomically preshaped angular stable plate was used with an anterior approach. An excellent result with good bone consolidation was present at the 1-year follow-up examination. PMID:25998475

  2. CT arthrography and virtual arthroscopy in the diagnosis of the anterior cruciate ligament and meniscal abnormalities of the knee joint

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Whal; Chung, Jin-Wook; Kang, Heung-Sik; Hong, Sung-Hwan; Choi, Ja-Young [Seoul National University, Seoul (Korea, Republic of); Kim, Ho-Sung; Kim, Seok-Jung; Kim, Hyung-Ho [Aeromedical Center, Seoul (Korea, Republic of)

    2004-03-15

    To determine the diagnostic accuracy of CT arthrography and virtual arthroscopy in the diagnosis of anterior cruciate ligament and meniscus pathology. Thirty-eight consecutive patients sho underwent CT arthrography and arthroscopy of the knee were included in this study. The ages of the patients ranged from 19 to 52 years and all of the patients were male. Sagittal, coronal, transverse and oblique coronal multiplanar reconstruction images were reformatted from CT arthrography. Virtual arthroscopy was performed from 6 standard views using a volume rendering technique. Three radiologists analyzed the MPR images and two orthopedic surgeons analyzed the virtual arthroscopic images. The sensitivity and specificity of CT arthrography for the diagnosis of anterior cruciate ligament abnormalities were 87.5%-100% and 93.3%-96.7%, respectively and those for meniscus abnormalities were 91.7%-100% and 98.1%, respectively. The sensitivity and specificity of virtual arthroscopy for the diagnosis of anterior cruciate ligament abnormalities were 87.5% and 83.3%-90%, respectively, and those for meniscus abnormalities were 83.3%-87.5% and 96.1-98.1%, respectively. CT arthrography and virtual arthroscopy showed good diagnostic accuracy for anterior cruciate ligament and meniscal abnormalities.

  3. Radiographic and anatomic landmarks to approach the anterior capsule in hip arthroscopy.

    Science.gov (United States)

    Salas, Antonio Porthos

    2015-12-01

    Hip arthroscopy (HA) is considered to be a very difficult and demanding surgical procedure, special instruments, an image intensifier and a fracture table or hip distractor are required to access the hip joint, the most common and worldwide used HA technique is entering blindly to the central compartment with the use of fluoroscopy and continuous distraction; with the potential danger if performed in unskillful hands of labral penetrations, labral resections and scuffing of the femoral head cartilage. Our technique describes the arthroscopic management of femoroacetabular impingement (FAI), performing a preoperative planning using radiographic and anatomic landmarks to approach the anterior capsule without the use of fluoroscopy. Access to the hip joint is made extra-articularly from the peritrochanteric compartment palpating the greater trochanter and posteriorly penetrating the iliotibial band sliding the arthroscopic sheath and obturator from the trochanteric border to the anterior femoral neck to visualize the anterior capsule bursa and anterior capsule fibers and posteriorly following our previous landmarks perform an anterior oblique Inverted 'T' or 'H' capsulotomy with a radiofrequency wand to access the cam-type impingement and distraction is made under direct controlled arthroscopic vision. Our technique in HA aiming the anterior capsule using radiographic and anatomic landmarks is safe, reliable and reproducible in FAI with big cams, deep sockets and cases with mild arthritis where the capsule is thick, stiff and calcified. PMID:27011869

  4. 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

  5. Combined sciatic femoral nerve block in a case of restrictive cardiomyopathy for arthroscopy and anterior cruciate ligament (ACL reconstruction

    Directory of Open Access Journals (Sweden)

    Gaurab Maitra

    2007-01-01

    Full Text Available Restrictive cardiomyopathy is a rare heart muscle disease resulting in impaired ventricular filling, low cardiac output and a propensity for development of heart failure with minimal fluid overload. Here, we present the management of a case of restrictive cardiomyopathy undergoing arthroscopy and anterior cruciate liga-ment (ACL reconstruction.

  6. Chronic instability of the anterior syndesmosis of the ankle: Biomechanical, kinematical, radiological and clinical aspects

    OpenAIRE

    Beumer, Annechien

    2007-01-01

    textabstractThis thesis is concerned with chronic anterior instability of the tibiofibular syndesmosis of the ankle. The ankle plays a fundamental role in locomotion. It consists of the talocrural and distal tibiofibular joint. The latter is a syndesmosis, a fibrous joint with ample intervening fibrous connective tissue. The syndesmosis consists of the anterior inferior tibiofibular ligament (ATiFL, also known as the anterior syndesmosis), the interosseous ligament (IL), and the posterior inf...

  7. Simultaneous reconstruction of anterior cruciate ligament and posterior cruciate ligament by using allogeneic patellar tendon under arthroscopy

    Institute of Scientific and Technical Information of China (English)

    ZHOU Li-ping; ZHEN Min-qing; XU Zhong-he

    2005-01-01

    Objective: To evaluate operative effects of a new method to reconstruct anterior crucial ligament (ACL) and posterior crucial ligament (PCL) simultaneously by using patellar tendon under arthroscopy.Methods: From November 1999 to November 2003,the injured ACL and PCL of 11 patients were fixated with compressed screws and reconstructed under arthroscopy with the bone-patellar tendon-bone treated with deep hypothermia and T radiation. At the same time, 2 patients were treated with medial collateral ligament (MCL)reconstruction, 3 with lateral collateral ligament (LCL)reconstruction, 1 with meniscus suture and 4 with whole or partial resection.Results: All patients were followed up for 12-26months (average 16.5 months ). The Lysholm score method was employed to evaluate the knee function. The average preoperative score was 45.3 and the postoperative score was 86.4. Anterior drawer test (ADT) was positive in 11 knees preoperatively and feeble positive in one knee postoperatively. Lachman test was positive in 11 knees preoperatively and in one postoperatively, and feebly positive in two postoperatively. Posterior drawer test was positive in 11 knees preoperatively and feebly positive in 2postoperatively. There were 2 knees with tolerable pain and 2 with knee flexion of 5°-20°.Conclusions: As for simultaneous reconstruction of ACL and PCL under arthroscopy, ailogeneic bone-patellar tendon-bone can not only avoid injury and complication caused by autografting, but also help rehabilitation of the knee function.

  8. Irreducible ankle fracture-dislocation due to tibialis anterior subluxation: a case report.

    Science.gov (United States)

    Natoli, Roman M; Summers, Hobie D

    2015-01-01

    Irreducible ankle fracture-dislocations are rare. Several cases of irreducible ankle fracture-dislocation have been reported in published studies secondary to the tibialis posterior tendon, deltoid ligament, or extensor digitorum longus tendon blocking the reduction. We report a case of irreducible ankle fracture-dislocation resulting from posteromedial subluxation of the tibialis anterior tendon around a medial malleolar fracture fragment. Ultimately, the ankle required open reduction of the incarcerated tendon to reduce the joint and proceed with internal fixation of the associated fracture. The patient's postoperative course was uncomplicated, and the tibialis anterior tendon was functioning at 10 months postoperatively, after which he did not return for follow-up examinations. To our knowledge, this is the first reported case of the tibialis anterior tendon blocking closed reduction of an ankle fracture-dislocation. PMID:25618805

  9. Arthroscopy-assisted anterior cruciate ligament reconstruction with patellar tendon or hamstring autografts.

    Science.gov (United States)

    Doral, M N; Leblebicioglu, G; Atay, O A; Baydar, M L; Tetik, O; Atik, S

    2000-01-01

    Isolated ACL reconstructions were performed in 138 patients between 1994 and 1998. Patellar bone-patellar tendon-bone, and hamstring tendon autografts were used in 88 patients, and allografts were used in 50 patients. Eighty-eight knees of 88 patients with autograft reconstructions (17 female, 71 male) were included in this study and evaluation of the patients with allograft reconstruction reported separately. The mean age at the time of the operation was 32 years. All ACL reconstructions were performed arthroscopically. Twenty-seven bone-patellar tendon-bone, and 61 hamstring tendon autografts were used. The mean follow-up was 29 months. In the postoperative course the Lachman test was negative in 62 patients, 1+ in 22 patients, and 2+ in 4 patients. In 17 patients, anterior drawer sign were 1+ in comparison to the contralateral side. Pivot shift test was moderately positive only in 5 cases in the bone-patellar tendon-bone and hamstring tendon autograft groups postoperatively. There were 3 patients with subjective "giving way" symptoms. Second look arthroscopy revealed rupture of the neo-ligament. Arthroscopic washout and debridement were performed, and no revision ligamentoplasties were performed. Two of these patients improved with accelerated proprioceptive physical therapy, and one had to decrease his previous level of activity. There were no cases of arthrofibrosis, infection, or extension lag. Clinical results of patellar bone-tendon-bone and hamstring groups did not show any significant clinical difference. Avoiding the disturbance of the extensor mechanism of the knee is probably the most significant advantage of the hamstring autograft.

  10. Arthroscopy-assisted anterior cruciate ligament reconstruction with patellar tendon or hamstring autografts.

    Science.gov (United States)

    Doral, M N; Leblebicioglu, G; Atay, O A; Baydar, M L; Tetik, O; Atik, S

    2000-01-01

    Isolated ACL reconstructions were performed in 138 patients between 1994 and 1998. Patellar bone-patellar tendon-bone, and hamstring tendon autografts were used in 88 patients, and allografts were used in 50 patients. Eighty-eight knees of 88 patients with autograft reconstructions (17 female, 71 male) were included in this study and evaluation of the patients with allograft reconstruction reported separately. The mean age at the time of the operation was 32 years. All ACL reconstructions were performed arthroscopically. Twenty-seven bone-patellar tendon-bone, and 61 hamstring tendon autografts were used. The mean follow-up was 29 months. In the postoperative course the Lachman test was negative in 62 patients, 1+ in 22 patients, and 2+ in 4 patients. In 17 patients, anterior drawer sign were 1+ in comparison to the contralateral side. Pivot shift test was moderately positive only in 5 cases in the bone-patellar tendon-bone and hamstring tendon autograft groups postoperatively. There were 3 patients with subjective "giving way" symptoms. Second look arthroscopy revealed rupture of the neo-ligament. Arthroscopic washout and debridement were performed, and no revision ligamentoplasties were performed. Two of these patients improved with accelerated proprioceptive physical therapy, and one had to decrease his previous level of activity. There were no cases of arthrofibrosis, infection, or extension lag. Clinical results of patellar bone-tendon-bone and hamstring groups did not show any significant clinical difference. Avoiding the disturbance of the extensor mechanism of the knee is probably the most significant advantage of the hamstring autograft. PMID:10983256

  11. Immediate effects of anterior to posterior talocrural joint mobilizations following acute lateral ankle sprain

    OpenAIRE

    Cosby, Nicole L.; Koroch, Michael; Grindstaff, Terry L.; Parente, William; Hertel, Jay

    2011-01-01

    Restrictions in ankle dorsiflexion range of motion (ROM) have been associated with decreased posterior talar glide in individuals with an acute lateral ankle sprain. Talocrural joint mobilizations may be used to restore joint arthrokinematics. Our purpose was to examine the effects of a single bout of anterior to posterior (AP) talocrural joint mobilization on self-reported function, dorsiflexion ROM, and posterior talar translation in individuals with an acute lateral ankle sprain. This sing...

  12. Chronic instability of the anterior syndesmosis of the ankle: Biomechanical, kinematical, radiological and clinical aspects

    NARCIS (Netherlands)

    A. Beumer (Annechien)

    2007-01-01

    textabstractThis thesis is concerned with chronic anterior instability of the tibiofibular syndesmosis of the ankle. The ankle plays a fundamental role in locomotion. It consists of the talocrural and distal tibiofibular joint. The latter is a syndesmosis, a fibrous joint with ample intervening fibr

  13. 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.

  14. 关节镜监视下踝关节植骨融合术的疗效分析%Outcome evaluation of arthroscopy-assisted ankle arthrodesis

    Institute of Scientific and Technical Information of China (English)

    王俊良; 刘玉杰; 李众利; 王志刚; 魏民

    2011-01-01

    Objective:To evaluate the methods and results of arthroscopy-assisted ankle arthrodesis. Methods:From January 2001 to May 2009,25 patients with end-stage ankle joint pathology were treated with arthroscopy-assisted ankle arthrodesis. There were 18 males and 7 females with an average age of 47.5 years (ranged, 32 to 70 years). The locations were left ankle in 10 cases and right ankle in 15 cases, including 13 cases of post-traumatic osteoarthritis, 10 cases of Kaschin-Beck disease and 2 cases of rheumatoid arthritis. At pre- and post-operation, the 10-point VAS score for ankle pain was obtained;the ankle functional was evaluated by the American Orthopaedic Foot & Ankle Society ankle and hindfoot score, which include pain,activity limitations,maximum walking distance,walking surfaces,gait abnormality,sagittal motion,hindfoot motion,ankle-hindfoot stability,and alignment. Results:All the patients were follow-up,with a mean period of 27.5 months (ranged,20 to 35 months). All the patients were free of pain and the gait was improved. There were no complications,such as neurovascular injuries, infection or hardware failure. All the patients achieved fusion in a mean of 11.7 weeks (ranged, 8 to 15 weeks). Overall, the mean 10-point visual analog scale (VAS) score decreased from (8.60±0.96) preoperatively to (1.20±0.82) postoperatively (t=27.326,P=0.000). After operation, the items of pain, activity limitations, maximum walking distance, walking surfaces, gait abnormality,sagittal motion,hindfoot motion,ankle-hindfoot stability,and alignment improved. AOFAS score was significantly increased from (36.44±9.90) points preoperatively to (82.44±4.96) points postoperatively (t=-19.178,P=0.000). Conclusion: Arthroscopy-assisted ankle arthrodesis offered minimal trauma,high fusion rates,rapid recovery and low morbidity. This study confirmed the efficacy of the arthroscopy-assisted ankle arthrodesis for ankle joint pathology.%目的:探讨关节镜辅助下踝关节清理、

  15. 改良 Brostrom 法联合踝关节镜治疗踝关节扭伤致慢性踝关节不稳的研究%Modified Brostrom precedure combined with ankle arthroscopy for chronic ankle instability derived from ankle sprains

    Institute of Scientific and Technical Information of China (English)

    陈冬; 姚建华; 黄炎; 伍罕

    2015-01-01

    Objective To investigate the therapeutic effect of modified Brostrom procedure combined with ankle arthroscopy for chronic ankle instability derived from ankle sprains. Methods A total of 23 cases of chronic ankle instability derived from ankle sprain were investigated. The modified Brostrom procedure combined with ankle arthroscopy were used for treatment. AOFAS score were respectively evaluated before surger-y and three months and one year after treatment. Results Ankle arthroscopy found varying degrees of synovial hyperplasia in all patients and carti-lage damage in 18 patients(mainly Ⅱ ~ Ⅲ degree). After one year of surgery,AOFAS score was significantly improved. Conclusion Short -term postoperative follow - up indicates the combination of modified Brostrom procedure and ankle arthroscopy exhibits good treatment effect and better recovery of ankle function in chronic ankle instability patients.%目的:探讨改良 Brostrom 法联合踝关节镜治疗踝关节扭伤致慢性踝关节不稳的临床效果。方法选择踝关节扭伤治疗后发展为慢性踝关节不稳的患者共23例,采用改良的 Brostrom 法联合踝关节镜进行治疗,AOFAS 评分评价患者术前、术后3个月、术后1年时的治疗效果。结果踝关节镜检查发现患者均存在不同程度滑膜增生,其中发生软骨损伤18例,Ⅱ~Ⅲ度损伤为主。术后1年患者 AOFAS 分项及总分均显著高于术前。结论采用改良 Brostrom术式结合踝关节镜治疗踝关节扭伤致慢性踝关节不稳可获得较好的治疗效果,术后短期随访踝关节功能恢复较好。

  16. 改良 Brostrom 法联合踝关节镜治疗踝关节扭伤致慢性踝关节不稳的研究%Modified Brostrom precedure combined with ankle arthroscopy for chronic ankle instability derived from ankle sprains

    Institute of Scientific and Technical Information of China (English)

    陈冬; 姚建华; 黄炎; 伍罕

    2015-01-01

    目的:探讨改良 Brostrom 法联合踝关节镜治疗踝关节扭伤致慢性踝关节不稳的临床效果。方法选择踝关节扭伤治疗后发展为慢性踝关节不稳的患者共23例,采用改良的 Brostrom 法联合踝关节镜进行治疗,AOFAS 评分评价患者术前、术后3个月、术后1年时的治疗效果。结果踝关节镜检查发现患者均存在不同程度滑膜增生,其中发生软骨损伤18例,Ⅱ~Ⅲ度损伤为主。术后1年患者 AOFAS 分项及总分均显著高于术前。结论采用改良 Brostrom术式结合踝关节镜治疗踝关节扭伤致慢性踝关节不稳可获得较好的治疗效果,术后短期随访踝关节功能恢复较好。%Objective To investigate the therapeutic effect of modified Brostrom procedure combined with ankle arthroscopy for chronic ankle instability derived from ankle sprains. Methods A total of 23 cases of chronic ankle instability derived from ankle sprain were investigated. The modified Brostrom procedure combined with ankle arthroscopy were used for treatment. AOFAS score were respectively evaluated before surger-y and three months and one year after treatment. Results Ankle arthroscopy found varying degrees of synovial hyperplasia in all patients and carti-lage damage in 18 patients(mainly Ⅱ ~ Ⅲ degree). After one year of surgery,AOFAS score was significantly improved. Conclusion Short -term postoperative follow - up indicates the combination of modified Brostrom procedure and ankle arthroscopy exhibits good treatment effect and better recovery of ankle function in chronic ankle instability patients.

  17. 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

  18. 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.

  19. Tendinopatia do compartimento anterior do tornozelo Tendinopathy of the anterior compartment of the ankle

    Directory of Open Access Journals (Sweden)

    Antonio Egydio de Carvalho Junior

    2010-01-01

    Full Text Available OBJETIVO: Análise retrospectiva da etiopatogenia, diagnóstico e opções de tratamento nos casos de tendinopatias do compartimento anterior do tornozelo (TCAT. MÉTODO: No período de setembro de 1998 a fevereiro de 2009, 13 pacientes foram operados por tendinopatia do compartimento anterior do tornozelo. A casuística constou de 10 pacientes do sexo masculino e três do feminino. O lado direito foi acometido em 12 pés e um do esquerdo. A média de idade foi de 35 anos (15-67. A etiologia foi traumática em oito pacientes e em cinco, degenerativa (atraumática. O tempo médio do diagnóstico ao tratamento foi de 19 meses (1-60 e o seguimento foi de 34 meses (4-127. O diagnóstico foi feito através da história e exame clínico. A ressonância magnética foi realizada em nove pacientes para estadiamento e planejamento. O tratamento cirúrgico foi personalizado para cada caso (sinovectomia, ressecção de ventre muscular, solidarização com o tendão adjacente e enxerto livre de tendão semitendíneo. Para a avaliação dos resultados foram utilizadas as escalas: 1 graduação subjetiva de satisfação, 2 AOFAS e 3 Maryland. RESULTADO: Em relação à escala de graduação subjetiva de satisfação, 12 pacientes satisfeitos e um paciente insatisfeito. A média da escala AOFAS foi de 80 pontos, a média da escala Maryland foi de 86 pontos. CONCLUSÃO: O tratamento cirúrgico é eficaz para recuperação funcional. As técnicas cirúrgicas devem ser personalizadas. A opção do enxerto livre de tendão semitendíneo é eficiente nas falhas maiores que cinco centímetros.OBJECTIVE: To carry out a retrospective analysis of the etiopathogeny, diagnosis and therapeutic options in cases of tendinopathies of the anterior compartment of the ankle. METHOD: 13 patients underwent surgery between September 1998 and February 2009; ten men and three women. The right side was involved in twelve patients and the left in one. The averaging age was 35 years of

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2000-01-01

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

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

    International Nuclear Information System (INIS)

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

  2. Value of fat-suppressed PD-weighted TSE-sequences for detection of anterior and posterior cruciate ligament lesions-Comparison to arthroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Schaefer, Fritz K.W. [Department of Diagnostic Radiology, University Hospital of Schleswig-Holstein Campus Kiel, Arnold-Heller-Strasse 9, 24105 Kiel (Germany)]. E-mail: f.schaefer@rad.uni-kiel.de; Schaefer, Philipp J. [Department of Diagnostic Radiology, University Hospital of Schleswig-Holstein Campus Kiel, Arnold-Heller-Strasse 9, 24105 Kiel (Germany); Brossmann, Joachim [Department of Diagnostic Radiology, University Hospital of Schleswig-Holstein Campus Kiel, Arnold-Heller-Strasse 9, 24105 Kiel (Germany); Frahm, Christian [Department of Diagnostic Radiology, University Hospital of Schleswig-Holstein Campus Kiel, Arnold-Heller-Strasse 9, 24105 Kiel (Germany); Muhle, Claus [Department of Diagnostic Radiology, University Hospital of Schleswig-Holstein Campus Kiel, Arnold-Heller-Strasse 9, 24105 Kiel (Germany); Hilgert, Ralf Erik [Department of Diagnostic Radiology, University Hospital of Schleswig-Holstein Campus Kiel, Arnold-Heller-Strasse 9, 24105 Kiel (Germany); Heller, Martin [Department of Diagnostic Radiology, University Hospital of Schleswig-Holstein Campus Kiel, Arnold-Heller-Strasse 9, 24105 Kiel (Germany); Jahnke, Thomas [Department of Diagnostic Radiology, University Hospital of Schleswig-Holstein Campus Kiel, Arnold-Heller-Strasse 9, 24105 Kiel (Germany)

    2006-06-15

    Objective: To evaluate fat-suppressed (FS) proton-density-weighted (PDw) turbo spin-echo (TSE) magnetic resonance imaging for the detection of anterior and posterior cruciate ligament lesions in comparison to arthroscopy. Materials and methods: In a prospective study 31 knee joints were imaged on a 1.5 T MR scanner (Vision[reg], Siemens, Erlangen) prior to arthroscopy using following sequences: (a) sagittal FS-PDw/T2w TSE (TR/TE: 4009/15/105 ms); (b) sagittal PDw/T2w TSE (TR/TE:3800/15/105 ms). Further imaging parameters: slice thickness 3 mm, FOV 160 mm, matrix 256 x 256. A total of 62 anterior and posterior cruciate ligaments (ACL/PCL) were evaluated, standard of reference was arthroscopy. Sensitivity, specificity, positive (ppv) and negative predictive value (npv) and accuracy were calculated. Results: Twenty-one cruciate ligament ruptures were detected in arthroscopy, 19 ACL- and 2 PCL-ruptures (on MRI 34/124, 25/62 ACL, 9/62 PCL lesions). For all four sequences in the 31 patients with arthroscopic correlation sensitivity, specificity, ppv, npv and accuracy were 86%, 98%, 95%, 93% and 94% for detection of tears, and 84%, 100%, 100%, 80% and 90% for ACL-ruptures respectively. The two PCL-ruptures were true positive in all sequences, one intact PCL was diagnosed as torn (false positive). Conclusions: Fat-suppressed PDw/T2w TSE-MR sequences are comparable to PDw TSE sequences for the detection of ACL/PCL-lesions.

  3. Nursing after Anterior Cruciate Ligament Reconstruction Surgery under Arthroscopy%关节镜下前交叉韧带重建患者的护理

    Institute of Scientific and Technical Information of China (English)

    辛海霞; 段元君; 张晓霞; 国美娥

    2012-01-01

    目的 探讨关节镜下前交叉韧带重建术后正确的护理方法.方法 回顾性分析并总结2007年10月至2010年12月济南军区总医院骨创伤外科收治的59例关节镜下前交叉韧带重建患者的临床资料.结果 59例患者均顺利拆线出院,术后膝关节功能恢复良好.结论 围术期正确的护理与康复指导对患者膝关节的功能康复具有关键的作用.%Objective To explore the proper nursing methods after anterior cruciate ligament reconstruction surgery by arthroscopy. Methods The clinical data of 59 patients after anterior cruciate ligament surgery under arthroscopy from October 2007 to December 2010 in the hospital were analyzed and summarized retrospectively. Results Fifty-nine patients were discharged from hospital smoothly, and their knee joint function were well recovered. Conclusion The proper nursing in perioperative period and functional rehabilitation training play a critical part in successful recovery of patients after anterior cruciate ligament surgery.

  4. Weber B Fracture of the Lateral Malleolus with Concomitant Anterior Talofibular Ligament Injury following an Ankle Supination Injury.

    Science.gov (United States)

    Faqi, Mohammed Khalid; AlJawder, Abdulla; Alkhalifa, Fahad; Almajed, Ali H

    2016-01-01

    The Lauge-Hansen (LH) classification attempts to predict patterns of ankle injuries based upon the preceding mechanism of injury. Although it is widely used in clinical practice, it has been criticized mainly due to numerous reports of cases conflicting the prediction system. Here, we report a case of a 32-year-old male who sustained a Weber B fracture of the lateral malleolus following a supination ankle injury, which was treated conservatively, following which the patient presented with ankle instability and was found to have concurrent anterior talofibular ligament tear. Critical review of the LH classification along with its shortcomings is discussed. PMID:27313928

  5. Weber B Fracture of the Lateral Malleolus with Concomitant Anterior Talofibular Ligament Injury following an Ankle Supination Injury

    Directory of Open Access Journals (Sweden)

    Mohammed Khalid Faqi

    2016-01-01

    Full Text Available The Lauge-Hansen (LH classification attempts to predict patterns of ankle injuries based upon the preceding mechanism of injury. Although it is widely used in clinical practice, it has been criticized mainly due to numerous reports of cases conflicting the prediction system. Here, we report a case of a 32-year-old male who sustained a Weber B fracture of the lateral malleolus following a supination ankle injury, which was treated conservatively, following which the patient presented with ankle instability and was found to have concurrent anterior talofibular ligament tear. Critical review of the LH classification along with its shortcomings is discussed.

  6. ANKLE POSITION AND VOLUNTARY CONTRACTION ALTER MAXIMAL M WAVES IN SOLEUS AND TIBIALIS ANTERIOR

    Science.gov (United States)

    FRIGON, ALAIN; CARROLL, TIMOTHY J.; JONES, KELVIN E.; ZEHR, E. PAUL; COLLINS, DAVID F.

    2016-01-01

    Compound muscle action potentials (CMAPs) recorded using surface electrodes are often used to assess the excitability of neural pathways to skeletal muscle. However, the amplitude of CMAPs can be influenced by changes at the recording site, independent of mechanisms within the central nervous system. We quantified how joint angle and background contraction influenced CMAP amplitude. In seven subjects CMAPs evoked by supramaximal transcutaneous electrical stimulation of motor axons (Mmax) were recorded using surface electrodes from soleus and tibialis anterior (TA) at static positions over the full range of ankle movement at 5° intervals. Across subjects the peak-to-peak amplitude of Mmax was 155% and 159% larger at the shortest than longest muscle lengths for soleus and TA, respectively. In five subjects the effect of ankle position and voluntary contraction on M-wave/H-reflex recruitment curves was assessed in the soleus. Both ankle position and level of contraction significantly influenced Mmax, Hmax, and the Hmax to Mmax ratio, but there were no interactions between the two parameters. These peripheral changes that influence Mmax will also impact other CMAPs such as submaximal M-waves, H-reflexes, and responses to transcranial magnetic stimulation. As such, during experimental studies CMAPs evoked at a given joint angle and contraction level should be normalized to Mmax recorded at similar joint angle and contraction strength. PMID:17295303

  7. Relationship between mucoid hypertrophy of the anterior cruciate ligament (ACL) and morphologic change of the intercondylar notch: MRI and arthroscopy correlation

    Energy Technology Data Exchange (ETDEWEB)

    Cha, Ji Hyeon; Shin, Myung Jin; Choi, Byeong Kyoo [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Medical Center, Seoul (Korea); Lee, Sang Hoon [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Medical Center, Seoul (Korea); University of Ulsan College of Medicine, Department of Radiology, Asan Medical Center, Seoul (Korea); Bin, Sung Il [University of Ulsan College of Medicine, Department of Orthopedic Surgery, Asan Medical Center, Seoul (Korea)

    2008-09-15

    The purpose of this study was to evaluate the relationship between mucoid hypertrophy of the anterior cruciate ligament (ACL) and morphologic change of the intercondylar notch. We retrospectively reviewed the 105 patients with knee magnetic resonance imaging (MRI) with or without knee arthroscopy [group 1: patients with arthroscopic notchplasty (N = 47), group 2: knee arthroscopy demonstrating intact ACL (N = 33), and group 3: patients with normal knee MRI but no arthroscopy (N = 25)]. Groups 2 and 3 served as an arthroscopic and MR control group, respectively. Two musculoskeletal radiologists reviewed all MR examinations. The intercondylar notch width, notch index (width of intercondylar notch/width of femoral condyle), transverse notch angle (TNA), sagittal notch angle (SNA), and notch area were recorded on axial and sagittal MR images at the midpoint of Blumensaat's line which was identified on sagittal images. The diameter of the ACL was recorded on coronal MR images at the posterior end of Blumensaat's line. The mean values of the intercondylar notch width, notch index, TNA, SNA, notch area, and ACL diameter for the three groups were 16.0 mm/0.2/50.3 /36.5 /249.0 mm{sup 2}/7.7 mm (group 1); 19.3 mm/0.3/52.9 /40.2 /323.4 mm{sup 2}/4.8 mm (group 2); and 20.3 mm/0.3/51.4 /39.1 /350.8 mm{sup 2}/4.5 mm (group 3). The intercondylar notch width, notch index, SNA, and notch area were smaller, and ACL diameter was thicker in group 1 compared with the other groups (p < 0.05). Patients with mucoid ACL hypertrophy show a narrower notch, a steeper notch angle, and a smaller notch area than control groups. (orig.)

  8. MR-imaging of anterior tibiotalar impingement syndrome: Agreement, sensitivity and specificity of MR-imaging and indirect MR-arthrography

    Energy Technology Data Exchange (ETDEWEB)

    Haller, Joerg [Department of Radiology, Hanusch Hospital, Heinrich Collin-Strasse 30, A-1140 Vienna (Austria); Ludwig Boltzmann Institute for Osteology, Hanusch Hospital, Heinrich Collin-Strasse 30, A-1140 Vienna (Austria); Bernt, Reinhard [Department of Radiology, Hanusch Hospital, Heinrich Collin-Strasse 30, A-1140 Vienna (Austria)]. E-mail: reinhard.bernt@wgkk.sozvers.at; Seeger, Thomas [Department of Trauma Surgery, Hanusch Hospital, Heinrich Collin-Strasse 30, A-1140 Vienna (Austria); Weissenbaeck, Alexander [Department of Trauma Surgery, Hanusch Hospital, Heinrich Collin-Strasse 30, A-1140 Vienna (Austria); Tuechler, Heinrich [Ludwig Boltzmann Institute for Hematology, Hanusch Hospital, Heinrich Collin-Strasse 30, A-1140 Vienna (Austria); Resnick, Donald [Department of Radiology, VA Medical Center, UCSD, 3350 La Jolla Village Dr, San Diego, CA 92161 (United States)

    2006-06-15

    Objective: To clarify the role of MR-imaging in the diagnosis of anterior ankle impingement syndromes. Materials and methods: We prospectively examined 51 consecutive patients with chronic ankle pain by MR-imaging. Arthroscopy was performed in 29 patients who previously underwent non-enhanced MR-imaging; in 11 patients, indirect MR-arthrography additionally was performed. MR-examinations were correlated with clinical findings; MR and arthroscopy scores were statistically compared, agreement was measured. Results: Arthroscopy demonstrated granulation tissue in the lateral gutter (38%) and anterior recess (31%), lesions of the anterior tibiofibular (31%) and the anterior talofibular ligament (21%) as well as intraarticular bodies (10%). Stenosing tenosynovitis and a ganglionic cyst were revealed as extraarticular causes for chronic ankle pain by MR-examination (17%). Agreement of MR-imaging and arthroscopy was fair for the anterior talofibular ligament and the anterior joint cavity (kappa 0.40). Major discrepancy was found for non-enhanced MR scans (kappa 0.49) when compared with indirect MR-arthrography (kappa 0.03) in the anterior cavity. The sensitivity for lesions of the anterior talofibular and calcaneofibular ligament and the anterior cavity (0.91-0.87) detected by MR-imaging was superior in comparison to lesions of the anterior tibiofibular ligament and anteromedial cavity (0.50-0.24). Conclusion: MR-imaging provides additional information about the mechanics of chronic ankle impingement rather than an accurate diagnosis of this clinical entity. The method is helpful in differentiating extra- from intra-articular causes of ankle impingement. Indirect MR-arthrography has little or no additional value in patients with ankle impingement syndrome.

  9. American College of Foot and Ankle Surgeons

    Science.gov (United States)

    ... Week @ ACFAS Poll Results Arthroscopy e-Book The Journal of Foot & Ankle Surgery Read some of the latest research from the official peer-reviewed scientific journal of ACFAS, The Journal of Foot & Ankle Surgery ( ...

  10. Timing of Reconstruction of Anterior Crucite Ligament Under Arthroscopy%关节镜下前交叉韧带重建术的时间选择

    Institute of Scientific and Technical Information of China (English)

    王仁鹏; 曹南开; 吕景波

    2015-01-01

    目的:通过不同时间前交叉韧带(ACL)重建的术后患者优良率的比较,探讨ACL重建的最佳时机。方法对86例(早期(A组)54例,晚期(B组)32例)ACL损伤患者在关节镜下手术重建后并对结果进行分析。结果术后随访6个月,根据Lysholm评分,两组分别取得90.3%和79.6%的优良率,差异有统计学意义(P<0.05)。结论于早期进行前交叉韧带(ACL)重建术会影响患者部分关节功能,而晚期进行重建会增加继发性损伤的发生率。综合判断,早期重建疗效优于晚期。%Objective To compare the excellent and good rate of different timing of reconstruction of anterior cruciate ligament (A-CL) reconstruction under arthroscopy so as to explore the optimal time. Methods The results of reconstruction of ACL under arthroscopy of 86 patients, 45 of whom were assigned to group A who received operation early, and 32 of whom were assigned to group B who received operation later, were analyzed. Results All patients were followed up for 6 months, according to Lysholm score, the excellent and good rate of the two groups was 90.3%and 79.6%. Conclusion Anterior cruciate ligament in the early (A-CL) reconstruction will affect the part of joint function in patients with advanced reconstruction, and may increase the incidence of secondary injury. Comprehensive judgment shows that early reconstruction effect is better than the late.

  11. Hip arthroscopy

    Directory of Open Access Journals (Sweden)

    Henrique Antônio Berwanger de Amorim Cabrita

    2015-06-01

    Full Text Available Hip arthroscopy is a safe method for treating a variety of pathological conditions that were unknown until a decade ago. Femoroacetabular impingement is the commonest of these pathological conditions and the one with the best results when treated early on. The instruments and surgical technique for hip arthroscopy continue to evolve. New indications for hip arthroscopy has been studied as the ligamentum teres injuries, capsular repair in instabilities, dissection of the sciatic nerve and repair of gluteal muscles tears (injuries to the hip rotator cuff, although still with debatable reproducibility. The complication rate is low, and ever-better results with fewer complications should be expected with the progression of the learning curve.

  12. Value of 13-MHz high-frequency ultrasound of the lateral ankle ligaments and the anterior tibiofibular ligament

    International Nuclear Information System (INIS)

    Purpose: Determination of the value of 13-MHz high-frequency ultrasound in the diagnosis of acute injuries of the lateral ankle ligaments and the anterior tibiofibular ligament by comparison with MRI. Method: Sonography was performed prospectively in 64 acutely injured patients using a mechanical 13-MHz sector probe; for diagnosis of the anterior tibiofibular ligament a 15-MHz sector probe was employed during the course of this trial. Using a 0.2-T unit for MRI examination, T1-weighted (TR 580 ms, TE 24 ms) and T2-weighted (TR 3000 ms, TE 80 ms) spin-echo sequences were obtained in various oblique axial imaging planes. Results: In the differentiation of intact and injured ligaments, ultrasound and MRI agreed in 95.3/% of cases for the anterior fibulotalar ligament, in 88.3% for the fibulocalcanear ligament and in 85.0% for the anterior tibiofibular ligament. Conclusion: Lesions of the anterior talofibular and fibulocalcanear ligament can be accurately demonstrated by ultrasound if a 13-MHz sector scanner is used. The detection of lesions in the anterior tibiofibular ligament is more difficult. With increasing experience and by using a 15-MHz sector scanner, better results can be expected for this ligament. (orig.)

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

    Directory of Open Access Journals (Sweden)

    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.

  14. 探析关节镜下前交韧带重建术的康复护理%Rehabilitated Nursing Care in the Reconstruction of Anterior Cruciate Ligament Under the Arthroscopy

    Institute of Scientific and Technical Information of China (English)

    苏敏; 郝桂兰; 杨娟; 季丹丹; 吴晓荣

    2014-01-01

    Objective To explore postoperative rehabilitated nursing care in the reconstruction of anterior cruciate ligament under the arthroscopy.Method 35 patients with reconstruction of anterior cruciate ligament under the arthroscopy received systemic rehabilitation training.Results The patients' knee joint have good function,no discomfort and no infection occurred after the operation. Conclusion Rehabilitation training is very important for the patients with reconstruction of anterior cruciate ligament to recover the function and prevent form complications.%目的:探讨关节镜下前交叉韧带重建术后的康复护理方法。方法总结35例关节镜下前交叉韧带重建术的患者,制定系统的功能锻炼方法进行康复训练。结果35例患者患侧膝关节活动范围均恢复良好,可正常生活,患膝无不适感和感染现象发生。结论正确的康复护理是韧带重建术后功能恢复的重要保证。

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

    DEFF Research Database (Denmark)

    Rasmussen, S; Hjorth Jensen, C

    2002-01-01

    A consecutive series of 105 patients with a median age of 35 (16-62) years who were operated on with arthroscopic resection for impingement of the ankle using standardized technique without distraction is presented. All patients complained of painful dorsiflexion and had failed to respond...... to conservative treatment. A total of 177 diagnoses were found, soft tissue impingement or synovitis in 89, anterior bony impingement in 44, chondral lesion in 20, loose bodies in 16 and osteoarthritis in eight. At follow-up after 2 years, 65 patients were pain free while 28 patients had experienced reduction...... synovectomy and intravenous antibiotics. In one patient persistent symptoms were recorded. Ankle arthroscopy yielded good results in the treatment of anterior impingement of the ankle as it effectively reduced pain and enhanced function....

  16. 关节镜下空心螺钉固定ACL胫骨止点撕脱骨折%Treatment of anterior cruciate ligament tibial eminence avulsionfractures with hollow screw through arthroscopy

    Institute of Scientific and Technical Information of China (English)

    李云华; 刘春磊; 王贵清; 王湘江; 邹华

    2013-01-01

    Objective To observe the clinical effect of treatment of anterior cruciate ligament tibial eminence avulsion fractures with hollow screw through arthroscopy.Method 13 cases with anterior cruciate ligament tibial eminence avulsion fractures were treated through arthroscopy from February 2010 to March 2011.Fractures were reduction and fixed with hollow screw through arthroscopy.All the cases were followed-up more than 1 year.The evaluation of knee function was taken with Lysholm score system.Result All the cases were followed-up with mean time 16months (12~25months).The preoperative Lysholm scores ranged from 23 to 65,with a mean of (48.45±5.23),and the postoperative Lysholm scores ranged from 83 to 96,with a mean of (91.34±6.53).11 cases were excellent,1 good and 1 fair,the excellent and good rate was 92.3%.Conclusion It is an effiective method in the treatment of anterior cruciate ligament tibial eminence avulsion fractures with hollow screw through arthroscopy.it may produce less trauma and with quick healing.%目的 观察关节镜下空心螺钉固定ACL胫骨止点撕脱骨折的临床效果.方法 2010年2月~2011年3月,关节镜下空心螺钉固定ACL胫骨止点撕脱骨折13例,在关节镜下复位骨折块,空心螺钉固定骨折块.通过1年以上随访行疗效评定.患者膝关节功能以Lysholm评分系统评分.结果 全部病例获完整随访,平均随访16m(12~25m).Lysholm膝关节功能评分:术前23~65分,平均(48.45±5.23)分;术后83~96分,平均(91.34±6.53)分.优11例,良1例,中1例,优良率92.3%.结论 关节镜下空心螺钉固定ACL胫骨止点撕脱骨折创伤小、恢复快,是一种可行的方法.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-06-01

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

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

    International Nuclear Information System (INIS)

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

  19. Trends in Wrist Arthroscopy

    Science.gov (United States)

    Obdeijn, Miryam C.; Tuijthof, Gabrielle J. M.; van der Horst, Chantal M. A. M.; Mathoulin, Christophe; Liverneaux, Philippe

    2013-01-01

    Background Wrist arthroscopy plays a role in both the diagnosis and the treatment of wrist pathology. It has evolved in the last three decades. Questions The present status of wrist arthroscopy was investigated by answering the following questions: -What is its current position in the treatment wrist pathologies according to the literature? -What is its current position according to hand surgeons? Methods Analysis of the number of publications on wrist arthroscopy was performed and compared with the number of publications on other arthroscopy topics to assess the current position of wrist arthroscopy. The members of the EWAS (European Wrist Arthroscopy Society) and the members of eight national hand surgery societies were questioned on wrist arthroscopy in daily practice. Results From 1975 till now, 925 papers on wrist arthroscopy were found. The publications on wrist arthroscopy increased from an average of 8/year (1986) to 26/year (2012). More than half (56.9%) of the respondents of the EWAS perform fewer than 5 wrist arthroscopies per month, and only 7 (10.8%) indicate the performance of more than 10 wrist arthroscopies per month. Seventy-four percent of the orthopedic hand surgeons perform wrist arthroscopy (in 48.5% for therapeutic indications) against 36.8% of plastic surgery hand surgeons (in 23.1% for therapeutic indications). Conclusion Wrist arthroscopy has taken up a place in the armamentarium of the hand surgeon. The place of wrist arthroscopy in daily practice is related to the background of the hand surgeon. PMID:24436823

  20. Syndesmosis injuries of the ankle

    OpenAIRE

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

    2013-01-01

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

  1. Knee arthroscopy - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000199.htm Knee arthroscopy - discharge To use the sharing features on ... had surgery to check for problems in your knee (knee arthroscopy). You may have been checked for: ...

  2. 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.

  3. The applications of arthroscopy on malleolus fractures

    Institute of Scientific and Technical Information of China (English)

    HOU Zhi-qi; Jegan Krishnan; Peter Tamblyn

    2005-01-01

    @@ Historical perspective It was well known that in 1918 Takagi performed the first arthroscopic inspection of a cadaver's knee in Japan. 1 His interest in this area laid the foundation for arthroscopy and facilitated the development of arthroscope. In 1931, Burman reported an experimental study on the arthroscopic exploration of cadaveric joints, but he believed that the ankle joint was unsuitable for such techniques because it was too narrow to pass through the posterior puncture.2Unexpectedly, several years later Takagi described a routine method for arthroscopic examination of the ankle.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-11-15

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

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

    International Nuclear Information System (INIS)

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

  6. Comparative X-ray investigation of lateral and anterior-posterior ankle-joint images - comparison with pathological and anatomical findings concerning lateral ankle-joint lesions and their clinical importance, studied in a special type of holding device

    International Nuclear Information System (INIS)

    The study reports on a possibility to interpret the relation of the different bone structures of the upper ankle-joint to one another in the X-ray picture without using contrast media. Modern funtional diagnostic methods increasingly make use of X-ray pictures taken in fixed position. It seems useful to standardize such X-ray images of the ankle-joint in order to make them reproducible. The author developed a device that would suit these purposes. A diagnosis required the reproduction of the accidental mechanism. The clinical symptoms do not permit to clearly state the extent of the lesion of the ligaments. The results of the post-operative follow-up examinations confirm the urgent necessity of the standardized diagnostic method presented and the success of the therapy applied. The presented X-ray method permits safe diagnosis of ruptures of the ligaments. Location of a certain rupture is not possible with the fixed-position X-ray screening. For a clear assessment of lesions of the ligaments at the lateral ankle-joint, X-ray pictures must be taken both in the anterior-posterior path of rays and in the lateral one. A normal result in the lateral path of rays does not exclude a pathologic result in the anterior-posterior path of rays, and vice versa. (orig./MG)

  7. History of arthroscopy

    Directory of Open Access Journals (Sweden)

    Marić Dušan M.

    2002-01-01

    Full Text Available Arthroscopy has developed as one of the branches of former cystoscopy. During the past 200 years a few people have made invaluable contributions to development of arthroscopy (Bozzini, Takagi, Watanabe After the World War II scientific and technological progress was so fast that arthroscopy proved to be a valuable tool in orthopedics, not only as a diagnostic, but also as a therapeutic procedure.

  8. 关节镜下部分重建治疗膝关节前交叉韧带不完全断裂%Selective reconstruction for incomplete injury to anterior cruciate ligament of the knee under arthroscopy

    Institute of Scientific and Technical Information of China (English)

    张羽飞; 王福生; 王立德; 张卫国; 汤欣

    2008-01-01

    Objective To explore the clinical skills and effects of arthroscopie diagnosis and se-lective reconstruction of incomplete anterior cruciate ligament (ACL) injury of the knee. Methods From June 2004 to December 2006, 267 eases of incomplete ACL lesion of the knee were admitted to our hospital and diagnosed under the arthroscopy. Of them, 29 cases (10.9%) were diagnosed as incomplete ACL injury (21 as anterior medial branch (AMB) rupture and 8 as posterior lateral branch (PLB) rupture). The damaged ligaments were reconstructed selectively under arthroscopy. Eleven eases underwent reconstruction with LARS ligament and 18 with autologous hamstring ligament. The undamaged ligament branches were reserved. Results All cases were followed up for an average period of 15 (12 to 30) months. Rehabilitation lasted 12 months. Statistically significant differences existed between preoperative Lysholm scores and postoperative l,yshotm scores (P < 0.05). Conclusions Selective reconstruction of the damaged ACL parts can keep integrity of double branches of the ligament, improve the joint function and avoid terminal complications. Appropriate treatment and early reconstruction of the damaged ACL under arthroscopy are clinically important for early recovery of the knee stabilization.%目的 探讨前交叉韧带(ACL)不完全断裂的关节镜下诊断及镜下部分蕈建治疗的疗效和意义. 方法 2004年6月至2006年12月,经关节镜确诊ACL不完伞断裂29例,其中前内侧束断裂21例,后外侧束断裂8例.全部患者于关节镜下重建损伤部分的韧带组织,选用LARS韧带蕈建11例,自体四股腘绳肌腱移植重建18例,术中完整保留未断裂部分的切带纤维束. 结果全部患者均获随访,平均随访15个月(12~30个月),治疗康复12个月时,门诊进行统一标准膝关节功能评定,膝关节Lysholm评分手术前、后比较差异有统计学意义(P<0.05). 结论正常ACL的前内侧束和后外侧束各自有不同的功

  9. 膝关节镜下前交叉韧带重建术的护理配合%Nursing cooperation in anterior cruciate ligament reconstruction with knee arthroscopy

    Institute of Scientific and Technical Information of China (English)

    杨红梅

    2011-01-01

    目的 探讨和总结膝关节镜下重建前交叉韧带的手术配合经验,以进一步提高配合水平.方法 通过对15例自体韧带重建前交义韧带的手术配合,总结配合要点、经验.结果 本组患者术后平均15.0d出院.无1例交叉感染,术后2个月Lysholm膝关节功能良好.结论 充分的术前准备,严格执行无菌操作,准确熟练地配合手术,正确使用仪器和器械是手术成功的关键.%Objective To explore and summarize nursing cooperation in anterior cruciate ligament reconstruction with knee arthroscopy in order to improve coordination level. Methods Key cooperation points and experience were summarized through 15 cases of autologous ligament reconstruction with anterior cruciate ligament surgery. Results The average time was 15.0 d before all patients were discharged. No crossing infection occurred. After two months Lysholm knee function was good. Conclusion Adequate preoperative preparation, strictly enforced aseptic manipulation, accurate and proficient surgery cooperation, correct use of instruments and equipments are key to any successful operation.

  10. Instability of the hindfoot after lesion of the lateral ankle ligaments: investigations of the anterior drawer and adduction maneuvers in autopsy specimens

    DEFF Research Database (Denmark)

    Kjaersgaard-Andersen, P.; Frich, Lars Henrik; Madsen, F.;

    1991-01-01

    The mobility patterns in the tibiotalocalcaneal joint complex with a solitary lesion of the anterior talofibular ligament (ATL) and a combined lesion of the ATL and calcaneofibular ligament (CFL) were studied in 22 human lower-extremity autopsy specimens mounted in a kinesiologic testing device. A...... solitary lesion of the ATL increased the anteroposterior (AP) laxity in the ankle joint in the entire range of flexion, with a maximum median of 3.1 mm in neutral flexion. Further cutting of the CFL increased AP laxity most obviously in dorsiflexion. A solitary lesion of the ATL resulted in a minor...

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

    OpenAIRE

    McAteer Eamon; Johnston Ruth; McKay Damian; Marron Conor D; Stirling WJ Ivan

    2005-01-01

    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 hig...

  12. Meniscal and cruciate ligaments tears diagnosed with MR imaging versus arthroscopy

    International Nuclear Information System (INIS)

    MR studies of knee joints in 37 patients were performed. The clinical diagnostics was traumatic lesions of menisci or cruciate ligaments. Arthroscopy of the knee joint was performed in 21 patients. MR showed meniscal lesion in 25 patients and anterior cruciate ligament (ACL) lesions in 18 patients. Arthroscopy showed meniscal lesions in 16 of 21 patients and ACL lesions in 11 of 21 patients. MR correlated with arthroscopy in 16 of examined menisci and 15 of 21 examined ACL. (author)

  13. MRI VERSUS ARTHROSCOPY: A COMPARISON OF FINDINGS

    Directory of Open Access Journals (Sweden)

    Somashekhara Reddy

    2016-06-01

    Full Text Available The purpose of this study is to correlate the findings of Magnetic Resonance Imaging with Arthroscopy in internal derangements of knee and to assess the sensitivity, specificity and accuracy of Magnetic Resonance Imaging in comparison to Arthroscopy. METHODS AND MATERIALS Fifty six patients with history of suspected internal derangement of knee were evaluated prospectively with MRI and correlated with arthroscopy during a one and half a year period from March 2012 to September 2013.1.5 Tesla MRI machine using a closed extremity coil is used. Sequences used in MRI of the knee include Turbo-spin echo (TSE, FFE (Gradient echo and Short Tau Inversion Recovery (STIR sequences in Axial, Sagittal and Coronal planes using a slice thickness of 3 mm with a 0.3 mm slice gap. Arthroscopy of the knee with standard anteromedial and anterolateral portals with the patient in supine position done in all the cases. RESULTS The diagnostic sensitivity, specificity and accuracy of MRI in detecting cruciate ligament and meniscal injuries as compared to Arthroscopy are as follows: Anterior Cruciate Ligament (ACL: 97.29%, 89.47%, 94.64%; Posterior Cruciate Ligament (PCL: 100%, 100%, 100%; Medial Meniscus (MM: 100%, 93.33%, 98.21% and Lateral Meniscus (LM: 93.10, 92.59, 92.85. Most common lesions found were ACL and Medial Meniscal tears (posterior horn of MM being the most common site. SUMMARY AND CONCLUSION  MRI is a useful non-invasive modality having high sensitivity, specificity and accuracy in diagnosing cruciate ligament and meniscal injuries.  MRI should be considered as the first line of investigation in all patients with suspected internal derangements of knee.  MRI being easily available and non-invasive is useful as a pre-operative screening modality, thus improves the quality of diagnostic and therapeutic arthroscopies and further reduces the morbidity.  Arthroscopy is the standard diagnosing tool in all patients with suspected internal

  14. Magnetic resonance imaging evaluation of capsulolabral tears after traumatic primary anterior shoulder dislocation. A prospective comparison with arthroscopy of 25 cases

    DEFF Research Database (Denmark)

    Suder, P.A.; Frich, Lars Henrik; Hougaard, K.;

    1995-01-01

    . Subacute MRI evaluation identified 15 labral tears, 12 Hill-Sachs lesions, 1 total rotator cuff lesion, 1 partial joint side rotator cuff lesion, and 1 partial rupture of the biceps tendon. Arthroscopic examination revealed 22 labral tears, 15 Hill-Sachs lesions, 1 total rotator cuff lesion, 1 partial...... joint side rotator cuff tear, 1 partial rupture of the biceps tendon, and 1 osseous Bankart lesion. Anterior capsulolabral tears and Hill-Sachs lesions appeared with a high incidence after acute anterior primary shoulder dislocation. Conventional MRI was only moderately reliable in the preoperative...... evaluation of labral tears and Hill-Sachs lesions, and it failed to give an accurate, differentiated preoperative diagnosis of the capsulolabral lesions....

  15. Nursing of tibial avulsion fracture of anterior cruciate ligament with arthroscopy%关节镜下治疗前交叉韧带胫骨止点撕脱性骨折的护理

    Institute of Scientific and Technical Information of China (English)

    孙文萍; 林芃; 陈传霞

    2012-01-01

    目的 探讨关节镜下治疗前交叉韧带(ACL)胫骨止点撕脱性骨折的临床护理.方法 通过对12例ACL胫骨止点撕脱性骨折的患者采取术前心理护理、术前准备、术前适应性训练,术后一般护理、患肢与疼痛的观察护理和康复护理相结合,并在工作中小断总结护理经验,提高护理水平.结果 本组12例患者平均随访16个月,所有骨折均获愈合,未出现骨折移位等并发症.结论 科学、系统、细致的护理措施及有效的功能锻炼是确保治疗成功的关键,有利于ACL胫骨止点撕脱性骨折患者关节功能的恢复,减少并发症的发生.%Objective To explore the clinical nursing of tibial avulsion fracture of anterior cruciate ligament (ACL) with arthroscopy. Methods Twelve patients with tibial avulsion fracture of anterior cruciate ligament were provided with preoperative psychological nursing, perioperative preparation, preoperative adaptive exercise, general postoperative nursing, limb and pain nursing, and rehabilitation nursing. The nursing experience has been summarized in order to improve nursing management. Results An average of 16 -month follow -up of all the 12 patients revealed that all fractures were healed with no complications such as fracture dislocation. Conclusion Scientific, systematic, careful nursing measures and effective functional exercise are essential to a successful treatment, which is conducive to the recovery of patients with tibial avulsion fracture of anterior cruciate ligament and the reduction of complications.

  16. Evaluation of anterior talofibular ligament injury with stress radiography, ultrasonography and MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Oae, Kazunori; Uchio, Yuji [Shimane University School of Medicine, Department of Orthopaedics, Shimane, Izumo (Japan); Takao, Masato [Teikyo University, Department of Orthopaedic Surgery, Tokyo, Itabashi-ku (Japan); Ochi, Mitsuo [Hiroshima University, Department of Orthopaedic Surgery, Hiroshima, Minami-ku (Japan)

    2010-01-15

    The purpose of this study was to clarify the efficacy of stress radiography (stress X-P), ultrasonography (US), and magnetic resonance (MR) imaging in the detection of the anterior talofibular ligament (ATFL) injury. Thirty-four patients with ankle sprain were involved. In all patients, Stress X-P, US, MR imaging, and arthroscopy were performed. The arthroscopic results were considered to be the gold standard. The imaging results were compared with the arthroscopic results, and the accuracy calculated. Arthroscopic findings showed ATFL injury in 30 out of 34 cases. The diagnosis of ATFL injury with stress X-P, US, MR imaging were made with an accuracy of 67, 91 and 97%. US and MR imaging demonstrated the same location of the injury as arthroscopy in 63 and 93%. We have clarified the diagnostic value of stress X-P, US, and MR imaging in diagnosis of ATFL injury. We obtained satisfactory results with US and MR imaging. (orig.)

  17. Evaluation of anterior talofibular ligament injury with stress radiography, ultrasonography and MR imaging

    International Nuclear Information System (INIS)

    The purpose of this study was to clarify the efficacy of stress radiography (stress X-P), ultrasonography (US), and magnetic resonance (MR) imaging in the detection of the anterior talofibular ligament (ATFL) injury. Thirty-four patients with ankle sprain were involved. In all patients, Stress X-P, US, MR imaging, and arthroscopy were performed. The arthroscopic results were considered to be the gold standard. The imaging results were compared with the arthroscopic results, and the accuracy calculated. Arthroscopic findings showed ATFL injury in 30 out of 34 cases. The diagnosis of ATFL injury with stress X-P, US, MR imaging were made with an accuracy of 67, 91 and 97%. US and MR imaging demonstrated the same location of the injury as arthroscopy in 63 and 93%. We have clarified the diagnostic value of stress X-P, US, and MR imaging in diagnosis of ATFL injury. We obtained satisfactory results with US and MR imaging. (orig.)

  18. Advances in wrist arthroscopy.

    Science.gov (United States)

    Wolf, Jennifer Moriatis; Dukas, Alex; Pensak, Michael

    2012-11-01

    Since its introduction more than three decades ago, wrist arthroscopy has continually evolved. The procedure has a wide list of indications, including diagnostic and management applications. The scope of practice for the wrist arthroscopic surgeon includes management of triangulofibrocartilage complex pathology, evaluation and management of carpal instability, assistance in fracture reduction of the radius and scaphoid, treatment of trapeziometacarpal synovitis and arthritis, distal ulnar and carpal bone excisions, and salvage procedures. In addition, innovations such as new portals and smaller arthroscopes have expanded the applications of wrist arthroscopy. PMID:23118138

  19. Hip Arthroscopy: A Brief History.

    Science.gov (United States)

    Kandil, Abdurrahman; Safran, Marc R

    2016-07-01

    Hip arthroscopy is a fast-growing and evolving field. Like knee and shoulder arthroscopy, hip arthroscopy began as a diagnostic procedure and then progressed to biopsy and resection of abnormalities. Subsequently, it has evolved to repair of various tissues and treatment of underlying causes. As the understanding of the hip joint and its associated pathophysiology grows, indications will continue to expand for this diagnostic and therapeutic modality. This article outlines the historic developments of hip arthroscopy, including advancements in instrumentation and techniques from the days of the first hip arthroscopies to the present day.

  20. Hip Arthroscopy: A Brief History.

    Science.gov (United States)

    Kandil, Abdurrahman; Safran, Marc R

    2016-07-01

    Hip arthroscopy is a fast-growing and evolving field. Like knee and shoulder arthroscopy, hip arthroscopy began as a diagnostic procedure and then progressed to biopsy and resection of abnormalities. Subsequently, it has evolved to repair of various tissues and treatment of underlying causes. As the understanding of the hip joint and its associated pathophysiology grows, indications will continue to expand for this diagnostic and therapeutic modality. This article outlines the historic developments of hip arthroscopy, including advancements in instrumentation and techniques from the days of the first hip arthroscopies to the present day. PMID:27343387

  1. Ankle Fractures

    Science.gov (United States)

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

  2. Doctor, I sprained my ankle.

    Science.gov (United States)

    How, Choon How; Tan, Ken Jin

    2014-10-01

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

  3. Arthrography of the ankle

    International Nuclear Information System (INIS)

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

  4. Clinical research of arthroscopy for joint disorders after ankle sprain%关节镜诊治踝扭伤后关节功能紊乱的临床研究

    Institute of Scientific and Technical Information of China (English)

    何光联; 惠明; 欧迪军; 梁江山; 吴王敏

    2011-01-01

    Objective To discuss using arlhroscopic surgery for diagnosis and trealmenl of tong-term joint funclion disorders after wrenching the ankle. Methods 42 palienls with a hislory of ankle sprain were enrolled because of ankle pain and funclion disorders. All the palienls were diagnosed and trealed by arlhroscopic surgery. The resulls of the diagnosis and trealmenl were summarized and analysed. Results The 42 cases were all followed up for 6 to 36 monlhs, 18.2 monlhs in average. The evaluation resulls were ecellenl in 34 cases, well in five cases and medium in three cases; the excellent and well rale was 91%. There was no infection or damage in vessels and nerves. Conclusions Arlhroscopic surgery has excellent effecl in diagnosis and trealment for wrenched ankle that consislant pain and functional disorders. It has great value of restoring the ankle function and preventing osteoarlhritis.%目的探讨踝扭伤后长期存在踝关节疼痛、活动受限、反复扭伤等踝关节功能紊乱疾病的关节镜诊断和治疗.方法 对42例踝关节扭伤后症状反复发作,迁延不愈的患者行关节镜检查诊断并行关节镜下治疗,对诊断和治疗结果回顾性总结分析.结果 本组42例均获随访:随访时间为6~36个月,平均18.2个月.术后按AOFAS踝关节后足功能评分,优34例,良5例,中3例,优良率:91%,无感染,神经血管损伤病例.结论 关节镜对踝关节扭伤后疼痛持续存在,迁延不愈,活动受限,反复扭伤等症状的病例具有良好的诊断和治疗效果,对恢复踝关节功能,预防创伤性关节炎具有重要的价值.

  5. 关节镜下膝关节前交叉韧带断裂同种异体肌腱重建术的临床研究%A clinical study on reconstruction of anterior cruciate ligament with homologous under arthroscopy

    Institute of Scientific and Technical Information of China (English)

    张明; 王岩峰; 韩晓锐

    2011-01-01

    [ Objective ] To explore the clinical effect of anterior cruciate ligament with homologous ligaments under arthroscopy. [ Method ] Eighteen patients with anterior cruciate ligament injury were reviewed retrospectively. All were reconstructed by homologous ligaments under arthroscopy. The Lysholm score were recorded before and after operation. [ Result] All the patients were followed up for average of 25 months, statistically significant differences were seen in Lysholm score between preoperatively and postoperatively (average 41 ± 1.1 preoperatively and 92 ± 2.6 postoperatively) (P <0.01 ). The difference was significant.Symptoms were relieved and the function of knee joint was improved. The unstable symptom of two knees was still anterior drawer positive. [ Conclusion ] Reconstruction of anterior cruciate ligament with homologous ligaments is effective for avoiding complications of autografts. The operation under arthroscopy has advantages of less injury, rapid recovery and satisfactory effect.%[目的]探讨膝关节镜下采用同种异体肌腱重建前交叉韧带的方法和效果.[方法]回顾性分析2007年3月~2009年4月18例关节镜下应用同种异体肌腱重建前交又韧带的情况,应用山西骨组织库提供的同种异体肌腱进行前交叉韧带重建,观察并记录治疗前后的症状、体征变化,采用Lvsholm关节评分评价疗效.[结果]全部病例均获得随访,平均随访25个月,Lysholm关卫评分山术前(41±1.1)分提高到术后(92±2.6)分(P<0.01),在统计学上有显著差异所有病例均无膝前区疼痛,2例体检仍出现阳性体征,关节功能明显改善,症状基本消失.[结论]关节镜下同种异体肌腱重建前交又韧带创伤小,稳定性好,并发症少,疗效优良.可避免自体移植物取材后造成的并发症.

  6. Mechanism of the anterior drawer test for diagnosis of ligaments injury at the ankle: a finite element study%踝关节韧带损伤前抽屉试验机制的有限元研究

    Institute of Scientific and Technical Information of China (English)

    许灿; 张明彦; 李康华

    2011-01-01

    目的 利用经过验证的踝关节模型研究前抽屉试验检测踝关节外侧韧带损伤的机制.方法 应用MRI扫描1个健康人的踝关节,利用MIMICS及ANSYS建立踝关节模型.验证模型正确性后,在踝关节不同屈曲角度下行前抽屉试验,观察距骨前移距离及踝关节周围主要韧带应力的变化规律.结果 踝关节中立位时距骨前移距离较大,前向拉力较小时距骨前移增加更明显.结论 踝关节处于跖屈位时,利用较小的前向拉力检测距腓前韧带断裂最为敏感.%Objective To devise a validated nonlinear 3D mathematical model of the anterior drawer test to calculate the forces in ligaments and the kinematics of talus and calcaneus.Methods MRI was used to obtain the configuration of a normal ankle.With the software of MIMICS and ANSYS, 3D model of the ankle was built.At different position of the ankle, the anterior drawer test was performed and the anterior translation of the talus was recorded.Results The highest laxity of the ankle was detected in the neutral position.The anterior translation of the talus was more obvious under low load.Conclusions The test performed in plantar flexion position with low anterior force is more sensitive for detecting the anterior talofihular ligament tear in comparison with the one performed in neutral position with high load.

  7. Clinical application and evaluation of anterior interlocking plate internal fixation in ankle arthrodesis%前路锁定钢板内固定在踝关节融合术中的应用及初步评价

    Institute of Scientific and Technical Information of China (English)

    余剑; 赵建宁; 郭亭; 蔡滕

    2012-01-01

    目的 评价前路锁定钢板内固定在踝关节融合术中的临床应用及疗效.方法 收治各类踝关节终末期病变21例,踝前部皮肤、软组织条件均良好.采用踝关节前正中手术入路暴露踝关节前方,凿除踝关节软骨面,摆正踝关节体位,取肱骨近端或胫骨近端锁定钢板于踝关节前方行内固定.结果 所有患者随访6~47个月,X线片示踝关节全部融合.按AOFAS踝-后足功能评价系统,本组优15例,良6例.结论 前方入路锁定钢板内固定技术具有操作简单、暴露充分、避免额外截骨、固定牢靠等优点,融合率高,矫形力强,并发症少,能够较好恢复和维持躁关节的正常外形,尤其适合于合并畸形、关节周围骨缺损及骨质疏松等各类复杂踝关节终末期病变.%Objective To evaluate the the clinical application and efficacy of anterior approach plus internal fixation with interlocking plate in ankle arthrodesis. Methods From January 2007 to February 2011, twenty-one patients with end-stage disease of ankle joint were treated, and the skin and soft tissue conditions before the ankle were fine. All received operations including following steps: exposed the ankle with the anterior approach,chiseled to the ankle joint cartilage, straightened position of the ankle, made internal fixation with interlocking plate to ankle. Results All patients were followed up for 6 to 47 months, X-ray showed that full integration of ankle. According to the AOFAS assessment of ankle-foot functions, in this groups, 15 cases were excellent,6 cases were good. Conclusion The anterior approach plus internal fixation with interlocking plate in ankle arthrodesis have the advantages of simple operating, completely exposing, rigid fixing, avoiding osteotomy, which leads to high rate of fusion and correction and low rate of complication. In conclusion, this technique could correct deformity of ankle and maintain the stability excellently, and so it is

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

    International Nuclear Information System (INIS)

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

  9. DIAGNOSTIC AND THERAPEUTIC ARTHROSCOPY IN SYMPTOMATIC PATIENTS AFTER KNEE ARTHROPLASTY

    Science.gov (United States)

    Severino, Fabricio Roberto; Souza, Clodoaldo José Duarte de; Severino, Nilson Roberto

    2015-01-01

    Objectives: Assess the worthiness of arthroscopy in investigating and treating knee pain after arthroplasty unexplained by clinical and subsidiary examinations. Methods: Among 402 patients submitted to total or unicompartimental arthroplasty between September 2001 and April 2007 at a public university hospital, 17 presented with pain on prosthetic articulation, without clear diagnosis by clinical, X-ray, laboratory, scintiscan, or nuclear magnetic resonance tests. All patients were submitted to arthroscopy and symptoms were assessed by using the Lysholm scale, comparing pre-and post-arthroscopy periods. Peroperative findings have been recorded. Results: The procedure was effective for pain relief in 14 of 17 patients (82.35%). The median for Lysholm scale climbed from 36 points before arthroscopy to 94 points after the procedure (p < 0.001). Most of the patients (12) were arthroscopically diagnosed with fibrosis known as “cyclop”; on the remaining five patients, anterior synovitis was found. All patients were treated by resection. Conclusions: Knee arthroscopy after arthroplasty in patients presenting unclear persistent pain shows localized arthrofibrosis (“cyclops”) or synovitis, which can be treated by using the same procedure, resulting in pain relief. PMID:27022517

  10. MR imaging before arthroscopy in knee joint disorders?

    Energy Technology Data Exchange (ETDEWEB)

    Rappeport, E.D. [Dept. of Diagnostic Radiology, Harlev Hospital, Univ. of Copenhagen (Denmark); Mehta, S. [Stockport Acute Services NHS Trust (United Kingdom); Wieslander, S.B. [Dept. of Diagnostic Radiology, Harlev Hospital, Univ. of Copenhagen (Denmark); Schwarz Lausten, G. [Dept. of Orthopaedic Surgery, Herlev Hospital, Univ. of Copenhagen (Denmark); Thomsen, H.S. [Dept. of Diagnostic Radiology, Harlev Hospital, Univ. of Copenhagen (Denmark)

    1996-09-01

    Purpose: To review the current literature examining the relative merits of arthroscopy and MR imaging of the knee. Material and Methods: All papers comparing MR imaging with arthroscopy published within the last 10 years according to Medline were collected and read. Results: Technology has improved considerably during recent years allowing detailed non-invasive visualization of the knee. In particular, the development of cheaper whole-body and dedicated low-field MR units has opened up for non-invasive inspection of the knee at reasonable cost. Meniscal tears can be detected with accuracy rates of around 90% and rupture of the anterior cruciate ligament with accuracy rates of around 93% compared to arthroscopy. However, arthroscopy is not the ideal gold standard, since it has weak points, e.g. peripheral meniscal tears or osteochondritis without apparent damage to the cartilage. Conclusion: Based on the overwhelming literature it seems safe to conclude that MR examinations of the knee should be performed before arthroscopy is undertaken. (orig.).

  11. Efficacy of lateral collateral ligament reconstruction surgery combined with arthroscopy in treatment of chro-nic lateral ankle instability%外侧副韧带重建手术结合关节镜检查治疗慢性踝关节外侧不稳的疗效观察

    Institute of Scientific and Technical Information of China (English)

    姜新强; 汪明星

    2015-01-01

    目的:观察外侧副韧带重建手术结合关节镜检查治疗慢性踝关节外侧不稳的临床疗效。方法选取慢性踝关节外侧不稳患者60例,按照随机数字表法将患者分为研究组和对照组,每组30例。对照组给予保守治疗,研究组行踝关节镜探查清理联合腓骨短肌腱外侧韧带重建手术进行治疗,应用美国足踝外科踝-后足功能评分系统( AOFAS)评价两组治疗前后的评分,并比较两组优良率、复发率以及并发症发生率。结果两组治疗前AOFAS功能评分差异无统计学意义(P>0.05),两组治疗后AOFAS功能评分均显著升高,且研究组显著高于对照组,两组差异有统计学意义(t=9.837、10.873、8.789,均P<0.05);研究组优良率96.7%(29/30),显著高于对照组的73.3%(22/30);研究组复发率0.0%(0/30),显著低于对照组的13.3%(4/30);研究组并发症发生率3.3%(1/30),显著低于对照组的20.0%(6/30),两组差异均有统计学意义(χ2=13.982、15.037、13.298,均P<0.05)。结论外侧副韧带重建手术结合关节镜检查治疗慢性踝关节外侧不稳具有较好的临床疗效,且复发率较低,并发症较少。%Objective To study the clinical efficacy of lateral collateral ligament reconstruction surgery com-bined with arthroscopy in treatment of chronic lateral ankle instability.Methods 60 cases with chronic lateral ankle instability were selected,the patients were divided into the study group and the control group according to a random number table,which has 30 cases in each group.The control group was received conservative treatment, the study group was underwent exploratory arthroscopic ankle cleanup combined with peroneus brevis tendon lateral ligament reconstruction surgery.Scores before and after treatment of the two groups were detected in American bare foot and ankle

  12. Arthroscopically Assisted Open Reduction-Internal Fixation of Ankle Fractures: Significance of the Arthroscopic Ankle Drive-through Sign.

    Science.gov (United States)

    Schairer, William W; Nwachukwu, Benedict U; Dare, David M; Drakos, Mark C

    2016-04-01

    Standalone open reduction-internal fixation (ORIF) of unstable ankle fractures is the current standard of care. Intraoperative stress radiographs are useful for assessing the extent of ligamentous disruption, but arthroscopic visualization has been shown to be more accurate. Concomitant arthroscopy at the time of ankle fracture ORIF is useful for accurately diagnosing and managing syndesmotic and deltoid ligament injuries. The arthroscopic ankle drive-through sign is characterized by the ability to pass a 2.9-mm shaver (Smith & Nephew, Andover, MA) easily through the medial ankle gutter during arthroscopy, which is not usually possible with both an intact deltoid ligament and syndesmosis. This arthroscopic maneuver indicates instability after ankle reduction and fixation and is predictive of the need for further stabilization. Furthermore, when this sign remains positive after fracture fixation, it may guide the surgeon to further evaluate the adequacy of fixation for the possible need for further fixation of the syndesmosis or deltoid. We present the case of an ankle fracture managed with arthroscopy-assisted ORIF and describe the clinical utility of the arthroscopic ankle drive-through sign. PMID:27462542

  13. Meniscal and cruciate ligaments tears diagnosed with MR imaging versus arthroscopy; Uszkodzenie lakotek i wiazadel krzyzowych w stawie kolanowym w badaniu MR i artroskopii

    Energy Technology Data Exchange (ETDEWEB)

    Ziemianski, A.; Kruczynski, J.; Bruszewski, J. [Akademia Medyczna, Poznan (Poland)

    1993-12-31

    MR studies of knee joints in 37 patients were performed. The clinical diagnostics was traumatic lesions of menisci or cruciate ligaments. Arthroscopy of the knee joint was performed in 21 patients. MR showed meniscal lesion in 25 patients and anterior cruciate ligament (ACL) lesions in 18 patients. Arthroscopy showed meniscal lesions in 16 of 21 patients and ACL lesions in 11 of 21 patients. MR correlated with arthroscopy in 16 of examined menisci and 15 of 21 examined ACL. (author).

  14. Arthrography of the ankle sprains

    International Nuclear Information System (INIS)

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

  15. Heterotopic ossification after hip arthroscopy.

    Science.gov (United States)

    Amar, Eyal; Sharfman, Zachary T; Rath, Ehud

    2015-12-01

    Heterotopic ossification (HO) after hip arthroscopy is the abnormal formation of mature lamellar bone within extra skeletal soft tissues. HO may lead to pain, impaired range of motion and possibly revision surgery. There has been a substantial amount of recent research on the pathophysiology, prophylaxis and treatment of HO associated with open and arthroscopic hip surgery. This article reviews the literature on the aforementioned topics with a focus on their application in hip arthroscopy. PMID:27011859

  16. Heterotopic ossification after hip arthroscopy

    OpenAIRE

    Amar, Eyal; Sharfman, Zachary T.; Rath, Ehud

    2015-01-01

    Heterotopic ossification (HO) after hip arthroscopy is the abnormal formation of mature lamellar bone within extra skeletal soft tissues. HO may lead to pain, impaired range of motion and possibly revision surgery. There has been a substantial amount of recent research on the pathophysiology, prophylaxis and treatment of HO associated with open and arthroscopic hip surgery. This article reviews the literature on the aforementioned topics with a focus on their application in hip arthroscopy.

  17. Ankle Sprains

    Science.gov (United States)

    ... start with arthroscopy. This involves inserting a small camera device into the joint through a tiny cut. ... Nemours Foundation, iStock, Getty Images, Corbis, Veer, Science Photo Library, Science Source Images, Shutterstock, and Clipart.com

  18. Staging of osteochondritis dissecans of the knee and ankle with MRI. Comparison with conventional radiography and arthroscopy; Die Stadienbestimmung der Osteochondrosis dissecans am Knie- und Sprunggelenk mit der MRT. Vergleich mit konventioneller Radiologie und Arthroskopie

    Energy Technology Data Exchange (ETDEWEB)

    Bachmann, G. [Abt. Diagnostische Radiologie, Klinikum der Justus-Liebig-Universitaet, Giessen (Germany); Juergensen, I. [Orthopaedische Klinik, Klinikum der Justus-Liebig-Universitaet, Giessen (Germany); Siaplaouras, J. [Orthopaedische Klinik, Klinikum der Justus-Liebig-Universitaet, Giessen (Germany)

    1995-07-01

    A prospective study was performed on 50 patients suffering from osteochondritis dissecans of the knee and ankle to define criteria for stability and fixation of osteochondral lesions. Morphological parameters in MRI (size, fragmentation, cartilage, interface) and conventional radiology (separation, fragmentation) were registered and compared with arthroscopical staging. MRI staging based on different types of interfaces was demonstrated on T{sub 1}- and T{sub 2}-weighted images. MRI could correctly predict a Grade 1 lesion in 50%, a Grade 2 lesion in 90%, a Grade 3 lesion on 0%, and a Grade 4 lesion in 79%. Stable lesions were differentiated from unstable lesions in 90%. Radiographic findings corresponded with arthroscopic staging in only 56% of the cases because fibrotic connection may guarantee stability in case of bony separation. (orig./MG) [Deutsch] In einer prospektiven Studie an 50 Patienten mit einer Osteochondrosis dissecans (OD) des Knie- und Sprunggelenkes sollten MRT-Kriterien zur Beurteilung der Stabilitaet bzw. Einbindung des osteochondralen Fragmentes bestimmt werden. Fuer jede Laesion wurden verschiedene morphologische Merkmale im MRT (Groesse, Sinterung, Vitalitaet, Knorpelbeschaffenheit, Grenzzone) und im konventionellen Roentgenbild (Separation, Sinterung) bestimmt und mit den entsprechenden arthroskopischen Stadien verglichen. Das MRT-Stadium wurde anhand der Morphologie der Grenzzone der OD im T{sub 1}- und T{sub 2}-gewichteten Bild definiert. Mit der MRT wurde das Stadium 1 in 50%, das Stadium 2 in 90%, das Stadium 3 in 0% und das Stadium 4 in 79% richtig vorhergesagt. Eine korrekte Einstufung in stabile und instabile Fragmente gelang in 90% der Faelle. Mit der konventionellen Radiologie war eine Uebereinstimmung mit den arthroskopischen Stadien nur in 56% zu erreichen, da auch nativradiologisch abgetrennt erscheinende Fragmente noch stabil mit dem Mausbett verbunden sein koennen. (orig./MG)

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

    OpenAIRE

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

    2013-01-01

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

  20. Arthroscopy in the diagnosis of meniscus lesions

    OpenAIRE

    Taser, Omer

    2004-01-01

    Approaches and their specialities in diagnostic arthroscopy have been presented. The things which should be noticed in the inspection of the menisci during arthroscopy have been put formend and indirect signs of meniscus lesion and their importance have been emphasized.

  1. Clinical effect study on reconstruction of anterior cruciate ligament with allo-autologous tendon grafts under arthroscopy%关节镜下异体与自体肌腱联合编织重建前交叉韧带疗效研究

    Institute of Scientific and Technical Information of China (English)

    梁杰; 陈波; 尚峥晖

    2012-01-01

    目的 观察自体胭绳肌肌腱与同种异体移植物关节镜下重建膝关节前交叉韧带(ACL)的疗效.方法 回顾性分析我院2006年2月~2010年6月收治入院的自体胭绳肌肌腱与同种异体移植物关节镜下重建膝关节前交叉韧带(ACL)患者30例临床资料,均采用美国强生公司生产的Rigidfix及Intrafix系统固定,评价项目包括手术时间、发热天数、大腿周径患健侧比值、Lachman试验、中立位前抽屉试验(ADD)和国际膝关节评分委员会(IKDC)评分、Lysholm及Tegner评分.随访时间为12~24个月.结果 30例患者术后膝关节稳定性均得到明显好转;手术前后大腿周径患健侧比值、IKDC评分、lysholm评分及Tegner评分等指标比较差异均有统计学意义(P < 0.05);随访(14.5±2.3)个月,膝前区疼痛5例,手术感染性关节炎1例,给予抗生素及激素治疗1个月后痊愈.术后随访发现肌腱没有免疫排斥反应.结论 自体胭绳肌肌腱与同种异体移植物联合关节镜下重建膝关节前交叉韧带有较好的疗效.%Objective To observe therapeutic effects for reconstruction of anterior cruciate ligament (ACL) with alto-hamstring tendon and antologous tendon grafts under arthroscopy. Methods The clinical data of 30 patients with reconstruction of anterior cruciate ligament (ACL) with alto-hamstring tendon and antologous tendon grafts under arthroscopy were collected and analyzed retrospectively in our hospital from February 2006 to June 2010. All cases were fixed by Rigidfix and Intrafix system of Johnson & Johnson production. Evaluation project included the operation time, the duration of fever, the ratio of thigh diameter between paretic and non paretic side, Lachman test, neutral anterior drawer test (ADD), Lysholm, Tegner and international knee documentation committee (IKDC) scores. All had been followed up for 12 to 24 months. Results Knee stability of 30 patients was improved obviously after operation. The the

  2. PILL series. Doctor, I sprained my ankle

    OpenAIRE

    How, Choon How; Tan, Ken Jin

    2014-01-01

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

  3. Analysis of therapeutic effect of rehabilitation treatment improving function of knee joint following reconstruction anterior crucial ligament with allogenic achilles tendon under arthroscopy%跟腱重建前十字韧带术后康复治疗恢复膝关节功能的疗效分析

    Institute of Scientific and Technical Information of China (English)

    常青; 黄迅悟; 张晓鸥; 郑光新

    2002-01-01

    Objective Combining the reconstruction of anterior crucial ligament(ACL) with functional rehabilitation,we recover the injured knee as possible as can.Methods 38 patients received ACL reconstruction with allogenci Achilles tendon under arthroscopy.We reconstructed the injured ACL and the injured medial crucial ligament(MCL) by utilization of length of achiles tendon.Then we carried out different rehabilitations in accordance with special needs of the patients.Results The follow up was performed for more than 7 months in 34 cases.Lysholm method was used to evaluate patients' function before and after operation.Results showed average score was 53.8 preoperatively, and 84.2 postoperatively,the good rate was 84.4% .In the objective examination,anterior drawer test(ADT),31 cases were positive preoperatively,1 was positive postoperatively;lachman test:34 were positive preoperatively,1 was positive postoperatively;4 were weak positive postoperatively.There were 3 cases with pain of knee joints and 4 cases with limitation of activity of knee joints(5~ 20 degree) postopratively.Conclusion Combination of reconsgruction of ACL with allogenic achilles tendon and the functional rehabilitation can gain remarkable curative effect.

  4. 精细化康复护理模式在行关节镜下异体肌腱重建前交叉韧带术患者中的应用%Application of fine rehabilitation nursing mode in the patients with tendon allograft reconstruction of anterior cruciate ligament under arthroscopy

    Institute of Scientific and Technical Information of China (English)

    李爱珍; 马志芳

    2015-01-01

    Objective:To study the application of fine rehabilitation nursing mode in the patients with tendon allograft reconstruction of anterior cruciate ligament under arthroscopy.Methods:120 patients with tendon allograft reconstruction of anterior cruciate ligament under arthroscopy were selected.They were randomly divided into the control group and the experimental group with 60 cases in each.The control group was given routine nursing mode.The experimental group was given fine rehabilitation nursing mode.The knee stability and functional recovery,the health education awareness of patients,the satisfactions of patients or family on the nursing work of two groups were compared.Results:120 patients were all followed up. Using lysholm knee function score,the excellent and good rate of knee joint function in the experimental group reached 90.0%,the control group reached 60.0%.The health education awareness of patients in the experimental group was 98%,the control group was 85%.The satisfaction of the nursing work in the experimental group was 97%,the control group was 91%.Conclusion:The fine rehabilitation nursing mode has a actively promote role on the postoperative knee joint function recovery of tendon allograft reconstruction of anterior cruciate ligament under arthroscopy.It improves the health education awareness of patients and the satisfactions of patients or family on the nursing work.%目的:研究精细化康复护理模式在行关节镜下异体肌腱重建前交叉韧带术患者中的应用。方法:收治行该术患者120例,随机分为对照组和试验组各60例,对照组采用常规护理模式,试验组采用精细化康复护理模式,比较两组膝关节稳定性及功能恢复情况、患者对健康教育知晓率及患者或家属对护理工作的满意度。结果:120例患者均得到随访,采用lysholm膝关节功能评分,试验组膝关节功能优良率达90.0%,对照组达60.0%;患者对健

  5. Ankle impingement syndromes

    International Nuclear Information System (INIS)

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

  6. 应用半腱肌、股薄肌和髌韧带在关节镜下 重建前交叉韧带65例%Reconstruction of anterior cruciate ligament under arthroscopy using patellar ligament and hamstring ligament in 65 cases

    Institute of Scientific and Technical Information of China (English)

    夏亚一; 孙正义; 黑坂昌弘; 松井允三

    2001-01-01

    目的探讨应用髌韧带(bone-patellar tendon-bone, BTB)和半腱肌、股薄肌(bone-hamstring-bone, BHB)在关节镜下修复前交叉韧带(anterior cruciate ligament, ACL)损伤的临床疗效、手术要点及关节功能改善情况。方法在膝关节镜直视下,选用自体BTB和BHB行ACL重建手术65例,其中BTB重建30例,BHB重建31例,股四头肌腱重建4例。结果随访时间1个月~3年,手术前Lachman和 Pivot shift试验从阳性转为阴性,按日本骨科学会膝关节疗效评定标准,优48例,良7例,可10例。本组病人2个月后均恢复原来日常活动,半年后恢复体育活动。结论应用BTB、BHB在关节镜下修复ACL损伤,术中等长点的选择是手术关键,坚强固定是早期康复训练的前提。%Objective To observe the function recovery of anterior cruciate ligament under arthroscopy using patellar ligament and hamstring ligament.   Methods A total of 65 cases, of which 30 cases were with BTB, 31 with BHB and 4 with quadriceps tendon were reconstructed under arthroscopy. Results The results showed that all cases attained excellent results. Lanchman test and pivot shift test changed from positive to negative with 1 month to 3 years of follow-up. And all patients return to primary life activity in 2 months and sports in 6 months after ACL reconstruction. Conclusions The key to immediate rahabilitation and operative success is a firm fixation and a right select of isometric point.

  7. New advances in wrist arthroscopy.

    Science.gov (United States)

    Bain, Gregory I; Munt, Justin; Turner, Perry C

    2008-03-01

    Wrist arthroscopy is a commonly used procedure that has undergone many modifications and improvements since it was first described. The advent of new portals (both dorsal and volar) means that the wrist joint can be viewed from virtually any perspective ("box concept"). Indications for wrist arthroscopy have continued to expand and include diagnostic and reparative procedures and, more recently, reconstructive, soft-tissue, and bony procedures. Arthroscopic grading of Kienböck's disease better describes articular damage compared with plain radiographs and can help guide surgical treatment options. Triangular fibrocartilage complex injury diagnosis, classification, and treatment can be performed arthroscopically, including distal ulna resection (wafer procedure). Assessment of fracture reduction of the distal radius and scaphoid is superior to that obtained with fluoroscopy, with the advantage of being able to look for associated soft-tissue and chondral injuries. Arthroscopic assessment of intercarpal ligament injuries and instability is now considered the gold standard by many authors. Arthroscopy can also aid us in the management of post-traumatic capsular contraction, resection of ganglia, and the relatively rare isolated ulna styloid impaction. Complications of wrist arthroscopy are relatively uncommon. With the ever-expanding list of indications and procedures that can be performed with this technique, it exists as an essential diagnostic and therapeutic tool for the orthopaedic surgeon. PMID:18308189

  8. Current innovations in wrist arthroscopy.

    Science.gov (United States)

    Slutsky, David J

    2012-09-01

    It has become clear that the stability of the scapholunate joint does not depend wholly on the scapholunate interosseous ligament, but rather on both primary and secondary stabilizers, which form a scapholunate ligament complex. Each case of scapholunate instability is unique and should be treated with tissue-specific repairs, which may partly explain why one procedure cannot successfully restore joint stability in every case. Wrist arthroscopy has a pivotal role in both the assessment and treatment of the scapholunate ligament complex derangements. Tears of the foveal attachment of the triangular fibrocartilaginous complex can be an underdiagnosed cause of distal radioulnar joint instability, because the foveal fibers cannot be visualized using the standard radiocarpal arthroscopy portals. Distal radioulnar joint arthroscopy allows for direct visualization and assessment of these fibers, which in turn has spawned a number of open and arthroscopic repair methods. Wrist arthroscopy has gained wider acceptance as a method to fine-tune articular reduction during open and percutaneous fixation of distal radius fractures, and simplifies intra-articular osteotomies for malunion. It can facilitate percutaneous bone grafting of scaphoid nonunions and has a role in the diagnosis and treatment of associated soft tissue lesions. These and other recent developments will be discussed in the following article. PMID:22916867

  9. Chronic Ankle Instability

    Science.gov (United States)

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

  10. Ankle sprain (image)

    Science.gov (United States)

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

  11. MR Imaging of Ankle Impingement Syndromes

    Directory of Open Access Journals (Sweden)

    Seyed Hassan Mostafavi

    2010-05-01

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

  12. Diagnostic value of oblique axial scan for anterior talofibular ligament in ankle%斜横轴位扫描在距腓前韧带损伤诊断中的价值

    Institute of Scientific and Technical Information of China (English)

    蒋拥军; 董御曦; 徐伟; 陈伟

    2015-01-01

    Objective To clarify the diagnostic value of oblique axial scan parallel to the course of the anterior talofibular ligament in magnetic resonance imaging of anterior talofibular ligament in patients with chronic ankle instability. Methods 96 patients with ankle injury who were admitted into our hospital form June 2010 to March 2015 were examed with oblique axial scan beside the routine axial magnetic res-onance imaging examination. The grade of the anterior talofibular ligament injury and confirmed full-length views of the anterior talofibular lig-ament were analyzed by two musculoskeletal radiologists ( with more than 5 years experience) , and associated lesions were also checked. Re-sults The full-length view of the anterior talofibular ligament was checked in 69 patients (71. 8%) through the routine axial view and it was checked in 93 patients (96. 9%) through the oblique axial scan view. Anterior talofibular ligament injury was checked in 71 patients through the oblique axial scan, which was 19 patients more than that through the routine axial. Conclusion An additional oblique axial scan is use-ful in evaluation of anterior talofiibular ligament in patients with ankle injury.%目的:探讨平行于距腓前韧带斜横轴位扫描在距腓前韧带损伤诊断中的价值。方法收集我院2010年6月至2015年3月踝关节外伤患者96例,全部患者除踝关节行常规MRI检查序列外,增加沿距腓前韧带走行的斜横轴位检查,由2名放射诊断医师(5年以上关节MRI诊断经验)分析对比常规轴位和斜横轴位对距腓前韧带完整显示率和距腓前韧带损伤分级,并观察分析踝关节的其他损伤。结果常规横轴位完整显示距腓前韧带69例(71.8%),斜横轴位完整显示距腓前韧带93例(96.9%)。斜横轴位诊断距腓前韧带损伤71例,常规横轴位诊断距腓前韧带损伤52例,斜横轴位较常规横轴位增加19例。结论增加斜横轴位有助于评价外踝不稳的距腓前韧带损伤。

  13. Sprained Ankles

    Science.gov (United States)

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

  14. Sonographic anatomy of the ankle

    OpenAIRE

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

    2013-01-01

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

  15. Anterior approach for knee arthrography

    International Nuclear Information System (INIS)

    Objective. To develop a new method of magnetic resonance arthrography (MRA) of the knee using an anterior approach analogous to the portals used for knee arthroscopy.Design. An anterior approach to the knee joint was devised mimicking anterior portals used for knee arthroscopy. Seven patients scheduled for routine knee MRA were placed in a decubitus position and under fluoroscopic guidance a needle was advanced from a position adjacent to the patellar tendon into the knee joint. After confirmation of the needle tip location, a dilute gadolinium solution was injected.Results and conclusion. All the arthrograms were technically successful. The anterior approach to knee MRA has greater technical ease than the traditional approach with little patient discomfort. (orig.)

  16. Fibrous scar in the infrapatellar fat pad after arthroscopy. MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Tang, Guangyu; Niitsu, Mamoru; Ikeda, Kotaro; Itai, Yuji [Tsukuba Univ., Ibaraki (Japan). Inst. of Clinical Medicine; Endo, Hideho

    2000-02-01

    We describe the MR appearance of fibrous scars in the infrapatellar fat pad after arthroscopy. The subjects were 96 patients who underwent arthroscope-assisted anterior cruciate ligament (ACL) reconstruction and were examined by oblique sagittal MR imaging at different follow-up intervals. Two observers evaluated the characteristics of the fibrous scars in the infrapatellar fat pad. All fibrous scars with low signal intensity were accentuated at the portal and coursed horizontally through the infrapatellar fat pad. The fibrous scar within the fat pad occurred and peaked within 6 months after arthroscopy. It then subsided gradually and had disappeared by one year later in nearly half of the patients. Identifying MR imaging characteristics of fibrous scars in the fat pad after arthroscopy may be clinically helpful to differentiate these scars from other abnormalities that involve the infrapatellar fat pad. (author)

  17. Ankle replacement

    Science.gov (United States)

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

  18. Ankle replacement

    Science.gov (United States)

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

  19. Ankle sprain

    OpenAIRE

    Struijs, Peter AA; Kerkhoffs, Gino MMJ

    2010-01-01

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

  20. Hip Arthroscopy: Tales From the Crypt.

    Science.gov (United States)

    Matsuda, Dean K; Philippon, Marc J; Safran, Marc R; Sampson, Thomas G

    2016-01-01

    Complications after hip arthroscopy vary in frequency and severity, even for experienced surgeons. It is important for surgeons to be aware of some of the more dramatic, often unusual, and always memorable (nightmarish) complications of hip arthroscopy and understand how they are caused, how they can be treated, and how they can be prevented.

  1. Hip Arthroscopy: Tales From the Crypt.

    Science.gov (United States)

    Matsuda, Dean K; Philippon, Marc J; Safran, Marc R; Sampson, Thomas G

    2016-01-01

    Complications after hip arthroscopy vary in frequency and severity, even for experienced surgeons. It is important for surgeons to be aware of some of the more dramatic, often unusual, and always memorable (nightmarish) complications of hip arthroscopy and understand how they are caused, how they can be treated, and how they can be prevented. PMID:27049210

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-11-15

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

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

    Fan, Ka Yuk; Lui, Tun Hing

    2014-01-01

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

  5. First Metatarsophalangeal Joint Arthroscopy for Osteochondral Lesions.

    Science.gov (United States)

    Sherman, Thomas I; Kern, Michael; Marcel, John; Butler, Alexander; McGuigan, Francis X

    2016-06-01

    Small-joint arthroscopy has supplanted open procedures because it offers the potential for improvement in joint visualization, reduced scarring, and accelerated recovery. Despite these advantages, arthroscopy of the first metatarsophalangeal joint is not commonly performed and reports of its use are lacking. The reason for this is not clear but may be because of perceived technical complexity and poorly defined indications. In our experience, however, arthroscopy of the first metatarsophalangeal joint is a versatile procedure that facilitates treatment of many different pathologic processes through a minimally invasive approach with few complications. We present our technique for arthroscopic management of osteochondral lesions of the hallux. PMID:27656371

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-03-15

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

  8. LARS人工韧带同时重建前、后交叉韧带%Reconstruction of both the anterior cruciate ligament and posterior cruciate ligament with ligament advanced reinforcement system artificial ligament transplantation under knee arthroscopy

    Institute of Scientific and Technical Information of China (English)

    尚平; 贺宪; 江永发; 刘志祥; 才忠民; 杨俊龙

    2007-01-01

    目的 探讨关节镜下LARS(Ligament Advanced Reinforcement System,LARS)人工韧带同时重建前(Anterior cruciate ligament,ACL)、后交叉韧带(posterior cruciate ligament,PCL)的方法和临床疗效.方法 从2006年1月至2007年4月,用LARS人工韧带同时重建ACL、PCL2例.应用Lysholm功能评分表评估膝关节功能,采用抽屉实验检查膝关节前后松弛度.结果 2例均获得随访,随访时间分别为8月、3月.2例患者术后患膝关节不稳定症状消失,胫骨后坠征阴性,前、后抽屉试验阴性.膝关节功能评估采用Lysholm功能评分标准,术前平均分别为45.6±7.6分,术后平均为80.3±9.1分.结论 关节镜下应用LARS人工韧带同时重建ACL、PCL可更好地恢复膝关节的稳定性,且创伤小,并发症少,近期疗效满意,但远期效果仍需进一步观察.

  9. 本体感觉训练在关节镜下前交叉韧带重建术后患者中的应用研究%The practice research about proprioception training in the reconstruction of anterior cruciate ligament under arthroscopy

    Institute of Scientific and Technical Information of China (English)

    单萍; 肖海涛

    2016-01-01

    Objective: To discuss the effciency of proprioception training methods for patients atfer the operation of anterior cruciate ligament reconstruction (ACL) under arthroscopy.Methods: From May 2014 to May 2015, 70 patients who underwent the operation of reconstruction of ACL were randomly divided into 2 groups, 35 patients for each group. Experiment group used the proprioception training methods customized by our department, the control group used the routine nursing. hTe patients followed up for 6 months atfer surgery. Position sense/stability and ROM of knees were tested before the surgery and 6 months atfer the surgery. hTe Berg balance scale and Lysholm score were tested before the surgery and 3, 6 months atfer the surgery.Results: hTere were 70 patients followed up for 6 months. There were significant difference in position sense/stability and ROM between the 2 groups (P<0.05) atfer 6 months of surgery. hTree and six months atfer surgery, the berg balance scale and the Lysholm of experiment group was higher than that of the control group (P<0.05).Conclusion: Making a correctly and personal proprioception training planning can help patients of ACL reconstruction under arthroscopy recovery quickly.%目的:探讨关节镜下前交叉韧带重建术后本体感觉训练和康复训练的方法及其效果。方法:选取2014年5月至2015年5月入住我院骨科70例关节镜下前交叉韧带重建术后患者,使用随机数字表法分成两组,实验组35人,给予本科室制定的本体感觉训练计划,对照组35人,给予常规骨科护理。出院后随访6个月。观察患者术前及6个月结束时的位置觉测定、膝关节稳定度、膝关节活动度,并且评定术前、术后3个月及6个月结束时Berg平衡量表及膝关节Lysholm评分。结果:70人均完成6个月随访。术后6个月时,实验组关节位置觉、稳定度与活动度明显高于对照组,差异有统计学意义(P<0.05)。术后3个月及6

  10. The practice research about proprioception training in the reconstruction of anterior cruciate ligament under arthroscopy%本体感觉训练在关节镜下前交叉韧带重建术后患者中的应用研究

    Institute of Scientific and Technical Information of China (English)

    单萍; 肖海涛

    2016-01-01

    目的:探讨关节镜下前交叉韧带重建术后本体感觉训练和康复训练的方法及其效果。方法:选取2014年5月至2015年5月入住我院骨科70例关节镜下前交叉韧带重建术后患者,使用随机数字表法分成两组,实验组35人,给予本科室制定的本体感觉训练计划,对照组35人,给予常规骨科护理。出院后随访6个月。观察患者术前及6个月结束时的位置觉测定、膝关节稳定度、膝关节活动度,并且评定术前、术后3个月及6个月结束时Berg平衡量表及膝关节Lysholm评分。结果:70人均完成6个月随访。术后6个月时,实验组关节位置觉、稳定度与活动度明显高于对照组,差异有统计学意义(P<0.05)。术后3个月及6个月时,实验组Berg平衡量表评分及Lysholm评分明显高于对照组,差异有统计学意义(P<0.05)。结论:制定合理的本体感觉训练计划能帮助关节镜下前交叉韧带重建术后功能尽快恢复。%Objective: To discuss the effciency of proprioception training methods for patients atfer the operation of anterior cruciate ligament reconstruction (ACL) under arthroscopy.Methods: From May 2014 to May 2015, 70 patients who underwent the operation of reconstruction of ACL were randomly divided into 2 groups, 35 patients for each group. Experiment group used the proprioception training methods customized by our department, the control group used the routine nursing. hTe patients followed up for 6 months atfer surgery. Position sense/stability and ROM of knees were tested before the surgery and 6 months atfer the surgery. hTe Berg balance scale and Lysholm score were tested before the surgery and 3, 6 months atfer the surgery.Results: hTere were 70 patients followed up for 6 months. There were significant difference in position sense/stability and ROM between the 2 groups (P<0.05) atfer 6 months of surgery. hTree and six months atfer surgery, the berg balance scale and the

  11. Clinical observation of early anterior ankle pain after closed reduction and intramedullary nail fixation of tibial shaft fracture%胫骨干骨折闭合复位髓内钉固定术后早期踝前疼痛的临床观察

    Institute of Scientific and Technical Information of China (English)

    田竞; 周大鹏; 于海龙; 赵勇; 项良碧

    2013-01-01

    Objective To observe the incidence rate of early anterior ankle pain after the therapy of tibial shaft fracture by closed reduction and intramedullary nail fixation method and to analyze the reason of occurrence of related complications.Methods All of 307 patients with tibial shaft fracture were treated by closed reduction and intramedtllary nail fixation method.The incidence rate and the average duration of early anterior ankle pain,VAS score and ankle function score was recorded after operation and during 3 and 12 months' follow up.Results Thirty nine cases had the anterior ankle pain at early stage after operation and the incidence rate was 12.7%.The average duration of early anterior ankle pain was (6.2±3.4)d.VAS score in resting state was (3.1±1.5) and in functional exercise state was (4.0±0.9).There were significant differences in the VAS score of two states(P <0.05).But there were no significant differences in ankle function score after operation and during 3 and 12 months' follow up.Conclusion Early anterior ankle pain is one of the complications in treating tibial shaft fracture by closed reduction and intramedullary nail fixation method.The incidence rate is related to the way of distal interlocking screw placement and intraoperative reaming.Early anterior ankle pain can increase the VAS score in functional exercise stage but has no significant effect on the ankle function.%目的 观察胫骨干骨折闭合复位髓内钉固定术后早期踝前疼痛的发生率,分析相关并发症的发生原因.方法 对307例胫骨干骨折采用闭合复位、交锁髓内钉固定术治疗,观察早期踝前痛的发生率、VAS疼痛评分和早期踝前疼痛的平均持续时间等,分别于术后即刻、3个月、1年进行踝关节功能评分.结果 39例术后早期发生踝前疼痛,发生率为12.7%,平均持续时间(6.2±3.4)d;静息状态VAS疼痛评分平均(3.1±1.5)分,功能锻炼时VAS疼痛评分平均(4.0±0.9)分,两组比

  12. Postoperative pectoral swelling after shoulder arthroscopy

    Science.gov (United States)

    ERCIN, ERSIN; BILGILI, MUSTAFA GOKHAN; ONES, HALIL NADIR; KURAL, CEMAL

    2015-01-01

    Fluid extravasation is possibly the most common complication of shoulder arthroscopy. Shoulder arthroscopy can lead to major increases in the compartment pressure of adjacent muscles and this phenomenon is significant when an infusion pump is used. This article describes a case of pectoral swelling due to fluid extravasation after shoulder arthroscopy. A 24-year-old male underwent an arthroscopic Bankart repair for recurrent shoulder dislocation. The surgery was performed in the beach chair position and lasted two hours. At the end of the procedure, the patient was found to have left pectoral swelling. A chest radiography showed no abnormality. Pectoral swelling due to fluid extravasation after shoulder arthroscopy has not previously been documented. PMID:26889473

  13. ARTHROSCOPY OF THE SCAPULOTHORACIC JOINT: CASE REPORTS

    OpenAIRE

    Andreoli, Carlos Vicente; Ejnisman, Benno; Pochini, Alberto de Castro; Monteiro, Gustavo Cará; Cohen, Moisés; Faloppa, Flávio

    2015-01-01

    Scapulothoracic arthroscopy is a procedure presenting restricted indications, for resecting free bodies, benign tumors, bursitis, and snaping scapula. The authors report four cases of scapulothoracic joint arthroscopy; in the first case, only a benign tumor (osteochondroma) could be visualized; in the second case, arthroscopic resection of an osteochondroma was found; in the third case, arthroscopic bursectomy due to scapulothoracic bursitis, and; in the fourth case, bursectomy and partial su...

  14. Arthroscopy assisted management of tibia plateau fractures

    OpenAIRE

    Cetik, Ozgur; Asik, Mehmet; Sozen, Yunus V.; Taser, Omer F.; Cetinkaya, Sarper M.

    2004-01-01

    We report our experience with the arthroscopy management of tibial plateau fractures. Twenty eight closed tibial plateau fractures in twenty seven patients were treated with arthroscopy assisted reduction between January 1993 and December 1997. The mean follow-up period was 25 months (range 6 months to 55 months). Schatzker classification system was used for evaluation and classification of the fractures patterns. The plateau depression has been reconstructed with elevation through a window...

  15. Articular cartilage damage with intramedullary lesion (bone bruise) in anterior cruciate ligament rupture

    Energy Technology Data Exchange (ETDEWEB)

    Ide, Shuya; Ohdera, Toshihiro; Tokunaga, Masami; Hiroshima, Shiro; Yoshimoto, Eiji [Fukuoka Orthopaedic Hospital (Japan)

    2002-09-01

    We evaluated the relationship between the intramedullary lesion on MRI and cartilage damage in patients associated with acute anterior cruciate ligament (ACL) rupture. Thirty-two cases documented by MRI and arthroscopy within one month from injury underwent ACL reconstruction using ST-G, and arthroscopy was performed again after surgery. The mean term between reconstruction and postoperative arthroscopy was twelve months. The cartilage damage on arthroscopy was compared with the intramedullary lesion on MRI. Cartilage damage was observed in 9 cases (28.1%) during the initial arthroscopy and in 16 cases (50.0%) during the second arthroscopy. Intramedullary lesion was detected in all 32 cases (total: 73 lesions) on MRI. Intramedullary lesion leading to cartilage damage was common in the geographic-type lateral femoral condyle. There was significant difference between the lateral meniscus tear and the cartilage damage of the lateral compartment. (author)

  16. Diagnostic accuracy of Magnetic Resonance Imaging in assessment of Meniscal and ACL tear: Correlation with arthroscopy

    OpenAIRE

    Yaqoob, Jamal; Alam, Muhammad Shahbaz; Khalid, Nadeem

    2015-01-01

    Objective: To determine the diagnostic accuracy of magnetic resonance imaging (MRI) in injuries related to anterior cruciate ligament and menisci and compare its effectiveness with that of arthroscopy. Methods: This retrospective cross-sectional study was conducted in the department of Radiology & Medical Imaging of Dallah Hospital, Riyadh, Kingdom of Saudi Arabia from September 2012 to March 2014. Fifty four patients (including 30 men and 24 women) with internal derangement of knee referred ...

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

    Science.gov (United States)

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

    2015-12-01

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

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

    OpenAIRE

    Wilkerson, Ricky D; Mason, Melanie A

    2000-01-01

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

  19. Understanding acute ankle ligamentous sprain injury in sports

    OpenAIRE

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

    2009-01-01

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

  20. Ankle sprain - aftercare

    Science.gov (United States)

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

  1. Iliotibial band syndrome following hip arthroscopy: An unreported complication

    Directory of Open Access Journals (Sweden)

    Roberto Seijas

    2016-01-01

    Conclusions: This is a newly described observation within followup of hip arthroscopy. These findings may help orthopedic surgeons when planning rehabilitation after hip arthroscopy, including stretching exercises to prevent this syndrome.

  2. MRI of ankle sprain

    International Nuclear Information System (INIS)

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

  3. MRI of ankle sprain

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-06-01

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

  4. 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.

  5. Rehabilitation following hip arthroscopy - A systematic review

    Directory of Open Access Journals (Sweden)

    Jeffrey S Grzybowski

    2015-05-01

    Full Text Available CONTEXT: Rehabilitation following hip arthroscopy is an integral component of the clinical outcome of the procedure. Given the increase in quantity, complexity, and diversity of procedures performed, a need exists to define the role of rehabilitation following hip arthroscopy.OBJECTIVES: 1 To determine the current rehabilitation protocols utilized following hip arthroscopy in the current literature, 2 to determine if clinical outcomes are significantly different based on different post-operative rehabilitation protocols; and 3 to propose the best-available evidence-based rehabilitation program following hip arthroscopy.DATA SOURCES: Per PRISMA guidelines and checklist, Medline, SciVerse Scopus, SportDiscus, and Cochrane Central Register of Controlled Trials were searched.STUDY SELECTION: Level I-IV evidence clinical studies with minimum two-year follow-up reporting outcomes of hip arthroscopy with post-operative rehabilitation protocols described were included. DATA EXTRACTION: All study, subject, and surgery parameters were collected. All elements of rehabilitation were extracted and analyzed. Descriptive statistics were calculated. Study methodological quality was analyzed using the Modified Coleman Methodology Score (MCMS.RESULTS: 18 studies were included (2,092 subjects; 52% male, mean age 35.1 +/- 10.6 years, mean follow-up 3.2 +/- 1.0 years. Labral tear and femoroacetabular impingement were the most common diagnoses treated and labral debridement and femoral/acetabular osteochondroplasty the most common surgical techniques performed. Rehabilitation protocol parameters (weight-bearing, motion, strengthening, and return-to-sport were poorly reported. Differences in clinical outcomes were unable to be assessed given heterogeneity in study reporting. Time-, phase-, goal-, and precaution-based guidelines were extracted and reported.CONCLUSIONS: The current literature of hip arthroscopy rehabilitation lacks high-quality evidence to support a

  6. 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.

  7. Anterior impingement syndrome in dancers

    OpenAIRE

    O’Kane, John William; Kadel, Nancy

    2007-01-01

    Anterior impingement is a common problem in dancers occurring primarily secondary to the repetitive forced ankle dorsiflexion inherent in ballet. Symptoms generally occur progressively and may respond to conservative treatment including addressing biomechanical faults that contribute to the problem. As impingement progresses, movements essential to ballet may become impossible and arthroscopic ankle surgery is often effective for both diagnosis and treatment, allowing athletes to return to da...

  8. [Ankle sprain during a volleyball game].

    Science.gov (United States)

    Boersma, Anton R; Munzebrock, Arvid V E

    2015-01-01

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

  9. Diagnosis of ligament injuries in the superior ankle joint

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

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

    2011-01-01

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

  11. MRI of anterior cruciate ligament autografts

    Energy Technology Data Exchange (ETDEWEB)

    Ogi, Shigeyuki; Ariizumi, Mitsuko; Yamagishi, Tsuneo [The Aoyama Tokyo Metropolitan office' s Hospital (Japan); Agata, Toshihiko; Tada, Shinpei; Fukuda, Kunihiko

    2000-09-01

    The purpose of this study was to assess the usefulness of MRI in the evaluation of autografts after anterior cruciate ligament reconstruction. The subjects were 110 patients with anterior cruciate ligament reconstruction using patellar tendon autografts who underwent clinical examination, MRI, and arthroscopy of the knee. T1- and T2-weighted MR images were obtained in sagittal plane. Clinical findings were categorized into three groups: normal, borderline, and abnormal. The MRI appearances of the autografts were categorized into three types: straight continuous band (type I), interrupted band (type II) and generalized increased intensity band (type III). The clinical findings and MRI findings were compared with arthroscopic findings. Ninety-six percent of the type I showed no autograft tear on arthroscopy. In comparison with the clinical findings, MRI was found to be well correlated with arthroscopic findings. In conclusion, if the clinical findings are normal, patients are to be followed-up without MRI and arthroscopy. However, if clinical findings are either borderline or abnormal, MRI should be performed prior to arthroscopy. (author)

  12. The single-bundle and single-tunnel reconstruction of anterior cruciate ligament using achilles tendon allograft with attached calcaneus under arthroscopy%关节镜下带跟骨异体跟腱单束单隧道重建前交叉韧带

    Institute of Scientific and Technical Information of China (English)

    冯会成; 黄迅悟; 孙继桐; 常青; 毕龙; 余方圆

    2013-01-01

    Objective To investigate the effectiveness of anterior cruciate ligament (ACL) reconstruction using achilles tendon allograft with attached calcaneus in promoting the tendon-bone healing through comparing with that of ACL reconstruction using simple tendon allograft under arthroscopy. Methods From January 2008 to December 2009, 41 patients with ACL injuries in accordance with the inclusion criteria were treated. They were randomly divided into 2 groups according to different treatment methods. In the trial group, ACL reconstruction using achilles tendon allograft with attached calcaneus was performed on 21 patients. In the control group, ACL reconstruction using simple tendon allograft was performed on 20 patients. There were no significant differences in such general data as the age, gender, cause of injury, disease duration, preoperative functional score and so on between the 2 groups (P>0.05), which were comparable. The single-bundle and single-tunnel ACL reconstruction was performed in both groups. Results All the incisions in both groups were healed by the first intention 2 weeks postoperatively. The patients were followed up for an average period of 26 months (range; 24-28 months) in the trial group, and 28 months (range; 24-30 months) in the control group. 2 years after the operation, 15 cases (71.4%) were negative in the Lachman test, and 16 cases (76.2%) were negative in the anterior drawer test in the trail group. In contrast, 14 cases (70.0%) and 15 cases (75.0%) were negative respectively in the control group. There were no significant differences in the Lysholm score and International Knee Documentation Committee (IKDC) score between the 2 groups 2 years after the operation (P>0.05). The CT exam showed the bone tunnel diameter was enlarged in different degrees in both groups 2 years after the operation, when compared with that 1 month postoperatively. However, the rate of bone tunnel enlargement in the trial group (4/21, 19.0%) was obviously less than

  13. 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.

  14. Hip arthroscopy in the setting of hip dysplasia

    OpenAIRE

    Yeung, M.; Kowalczuk, M.; Simunovic, N.; Ayeni, O. R.

    2016-01-01

    Objective Hip arthroscopy in the setting of hip dysplasia is controversial in the orthopaedic community, as the outcome literature has been variable and inconclusive. We hypothesise that outcomes of hip arthroscopy may be diminished in the setting of hip dysplasia, but outcomes may be acceptable in milder or borderline cases of hip dysplasia. Methods A systematic search was performed in duplicate for studies investigating the outcome of hip arthroscopy in the setting of hip dysplasia up to Ju...

  15. Ankle Sprain Treatment

    Science.gov (United States)

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

  16. Assessment of Ankle Injuries

    Science.gov (United States)

    Mai, Nicholas; Cooper, Leslie

    2009-01-01

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

  17. Ottawa ankle rules.

    OpenAIRE

    Stiell, I.

    1996-01-01

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

  18. [Arthroscopy-assisted management of wrist fractures].

    Science.gov (United States)

    Deiler, S; Häberle, S; Quentmeier, P; Biberthaler, P; Ahrens, P

    2013-04-01

    Distal radius fractures are the most common fractures in humans and early surgical intervention with modern plating systems is becoming increasingly more established to avoid secondary dislocation. Even fractures with slight dislocations are adequately stabilized and the affinity for surgical intervention and plating procedures is applied to secure these simple fractures. In this aspect the surgical indications are significantly dependent on X-ray examination results. Further diagnostics with respect to ligamentous and soft tissue injury are the exception although the impact energy which creates osseus fractures is sufficient by far to destroy functional soft tissue, cartilage and ligaments. The ongoing development of wrist arthroscopy enables new possibilities especially concerning concomitant articular involvement of distal radius fractures. Arthroscopy-assisted reduction and stabilization as well as minimally invasive soft tissue repair and loose body removal seem to be adequate methods to improve the surgical treatment of distal radius fractures. PMID:23515646

  19. Arthroscopy Journal Prizes Are Major Decisions.

    Science.gov (United States)

    Lubowitz, James H; Brand, Jefferson C; Provencher, Matthew T; Rossi, Michael J

    2016-01-01

    According to the Harvard Business Review, the optimal number of people in a decision-making group is no more than 8. Thus, it is no surprise that 18 Arthroscopy journal associate editors had difficulty making a major decision. In the end, 18 editors did successfully select the 2015 winner of the Best Comparative Study Prize. All studies have limitations, but from a statistical standpoint, the editors believe that the conclusions of the winning study are likely correct.

  20. Arthroscopy Journal Prizes Are Major Decisions.

    Science.gov (United States)

    Lubowitz, James H; Brand, Jefferson C; Provencher, Matthew T; Rossi, Michael J

    2016-01-01

    According to the Harvard Business Review, the optimal number of people in a decision-making group is no more than 8. Thus, it is no surprise that 18 Arthroscopy journal associate editors had difficulty making a major decision. In the end, 18 editors did successfully select the 2015 winner of the Best Comparative Study Prize. All studies have limitations, but from a statistical standpoint, the editors believe that the conclusions of the winning study are likely correct. PMID:26743401

  1. Sonographic anatomy of the ankle.

    Science.gov (United States)

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

    2014-06-01

    Ankle sonography is one of the most commonly ordered examinations in the field of osteoarticular imaging, and it requires intimate knowledge of the anatomic structures that make up the joint. For practical purposes, the examination can be divided into four compartments, which are analyzed in this pictorial essay: the anterior compartment, which includes the tibialis anterior, extensor hallucis longus, and extensor digitorum longus tendons; the accessory peroneus tertius tendon; and the extensor retinaculum; the medial compartment (tibialis posterior, flexor digitorum longus, and flexor hallucis longus tendons; the flexor retinaculum; the medial collateral-or deltoid-ligament, and the neurovascular bundle); the lateral compartment (peroneus longus, peroneus brevis, and peroneus quartus tendons; superior and inferior peroneal retinacula, lateral collateral ligament); and the posterior compartment (Achilles tendon, plantaris tendon, Kagar's triangle, superficial, and deep retrocalcaneal bursae). Scanning techniques are briefly described to ensure optimal visualization of the various anatomic structures. PMID:24883130

  2. [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.

  3. 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.

  4. Total ankle joint replacement.

    Science.gov (United States)

    2016-02-01

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

  5. DIAGNOSTIC AND THERAPEUTIC ARTHROSCOPY IN SYMPTOMATIC PATIENTS AFTER KNEE ARTHROPLASTY

    Science.gov (United States)

    Severino, Fabricio Roberto; Souza, Clodoaldo José Duarte de; Severino, Nilson Roberto

    2015-01-01

    Objectives: Assess the worthiness of arthroscopy in investigating and treating knee pain after arthroplasty unexplained by clinical and subsidiary examinations. Methods: Among 402 patients submitted to total or unicompartimental arthroplasty between September 2001 and April 2007 at a public university hospital, 17 presented with pain on prosthetic articulation, without clear diagnosis by clinical, X-ray, laboratory, scintiscan, or nuclear magnetic resonance tests. All patients were submitted to arthroscopy and symptoms were assessed by using the Lysholm scale, comparing pre-and post-arthroscopy periods. Peroperative findings have been recorded. Results: The procedure was effective for pain relief in 14 of 17 patients (82.35%). The median for Lysholm scale climbed from 36 points before arthroscopy to 94 points after the procedure (p Knee arthroscopy after arthroplasty in patients presenting unclear persistent pain shows localized arthrofibrosis (“cyclops”) or synovitis, which can be treated by using the same procedure, resulting in pain relief. PMID:27022517

  6. 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.

  7. 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

  8. Return to Play Following Hip Arthroscopy.

    Science.gov (United States)

    Lee, Simon; Kuhn, Andrew; Draovitch, Pete; Bedi, Asheesh

    2016-10-01

    Femoroacetabular impingement may be particularly disabling to the high-demand athlete, especially those with significant cutting and pivoting requirements. If nonoperative treatment fails to adequately alleviate symptoms or sufficiently restore function in the athlete, hip arthroscopy can lead to improved pain, improved range of motion, and high rates of return to play with proper postoperative rehabilitation. The rate of return to previous level of competition is also high with accurate diagnosis and well-executed correction of deformity. A clear understanding of the etiology, diagnosis, management, and outcomes is essential for clinicians to optimally help patients to return to play. PMID:27543404

  9. Closed posteromedial dislocation of ankle in a 12 year-old boy: a case report

    OpenAIRE

    Yurttaş, Yüksel; Kilinçoğlu, Volkan; Toker, Serdar; Kürklü, Mustafa; Atilla, Atil; Başbozkurt, Mustafa

    2009-01-01

    Ankle fractures and fracture dislocations are common injuries in orthopaedic practice however pure ankle dislocation without an associated fracture is extremely rare. There are a few cases reporting such a lesion in the literature. Also this injuries are generally open high energy trauma injuries. Closed treatments are reported to be effective and ligament injuries are generally not reported. In this study, we report a closed pure posteromedial ankle dislocation with anterior talofibular liga...

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

    OpenAIRE

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

    2014-01-01

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

  11. Ankle Sprains. A Round Table.

    Science.gov (United States)

    Physician and Sportsmedicine, 1986

    1986-01-01

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

  12. Foot, leg, and ankle swelling

    Science.gov (United States)

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

  13. How to Tape an Ankle

    Science.gov (United States)

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

  14. Isolated Pulmonary Embolism following Shoulder Arthroscopy

    Directory of Open Access Journals (Sweden)

    Nicole H. Goldhaber

    2014-01-01

    Full Text Available Pulmonary embolism (PE following shoulder arthroscopy is a rare complication. We present a unique case report of a 43-year-old right-hand dominant female who developed a PE 41 days postoperatively with no associated upper or lower extremity DVT. The patient had minimal preoperative and intraoperative risk factors. Additionally, she had no thromboembolic symptoms postoperatively until 41 days following surgery when she developed sudden right-hand swelling, labored breathing, and abdominal pain. A stat pulmonary computed tomography (CT angiogram of the chest revealed an acute PE in the right lower lobe, and subsequent extremity ultrasounds showed no upper or lower extremity deep vein thrombosis. After a thorough review of the literature, we present the first documented isolated PE following shoulder arthroscopy. Although rare, sudden development of an isolated PE is possible, and symptoms such as sudden hand swelling, trouble breathing, and systemic symptoms should be evaluated aggressively with a pulmonary CT angiogram given the fact that an extremity ultrasound may be negative for deep vein thrombosis.

  15. Arthroscopy of the knee without pathological findings.

    Science.gov (United States)

    Schlepckow, P; Weber, M; Hempel, K

    1994-01-01

    From 1983 to 1990, 82 knee arthroscopies (8.2%) carried out in our patients found nothing pathological. Sixty-four percent of these patients were active in sports, but trauma was noted in 32% of the cases only. Football and other ball games, skiing, and track and field athletics were the main causes. Twenty-six percent of the patients had undergone previous surgery in the affected knee. At a mean of 4.6 years postoperatively, clinical and radiological re-assessment was conducted so as to compare our pre- and intraoperative findings with the further course of events. We found that 48.2% of the patients were symptom-free after the diagnostic arthroscopy, 37.5% had persistent discomfort and 14.3% had a recurrence of discomfort after 6 months to 2 years. The objective measurement score (Zarins Rowe score), at 47.5 out of 50 points, was better than the subjective score, at 40 out of 50 points. Our diagnoses had to be changed retrospectively: meniscal lesions were diagnosed too frequently, while chondropathia patellae and instability were often missed. Additionally, complaints could be related to abnormal axis, limited range of motion of the hip or knee, leg length inequality and hypermobility. Being unable to verify a presumed intra-articular lesion arthroscopically is frustrating for both doctor and patient. Our data suggest that meniscal signs should be looked at more critically and emphasise the need for a complete evaluation of the whole locomotor system.

  16. The foot and ankle

    International Nuclear Information System (INIS)

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

  17. Ankle sprain - slideshow

    Science.gov (United States)

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

  18. Value of 13-MHz high-frequency ultrasound of the lateral ankle ligaments and the anterior tibiofibular ligament; 13-MHz-Hochfrequenzsonographie der lateralen Baender des oberen Sprunggelenkes einschliesslich der ventralen Syndesmose. Ein Vergleich mit den Ergebnissen der MRT bei 64 Patienten

    Energy Technology Data Exchange (ETDEWEB)

    Milz, P.; Steinborn, M.; Reiser, M. [Muenchen Univ. (Germany). Inst. fuer Radiologische Diagnostik; Milz, S. [Muenchen Univ. (Germany). Anatomische Anstalt; Mittlmeier, T. [Unfall- und Wiederherstellungschirurgie, Virchow-Klinikum, Humbolt-Univ. Berlin (Germany)

    1999-01-01

    Purpose: Determination of the value of 13-MHz high-frequency ultrasound in the diagnosis of acute injuries of the lateral ankle ligaments and the anterior tibiofibular ligament by comparison with MRI. Method: Sonography was performed prospectively in 64 acutely injured patients using a mechanical 13-MHz sector probe; for diagnosis of the anterior tibiofibular ligament a 15-MHz sector probe was employed during the course of this trial. Using a 0.2-T unit for MRI examination, T1-weighted (TR 580 ms, TE 24 ms) and T2-weighted (TR 3000 ms, TE 80 ms) spin-echo sequences were obtained in various oblique axial imaging planes. Results: In the differentiation of intact and injured ligaments, ultrasound and MRI agreed in 95.3/% of cases for the anterior fibulotalar ligament, in 88.3% for the fibulocalcanear ligament and in 85.0% for the anterior tibiofibular ligament. Conclusion: Lesions of the anterior talofibular and fibulocalcanear ligament can be accurately demonstrated by ultrasound if a 13-MHz sector scanner is used. The detection of lesions in the anterior tibiofibular ligament is more difficult. With increasing experience and by using a 15-MHz sector scanner, better results can be expected for this ligament. (orig.) [Deutsch] Fragestellung: Durch einen Vergleich mit den Befunden der MRT sollte die Aussagekraft der hochaufloesenden 13-MHz-Sonographie in der Diagnostik von akuten Verletzungen des Aussenbandapparates des Sprunggelenkes und der Syndesmose ueberprueft werden. Methodik: 64 akut verletzte Patienten wurden prospektiv mit einem mechanischen 13-MHz-Sektorscanner untersucht. Zur Beurteilung des Lig.tibiofibulare anterius wurde ergaenzend ein 15-MHz-Sektorscanner verwendet. Alle MRT wurden an einem 0,2-Tesla-Niederfeldgeraet durchgefuehrt. In unterschiedlichen schraeg axialen Schichtkippungen wurden T1-gewichtete SE-Sequenzen (TR 580 ms, TE 24 ms) und T2-gewichtete SE-Sequenzen (TR 3000 ms, TE 80 ms) angefertigt. Ergebnisse: Bei der Differenzierung intakter und

  19. Symptoms of Nerve Dysfunction After Hip Arthroscopy

    DEFF Research Database (Denmark)

    Dippmann, Christian; Thorborg, Kristian; Kraemer, Otto;

    2014-01-01

    year after HA concerning symptoms of nerve dysfunction, possible localization, and erectile dysfunction. Fifty patients participated and returned fully completed questionnaires. Patients reporting symptoms of nerve dysfunction 1 year after HA were re-examined. RESULTS: Twenty-three of 50 patients (46......%) reported symptoms of nerve dysfunction during the first week after HA; this was reduced to 14 patients (28%) after 6 weeks, 11 patients (22%) after 26 weeks, and 9 patients (18%) after 1 year. One patient experienced temporary erectile dysfunction. No difference in traction time between patients......PURPOSE: The primary purpose of this study was to analyze the rate, pattern, and severity of symptoms of nerve dysfunction after hip arthroscopy (HA) by reviewing prospectively collected data. The secondary purpose was to study whether symptoms of nerve dysfunction were related to traction time...

  20. Indications for arthroscopy in the lesions of knee-joint

    OpenAIRE

    Taser, Omer; Alturfan, Aziz; Akalın, Yılmaz; Baskir, Orhan

    2004-01-01

    Attempts were made to present the results obtained from 158 cases on whom arthroscopy was employed in their knee joints at the Department of Orthopaedics and Traumatology in the İstanbul Medical School of the Istanbu University between Dec 1983 and May 1986. It was concluded under the light of literature and the results obtained that arthroscopy was an indispensable aid the diagnosis of the lesions of knee joint.

  1. Valid MR imaging predictors of prior knee arthroscopy

    International Nuclear Information System (INIS)

    To determine whether fibrosis of the medial patellar reticulum (MPR), lateral patellar reticulum (LPR), deep medial aspect of Hoffa's fat pad (MDH), or deep lateral aspect of Hoffa's fat pad (LDH) is a valid predictor of prior knee arthroscopy. Institutional review board approval and waiver of informed consent were obtained for this HIPPA-compliant study. Initially, fibrosis of the MPR, LPR, MDH, or LDH in MR imaging studies of 50 patients with prior knee arthroscopy and 100 patients without was recorded. Subsequently, two additional radiologists, blinded to clinical data, retrospectively and independently recorded the presence of fibrosis of the MPR in 50 patients with prior knee arthroscopy and 50 without. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for detecting the presence of fibrosis in the MPR were calculated. κ statistics were used to analyze inter-observer agreement. Fibrosis of each of the regions examined during the first portion of the study showed a significant association with prior knee arthroscopy (p < 0.005 for each). A patient with fibrosis of the MPR, LDH, or LPR was 45.5, 9, or 3.7 times more likely, respectively, to have had a prior knee arthroscopy. Logistic regression analysis indicated that fibrosis of the MPR supplanted the diagnostic utility of identifying fibrosis of the LPR, LDH, or MDH, or combinations of these (p ≥ 0.09 for all combinations). In the second portion of the study, fibrosis of the MPR demonstrated a mean sensitivity of 82%, specificity of 72%, PPV of 75%, NPV of 81%, and accuracy of 77% for predicting prior knee arthroscopy. Analysis of MR images can be used to determine if a patient has had prior knee arthroscopy by identifying fibrosis of the MPR, LPR, MDH, or LDH. Fibrosis of the MPR was the strongest predictor of prior knee arthroscopy. (orig.)

  2. Valid MR imaging predictors of prior knee arthroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Discepola, Federico; Le, Huy B.Q. [McGill University Health Center, Jewsih General Hospital, Division of Musculoskeletal Radiology, Montreal, Quebec (Canada); Park, John S. [Annapolis Radiology Associates, Division of Musculoskeletal Radiology, Annapolis, MD (United States); Clopton, Paul; Knoll, Andrew N.; Austin, Matthew J.; Resnick, Donald L. [University of California San Diego (UCSD), Division of Musculoskeletal Radiology, San Diego, CA (United States)

    2012-01-15

    To determine whether fibrosis of the medial patellar reticulum (MPR), lateral patellar reticulum (LPR), deep medial aspect of Hoffa's fat pad (MDH), or deep lateral aspect of Hoffa's fat pad (LDH) is a valid predictor of prior knee arthroscopy. Institutional review board approval and waiver of informed consent were obtained for this HIPPA-compliant study. Initially, fibrosis of the MPR, LPR, MDH, or LDH in MR imaging studies of 50 patients with prior knee arthroscopy and 100 patients without was recorded. Subsequently, two additional radiologists, blinded to clinical data, retrospectively and independently recorded the presence of fibrosis of the MPR in 50 patients with prior knee arthroscopy and 50 without. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for detecting the presence of fibrosis in the MPR were calculated. {kappa} statistics were used to analyze inter-observer agreement. Fibrosis of each of the regions examined during the first portion of the study showed a significant association with prior knee arthroscopy (p < 0.005 for each). A patient with fibrosis of the MPR, LDH, or LPR was 45.5, 9, or 3.7 times more likely, respectively, to have had a prior knee arthroscopy. Logistic regression analysis indicated that fibrosis of the MPR supplanted the diagnostic utility of identifying fibrosis of the LPR, LDH, or MDH, or combinations of these (p {>=} 0.09 for all combinations). In the second portion of the study, fibrosis of the MPR demonstrated a mean sensitivity of 82%, specificity of 72%, PPV of 75%, NPV of 81%, and accuracy of 77% for predicting prior knee arthroscopy. Analysis of MR images can be used to determine if a patient has had prior knee arthroscopy by identifying fibrosis of the MPR, LPR, MDH, or LDH. Fibrosis of the MPR was the strongest predictor of prior knee arthroscopy. (orig.)

  3. Diagnostic and therapeutic arthroscopy of the wrist: clinical experience

    OpenAIRE

    Tuzuner, Serdar; Ozdemir, Hakan; Gur, Semih

    2004-01-01

    Wrist arthroscopy can facilitate early definitive diagnosis of soft tissue, carpal bone cartilage, the triangular fibrocartilage complex and carpal ligaments injuries. Many such injuries can be treated successfully with minimally invasive arthroscopic techniques, reducing the morbidity associated with surgical exposure and permitting earlier return to work. Between November 1991 and May 1996 19 wrist arthroscopies were performed in the Department of Orthopedics and Trauma Surgery, University ...

  4. Injury of the ankle joint ligaments

    International Nuclear Information System (INIS)

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

  5. Understanding acute ankle ligamentous sprain injury in sports

    Directory of Open Access Journals (Sweden)

    Fong Daniel TP

    2009-07-01

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

  6. 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.

  7. 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.

  8. Arthrography of the ankle

    International Nuclear Information System (INIS)

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

  9. Arthrography of the ankle

    International Nuclear Information System (INIS)

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

  10. Ankle fracture - aftercare

    Science.gov (United States)

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

  11. Spiral CT arthrography of multiplanar reconstruction and virtual arthroscopy technique in diagnosis of knee with internal derangements

    Institute of Scientific and Technical Information of China (English)

    熊传芝; 郝敬明

    2004-01-01

    5Objective:To evaluate the values of spiral CT arthrography with multiplanar reconstruction and virtual arthroscopy technique in diagnosis of internal derangements of the knee. Methods:Ten bovine knees were used for experiment. The menisci, anterior and posterior cruciate ligaments and cartilage of these 10 bovine knees were injured with a hook. Each of the joints was injected with 100 mi air, then soon scanned with a PQ6000 spiral computed tomography scanner. The data obtained was input into the work station, and multiplanar reconstruction technique was used to illustrate lesions in the knees. The results of CT diagnosis were compared to those found by gross inspection of the specimens. Clinically, 10 knees of 9 patients diagnosed as internal derangement were evaluated with the same method after 50-70 ml air was injected into each of the joints. Nine months later, the data of 2 patients were used for CT endoscopy reconstruction. The results were compared with intraoperative findings. Results:Experimentally,the sensitivity and specificity were 88.9% and 93.9% by detection of meniscal abnormalities, 85.7% and 100% by detection of cruciate ligament lesions, and 72.7% and 100% by detection of cartilage damage, respectively. Clinically, the sensitivity and specificity were 90. 0% and 95.0% by detection of meulscal lesion. As to ligament, the figures were 85.7% and 100% respectively. Images of virtual arthroscopy simulated the images of real arthroscopy. Conclnsious:Spiral CT arthrography of multiplanar reconstruction technique offers fime images of internal structures of the knee, with clear border and internal structure. It is an accurate method for detecting meulscal, cruciate and collateral ligament and cartilaginous lesions that cause internal derangement of the knee.Virtual arthroscopy technique is a hopeful method for detecting reasons of derangement of the knee.

  12. Diagnosis of ligament injuries in the superior ankle joint. Roentgendiagnostik der Bandlaesionen des oberen Sprunggelenks

    Energy Technology Data Exchange (ETDEWEB)

    Gebing, R.; Fiedler, V. (Staedtische Krankenanstalten Krefeld (Germany, F.R.). Inst. fuer Roentgendiagnostik)

    1991-12-01

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

  13. 胫前动脉内踝前穿支蒂足内侧岛状皮瓣修复踝周较小创面%Repairing small wounds around ankle by medial planta island flaps pedicled with anterior tibial artery perforator infront of inner malleolus

    Institute of Scientific and Technical Information of China (English)

    魏在荣; 邵星; 帅霞; 孙广峰; 韩文杰; 金文虎; 王达利

    2010-01-01

    Objective To discuss the application of medial planta island flaps pedicled with anterior tibial artery perforator in front of inner malleolus for repairing small wounds around ankle.Methods From Jan. 2005 to Jun. 2009, 10 cases with small wounds around ankle were treated with medial planta island flaps pedicled with anterior tibial artery perforator. The flap size ranged from 7.5 cm×2.8 cm to 13.0 cm × 5.0 cm. The wounds at the donor sites were covered with skin grafts. Results All the 10 flaps and skin grafts were survived with primary healing. The patients were followed up for 6-12 months with satisfactory cosmetic results. The 2-point discrimination was 4-6 mm when the proximal end of saphenous nerve was not injured, and it was 9-10 mm when the nerve was injuried or cut off. The patients could walk with no occurrence of ulcer in flaps or donor site. Conclusions The medial planta island flaps pedicled with anterior tibial artery perforator can effectively repair the small wounds around ankle with reliable blood supply.%目的 探讨胫前动脉内踝前穿支蒂足内侧岛状皮瓣修复踝周较小创面的可行性.方法 采用胫前动脉内踝前穿支蒂足内侧岛状皮瓣修复踝周较小创面,皮瓣面积:7.5 cm×2.8 cm~13.0 cm×5.0 cm.供区移植皮片覆盖.结果 2005年1月至2009年6月于临床应用10例,术后皮瓣及供区所植皮片均顺利成活,供、受区切口均一期愈合.术后随访6~12个月,皮瓣外形良好,隐神经近端未受伤者皮瓣两点辨别觉4~6 mm,隐神经近端受伤、中断者皮瓣两点辨别觉9~10mm.皮瓣供区周围感觉未见异常.患足可负重行走,皮瓣及供区无溃疡.结论 胫前动脉内踝前穿支蒂足内侧岛状皮瓣可修复踝周较小创面,皮瓣血供可靠,操作简单.

  14. Ankle injuries in basketball players.

    Science.gov (United States)

    Leanderson, J; Nemeth, G; Eriksson, E

    1993-01-01

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

  15. 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? ...

  16. Editorial Commentary: Arthroscopy Is a Generally Effective Treatment for Septic Arthritis.

    Science.gov (United States)

    Lubowitz, James H

    2015-07-01

    Hip bacterial septic arthritis is an indication for arthroscopy in combination with medical management. After arthroscopy, patients must be vigilantly observed; some patients require more than one irrigation and debridement.

  17. Ankle ligament injuries

    Directory of Open Access Journals (Sweden)

    Per A.F.H. Renström

    1998-06-01

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

  18. Cervicoplastia anterior Anterior cervicoplasty

    Directory of Open Access Journals (Sweden)

    Lucas Gomes Patrocínio

    2004-10-01

    Full Text Available Muitos pacientes buscam correção estética da frouxidão da pele do pescoço, depósito de gordura na região submentoneana ou bandas de platisma. Em grande parte dos casos a ação medial, via cervicoplastia anterior é necessária. OBJETIVO: Demonstrar a casuística e avaliar os resultados e complicações com a técnica de cervicoplastia anterior no Serviço de Otorrinolaringologia da Universidade Federal de Uberlândia. FORMA DE ESTUDO: Relato de série. PACIENTES E MÉTODOS: Quarenta e dois pacientes, entre 39 e 65 anos de idade, sendo 40 (95,2% do sexo feminino e 2 (4,8% do masculino, foram submetidos a cervicoplastia anterior. Retrospectivamente foram avaliados resultados e complicações. RESULTADOS: Destes, 34 apresentaram resultados satisfatórios, 4 apresentaram déficit estético notado somente pelo cirurgião, 3 apresentaram déficit estético notado somente pelo paciente e 1 apresentou déficit estético necessitando cirurgia revisional. Ao estudo fotográfico, todos os pacientes apresentaram melhora do perfil cervical, redução das bandas de platisma e da frouxidão da pele, estabilização da musculatura cervical e acentuação do ângulo cervicomental, em graus variados. Houve complicação em 2 casos (discreto serohematoma e cicatriz um pouco alargada. CONCLUSÃO: A cervicoplastia, associada ou não à tração lateral pela ritidoplastia, é uma técnica que produz resultados satisfatórios na grande maioria dos casos.Many patients look for aesthetic correction of the laxity of neck skin, submandibular fat deposit or platisma bands. In a large part of the cases, medial action, through anterior cervicoplasty is necessary. AIM: To demonstrate the casuistic and to evaluate the results and complications with anterior cervicoplasty technique in the Otorhinolaryngology Service of the Federal University of Uberlândia. STUDY DESIGN: Serie report. PATIENTS AND METHODS: Forty-two patients, between 39 and 65 years of age, being 40 (95

  19. Clinical evaluation of a dynamic test for lateral ankle ligament laxity

    NARCIS (Netherlands)

    J.S. de Vries; G.M.M.J. Kerkhoffs; L. Blankevoort; C.N. van Dijk

    2010-01-01

    The dynamic anterior ankle tester (DAAT) has shown a good reliability in testing anterior talar translation in earlier studies. The goal of the present study was first to evaluate the reliability of the DAAT in a clinical setting and second to analyze its ability to detect increased ligament laxity.

  20. MRI of the anterior talofibular ligament, talar cartilage and os subfibulare: Comparison of isotropic resolution 3D and conventional 2D T2-weighted fast spin-echo sequences at 3.0 T

    Energy Technology Data Exchange (ETDEWEB)

    Yi, Jisook; Cha, Jang Gyu [Soonchunhyang University Bucheon Hospital, Department of Radiology, Wonmi-gu, Bucheon-si (Korea, Republic of); Lee, Young Koo [Soonchunhyang University Bucheon Hospital, Department of Orthopedics, Wonmi-gu, Bucheon-si (Korea, Republic of); Lee, Bo Ra [Soonchunhyang University Bucheon Hospital, Department of Biomedical Statistics, Wonmi-gu, Bucheon-si (Korea, Republic of); Jeon, Chan Hong [Soonchunhyang University Bucheon Hospital, Division of Rheumatology, Department of Internal Medicine, Wonmi-gu, Bucheon-si (Korea, Republic of)

    2016-07-15

    To determine the accuracy of a three-dimensional (3D) T2-weighted fast spin-echo (FSE) magnetic resonance (MR) sequence compared with two-dimensional (2D) sequence for diagnosing anterior talofibular ligament (ATFL) tears, chondral lesion of the talus (CLT) and os subfibulare/avulsion fracture of the distal fibula (OSF). Thirty-five patients were included, who had undergone ankle MRI with 3D T2-weighted FSE and 2D T2-weighted FSE sequences, as well as subsequent ankle arthroscopy, between November 2013 and July 2014. Each MR imaging sequence was independently scored by two readers retrospectively for the presence of ATFL tears, CLT and OSF. The area under the receiver operating curve (AUC) was compared to determine the discriminatory power of the two image sequences. Interobserver agreement was expressed as unweighted kappa value. Arthroscopic findings confirmed 21 complete tears of the ATFL, 14 partial tears of the ATFL, 17 CLTs and 7 OSFs. There were no significant differences in the diagnoses of ATFL tears (p = 0.074-0.501), CLT (p = 0.090-0.450) and OSF (p = 0.317) obtained from the 2D and 3D sequences by either reader. The interobserver agreement rates between two readers using the 3D T2-weighted FSE sequence versus those obtained with the 2D sequence were substantial (κ = 0.659) versus moderate (κ = 0.553) for ATFL tears, moderate (κ = 0.499) versus substantial (κ = 0.676) for CLT and substantial (κ = 0.621) versus substantial (κ = 0.689) for OSF. Three-dimensional isotropic T2-weighted FSE MRI of the ankle resulted in no statistically significant difference in diagnostic performance compared to two-dimensional T2-weighted FSE MRI in the evaluation of ATFL tears, CLTs and OSFs. (orig.)

  1. Elbow arthroscopy: treatment of the thrower's elbow.

    Science.gov (United States)

    O'Holleran, James D; Altchek, David W

    2006-01-01

    The athlete's elbow has been described as one of the last frontiers in orthopaedic sports medicine. It has been considered separately from other athletic injuries because of the unique constellation of pathology that results from repetitive overhead throwing. Tremendous gains in understanding the complex interplay between the dynamic and static stabilizers of the athlete's elbow have occurred over the past decade. The desire to treat these injuries in a minimally invasive manner has driven the development of techniques and instrumentation for elbow arthroscopy, a successful and essential technique in the treatment of the thrower's elbow. Medial collateral ligament injuries, ulnar neuritis, valgus extension overload with osteophyte formation and posteromedial impingement, flexor pronator strain, medial epicondyle pathology, and osteochondritis dissecans of the capitellum have all been described as consequences of the overhead throwing motion. In addition, loose body formation, bony spur formation, and capsular contracture can each be present in conjunction with these conditions or as isolated entities. Not all pathology in the thrower's elbow is amenable to arthroscopic treatment; however, the clinician must be familiar with all of these conditions to form a comprehensive differential diagnosis for an athlete with elbow pain. The surgeon treating the athlete's elbow should be comfortable with both open and arthroscopic treatments. An understanding of the anatomy and biomechanics of the thrower's elbow is essential for good patient care. The preoperative evaluation should focus on a thorough history and physical examination, as well as specific diagnostic imaging modalities. PMID:16958443

  2. Low dose spinal anesthesia for knee arthroscopy

    Directory of Open Access Journals (Sweden)

    Lakhin R.E.

    2015-06-01

    Full Text Available Objective: to evaluate the nature of unilateral spinal anesthesia using various modes of administration of low doses of hyperbaric bupivacaine. Materials and Methods. Prospectively, the randomized study included 56 patients undergoing knee arthroscopy. In the control group bupivacaine of 5mg was administered simultaneously, in the main group — fractionally by 2.5 mg. The development of thermal and pain blocks from different sides was investigated. The data were statistically processed. Results. In the control group, the positioning of the patient usually began after the entire dose of anesthetic had been administered. In the case of temperature paresthesia in the area of the sacral segments of the full anesthesia throughout underlying limb was not always achieved. In 6 cases of block was not sufficient. In the main group patient positioning was performed after the administration of 2.5 mg of anesthetic and evaluate temperature paresthesia and in 2 cases the total dose was increased to 7.5 mg. The successful development of sensory block at fractional administration was significantly higher than in the single-step introduction. Conclusion. Temperature paresthesia occurs within the first minute and is an early predictor of developing spinal anesthesia. The area of arising paresthesia shows preferential distribution of the anesthetic. In the application of low dose local anesthetic the desired upper level of anesthesia via the patient positioning and dose adjustment may be achieved.

  3. Anterior process fractures of the calcaneus

    Energy Technology Data Exchange (ETDEWEB)

    Renfrew, D.L.; El-Khoury, G.Y.

    1985-07-01

    Fractures of the anterior process of the calcaneus are often missed. This error follows from the tendency to focus exclusively on the mortise and malleoli when a history of ankle trauma is supplied. Seven patients with this fracture are presented. The anatomy, mechanism of injury, clinical presentation, and the radiographic features of this injury are discussed.

  4. Cruciate ligament reconstruction using LARS artificial ligament under arthroscopy: 81 cases report

    Institute of Scientific and Technical Information of China (English)

    HUANG Jian-ming; WANG Qian; SHEN Feng; WANG Zi-min; KANG Yi-fan

    2010-01-01

    Background There are many different materials used for ligament reconstruction. Currently, autograft, allograft, and artificial ligaments are used in the reconstruction. The objective of this study was to explore the clinical result of cruciate ligament reconstruction under arthroscopy.Methods Eighty-one cases were reconstructed with the LARS ligament under arthroscopy, including 43 cases of anterior cruciate ligament (ACL) injury, 20 cases of posterior cruciate ligament (PCL) injury, and 18 cases of ACL combined with PCL injuries of the knee. The follow up period was 10 to 49 months. The International Knee Documentation Committee (IKDC) and Lysholm knee score scales were used for functional evaluation. We examined the anterior and posterior stability of the knee with KT-1000.Results According to the Lysholm knee function score scale, the average preoperative score of (44.6±1.4) increased to a postoperative score of (82.8±2.5) in the ACL group and from (46.6±2.3) to (80.8±2.0) in the PCL group. In the ACL combined with PCL injury group, the preoperative score increased from (45.2±1.2) to (85.5±2.3). According to IKDC score standards, in ACL group we evaluated 19 cases as C and 24 cases as D, preoperatively, and postoperatively 27 cases as A, 14 cases as B and two cases as C. In the preoperative PCL group, we had 11 cases defined as C and nine cases as D that resolved to 12 cases as A, seven as B and one case of C in postoperative evaluation. In the ACL combined with PCL injury group we defined four cases as C and 14 as D during preoperative scoring. These patients had postoperative grades of six cases as A, 10 as B, and two cases as C. All of the results have statistical significance. Conclusions ACL, PCL, or combined ACL and PCL reconstruction using the LARS ligament under arthroscopy is a minimally invasive, safe and effective method to treat cruciate ligament injuries of the knee. Clinical results are satisfactory in the short term.

  5. Validation of a simulator for temporomandibular joint arthroscopy.

    Science.gov (United States)

    Monje Gil, F; Hernandez Vila, C; Moyano Cuevas, J L; Lyra, M; Pagador, J B; Sanchez Margallo, F M

    2016-07-01

    The traditional method of surgical training has followed the 'observe, practice, and teach' model, which is useful for open surgery, but is insufficient for minimally invasive surgery. This study presents the validation of a new simulator designed for TMJ arthroscopy training. A group of 10 senior maxillofacial surgeons performed an arthroscopy procedure using the simulator. They then completed a questionnaire analyzing the realism of the simulator, its utility, and the educational quality of the audiovisual software. The mean age of the 10 surgeons was 42.6 years, and they had performed a mean 151 arthroscopies. With regard to the realism of the simulator, 80% reported that it was of an appropriate size and design and 70% referred to the very realistic positions and relationships between the internal structures. Regarding its educational potential, 80% reported the simulator to be very useful for acquiring the basic skills and to acquire the sensation of depth during access to the TMJ. Finally, 90% reported the prototype to be very useful for TMJ arthroscopy training. These preliminary results showed a high degree of approval. The general opinion of the group of experts was that the experience was rewarding and inspiring, and that the prototype has the educational potential for the achievement of basic TMJ arthroscopy skills. PMID:26850940

  6. Post-arthroscopy septic arthritis: Current data and practical recommendations.

    Science.gov (United States)

    Bauer, T; Boisrenoult, P; Jenny, J Y

    2015-12-01

    Septic arthritis develops after less than 1% of all arthroscopy procedures. The clinical symptoms may resemble those seen after uncomplicated arthroscopy, raising diagnostic challenges. The diagnosis rests on emergent joint aspiration with microscopic smear examination and prolonged culturing on specific media. Urgent therapeutic measures must be taken, including abundant arthroscopic lavage, synovectomy, and the concomitant administration of two effective antibiotics for at least 6 weeks. Preservation of implants or transplants is increasingly accepted, and repeated joint lavage is a component of the treatment strategy. After knee arthroscopy, infection is the most common complication; most cases occur after cruciate ligament reconstruction, and staphylococci are the predominant causative organisms. Emergent synovectomy with transplant preservation and appropriate antibiotic therapy ensures eradication of the infection in 85% of cases, with no adverse effect on final functional outcomes. After shoulder arthroscopy, infection is 10 times less common than neurological complications and occurs mainly after rotator cuff repair procedures; the diagnosis may be difficult and delayed if Propionibacterium acnes is the causative organism. The update presented here is based on both a literature review and a practice survey. The findings have been used to develop practical recommendations aimed at improving the management of post-arthroscopy infections, which are exceedingly rare but can induce devastating functional impairments.

  7. The stress-tenogram in the diagnosis of ruptures of the lateral ligament of the ankle

    International Nuclear Information System (INIS)

    The stress-tenogram is a radiological technique for the investigation of injuries to the lateral ligament of the ankle, and combines the information previously provided by inversion and anterior stress radiographs, and the peroneal tenogram. It is designed to differentiate between stable and unstable ankles, and between isolated ruptures of the anterior talofibular ligament and combined tears of the anterior talofibular and calcaneofibular ligaments. A high degree of diagnostic accuracy has been confirmed at operative repair in a group of thirty-two patients. (author)

  8. Muscular reflexes elicited by electrical stimulation of the anterior cruciate ligament in humans

    DEFF Research Database (Denmark)

    Dyhre-Poulsen, P; Krogsgaard, M R

    2000-01-01

    Anterior cruciate ligament (ACL)-deficient knees have impaired proprioception, and, although mechanoreceptors have been found in the ACL, the existence of a reflex elicited from these receptors has not been directly demonstrated in humans. In eight patients that underwent knee arthroscopy and had...

  9. Ankle Fractures Often Not Diagnosed

    Science.gov (United States)

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

  10. X-Ray Exam: Ankle

    Science.gov (United States)

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

  11. Hip arthroscopy in the setting of hip dysplasia

    Science.gov (United States)

    Yeung, M.; Kowalczuk, M.; Simunovic, N.

    2016-01-01

    Objective Hip arthroscopy in the setting of hip dysplasia is controversial in the orthopaedic community, as the outcome literature has been variable and inconclusive. We hypothesise that outcomes of hip arthroscopy may be diminished in the setting of hip dysplasia, but outcomes may be acceptable in milder or borderline cases of hip dysplasia. Methods A systematic search was performed in duplicate for studies investigating the outcome of hip arthroscopy in the setting of hip dysplasia up to July 2015. Study parameters including sample size, definition of dysplasia, outcomes measures, and re-operation rates were obtained. Furthermore, the levels of evidence of studies were collected and quality assessment was performed. Results The systematic review identified 18 studies investigating hip arthroscopy in the setting of hip dysplasia, with 889 included patients. Criteria used by the studies to diagnose hip dysplasia and borderline hip dysplasia included centre edge angle in 72% of studies but the range of angles were quite variable. Although 89% of studies reported improved post-operative outcome scores in the setting of hip dysplasia, revision rates were considerable (14.1%), with 9.6% requiring conversion to total hip arthroplasty. Conclusion The available orthopaedic literature suggests that although improved outcomes are seen in hip arthroscopy in the setting of hip dysplasia, there is a high rate of re-operation and conversion to total hip arthroplasty. Furthermore, the criteria used to define hip dysplasia vary considerably among published studies. Cite this article: M. Yeung, M. Kowalczuk, N. Simunovic, O. R. Ayeni. Hip arthroscopy in the setting of hip dysplasia: A systematic review. Bone Joint Res 2016;5:225–231. DOI: 10.1302/2046-3758.56.2000533. PMID:27313136

  12. Current status of temporomandibular joint arthroscopy in the United Kingdom.

    Science.gov (United States)

    Thomas, Sangeetha M; Matthews, N Shaun

    2012-10-01

    In an era during which minimally invasive procedures are increasingly becoming the norm, arthroscopy of the temporomandibular joint (TMJ) seems to be infrequently used for diagnosis and treatment of disorders of the TMJ. The reasons for this are not clear. The purpose of this study was to find out the current state of arthroscopy of the TMJ in the UK and, more specifically, how often it is used, the indications for its use, the level of experience of practising surgeons, and the reasons for not using it. Information was gathered between 2009 and 2010 from a postal and e-mail questionnaire to all oral and maxillofacial consultants in the UK. Of the 346 consultants, 215 (60%) responded to the questionnaire. Forty-two said that they currently used arthroscopy of the TMJ, and 33 of those (81%) have more than 5 years' experience. During the past year, a total of 8 consultants nationally have done 20 arthroscopies or more. Thirty-three of the procedures (81%) were done for both diagnosis and treatment. Lack of perceived need of patients and lack of interest in this specialty were the main reasons given for not doing arthroscopy, lack of training being a key secondary reason. The Storz and Olympus systems were the most commonly used within the UK. Results seem to support the opinion that arthroscopy of the TMJ is under-used, and consideration should be given to ensuring that trainees are instructed in its use, which is important in the diagnosis and treatment of disorders of the TMJ.

  13. 手术治疗慢性踝关节外侧不稳106例%Treatment for chronic anterolateral ankle instability in 106 patients with surgical method

    Institute of Scientific and Technical Information of China (English)

    马骁; 胡跃林

    2011-01-01

    目的 探讨慢性踝关节外侧不稳继发病损及其有效的手术方法.方法 本组行手术解剖重建外踝韧带治疗慢性踝关节外侧不稳的患者106例,观察其继发病损在关节镜下的表现.结果 对本组患者随访12~111个月,平均31.2个月,术后所有踝关节均达到功能稳定,关节活动度基本恢复正常,没有复发性踝关节不稳发生.运用美国AOFAS足踝评分系统对患者手术前后踝关节功能进行评估,术前与术后AOFAS后足评分间的差异有统计学意义.结论 解剖重建距腓前韧带、跟腓韧带,有效地矫正了踝关节外侧不稳定和距下关节不稳定,是治疗踝关节慢性前外侧严重不稳定的合理而有效的治疗方法.%Objective To discuss secondary lesion and effective surgical method for the treatment of chronic anterolateral ankle instability. Methods From 1997 to 2007. reconstruction was used in surgical treatment for chronic anterolateral ankle instability in 106 patients. and secondary lesion was observed hy arthroscopy. Results Postoperative follow-up time was from 12 to 111 months. with an average of 30. 2 months. Functional stahility was achieved and range of motion generally recovered without recurrent instahility. The therapeutic results were evaluated with grading scale developed by AOFAS et al. There were significant differences in AOFAS values before and after operation. Conclusions With reconstruction technique, anterior talofibular and calcaniofibular ligaments can all be reconstructed, so that both lateral and subtalar instahility of ankle can be restabilized effectively. It is a reasonable and effective surgical method for the treatment of chronic anterolateral ankle instability.

  14. Knee arthropathy in ochronosis: diagnosis by arthroscopy with ultrastructural features.

    Science.gov (United States)

    Lurie, D P; Musil, G

    1984-02-01

    Knee arthroscopy in a patient with undiagnosed chronic monoarticular arthritis revealed dark pigmentation of the snyovium; synovial biopsy revealed histologic and ultrastructural features characteristic of ochronosis. Synovial fluid (SF) was non-inflammatory, without pigmented shards of cartilage; calcium pyrophosphate dihydrate crystals were absent in both the SF and biopsy specimen. Homogentisic acid was detectable in the urine by thin layer chromatography, and asymptomatic spondylosis with intervertebral disc calcification was found. The negative family history, lack of mucocutaneous pigmentation and failure of the urine to spontaneously darken obscured the diagnosis, which was easily made by arthroscopy. PMID:6699824

  15. 髋关节镜的临床应用进展%Clinical application progress of hip arthroscopy

    Institute of Scientific and Technical Information of China (English)

    阮建伟; 陈明

    2011-01-01

    髋关节镜技术近20年飞速发展,在髋关节损伤诊断治疗领域的作用愈加显著.以往通过X线、CT或MRI等检查无法确定的髋关节病损也可通过髋关节镜检查得到较为明确的诊断,该技术逐渐成为髋关节疾病诊断的金标准.目前,髋关节镜检查入路主要有外侧入路、前侧入路、后外侧入路,应用范围主要包括孟唇撕裂、股骨髋臼撞击症、圆韧带损伤、软骨损伤、滑膜疾病、关节内感染、关节内游离体等.髋关节镜技术是一项综合性技术,其优点得以良好体现须手术者熟悉掌握该技术的适应证、禁忌证以及手术操作方法,必须在术前进行细致的物理检查及影像学检查,在术后进行合理有效的康复功能训练.%The hip arthroscopy develops quickly in the past 20 years. Its use in the diagnosis and treatment of the hip injury get more notably. Many of pathologic conditions previously unrecognized through X-ray,CT or MRI have been diagnosed correctly under hip arthroscopy. The technology has become gradually a golden standard to confirm the hip discords. In the present, the examining path of the hip arthroscopy contains mainly the outside path, the anterior path, the outside-posterior path. The application range of the hip arthroscopy includes the management of labral tears, the femoroacetabular impingement, the ligamentum tear injuries,the chondral lesions,the synovical abnormalities,the intra-articular infection,the loose bodies in the joint etc. The hip arthroscopy is a comprehensive technology. Its superiority can be reflect well if the doctors are familiar with the indication,the contraindication and the operation procedure. And also the thorough physical examination and imaging examination should be made before operation,as well as reasonable and effective postoperative function training should be conducted.

  16. 前后交叉韧带及半月板损伤的MDCT与关节镜的对比研究%Comparative study between multi-slice spiral CT and knee arthroscopy in diagnosis of anterior and posterior cruciate ligament injury and meniscus injury

    Institute of Scientific and Technical Information of China (English)

    黄瑞庭; 刘玉涛; 张德佳; 杜中立; 张应鹏; 郭宗义; 黄海松

    2013-01-01

    目的 探讨多层螺旋CT在膝关节外伤中前后交叉韧带与半月板损伤的诊断价值.方法 回顾性分析45例经膝关节镜证实的前后交叉韧带和半月板损伤的多层螺旋CT直接征象和间接征象.结果 前后交叉韧带损伤的直接征象表现为韧带断裂、密度欠均匀,韧带附着点撕脱性骨折,间接征象表现为韧带肿胀,周围脂肪间隙模糊欠清;半月板损伤的MDCT直接征象是形态失常、密度不均匀及裂隙征,间接征象是膝关节滑膜增厚、关节囊关节腔内积液、损伤的半月板周围软组织肿胀等.45例患者中,MDCT显示前交叉韧带损伤14例(14/20),后交叉韧带损伤11例(11/15),内侧半月板损伤8个(8/12),外侧半月板损伤12个(12/20),交叉韧带与半月板同时损伤10例,韧带附着点及胫骨平台骨折18例.结论 多层螺旋CT在膝关节外伤中的前后交叉韧带及半月板的损伤有一定的诊断价值,可为缺少磁共振设备的基层医院提供一有用的检查方法.%Objective To evaluate the diagnotic value of multi-slice spiral CT(MDCT) in anterior and posterior cruciate ligament injury and meniscus injury. Methods Retrospective analysis of the CT direct signs and indirect signs in 45 cases diagnosed with anterior and posterior cruciate ligament injury and meniscus injury confirmed by knee arthroscopic was conducted. Results MDCT findings of the direct signs of the anterior and posterior cruciate ligament injury included the ligament rupture, less uniform density, ligament attachment points avulsion fracture. Indirect signs included ligament swelling, fuzzy around the fat space less clear; MDCT findings of the direct signs of the meniscus injury included morphological disorders, uneven density and broken sign. Indirect signs included thickening of the synovium, joint capsule effusion, soft tissue swelling of the injuryed meniscus. In 45 patients, MDCT showed the anterior cruciate ligament injury in 14 cases (14

  17. Clinical observation on reconstructing the anterior and posterior cruciate ligaments of knee joint with allograft-tendon by arthroscopy%关节镜下同种异体肌腱重建膝关节前后交叉韧带的临床观察

    Institute of Scientific and Technical Information of China (English)

    阳波; 谭雄进

    2014-01-01

    目的:比较关节镜下同种异体肌腱移植和自体肌腱移植重建膝关节前后交叉韧带的临床效果。方法将130例膝关节前后交叉韧带断裂的患者按手术方式的不同分为2组,观察组采用同种异体肌腱移植,对照组采用自体肌腱移植,观察患者临床疗效。结果观察组手术时间明显少于对照组(P0.05);2组患者术后Lysholm及Tengner评分均明显高于术前,2组差异有统计学意义(P0.05)。结论同种异体与自体肌腱重建ACL及PCL的疗效相近,是重建ACL及PCL良好的移植物。%Objective To compare the clinical effect of reconstructing the anterior and posterior cruciate ligaments of knee joint with al-lografttendon and autogenous tendon transplantation. Methods 130 patients with anterior and posterior cruciate ligaments of knee fractured were randomly divided into two groups:the observation group were given allogeneic tendon transplantation while the control group were autol-ogous tendon transplantation. Observed the clinical efficacy of the two groups. Results The operation time of the observation group was ob-viously less than control group(P0. 05);the Lysholm and Tengner score of the two groups were significantly higher compared with the preoperative scores with a statistically significant difference (P0. 05). Conclusion Allogeneic tendon transplantation has similar curative effect with autologous tendon transplantation, both of them are good transplantation material for anterior and posterior cruciate ligaments reconstruction.

  18. Arthrography of the ankle joint in chronic instability

    International Nuclear Information System (INIS)

    Papers on arthrography of injuries of the lateral ligaments of the ankle relate mainly to recent distortion of the joint. Arthrography performed at a later stage after injury generally is considered useless. In fact, changes in chronic instability are observed; they are subtle and consist either of small recesses adjacent to the lateral malleolus or communication of the joint with the peroneal tendon sheaths. Arthrography was assessed in 61 cases of recurrent lateral sprains of the ankle more than 2 weeks after acute injury; 38 were considered as positive. Twenty-five patients had operative evaluation, with four false negative and one false positive results. Small recesses adjacent to the lateral malleolus or opacification of the peroneal tendon sheaths are sequelae of an acute sprain with tear of the anterior talofibular and/or the calcaneofibular ligaments. Although false negative results occur, arthrography is useful in the preoperative assessment of chronic ankle instability. (orig.)

  19. Injured lateral ankle ligaments: technique and assessment of MRI

    International Nuclear Information System (INIS)

    56 patients with the clinical diagnosis of sprained ankles were investigated. Evaluation of the anterior (AFTL) and posterior fibulotalar ligament (PFTL) was performed with the foot in dorsiflexion (20 ) and of the fibulo calcanear ligament (FCL) in plantarflexion (45 ). Axial T1w-SE and T2w-TSE images were obtained. Full-length visualisation of ligmaments in one slice and the extent of injury were evaluated. 12 ankle injuries were confirmed by operation. With MRI full-length visualisation of lateral ankle ligaments was possible in 86%. A partial/complete rupture of the AFTL was noticed in 33/64% and of the FCI in 29/39%, and of the PFTL in 27/5%. Sensitivity/specificity of MRI when compared to surgery was 100/100% for injuries of the AFTL, 64/100% for the FCL, and 33/78% for the PFTL. (orig./MG)

  20. Arthrography of the ankle joint in chronic instability

    Energy Technology Data Exchange (ETDEWEB)

    Dory, M.A.

    1986-05-01

    Papers on arthrography of injuries of the lateral ligaments of the ankle relate mainly to recent distortion of the joint. Arthrography performed at a later stage after injury generally is considered useless. In fact, changes in chronic instability are observed; they are subtle and consist either of small recesses adjacent to the lateral malleolus or communication of the joint with the peroneal tendon sheaths. Arthrography was assessed in 61 cases of recurrent lateral sprains of the ankle more than 2 weeks after acute injury; 38 were considered as positive. Twenty-five patients had operative evaluation, with four false negative and one false positive results. Small recesses adjacent to the lateral malleolus or opacification of the peroneal tendon sheaths are sequelae of an acute sprain with tear of the anterior talofibular and/or the calcaneofibular ligaments. Although false negative results occur, arthrography is useful in the preoperative assessment of chronic ankle instability.

  1. 膝关节镜下自体腘绳肌腱和髌腱移植重建前交叉韧带近期效果对比临床观察%Clinical Observation on Anterior Cruciate Ligament Reconstruction by Autologous Hamstring and Patellar Tendon Transplant under Knee Arthroscopy

    Institute of Scientific and Technical Information of China (English)

    唐刚健; 靳嘉昌; 吕青; 周运勇; 柴晟

    2011-01-01

    Objective:To compare the short-term and long-term curative effects of two different operation modes on anterior cruciate ligament reconstruction. Methods: Lysholm scoring method was performed in the second month, third month and twelfth month respectively after operation to compare the two different operation methods of autologous hamstring-tendon-bone method and hamstring transplant method for anterior cruciate ligament reconstruction. Results: Knee joint score of anterior cruciate ligament reconstruction by hamstring was better than that of patellar tendon group in the second and third month after operation (P0. 05) ; operative incision of patellar tendon group was longer than that of hamstring group (P<0. 05). Conclusion:Both methods are the major operation modes for anterior cruciate ligament reconstruction at present, and hamstring reconstruction has advantages over patellar tendon reconstruction such as small incision and beautiful appearance, which is favorable for the early functional exercise of knee joint after operation as patients' suffering can be reduced. Compared with patellar tendon reconstruction method, operative wound is smaller and bone structure is less injured in hamstring reconstruction method. Therefore, hamstring reconstruction method is more suitable for anterior cruciate ligament reconstruction among teenagers; in addition, if medial collateral ligament and pes anserinus tendon etc. Were injured, and if medial articular structure was unsteady with anterior and posterior cruciate ligaments break at the same time, ligamenta cruci-ata reconstruction should be performed by patellar tendon.%目的:观察对比关节镜下自体腘绳肌腱和髌腱移植2种不同手术方式重建前交叉韧带的术后近、远期疗效.方法:在手术后第2、3、12个月采用Lysholm膝关节评分法分别进行评分,对2种术式进行比较,并对随访资料进行分析.结果:术后第2月、第3月Lysholm膝关节评分腘绳肌腱组为62.14±11

  2. Dynamic Evaluation of the Contact Characteristics and Three-Dimensional Motion for the Ankle Joint with Lateral Ligament Injuries

    Science.gov (United States)

    Kawakami, Kensaku; Omori, Go; Terashima, Shojiro; Sakamoto, Makoto; Hara, Toshiaki

    The purpose of this study was to clarify the dynamic changes in contact pressure distribution and three-dimensional ankle joint motion before and after lateral ligament injuries. Five fresh and frozen intact cadaveric ankles were examined. Each ankle was mounted on a specially designed frame that preserved five degrees of freedom motion. The direct linear transformation technique was used to measure the three-dimensional ankle motion, and a pressure-sensitive conductive rubber sensor was inserted into the talocrural joint space to determine the contact pressure distribution. The contact area on the talus for intact ankle moved anteriorly and laterally with increasing dorsiflexion. An area of high pressure was observed in the medial aspect of the articular surface after the ligament was cut. Supination significantly increased after a combined anterior talofibular ligament (ATF) and calcaneofibular ligament (CF) were cut in comparison with after only an ATF was cut, and no significant differences were observed in motional properties under each experimental condition.

  3. Haptic display for the VR arthroscopy training simulator

    Science.gov (United States)

    Ziegler, Rolf; Brandt, Christoph; Kunstmann, Christian; Mueller, Wolfgang; Werkhaeuser, Holger

    1997-05-01

    A specific desire to find new training methods arose from the new fields called 'minimal invasive surgery.' With the technical advance modern video arthroscopy became the standard procedure in the ORs. Holding the optical system with the video camera in one hand, watching the operation field on the monitor, the other hand was free to guide, e.g., a probe. As arthroscopy became a more common procedure it became obvious that some sort of special training was necessary to guarantee a certain level of qualification of the surgeons. Therefore, a hospital in Frankfurt, Germany approached the Fraunhofer Institute for Computer Graphics to develop a training system for arthroscopy based on VR techniques. At least the main drawback of the developed simulator is the missing of haptic perception, especially of force feedback. In cooperation with the Department of Electro-Mechanical Construction at the Darmstadt Technical University we have designed and built a haptic display for the VR arthroscopy training simulator. In parallel we developed a concept for the integration of the haptic display in a configurable way.

  4. Fifty Most Cited Articles for Femoroacetabular Impingement and Hip Arthroscopy

    Directory of Open Access Journals (Sweden)

    Simon eLee

    2015-08-01

    Full Text Available Growing awareness of femoroacetabular impingement (FAI and recent innovations in management has resulted in hip arthroscopy becoming one of the fastest-growing orthopaedic subspecialties. The purpose of this study was to identify the 50 most cited articles related to the topic of FAI and hip arthroscopy and to analyze their characteristics.The overall number of citations within these articles ranged from 99 to 820. Citation density ranged from 4.41 to 74.55. Seven countries produced these articles with the majority attributed to the United States (n=26 and Switzerland (n=18. Clinical studies made up more than half of the top articles (n=27. The JBJS level of evidence most commonly encountered was level IV (n=24 while the remaining articles were level III (n=3. No randomized controlled trials or non-randomized controlled trials were encountered in this search. The level of evidence was not significantly correlated with the overall number of citations, publication year, or citation density. The current top 50 list provides orthopaedic surgeons interested in hip arthroscopy with anup-to-date core list of the most cited articles in the scientific literature and represents a foundation to use to develop their knowledge regarding hip arthroscopy and FAI.

  5. Hip arthroscopy with labral repair for femoroacetabular impingement

    DEFF Research Database (Denmark)

    Dippmann, Christian; Thorborg, Kristian; Kraemer, Otto;

    2014-01-01

    PURPOSE: The purpose of this study was to examine the progression of clinical outcomes 3, 6 and 12 months after hip arthroscopy with labral repair for femoroacetabular impingement (FAI). METHODS: From May 2009 to December 2011, 87 consecutive patients [55 females (median age 38, range 17-63) and 32...

  6. Frequency of bone-bruises in ankle sprains. Magnetic resonance imaging studies

    Energy Technology Data Exchange (ETDEWEB)

    Uto, Yuji; Morooka, Masaaki [Morooka Orthopaedic Surgery Hospital, Fukuoka (Japan)

    2002-09-01

    We retrospectively studied MRI on the frequency of bone-bruises in ankle sprains, especially those of the lateral collateral ligaments of the ankle joint. Bone-bruises occurred in 3.8% (4/106) of ruptures of anterior talofibular ligament (ATFL), and 6.3% (5/79) of ruptures of ATFL and calcaneofibular ligament (CFL). Bone-bruises were more likely to be seen in ATFL and CFL ruptures than in ATFL rupture alone. (author)

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

    OpenAIRE

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

    2016-01-01

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

  8. Frequency of bone-bruises in ankle sprains. Magnetic resonance imaging studies

    International Nuclear Information System (INIS)

    We retrospectively studied MRI on the frequency of bone-bruises in ankle sprains, especially those of the lateral collateral ligaments of the ankle joint. Bone-bruises occurred in 3.8% (4/106) of ruptures of anterior talofibular ligament (ATFL), and 6.3% (5/79) of ruptures of ATFL and calcaneofibular ligament (CFL). Bone-bruises were more likely to be seen in ATFL and CFL ruptures than in ATFL rupture alone. (author)

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

    International Nuclear Information System (INIS)

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

  11. Dynamic postural control but not mechanical stability differs among those with and without chronic ankle instability.

    Science.gov (United States)

    Wikstrom, E A; Tillman, M D; Chmielewski, T L; Cauraugh, J H; Naugle, K E; Borsa, P A

    2010-02-01

    The purpose of this investigation was to compare dynamic postural control and mechanical ankle stability among patients with and without chronic ankle instability (CAI) and controls. Seventy-two subjects were divided equally into three groups: uninjured controls, people with previous ankle injury but without CAI, and people with CAI. Subjects completed a single-leg hop-stabilization task, and then had an anterior drawer test and lateral ankle radiograph performed bilaterally. The dynamic postural stability index was calculated from the ground reaction forces of the single-leg hop-stabilization task. Ankle joint stiffness (N/m) was measured with an instrumented arthrometer during the anterior drawer test, and fibula position was assessed from the radiographic image. Patients with previous ankle injuries but without CAI demonstrated higher frontal plane dynamic postural stability scores than both the uninjured control and CAI groups (Pankle joint stiffness (P=0.045) relative to the control group. The increased frontal plane dynamic postural control may represent a component of a coping mechanism that limits recurrent sprains and the development of CAI. Mechanical stability alterations are speculated to result from the initial ankle trauma. PMID:19422654

  12. Ankle impingement syndromes; Impingement-Syndrome am Sprunggelenk

    Energy Technology Data Exchange (ETDEWEB)

    Eiber, Matthias; Woertler, Klaus [Klinikum rechts der Isar, Muenchen (Germany). Inst. fuer Roentgendiagnostik

    2010-06-15

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

  13. Diagnostic value of stress radiography in lesions of the lateral ligaments of the ankle

    International Nuclear Information System (INIS)

    The diagnostic accuracy of inversion and anterior stress radiography in rupture of the lateral ligaments of the ankle joint was assessed in 56 patients undergoing surgery. In inversion stress radiography, 58% of the patients with confirmed rupture of the lateral ligaments of the ankle had a talar tilt of 10 degrees or more, allowing a predicitive value of a positive test of 94%. In anterior stress radiography, 53% of the patients had a posterior tibiotalar distance of 9 mm or more, allowing a predictive value of a positive test of 81%. In measurements of talar tilt and anterior displacement of the talus values higher than normal in the injured ankle may be a sign of a rupture of the lateral ligament. (orig.)

  14. 关节镜下自制挤压螺钉在膝前交叉韧带重建中的应用%Application of self-made screw under arthroscopy on the reconstruction of anterior cruciate ligament of knee

    Institute of Scientific and Technical Information of China (English)

    黄巍峰; 杨渊; 余文君

    2010-01-01

    目的 探讨关节镜下自制挤压螺钉运用于膝前交叉韧带(anterior cruciate ligament of knee,ACLK)重建的临床疗效.方法 ACLK 断裂患者18例,在镜下利用自制挤压螺钉固定髌韧带中间1/3骨-髌腱-骨来重建ACL,术后随访7~36个月,平均24个月,观察膝关节功能活动情况.结果 术前前抽屉试验阳性16例,术后阳性1例;术前Lachman征阳性18例,术后阳性1例;术后18个月Lysholm评分(89.5±9.4)分,优良率92.9%,术后远期复查无关节功能障碍.结论 自制中空挤压螺钉运用于ACLK的重建取得良好的疗效,它是一种安全、经济、有效的重建材料.

  15. Systematic ankle stabilization and the effect on performance.

    Science.gov (United States)

    Robinson, J R; Frederick, E C; Cooper, L B

    1986-12-01

    Stabilization of the ankle joint is used as a deterrent to injury, however, insufficient or excessive ankle control can cause negative effects. This study determined the effects of systematic changes in ankle and subtalar joint stabilization on performance through an obstacle course. Data were collected on six subjects as they completed two test procedures. Ankle range of motion in the sagittal and frontal planes was determined using a modified Inman apparatus. Completion time through an obstacle course, set up on a basketball court, was used as a measure of performance. High-top basketball shoes were constructed with pockets which allowed strips of plastic (stiffeners) to be positioned just anterior and posterior to the medial and lateral malleoli. Four shoe conditions were used including the shoe with no stiffeners. Significant differences (P less than 0.05) in eversion, flexion, and inversion were found between the shoe conditions. A general trend of decreased range of motion with increased restriction was observed. Significant differences (P less than 0.05) in performance were found between the shoe conditions, with a general trend of increased times with increased restriction. These results indicate that systematic changes in the range of motion of the ankle and subtalar joints can measurably affect performance. PMID:3784875

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

    Delayed diagnosis of acute lateral ankle ligaments injury and subsequent inadequate treatment leads to the development of chronic instability and rapid progression of degenerative processes in the joint. The aim of our work was to improve treatment results by developing an diagnostic algorithm and treatment strategy of acute lateral ankle ligament injuries. The study included 48 patients with history of acute inversion ankle injury mechanism. Diagnostic protocol included clinical and radiological examination during 48 hours and after 7-10 days after injury. According to the high rate of inaccurate clinical diagnosis in the first 48 hours of the injury a short course of conservative treatment for 7-10 days is needed with follow-up and controlling clinical and radiographic instability tests. Clinical symptoms of ankle inversion injury showed that the combination of local tenderness in the projection of damaged ligaments, the presence of severe periarticular hematoma in the lateral department and positive anterior drawer and talar tilt tests in 7-10 days after the injury in 87% of cases shows the presence of ligament rupture. An algorithm for diagnosis of acute lateral ankle ligament injury was developed, which allowed us to determine differential indications for surgical repair of the ligaments and conservative treatment of these patients. PMID:27089717

  18. 关节镜下单束与双束同种异体腱重建前交叉韧带的临床观察%Clinical study of single bundle vs double-bundle reconstruction of anterior cruciate ligament with allograft tendons by arthroscopy

    Institute of Scientific and Technical Information of China (English)

    李兴中; 吴恙; 倪东亮; 童鑫; 马安军; 叶必谦; 付驰; 赵德伟; 王卫明

    2015-01-01

    Objective To compare the clinical effects of arthroscopic single tunnel double-bundle reconstruction anatomy system ( Intrafix system) vs Rigidfix plus Intrafix system on the treatment of anterior cruciate ligament (ACL) rupture.Methods From June 2011 to June 2013, 60 patients underwent ACL reconstruction with hamstring tendon allograft in Jinhua central hospital .According to the fixation method , the patients were divided into the Intrafix group ( 30 cases ) and the Rigidfix plus Intrafix group ( 30 cases).The range of motion (ROM) of the knee joint was compared before and after the knee surgery , as well as KT-1000 (flexion 70°30 lbs), anterior drawer test, Lachman test, Lysholm knee score and the symptoms of the involved knee .Results The Intrafix group were followed up for 12 to 36 months, 20.61 ± 8.20 months in average .The difference between the preoperative Lysholm knee score and the postoperative one was statistically significant (t=-29.2, P0.05).The difference of the postoperative Lysholm knee score between the Intrafix group and the Rigidfix plus Intrafix group was not statistically significant (t=0.538, P>0.05) .In the Intrafix group , Lachman test was positive in one patient , and in the Intrafix plus Rigidfix group, the anterior drawer test was positive in one patient .No extension deficit was observed .The ROM and KT-1000 measurement results were normal .Conclusion According to the short-term results, the single tunnel double-bundle reconstruction with Intrafix system and the anatomic single-bundle reconstruction with Rigidfix plus Intrafix are both reliable methods for the ACL reconstruction with allograft tendons.The long-term results need further follow-up.%目的:比较关节镜下运用Intrafix单隧道双束解剖重建系统和Rigidfix+Intrafix系统治疗前交叉韧带( ACL)断裂的临床疗效。方法2011年6月至2013年6月,我院使用同种异体腘绳肌腱重建ACL患者60例,根据固定方

  19. MR imaging of the ankle

    International Nuclear Information System (INIS)

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

  20. How to Care for a Sprained Ankle

    Science.gov (United States)

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

  1. Acute ankle sprain: an update.

    Science.gov (United States)

    Ivins, Douglas

    2006-11-15

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

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

    Directory of Open Access Journals (Sweden)

    Yan Wang

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

  3. MRI appearances of the anterior fibulocalcaneus muscle: a rare anterior compartment muscle

    Energy Technology Data Exchange (ETDEWEB)

    Upadhyay, Bhavin [Basildon and Thurrock University Hospitals NHS Foundation Trust, Imaging Department, Essex (United Kingdom); Amiras, Dimitri [Imperial College Health Care NHS Trust, Imaging Department, London (United Kingdom)

    2015-05-01

    MRI of a 62-year-old female presenting with ankle pain demonstrated an accessory muscle within the anterior compartment of the lower leg. The muscle originated from the fibula and anterior crural septum. The tendon passed anterior to the lateral malleolus and inserted at the critical angle of Gissane on the calcaneus. This muscle was initially described in the anatomic literature by Lambert and Atsas in 2010. To our knowledge, this is the first time the MRI appearances of this muscle has been described in the radiological literature. Awareness of the fibulocalcaneal muscle is important as it may represent a cause of ankle pain. In addition, the tendon could potentially be harvested for use in reconstructive procedures. (orig.)

  4. 关节镜下应用带跟骨异体跟腱联合重建前交叉韧带及内侧副韧带%Reconstruction of Both Anterior Cruciate Ligament and Medial Collateral Ligament Using Calcanei Combined Achilles Tendon Allograft under Arthroscopy

    Institute of Scientific and Technical Information of China (English)

    冯会成; 黄迅悟; 孙继桐; 常青; 毕龙; 余方圆

    2013-01-01

    目的:探讨关节镜下应用带跟骨异体跟腱联合重建前交叉韧带(anterior cruciate ligament,ACL)及内侧副韧带(medial col-ateml ligament,MCL)和恢复膝关节前内侧稳定性的效果.方法:选择2007年1月至2010年1月收治符合纳入标准的27例A CL合并MCL损伤患者.其中男18例,女9例;年龄16~48岁,平均32.5岁;右膝15例,左膝12例.患者在排除手术禁忌后,均在关节镜下采用带跟骨异体跟腱一期联合重建ACL和MCL.患者受伤至手术时间7~14天,平均10天.结果:术后2周所有患者切口均Ⅰ期愈合.所有病例获得长期随访,随访时间24~32个月,平均26个月.术后24个月,Lysholm评分由术前的32.10±4.35升至86.25±4.12分,国际膝关节文献委员会(IKDC)评分由术前的33.27±4.25分,升至82.46± 4.13分,术前与术后Lysholm评分及I KDC评分均有显著差别(P<0.05).结论:关节镜下应用带跟骨异体跟腱一期联合重建治疗膝关节脱位能够较好的恢复患者膝关节前内侧稳定行,近期效果良好.

  5. 关节镜下清除和保留断裂前交叉韧带残端重建术后疗效对比%Contrast the healing effect between removing and reserving the fractured anterior cruciate ligament under arthroscopy

    Institute of Scientific and Technical Information of China (English)

    姚楚亮; 陈少文; 杨焱鑫; 王华仁; 曾辉; 陈杰; 廖臻; 杨炎彬

    2015-01-01

    目的 探讨前交叉韧带(anterior cruciate ligament,ACL)断裂予施行膝关节镜下ACL单隧道单束重建术,分析清除和保留断裂ACL残端术后的疗效是否存在差异,探索出更适合临床操作的手术方式.方法 2008年1月-2013年6月,对40例ACL断裂施行膝关节镜下单隧道单束ACL重建术,移植物均为取自同侧半腱肌和股薄肌编织成的自体韧带,其中20例(A组)为断裂ACL残端进行清除干净后再施行膝关节镜下单隧道单束ACL重建术,20例(B组)为断裂ACL残端进行尽可能保留前提下施行膝关节镜下单隧道单束ACL重建术,手术均为同一组医师完成,2组手术前后Lysholm评分和IKDC评分结果进行t检验.结果 40例均获随访,时间为12~ 28个月,平均(20.7±3.7)个月,手术前后Lysholm评分和IKDC评分t检验结果,所得P=0.0183和P=0.0177,P值均<0.05,比较差异有统计学意义.结论 ACL断裂采用清除和保留断裂前交叉韧带残端进行自体韧带重建术后的疗效,在关节平衡性、关节自体感觉恢复存在显著性差异.保留ACL残端进行单隧道单束重建ACL,有利于移植肌腱的胫骨和股骨端隧道口的制作;ACL固定于原ACL残端中,避免重建的ACL在髁间窝被撞击;原ACL残端纤维围绕重建的ACL,可以覆盖隧道内口,减少关节液对移植肌腱与隧道愈合的影响.

  6. Intervention randomized controlled trials involving wrist and shoulder arthroscopy: a systematic review

    OpenAIRE

    Tadjerbashi, Kamelia; Rosales, Roberto S; Atroshi, Isam

    2014-01-01

    Background: Although arthroscopy of upper extremity joints was initially a diagnostic tool, it is increasingly used for therapeutic interventions. Randomized controlled trials (RCTs) are considered the gold standard for assessing treatment efficacy. We aimed to review the literature for intervention RCTs involving wrist and shoulder arthroscopy. Methods: We performed a systematic review for RCTs in which at least one arm was an intervention performed through wrist arthroscopy or shoulder arth...

  7. Arthroplasty versus arthroscopy for recurrent anterior dislocation of the shoulder joint with severe bone defects:3-year follow-up%关节置换与关节镜下修复肩关节复发性前脱位伴重度骨缺损:3年随访对比

    Institute of Scientific and Technical Information of China (English)

    陈辉; 王群; 燕双喜; 董天云; 邹海兵

    2015-01-01

    背景:随着外科技术、重建材料技术的发展,关节置换在肩关节脱位中也得到了广泛应用,特别是各种定制型或装配型假体使得置换适应证明显提高。  目的:观察与随访关节镜与关节置换治疗肩关节复发性前脱位伴重度骨缺损的远期疗效。  方法:纳入肩关节复发性前脱位伴重度骨缺损患者144例,根据随机抽签分为治疗组与对照组,每组72例。对照组行关节镜下内固定治疗,治疗组行关节置换治疗。通过电话调查与复诊完成3年随访,记录患者Neer肩关节功能评分、肩关节活动度及并发症发生情况。  结果与结论:随访3年,治疗组的肩关节功能优良率90%明显高于对照组81%(P RESULTS AND CONCLUSION:After 3-year fol owed-up, the excel ent and good rate of shoulder function was significantly higher in the treatment group (90%) than in the control group (81%) (P<0.05). The magnitude of the flexion in the 3-year fol owed-up was apparently increased, while the lateral margin external rotation was decreased, which showed significant differences after intragroup comparison (P<0.05). Simultaneously, the magnitude of the flexion and the lateral margin external rotation in the treatment group had statistical y significant differences compared to the control group in the 3-year fol owed-up (P<0.05). The complications of wound infection, shoulder dislocation, and implant loosening in the treatment group during fol ow-up were significantly lower than in the control group (P<0.05). These findings verified that compared with arthroscopic surgery, arthroplasty for treating recurrent anterior dislocation of the shoulder joint with severe bone defects in long-term fol ow-up can effectively restore shoulder function and range of motion, and it has few complications, thereby effectively rebuilds shoulder joint.

  8. Arthroscopy of the wrist: anatomy and classification of carpal instability.

    Science.gov (United States)

    Cooney, W P; Dobyns, J H; Linscheid, R L

    1990-01-01

    Carpal instability can be defined as the lack of ligamentous and skeletal support adequate to maintain a wrist stable to external forces of pinch and grasp. This instability may be static or dynamic. It has been classified as (a) carpal instability, dissociated (CID), a situation in which one or more of the ligaments are torn, and (b) carpal instability, nondissociative (CIND), a situation in which the ligaments are intact but stretched. Carpal instability can also be the result of carpal bone malalignment from various causes. Arthroscopy can be particularly useful in assessing carpal instability, however arthrography with contrast medium, fluoroscopy, and stress loading should precede this arthroscopic assessment. Arthroscopy allows visualization of the volar radiocarpal and ulnocarpal ligaments of the wrist, and the arthroscopic examination can be combined with manual manipulation of the carpal bones to detect laxity of those ligaments, to examine stability of the scapholunate and lunotriquetral interosseous ligaments, and to show instability of the distal radioulnar joint.

  9. Nursing care by children with arthroscopy of the knee joint.

    OpenAIRE

    ŠESTÁKOVÁ, Růžena

    2012-01-01

    With the increasing sports and physical activity pursued by young people, the spectrum of the knee joint injuries is extending. At the present time, arthroscopy represents one of the basic diagnostic and therapeutic methods in the case of the knee joint injuries. Owing to this method, the attending physician can examine the joint directly using the endoscopic instrument and they can possibly execute surgical treatment thereof as well. Thanks to development, this method can be applied in child...

  10. Comparison of Functional Ankle Motion Measures in Modern Dancers.

    Science.gov (United States)

    Dickson, Danelle; Hollman-Gage, Kendra; Ojofeitimi, Sheyi; Bronner, Shaw

    2012-09-01

    Ankle injuries are the most common lower extremity injury in dance and sports, often resulting in limitation of dorsiflexion or plantar flexion. Accurate assessment of any limitation in range of motion is an important factor in implementing effective preventative and rehabilitative regimens. Ankle range of motion has traditionally been quantified with goniometers. However, standard goniometry may not be an adequate method of assessing plantar flexion range of motion in dancers. An alternative technique using inclinometers to quantify ankle plantar flexion has been reported, but reliability and inter-instrument correlations for this method are limited. The dorsiflexion lunge distance method has been used to assess ankle dorsiflexion. Although shown to be reliable, this method has not been objectively correlated. The purpose of this study was to determine the most clinically appropriate tool for assessing functional ankle dorsiflexion and plantar flexion in dancers. The aims were to: 1. determine reliability of the weightbearing ankle dorsiflexion lunge method using inclinometer, goniometer, and distance; 2. assess the reliability of inclinometer and goniometer measurements of non-weightbearing active plantar flexion; 3. conduct inter-method and experienced versus novice rater correlations; and 4. determine if a relationship exists between dorsiflexion distance (cm) and dorsiflexion inclinometer angle (degrees) measurements. Twenty-six modern dancers (age: 20.2 ± 1.8 years) participated in the study. Four raters measured weightbearing dorsiflexion in a lunge position using a goniometer, two inclinometer placements, and a distance measurement. They also measured active ankle plantar flexion using an inclinometer placed on the anterior talonavicular joint and a goniometer placed at the lateral ankle. Intra- and inter-rater reliability and inter-method correlations were calculated with Intraclass Correlation Coefficients (ICC) and standard error of measurement (SEM

  11. Perioperative pain management in hip arthroscopy; what options are there?

    Science.gov (United States)

    Bech, N H; Hulst, A H; Spuijbroek, J A; van Leuken, L L A; Haverkamp, D

    2016-08-01

    Hip arthroscopy is a fast growing orthopedic field of expertise. As in any field of surgery adequate postoperative pain management regimes are of utmost importance. The purpose of this review is to provide an overview of current knowledge on anesthetic options for perioperative pain management for hip arthroscopy. We searched the Pubmed/Medline and Embase database for literature and included 10 studies for our analysis. Because of the variety of pain scales and different ways of measured pain no meta-analysis could be performed and a descriptive review is performed. There are several types of pain regimens that can mostly be divided in two groups: local anesthetics and nerve blocks. Included studies show a rather large variation in reported visual analogue scale scores, post anesthesia care unit admission time and opioid usage. There are several anesthetic options available for hip arthroscopy. Different studies use different dosages, anesthetic regimens and different protocols; this partly explains the differences between studies with similar techniques. Peripheral nerve blocks seems promising but regarding current literature no clear recommendation can be made about what the best perioperative pain management option is, an overview of all reported techniques is given. PMID:27583156

  12. Change in neck circumference after shoulder arthroscopy: An observational study

    Directory of Open Access Journals (Sweden)

    Shrividya Chellam

    2015-01-01

    Full Text Available Background and Aims: Shoulder arthroscopy requires fluid irrigation, which causes soft-tissue oedema around chest, neck, and arm intraoperatively, leading to postoperative airway complications. We decided to study the incidence of increase in the neck circumference in shoulder arthroscopy and its effects on the airway. Methods: We studied 32 cases of shoulder arthroscopies over a period of 1-year, performed under general anaesthesia with interscalene block. The neck circumference of patients before and after the procedure was measured along with other parameters. The endotracheal tube cuff was deflated at the end of surgery to determine air leak around the tube. The negative leak test suggested airway oedema. Results: Thirty out of 32 patients showed positive air leak test. The average change in neck circumference was 1.17 ± 1.16 cm and all could be extubated uneventfully. Two showed negative leak test with an increase in neck circumference by 4.5 and 6.4 cm and were not extubated. Multiple regression analysis for risk factors showed intraoperative hypertension as a single predictor for an increase in neck circumference. Conclusion: Change in the neck circumference beyond 4 cm may suggest airway compromise and below 4 cm, airway compromise is unlikely even in the presence of extensive soft-tissue oedema around the shoulder, upper arm and chest.

  13. Recurrent anterior glenohumeral instability: the quantification of glenoid bone loss using magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Martins e Souza, Patricia [Fleury Medicina e Saude and Instituto Nacional de Traumatologia e Ortopedia, Rio de Janeiro, RJ (Brazil); Brandao, Bruno Lobo; Motta, Geraldo; Monteiro, Martim [Instituto Nacional de Traumatologia e Ortopedia, Rio de Janeiro, RJ (Brazil); Brown, Eduardo [Grupo Fleury Medicina Diagnostica, Rio de Janeiro, RJ (Brazil); Marchiori, Edson [Universidade Federal do Rio de Janeiro, Petropolis, RJ (Brazil)

    2014-08-15

    To investigate the accuracy of conventional magnetic resonance imaging (MRI) in determining the severity of glenoid bone loss in patients with anterior shoulder dislocation by comparing the results with arthroscopic measurements. Institutional review board approval and written consent from all patients were obtained. Thirty-six consecutive patients (29 men, seven women; mean age, 34.5 [range, 18-55] years) with recurrent anterior shoulder dislocation (≥3 dislocations; mean, 37.9; range, 3-200) and suspected glenoid bone loss underwent shoulder MRI before arthroscopy (mean interval, 28.5 [range, 9-73] days). Assessments of glenoid bone loss by MRI (using the best-fit circle area method) and arthroscopy were compared. Inter- and intrareader reproducibility of MRI-derived measurements was evaluated using arthroscopy as a comparative standard. Glenoid bone loss was evident on MRI and during arthroscopy in all patients. Inter- and intrareader correlations of MRI-derived measurements were excellent (intraclass correlation coefficient = 0.80-0.82; r = 0.81-0.86). The first and second observers' measurements showed strong (r = 0.76) and moderate (r = 0.69) interreader correlation, respectively, with arthroscopic measurements. Conventional MRI can be used to measure glenoid bone loss, particularly when employed by an experienced musculoskeletal radiologist. (orig.)

  14. Recurrent anterior glenohumeral instability: the quantification of glenoid bone loss using magnetic resonance imaging

    International Nuclear Information System (INIS)

    To investigate the accuracy of conventional magnetic resonance imaging (MRI) in determining the severity of glenoid bone loss in patients with anterior shoulder dislocation by comparing the results with arthroscopic measurements. Institutional review board approval and written consent from all patients were obtained. Thirty-six consecutive patients (29 men, seven women; mean age, 34.5 [range, 18-55] years) with recurrent anterior shoulder dislocation (≥3 dislocations; mean, 37.9; range, 3-200) and suspected glenoid bone loss underwent shoulder MRI before arthroscopy (mean interval, 28.5 [range, 9-73] days). Assessments of glenoid bone loss by MRI (using the best-fit circle area method) and arthroscopy were compared. Inter- and intrareader reproducibility of MRI-derived measurements was evaluated using arthroscopy as a comparative standard. Glenoid bone loss was evident on MRI and during arthroscopy in all patients. Inter- and intrareader correlations of MRI-derived measurements were excellent (intraclass correlation coefficient = 0.80-0.82; r = 0.81-0.86). The first and second observers' measurements showed strong (r = 0.76) and moderate (r = 0.69) interreader correlation, respectively, with arthroscopic measurements. Conventional MRI can be used to measure glenoid bone loss, particularly when employed by an experienced musculoskeletal radiologist. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-05-15

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

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

    International Nuclear Information System (INIS)

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

  17. Correlation between MRI and Arthroscopy in Diagnosis of Shoulder Pathology

    Science.gov (United States)

    Bhonsle, Sachin; Mehta, Sonu

    2016-01-01

    Introduction Shoulder pain can cause significant pain, discomfort and reduce the ability to perform activities of daily living, thus making it the third most common cause of musculoskeletal consultation. The current gold standard diagnostic investigation is arthroscopy. MRI is a proved sensitive and accurate non-invasive tool in investigating shoulder pathology, but false and misleading results are equally reported. Aim The aim of the study is to compare the efficacy of MRI in diagnosing shoulder pathologies in comparison to arthroscopy, considering arthroscopy as the gold standard. Materials and Methods Thirty nine consecutive patients, between 18-80 years of age, presenting with chronic shoulder pain or instability of more than 6 weeks, or with clinical signs of impingement or tear were included in the study. MRI of the shoulder joint was done followed by shoulder arthroscopy. The data collected was analysed for the significant correlation between MRI of shoulder and arthroscopic findings by kappa statistics. Results Out of 39 patients, Rotator cuff (RC) tear was the most common pathology. MRI showed excellent sensitivity in the diagnosis of rotator cuff tears (0.91) and osteochondral defects (OCD), very good sensitivity for Bankart’s lesion (0.8) and had poor sensitivity to detect SLAP tear (0.15). MRI was specific for all shoulder pathologies. MRI detected RC tears with kappa score of 0.73, Bankart’s tear and OCD’s with kappa score of 0.83 and 1.0 respectively and SLAP lesion with kappa score of 0.14. The accuracy of MRI was highest in diagnosing OCD’s (1.0), followed by RC tear (0.9), Bankart’s tear (0.9) and accuracy was least in diagnosing SLAP lesion (0.7). False negative results were more than false positives. Conclusion The present study supports that MRI is effective in diagnosing rotator cuff tears, Bankart’s tear and ostechondral defects but was not found to be helpful in diagnosing SLAP lesions. MRI and arthroscopy have complimentary roles

  18. 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…

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

    OpenAIRE

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

    2008-01-01

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

  20. 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.

  1. Sports Injuries to the Foot and Ankle

    Science.gov (United States)

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

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

    Science.gov (United States)

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

    2016-05-01

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

  3. Graded stress radiography in acute injury to the lateral ligaments of the ankle

    International Nuclear Information System (INIS)

    The diagnostic accuracy of graded stress radiography in 26 patients with acute injury to the lateral ankle ligaments has been compared with findings at arthrography and surgery. Measuring talar tilt angles and anterior talar displacement over a range of pressures applied to the distal tibia using a commercially available stress device allows diagnostic distinction between isolated anterior talofibular ligament injury and a combined lesion that involves the calcaneofibular ligament. The results compare well with arthrographic and surgical findings. (orig.)

  4. COMPLICATIONS RESULTING FROM THE USE OF METAL ANCHORS IN SHOULDER ARTHROSCOPY

    Science.gov (United States)

    Godinho, Glaydson Gomes; França, Flavio Oliveira; Alves Freitas, José Marcio; Aguiar, Paulo Nascimento; de Carvalho Leite, Marcelo

    2015-01-01

    To identify the complications concerning the use of metal anchors in shoulder arthroscopic procedures. Methods: 28 shoulders of 28 patients (23 male and 5 female) have been re-operated in the period between December 1997 and August 2007, at Hospital Ortopédico, Belo Horizonte Hospital and Military Police Hospital in Belo Horizonte, MG, as a result of complications such as loose anchors and prominent anchors. The primary surgeries intended to treat 20 anterior traumatic instabilities (71.5%), one posterior instability (3.5%), one slap injury (3.5%), six procedures for treating injuries on the rotator cuff (21.5%). We used the X-ray classification suggested by Samilson and Prieto and Outerbridge arthroscopic classification for assessing patients' degree of arthrosis. All patients were evaluated by the UCLA (University of California at Los Angeles) index criteria. Results: In all patients, arthroscopic reviews were made. In two cases, after anchors removal, clinical signs of instability were seen, leading to the decision of providing open stabilization by Latarjet-Patte technique. Conclusion: the complications with metallic-suture anchors result from inappropriate surgical techniques applied in arthroscopy. PMID:26998465

  5. Evaluation of wrist arthroscopy outcomes in patients with chronic wrist pain

    Directory of Open Access Journals (Sweden)

    Reza Shahryar Kamrani

    2015-01-01

    Conclusion: According to our results, wrist arthroscopy have acceptable outcome in TFCC injuries and Kienbock disease. With the ever-expanding list of indications and procedures that can be performed with wrist arthroscopy, it can be considered as an essential diagnostic and therapeutic tool for the orthopedic surgeon.

  6. 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.

  7. Fractures of the ankle Fractures of the ankle

    OpenAIRE

    Taser, Omer; Goksan, Alp; Asik, Mehmet

    2004-01-01

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

  8. 踝关节镜结合中药外洗治疗20例创伤性踝关节炎的临床观察%Clinical Observation ofankle arthroscopy combined with external medicine wash treatment of traumaticankle arthritis

    Institute of Scientific and Technical Information of China (English)

    周松林; 王上增; 岳宗进; 刘福东; 刘彪

    2014-01-01

    Objective To explore the ankle arthroscopy combined with external medicine wash treatment of traumatic ankle arthritis wash effect.Methods From March 2008 to March 2013 ,treated 40 cases of traumatic ankle arthritis after arthroscopic ankle surgery patients ,16 males and 24 females ;aged 15 to 58 years,mean 32 years .Duration of 2 months to 4 years ,with an average of 12 months.The 40 patients were randomly divided into treatment group and control group ,20 cases in each group.Underwent arthroscop-ic examination,a clear situation of intra-articular lesions ,and the corresponding lesion debridement ,in which cartilage injury and degeneration in 26 cases,3 cases of free formation ,impingement syndrome in 1 1 cases.The treatment group received a combination of ankle arthroscopy with external medicine wash treatment,the control group,only the use of ankle arthroscopy .American Orthopaedic Foot and Ankle Society after adoption (AOFAS)score sheet after ankle ankle functional status score.Results The two groups have more efficient significant difference (P<0.05);mean follow-up (14.2 ±8.4)months (5 to 24 months ),postoperative joint func-tion AOFAS score for the treatment group improved (83.4 ±11.6)points,improving the control group (76.7 ±12.4)points,which is more subjective scores improved significantly.Statistical analysis showed that the total score difference was significant (P<0.05 ) between the two groups.Conclusion Ankle arthroscopy combined with external medicine wash traumatic ankle arthritis better,worthy of promotion.%目的:探讨踝关节镜结合中药外洗治疗创伤性踝关节炎的疗效。方法:将40例创伤性踝关节炎患者随机分为治疗组和对照组,每组20例。均行关节镜检查,明确关节内病变状况,并对相应病变行镜下清理术,其中软骨损伤及退变26例,游离体形成3例,撞击综合征11例。治疗组采用踝关节镜结合中药外洗治疗,对照组仅采用踝关节镜治疗。术

  9. Editorial Commentary: Lesions of the Superior Labrum From Anterior to Posterior (SLAP) Are a Slap in the Face to the Traditional Trinity of History, Examination, and Imaging.

    Science.gov (United States)

    Lubowitz, James H

    2015-12-01

    Superior labrum from anterior to posterior (SLAP) lesions are a slap in the face to the revered trinity of history, physical examination, and imaging. SLAP lesions are difficult to diagnose, and arthroscopy is not only the gold standard, but the current method on which expert arthroscopic shoulder subspecialists rely.

  10. 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

  11. Complications in Ankle Fracture Surgery

    OpenAIRE

    Ovaska, Mikko

    2014-01-01

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

  12. Total ankle arthroplasty in France

    OpenAIRE

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

    2010-01-01

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

  13. Absence of sensory function in the reconstructed anterior cruciate ligament

    DEFF Research Database (Denmark)

    Krogsgaard, Michael R; Fischer-Rasmussen, Torsten; Dyhre-Poulsen, Poul

    2011-01-01

    Cruciate ligaments provide sensory information that cause excitatory as well as inhibitory effects to the activity of the muscles around the knee. The aim of the study was to determine whether these muscular reflexes are reestablished after anterior cruciate ligament (ACL) re-construction. Wire...... electrodes were inserted during arthroscopy into the normal posterior cruciate ligament (PCL) and the reconstructed ACL in 11 patients who had a successful ACL re-construction 8 months to 12 years earlier. After the anesthesia had subsided, the PCL was stimulated electrically through the electrodes...

  14. MORPHOMETRIC STUDY OF MEDIAL COLLATERAL LIGAMENTS OF ANKLE

    Directory of Open Access Journals (Sweden)

    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

  15. Plasma bupivacaine levels following single dose intraarticular instillation for arthroscopy.

    Science.gov (United States)

    Meinig, R P; Holtgrewe, J L; Wiedel, J D; Christie, D B; Kestin, K J

    1988-01-01

    Arthroscopy of the knee was performed using 30 ml single dose intraarticular instillations of 0.5% or 0.25% solutions of bupivacaine (Marcaine). A total of 18 patients (mean age, 34 years), divided into two groups, participated in this study. Venous plasma levels were measured at 0, 10, 20, 30, 45, 60, 90, 120, and 240 minute intervals following a single instillation into the knee joint. All patients had suspected traumatic internal derangement of the knee. Electrocardiogram tracings, blood pressure, and neurologic assessment were monitored at each venous sampling interval or more often if clinically indicated. The type and amount of supplemental anesthesia were also recorded. None of our 18 patients required a general anesthetic because of pain although the following procedures were performed: meniscectomy, plica release, abrasion chondroplasty, loose body retrieval, and limited meniscal repair. A new methodology for the measurement of plasma bupivacaine using the gas chromatograph mass spectrometer is described. Monitoring specific molecular mass fragments allows the measurement of picogram per milliliter levels of bupivacaine. The highest peak plasma concentration occurred 20 minutes after instillation of 30 ml of 0.5% bupivacaine. The 625 +/- 225 ng/ml level was well below the 2,500 to 4,000 ng/ml reported to elicit early subjective CNS symptoms of bupivacaine toxicity. Thus, a single dose intraarticular instillation of 30 ml 0.5% or 0.25% bupivacaine is convenient, efficacious, and pharmacologically safe for routine clinical arthroscopy.

  16. Knee arthroscopies: who gets them, what does the radiologist report, and what does the surgeon find?

    Science.gov (United States)

    Bergkvist, Dan; Dahlberg, Leif E; Neuman, Paul; Englund, Martin

    2016-01-01

    Background and purpose Several randomized controlled trials have not shown any added benefit of arthroscopy over placebo surgery or physiotherapy in middle-aged patients with knee symptoms without trauma. We studied the characteristics of the knee arthroscopies performed in southern Sweden. Patients and methods From the orthopedic surgical records from 2007–2009 in the Skåne region of Sweden (with a population of 1.2 million), we retrieved ICD-10 diagnostic codes and selected all 4,096 arthroscopies that were diagnosed peroperatively with code M23.2 (derangement of meniscus due to old tear or injury) or code M17 (knee osteoarthritis). We extracted information on cartilage and meniscus status at arthroscopy, and we also randomly sampled 502 of these patients from the regional archive of radiology and analyzed the preoperative prevalence of radiographic or magnetic resonance imaging (MRI)-defined osteoarthritis. Results 2,165 (53%) of the 4,096 arthroscopies had the diagnostic code M23.2 or M17. In this subgroup, 1,375 cases (64%) had typical findings consistent with degenerative meniscal tear (i.e. that correspond to a degenerative meniscal tear in at least a third of all arthroscopies). Of the randomly sampled patients, the preoperative prevalence of radiological knee osteoarthritis was 46%. Interpretation There is a discrepancy between evidence-based medicine treatment guidelines and clinical practice regarding the amount of knee arthroscopies performed in patients with symptoms of degenerative knee disease. PMID:26012547

  17. 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.

  18. ATP economy of force maintenance in human tibialis anterior muscle

    DEFF Research Database (Denmark)

    Nakagawa, Yoshinao; Ratkevicius, Aivaras; Mizuno, Masao;

    2005-01-01

    -MRS). The total volume of ankle dorsiflexor muscles was assessed by H magnetic resonance imaging (MRI) (H-MRI), and the fiber type composition of the tibialis anterior muscle was evaluated using histochemical analysis of muscle biopsies. RESULTS: The tibialis anterior muscle occupied 59.7 +/- 0.6% (mean +/- SEM......) of the total ankle dorsiflexor muscle volume, which was 267 +/- 10 cm. Relative cross-sectional areas occupied by Type I, IIA, and IIB fibers in the tibialis anterior were 69.3 +/- 2.2, 27.4 +/- 2.76, and 3.2 +/- 1.0%, respectively. ATP economy of force maintenance did not change significantly during the 60-s...

  19. Accuracy of Lachman and Anterior Drawer Tests for Anterior Cruciate Ligament Injuries

    Directory of Open Access Journals (Sweden)

    Hadi Makhmalbaf

    2013-12-01

    Full Text Available   Background: The knee joint is prone to injury because of its complexity and weight-bearing function. Anterior cruciate ligament (ACL ruptures happen in young and physically active population and can result in instability, meniscal tears, and articular cartilage damage. The aim of this study is to evaluate the accuracy of Lachman and anterior drawer test in ACL injury in compare with arthroscopy.   Methods: In a descriptive, analytical study from 2009 to 2013, 653 patients who were suspected to ACL rapture were entered the study. Statistical analysis was performed by the usage of SPSS 19.0. Multiple comparison procedure was performed for comparing data between clinical examination and arthroscopic findings and their relation with age and sex. Results: Mean age of patients was 28.3±7.58 years (range from 16 to 68 years. From 428 patients, 41.2% (175 patients were between 26 and 35, 38.8% (165 ones between 15 and 25 and 20% (85 patients over 36 years. 414 patients were male (97.2% and 12 were female (2.8%. Sensitivity of anterior drawer test was 94.4% and sensitivity of Lachman test was 93.5%. Conclusion: The diagnosis and decision to reconstruct ACL injury can be reliably made regard to the anterior drawer and Lachman tests result. The tests did not have privilege to each other. These test accuracy increased considerably under anesthesia especially in women.

  20. Efficacy of labral repair, biceps tenodesis, and diagnostic arthroscopy for SLAP Lesions of the shoulder: a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Mowinckel Petter

    2010-10-01

    Full Text Available Abstract Background Surgery for type II SLAP (superior labral anterior posterior lesions of the shoulder is a promising but unproven treatment. The procedures include labral repair or biceps tenodesis. Retrospective cohort studies have suggested that the benefits of tenodesis include pain relief and improved function, and higher patient satisfaction, which was reported in a prospective non-randomised study. There have been no completed randomised controlled trials of surgery for type II SLAP lesions. The aims of this participant and observer blinded randomised placebo-controlled trial are to compare the short-term (6 months and long-term (2 years efficacy of labral repair, biceps tenodesis, and placebo (diagnostic arthroscopy for alleviating pain and improving function for type II SLAP lesions. Methods/Design A double-blind randomised controlled trial are performed using 120 patients, aged 18 to 60 years, with a history for type II SLAP lesions and clinical signs suggesting type II SLAP lesion, which were documented by MR arthrography and arthroscopy. Exclusion criteria include patients who have previously undergone operations for SLAP lesions or recurrent shoulder dislocations, and ruptures of the rotator cuff or biceps tendon. Outcomes will be assessed at baseline, three, six, 12, and 24 months. Primary outcome measures will be the clinical Rowe Score (1988-version and the Western Ontario Instability Index (WOSI at six and 24 months. Secondary outcome measures will include the Shoulder Instability Questionnaire (SIQ, the generic EuroQol (EQ-5 D and EQ-VAS, return to work and previous sports activity, complications, and the number of reoperations. Discussion The results of this trial will be of international importance and the results will be translatable into clinical practice. Trial Registration [ClinicalTrials.gov NCT00586742

  1. MRI of the lateral ankle ligaments: value of three-dimensional orientation

    International Nuclear Information System (INIS)

    Purpose: To determine the three-dimensional orientation of the lateral ankle ligaments with MRI. Materials and Methods: Twenty healthy volunteers without previous injury to the ankle were included in the study. With the right ankle in the normal anatomic position stabilized in a splint, coronal T2-weighted spin-echo sequences (TSE) were obtained. The three-dimensional orientation was determined by placing paths through the ligaments and by measuring the angles between corresponding tangents and the three main imaging planes. Results: Using the calculated angles, full-length visualization of the lateral ligaments of the ankle was achieved. The angles deviating from the axial imaging plane were 18.0 degrees for the anterior talofibular ligament, 52.3 degrees for the calcaneofibular ligament and 28.2 degrees for the posterior talofibular ligament. Conclusion: MRI enables the exact determination of the three-dimensional orientation of the lateral ankle ligaments. Orienting the imaging planes according to the calculated angular deviation allows the full-length visualization of the ligaments and is the basis for optimal imaging of the lateral ankle ligaments. (orig.)

  2. Posterior Ankle Structure Injury During Total Ankle Replacement.

    Science.gov (United States)

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

    2016-01-01

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

  3. Posterior Ankle Structure Injury During Total Ankle Replacement.

    Science.gov (United States)

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

    2016-01-01

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

  4. Long term outcomes of inversion ankle injuries

    OpenAIRE

    Anandacoomarasamy, A; Barnsley, L; Grujic, L

    2005-01-01

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

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

    OpenAIRE

    Lee, Sun-Min; Lee, Jung-Hoon

    2016-01-01

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

  6. MR imaging of the anterior intermeniscal ligament: classification according to insertion sites

    Energy Technology Data Exchange (ETDEWEB)

    Aydingoez, Uestuen; Kaya, Ayten [Department of Radiology, Hacettepe University Medical Center, Ankara (Turkey); Atay, Ahmet Oe.; Doral, Nedim M. [Department of Orthopaedics and Traumatology, Hacettepe University Medical Center, Ankara (Turkey); Oeztuerk, Halil M. [Department of Radiology, SSK Ankara Hospital, Ankara (Turkey)

    2002-04-01

    Our objective was to study the frequency of anterior intermeniscal ligament on MR imaging and to make a classification according to its insertion sites on MR images. Sagittal T1-weighted and thin-section transverse T2*-weighted MR images of the knee were prospectively evaluated in 229 subjects without significant synovial effusion or total rupture of the anterior cruciate ligament. By using thin-section transverse images, the ligament was classified into three types according to its insertion sites (type A: between anterior horns of medial and lateral menisci; type B: between anterior horn of medial meniscus and anterior margin of lateral meniscus; type C: between anterior margins of medial and lateral menisci). On sagittal images location of the ligament was determined with respect to a line drawn between anterior of the tibial epiphysis and posterior of the intercondylar notch to look for a relation between its type on transverse images and location on sagittal images. Separately, arthroscopy was made in 36 patients to verify the MR assessment of the presence of the ligament. Anterior intermeniscal ligament was found in 53% of the subjects. Type B was the most common group (58%). Magnetic resonance imaging has a sensitivity and a specificity of 67 and 100%, respectively, in the detection of the ligament. Types A and C had a statistically significant location posterior and anterior, respectively, to the master line on sagittal images. In arthroscopy, the ligament was either cord-like (67%) or flat (33%) in appearance. Routine sagittal MR images can help identify anterior intermeniscal ligament. (orig.)

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

    Science.gov (United States)

    Lee, Sun-Min; Lee, Jung-Hoon

    2016-01-01

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

  8. Osteoligamentous injuries of the medial ankle joint

    OpenAIRE

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

    2015-01-01

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

  9. Rehabilitation of Syndesmotic (High) Ankle Sprains

    OpenAIRE

    Williams, Glenn N; Allen, Eric J.

    2010-01-01

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

  10. Radiographer led supplementary anterior cruciate ligament MRI sequences: Technical report

    International Nuclear Information System (INIS)

    Aims: To compare different supplementary MRI sequences of the ACL to arthroscopy and determine the diagnostic performance of each sequence. To ascertain whether radiographers could identify patients requiring supplementary MRI sequences of anterior cruciate ligament (ACL) tears, without a supervising radiologist. Methods: The study had ethical approval and two hundred and thirty one consecutive prospective MRI patients with mechanical knee symptoms (77 females, 154 males, of mean age 43.5, range 18–82 years) gave written informed consent. They then had a knee arthroscopy within seven days of the MRI. This was a pragmatic study to see if the six general MRI radiographers, each with over four years experience, could evaluate the ACL on routine orthogonal sequences (sagittal T1, Gradient Echo T2, Coronal STIR and axial fat suppressed dual echo). If they identified no ACL, then two 3D volume sequences (Dual Echo Steady State and Fast Low Angle Shot) and 2D limited sagittal oblique T1 sequences were also performed. Patients requiring extra sequences, missed by the radiographers, were recalled. The MRI sequences were independently evaluated in a blinded fashion by two consultant radiologists and a specialist radiology registrar and compared to the subsequent knee arthroscopy, as the gold standard, to determine the diagnostic performance statistics. Results: The cohort was on the knee arthroscopy weighting list and comprised 205 patients with chronic, 20 acute and 6 acute on chronic mechanical knee symptoms. There were no posterior cruciate, medial, or lateral collateral ligament tears at arthroscopy, used as the gold standard. The arthroscopy was normal and the radiographers correctly did not scan the extra sequence in 140 patients (72%) who then had normal arthroscopies. The radiographers did perform additional ACL sequences in 63 patients (27%). Of these, 10 patients had a partial and 12 complete ACL tears. Only two patients (0.9%) were recalled for additional

  11. 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…

  12. 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

  13. Interventions for treating chronic ankle instability

    NARCIS (Netherlands)

    J.S. de Vries; R. Krips; I.N. Sierevelt; L. Blankevoort; C.N. van Dijk

    2011-01-01

    Chronic lateral ankle instability occurs in 10% to 20% of people after an acute ankle sprain. Initial treatment is conservative but if this fails and ligament laxity is present, surgical intervention is considered. To compare different treatments, conservative or surgical, for chronic lateral ankle

  14. [Minimally invasive treatment of tibial plateau fracture under arthroscopy monitoring].

    Science.gov (United States)

    Chen, Lixin; Ma, Shaoyun; Li, Xianpeng

    2014-05-01

    Twenty six patients with fracture of tibial plateau was under arthroscopy assisted reduction, the joint surface of bone graft, and USES the steel plate fixation treatment. Average surgery time was 65 min (70-120 min), average fracture healing time was 15 weeks (12-17 weeks), joint surface anatomical reattachment rate was 92.9%. Using break knee function criteria evaluation of curative effect: 18 cases great 6 cases wed, 2 cases ok, fine rate was 92.3%. No infection, deep venous thrombosis and small leg fascia chamber syndrome and other complications. Conclusion is that treatment of tibial plateau fractures under arthroscope has advantages of small trauma, check intuitively and reset accurately, functional recovery of patients are satisfied, the treatment has certain clinical application value. PMID:25241526

  15. Knee arthroscopy and exercise versus exercise only for chronic patellofemoral pain syndrome: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Seitsalo Seppo

    2007-12-01

    Full Text Available Abstract Background Arthroscopy is often used to treat patients with chronic patellofemoral pain syndrome (PFPS. As there is a lack of evidence, we conducted a randomized controlled trial to study the efficacy of arthroscopy in patients with chronic PFPS. Methods A total of 56 patients with chronic PFPS were randomized into two treatment groups: an arthroscopy group (N = 28, treated with knee arthroscopy and an 8-week home exercise program, and a control group (N = 28, treated with the 8-week home exercise program only. The arthroscopy included finding-specific surgical procedures according to current recommendations. The primary outcome was the Kujala score on patellofemoral pain and function at 9 months following randomization. Secondary outcomes were visual analog scales (VASs to assess activity-related symptoms. We also estimated the direct healthcare costs. Results Both groups showed marked improvement during the follow-up. The mean improvement in the Kujala score was 12.9 (95% confidence interval (CI 8.2–17.6 in the arthroscopy group and 11.4 (95% CI 6.9–15.8 in the control group. However, there was no difference between the groups in mean improvement in the Kujala score (group difference 1.1 (95% CI -7.4 - 5.2 or in any of the VAS scores. Total direct healthcare costs in the arthroscopy group were estimated to exceed on average those of the control group by €901 per patient (p Conclusion In this controlled trial involving patients with chronic PFPS, the outcome when arthroscopy was used in addition to a home exercise program was no better than when the home exercise program was used alone. Trial registration Current Controlled Trials ISRCTN 41800323

  16. Elbow arthroscopy: a new setup to avoid visual paradox and improve triangulation.

    Science.gov (United States)

    Sinha, Apurv; Pydah, Satya Kanth V; Webb, Mark

    2013-05-01

    Elbow arthroscopy is a useful diagnostic and therapeutic tool for various conditions. Conventional arthroscopy with the patient in the prone or lateral position where the screen is placed on the opposite side makes it difficult to interpret the image, results in visual paradox, and is associated with difficult triangulation. We present a modified setup for the operating room to help eliminate these problems and improve triangulation.

  17. [Rupture of the quadriceps tendon after lateral retinaculum release by arthroscopy].

    Science.gov (United States)

    Trobisch, P D; Baumann, M; Weise, K; Fischer, R

    2010-06-01

    Complications after arthroscopic surgery of the knee joint are infrequent. Quadriceps tendon ruptures after knee arthroscopy are rarities. Only two cases have been published in the medical literature. This article presents a case of a quadriceps tendon rupture that occurred in a 19-year-old patient 5 weeks after lateral release of the retinaculum by arthroscopy. The late occurrence differentiates this case from the other previously published cases.

  18. Contribution of thin slice (1 mm) oblique coronal proton density-weighted MR images for assessment of anteromedial and posterolateral bundle damage in anterior cruciate ligament injuries

    International Nuclear Information System (INIS)

    Purpose: To evaluate the diagnostic efficacy of using additional oblique coronal 1 mm proton density-weighted (PDW) MR imaging of the knee for detection and grading anterior cruciate ligament (ACL), anteromedial bundle (AMB) and posterolateral bundle (PLB) injuries. Materials and methods: We prospectively assessed preoperative MR images of 50 patients (36 men, 14 women; age range, 18–62 years). First, we compared the diagnostic performance of routine sagittal (3 mm) and additional oblique coronal images (1 mm) for ACL tears. Then, we compared the tear types (AMB or PLB) and grade presumed from oblique coronal MR imaging with arthroscopy. Results: Arthroscopy revealed ACL tear in 24 (48%) patients. There was significant difference between sagittal images and arthroscopy results for ACL tear recognition (p 0.05). Conclusion: Addition of thin slice oblique coronal images to conventional sequences could better contribute to better verifying the presence of ACL tear and in determining its grade

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

    Science.gov (United States)

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

    2014-03-01

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

  20. MR for assessing anterior cruciate ligament reconstructions by tendon grafts

    International Nuclear Information System (INIS)

    150 patients were examined via magnetic resonance (MR) after anterior cruciate (ACL) ligament reconstruction (76 patellar tendon grafts, 53 semitendinosous tendon grafts and 21 sutures). The results of MR were compared with clinical tests (Lachman, pivot-shift and anterior drawer test), in 2 cases with the operative findings, and in one case with arthroscopy findings. In 91% of patients with a clinically stable knee we found a continuous low-intensity ligamental structure. 10 patients were examined twice or more between 8 days and 6 months after surgery. Ligamental structures of low signal intensity did not significantly change their MR characteristics. MR is a valuable noninvasive method for evaluating ligament reconstructions. (orig./GDG)

  1. Syndesmotic ankle sprains in athletes.

    Science.gov (United States)

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

    2007-07-01

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

  2. Arthrography of the ankle joint

    Energy Technology Data Exchange (ETDEWEB)

    Crespi Porro, R.; Zellner, A.; Puricelli, G.; Quaglia, R.; Chelazzi, G.

    1984-02-01

    Arthrography of the ankle joint was first carried out by Johnson and Palmer at the Military Hospital in Stockholm in 1940. Arthrography can be used for judging the integrity of the articular cartilage, of osteochondritis dissecans, arthritis or adhesive capsulitis. The literature shows, however, that more than 95% of the patients on whom this examination has been performed has suffered from acute trauma.

  3. Anatomy and arthrokinematics of the human ankle and intertarsal joints

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-03-15

    The diagnosis of lateral collateral ankle ligament trauma is based on patient history, clinical examination and clinical stress tests. If the clinical stress test is positive, stress radiography can be performed. There is, however, no consensus about the usefulness of stress radiography in acute ankle sprain, and in particular about the cut-off talar tilt angle beyond which a two-ligament rupture would be certain, ranging from 5 to 30 . Today, magnetic resonance imaging (MRI) is not used in this area, although it does allow controlled positioning of the foot and defined section visualization of injured lateral collateral ankle ligaments. In acute and chronic sinus tarsi injuries, MRI forms the established basis for diagnostic imaging, and can provide a definitive answer in most cases. MRI is also the method of choice for chronic posttraumatic pain with anterolateral impingement after rupture of the anterior talofibular ligament. Generally, for the evaluation of acute ankle injuries, MRI has developed to be the most important second-step procedure when projection radiology is non-diagnostic. (orig.) [German] Die Diagnose einer lateralen Bandverletzung nach einem Sprunggelenktrauma basiert auf der Anamnese, der klinischen Untersuchung und klinischen Stresstests. Bei positiven klinischen Stresstests kann eine Stressradiographie durchgefuehrt werden. Es gibt keine Uebereinstimmung hinsichtlich des Stellenwerts der Stressradiographie beim frischen Supinationstrauma des Sprunggelenks, insbesondere fuer den Winkel der Aufklappbarkeit bei einer Zweibandverletzung, der von 5 -30 reicht. Die MRT wird bei dieser Indikation zurzeit nur in Einzelfaellen benutzt, obwohl sie mit definierter Fusspositionierung und Ausrichtung der Untersuchungsebene eine ausgezeichnete Beurteilung der Sprunggelenkbaender erlaubt. Sie ist im besonderen Masse geeignet, akute und chronische Verletzungen des Sinus tarsi zu beurteilen. Bei chronischen Beschwerden nach Bandverletzung ist die MRT zur

  5. Three-dimensional analysis of injured lateral ligaments of the ankle with FISP MR imaging

    International Nuclear Information System (INIS)

    In a series of 150 acutely injured or chronically unstable ankles, oblique reconstructions of the anterior talo-fibular (TFA) and calcaneo-fibular (CF) ligaments were performed. Fast three-dimensional (3D) imaging with a flip angle of 40 degrees, a TR/TE of 30/10 msec, and 128 1-mm-thick sections allowed the evaluation of the whole ankle joint in 16 minutes. Partial or complete ruptures of TFA and/or CF ligaments as well as associated bone or cartilage occult fractures are detected. The authors discuss how, by enabling assessment of the severity of ankle sprains, 3D imaging was found to be helpful in defining when surgical therapy was necessary

  6. Contribution of thin slice (1 mm) oblique coronal proton density-weighted MR images for assessment of anteromedial and posterolateral bundle damage in anterior cruciate ligament injuries

    Energy Technology Data Exchange (ETDEWEB)

    Gokalp, Gokhan, E-mail: drgokhangokalp@yahoo.com [Department of Radiology, Uludag University Medical Faculty, Gorukle, Bursa (Turkey); Demirag, Burak, E-mail: bdemirag@uludag.edu.tr [Department of Orthopedy, Uludag University Medical Faculty, Gorukle, Bursa (Turkey); Nas, Omer Fatih, E-mail: omerfatihnas@gmail.com [Department of Radiology, Uludag University Medical Faculty, Gorukle, Bursa (Turkey); Aydemir, Mehmet Fatih, E-mail: fatiha@yahoo.com [Department of Orthopedy, Uludag University Medical Faculty, Gorukle, Bursa (Turkey); Yazici, Zeynep, E-mail: zyazici@uludag.edu.tr [Department of Radiology, Uludag University Medical Faculty, Gorukle, Bursa (Turkey)

    2012-09-15

    Purpose: To evaluate the diagnostic efficacy of using additional oblique coronal 1 mm proton density-weighted (PDW) MR imaging of the knee for detection and grading anterior cruciate ligament (ACL), anteromedial bundle (AMB) and posterolateral bundle (PLB) injuries. Materials and methods: We prospectively assessed preoperative MR images of 50 patients (36 men, 14 women; age range, 18–62 years). First, we compared the diagnostic performance of routine sagittal (3 mm) and additional oblique coronal images (1 mm) for ACL tears. Then, we compared the tear types (AMB or PLB) and grade presumed from oblique coronal MR imaging with arthroscopy. Results: Arthroscopy revealed ACL tear in 24 (48%) patients. There was significant difference between sagittal images and arthroscopy results for ACL tear recognition (p < 0.001). No significant difference was detected for oblique coronal images when compared with arthroscopy results (p = 0.180). Sensitivity and specificity values for ACL tear diagnosis were 37.04% and 95.65% for sagittal images; 74.07% and 91.30% for oblique coronal images. There was no significant difference between arthroscopy and oblique coronal MR images in grading AMB and PLB injuries (p > 0.05). Conclusion: Addition of thin slice oblique coronal images to conventional sequences could better contribute to better verifying the presence of ACL tear and in determining its grade.

  7. Grade III injuries of the lateral ligaments of the ankle: the incidence and a simple stress test.

    OpenAIRE

    Muwanga, C L; Hellier, M; Quinton, D N; Sloan, J P; Dove, A F

    1986-01-01

    One hundred and seventy-five consecutive acute ankle injuries were assessed for instability. A simplified radiological anterior stress test, without anaesthesia, was used to assess instability. Nineteen patients (11%) showed evidence of gross instability (Grade III injuries). This is recommended as a simple screening test.

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

    OpenAIRE

    Lee, Sun-Min; Lee, Jung-Hoon

    2015-01-01

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

  9. Anatomy of the ankle ligaments: a pictorial essay

    NARCIS (Netherlands)

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

    2010-01-01

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

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

    OpenAIRE

    Kuznetsov, Vitali

    2013-01-01

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

  11. A systematic review on ankle injury and ankle sprain in sports.

    Science.gov (United States)

    Fong, Daniel Tik-Pui; Hong, Youlian; Chan, Lap-Ki; Yung, Patrick Shu-Hang; Chan, Kai-Ming

    2007-01-01

    This article systematically reviews epidemiological studies on sports injury from 1977 to 2005 in which ankle injury was included. A total of 227 studies reporting injury pattern in 70 sports from 38 countries were included. A total of 201,600 patients were included, with 32,509 ankle injuries. Ankle injury information was available from 14,098 patients, with 11 847 ankle sprains. Results show that the ankle was the most common injured body site in 24 of 70 included sports, especially in aeroball, wall climbing, indoor volleyball, mountaineering, netball and field events in track and field. Ankle sprain was the major ankle injury in 33 of 43 sports, especially in Australian football, field hockey, handball, orienteering, scooter and squash. In sports injuries throughout the countries studied, the ankle was the second most common injured body site after the knee, and ankle sprain was the most common type of ankle injury. The incidence of ankle injury and ankle sprain was high in court games and team sports, such as rugby, soccer, volleyball, handball and basketball. This systematic review provides a summary of the epidemiology of ankle injury in sports. PMID:17190537

  12. Artroscopia do quadril em atletas Hip arthroscopy in athletes

    Directory of Open Access Journals (Sweden)

    Giancarlo Cavalli Polesello

    2009-02-01

    Full Text Available OBJETIVO: Confirmar a importância terapêutica da artroscopia do quadril em atletas cuja dor impede a função desportiva da articulação do quadril, sendo capaz de minimizá-la a ponto de ajudar o retorno à atividade esportiva em níveis satisfatórios. MÉTODOS: Foram analisados 49 pacientes que praticam esporte (51 quadris, submetidos à artroscopia do quadril que apresentavam dor e incapacidade para a prática esportiva. O seguimento mínimo foi de 12 meses e o máximo de 74 meses (média de 39,0 meses. No período pré-operatório avaliou-se a localização da dor, sua intensidade segundo a Escala de Expressão Facial (EEF e o grau de incapacidade utilizando-se o critério de Harris Hip Score modificado (HHS. Anotaram-se diferentes diagnósticos que levaram à indicação da artroscopia, como impacto femoroacetabular, lesão do lábio acetabular não secundária ao impacto femoroacetabular e outros. No período pós-operatório, os pacientes foram avaliados pelos mesmos métodos do período pré-operatório e pela análise subjetiva de retorno ao esporte. RESULTADOS: Baseando-se no HHS e EEF pré e pós-operatórios, a análise estatística mostrou significância entre os valores. Observou-se alguma melhora em todos os casos e retorno ao esporte, de forma satisfatória, na maioria deles. CONCLUSÃO: Diante do que foi estudado, confirmamos que a artroscopia em atletas com lesões localizadas no quadril é técnica eficaz, capaz de promover o retorno à prática esportiva na maioria dos casos, sem dor e com função articular efetiva, desde que bem indicada.OBJECTIVE: To confirm the therapeutic importance of hip arthroplasty in athletes whose pain precludes sportive function of the hip joint, being able to minimize it to the extent of helping on the return of sports practice at satisfactory levels. METHODS: 49 athlete patients (51 hips submitted to hip arthroscopy complaining of pain and inability to practice sports were assessed. Follow

  13. Failure to restore sagittal tibiotalar alignment in total ankle arthroplasty: Its relationship to the axis of the tibia and the positioning of the talar component.

    Science.gov (United States)

    Cho, J; Yi, Y; Ahn, T K; Choi, H J; Park, C H; Chun, D I; Lee, J S; Lee, W C

    2015-11-01

    The purpose of this study was to evaluate the change in sagittal tibiotalar alignment after total ankle arthroplasty (TAA) for osteoarthritis and to investigate factors affecting the restoration of alignment. This retrospective study included 119 patients (120 ankles) who underwent three component TAA using the Hintegra prosthesis. A total of 63 ankles had anterior displacement of the talus before surgery (group A), 49 had alignment in the normal range (group B), and eight had posterior displacement of the talus (group C). Ankles in group A were further sub-divided into those in whom normal alignment was restored following TAA (41 ankles) and those with persistent displacement (22 ankles). Radiographic and clinical results were assessed. Pre-operatively, the alignment in group A was significantly more varus than that in group B, and the posterior slope of the tibial plafond was greater (p < 0.01 in both cases). The posterior slope of the tibial component was strongly associated with restoration of alignment: ankles in which the alignment was restored had significantly less posterior slope (p < 0.001). An anteriorly translated talus was restored to a normal position after TAA in most patients. We suggest that surgeons performing TAA using the Hintegra prosthesis should aim to insert the tibial component at close to 90° relative to the axis of the tibia, hence reducing posterior soft-tissue tension and allowing restoration of normal tibiotalar alignment following surgery.

  14. Clinical results of anatomical reconstruction of the lateral ligaments for chronic ankle instability%小切口解剖重建踝关节外侧韧带复合体治疗慢性外踝不稳的临床疗效

    Institute of Scientific and Technical Information of China (English)

    张磊; 李智尧; 刘劲松; 孙晋; 马佳; 张晟; 刘晓华

    2012-01-01

    an average age of 24 years (15 to 35 years). The duration of the disease ranged from 7 to 10 years,averaged 10 months. The main symptom was repeated ankle sprain. During physical examination, ankle varus and the anterior talar transition were conducted. There was (12.5 ±3.2)° more inversion activity than the contralateral ankle. Arthroscopy was performed for the chondral injury,and anatomic reconstruction of the lateral ligament with an autologous gracilis tendon graft was performed for lateral instability of the ankle. Clinical and radiological evaluations were performed before surgery and at the most recent follow-up. Results: All the patients with successful surgery,there was no fracture or infection. All the patients were followed up,and the duration ranged from 16 to 60 months,with an average of 28 months. There was no ankle instability or limited mobility of the 29 cases at the latest follow-up. According to the American Orthopedic Foot and Ankle Society ankle-hind foot scale, the mean score was 48.0± 6.7 before surgery and 92.8±6.2 at the most recent follow-up (P=0.010). The talar tilt angles on standard stress radiography were (12.5±3.2)° before surgery and (2.5±0.8)° at the most recent follow-up (P=0.012). The mean distance of anterior talar translation was (16.3±4.0) mm before surgery and (3.5±0.8) mm at the most recent follow-up (P=0.002). There were no severe complications, the results were satisfactory. Conclusion: Anatomical reconstruction of the lateral ligament with autologous gracilis tendon graft for the treatment of chronic lateral instability of the ankle can be recommended.

  15. 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.

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

    International Nuclear Information System (INIS)

    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

  17. How to sprain your ankle - a biomechanical case report of an inversion trauma.

    Science.gov (United States)

    Gehring, D; Wissler, S; Mornieux, G; Gollhofer, A

    2013-01-01

    In order to develop preventive measures against lateral ankle sprains, it is essential to have a detailed understanding of the injury mechanism. Under laboratory experimental conditions the examination of the joint load has to be restricted with clear margins of safety. However, in the present case one athlete sprained his ankle while performing a run-and-cut movement during a biomechanical research experiment. 3D kinematics, kinetics, and muscle activity of the lower limb were recorded and compared to 16 previously performed trials. Motion patterns of global pelvis orientation, hip flexion, and knee flexion in the sprain trail deviated from the reference trials already early in the preparatory phase before ground contact. During ground contact, the ankle was rapidly plantar flexed (up to 1240°/s), inverted (up to 1290°/s) and internally rotated (up to 580°/s) reaching its maximum displacement within the first 150 ms after heel strike. Rapid neuromuscular activation bursts of the m. tibialis anterior and the m. peroneus longus started 40-45 ms after ground contact and overshot the activation profile of the reference trials with peak activation at 62 ms and 74 ms respectively. Therefore, it may be suggested that neuromuscular reflexes played an important role in joint control during the critical phase of excessive ankle displacement. The results of this case report clearly indicate that (a) upper leg mechanics, (b) pre-landing adjustments, and (c) neuromuscular contribution have to be considered in the mechanism of lateral ankle sprains. PMID:23078945

  18. Traumatic rupture of the tibialis anterior tendon: A case report

    Directory of Open Access Journals (Sweden)

    Maria Elisa Rodrigues

    2013-06-01

    Full Text Available OBJECTIVE: The autors report a case of a traumatic rupture of the tibialis anterior tendon (TTA that was early diagnosed and treated in the emergency service. This is a rare clinical entity with few cases reported in the literature. CASE REPORT: A 66-year old female presented at the emergency service complaining about pain at the anterior aspect of her ankle and inability to walk normally, after a fall. Physical examination revealed clinical signs for TTA rupture, which was later confirmed by ultrasound. Surgical treatment was performed immediately â€" the tendon was anchored into the medial cuneiform with a soft tissue-to-bone anchor. The follow-up revealed good functional result. CONCLUSION: Physical examination and a high index of suspicion are important when facing a patient who had sustained an ankle trauma. The TTA rupture is a diagnosis to consider because unrecognized ruptures led to important functional deficits and poor functional results.

  19. Difference in balance measures between patients with chronic ankle instability and patients after an acute ankle inversion trauma

    NARCIS (Netherlands)

    J.S. de Vries; I. Kingma; L. Blankevoort; C.N. van Dijk

    2010-01-01

    Neuromuscular control of the ankle is disturbed in patients with chronic ankle instability due to an initial ankle inversion trauma. Static balance is assumed to be a measure for this disturbance. Functional (ankle) scores are another way to evaluate ankle impairment. The hypothesis was that there i

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

    OpenAIRE

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

    2005-01-01

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

  1. Modulation of recurrent inhibition from knee extensors to ankle motoneurones during human walking

    DEFF Research Database (Denmark)

    Lamy, Jean-Charles; Iglesias, Caroline; Lackmy, Alexandra;

    2008-01-01

    times in the gait cycle, when quadriceps (Quad) muscle activity overlaps that in tibialis anterior (TA) and soleus (Sol). The effects of femoral nerve stimulation on ankle motoneurones were investigated during treadmill walking and during tonic co-contraction of Quad and TA/Sol while standing. Recurrent...... could be implicated in the transition phases, from swing to stance to assist Sol activation during the stance phase, and from stance to swing, for its deactivation....

  2. Intraarticular Entrapment of Os Subfibulare Following a Severe Inversion Injury of the Ankle: A Case Report

    OpenAIRE

    Kose, Ozkan; Kilicaslan, Omer Faruk; Guler, Ferhat; Aktan, Cemil

    2015-01-01

    Introduction: Anterior Talofibular Ligament (ATFL) rupture is the most commonly injured anatomic structure in lateral ankle sprain. In some cases, ATFL avulsion fracture from the lateral malleolus may occur instead of purely ligamentous injuries. The ATFL avulsion fracture is detected as a small ossicle at the tip of lateral malleolus on direct radiographs, which is called os subfibulare in chronic cases. Case Presentation: Severe displacement of this ossicle to the tibiotalar joint space is ...

  3. Movement adjustments in preparation for single-leg jumps in individuals with functional ankle instability.

    Science.gov (United States)

    Nunes, Guilherme S; de Noronha, Marcos; Wageck, Bruna; Scirea, Juliana Bonetti; Haupenthal, Alessandro; Michaelsen, Stella Maris

    2016-10-01

    There is some evidence showing that people with functional ankle instability (FAI) can present changes in postural control during the landing phase of a jump. These studies also show preliminary results indicating possible changes during phases prior to landing. Therefore, the objective of this study was to investigate whether movement adjustments prior to a jump are different between people with and without FAI. Sixty participants with (n=30) and without (n=30) FAI participated in this study. The main outcome measures were the variability of range of motion in ankle inversion/eversion and dorsiflexion/plantarflexion; and variability of center of pressure for the directions anterior-posterior and medio-lateral during the pre-jump period for drop jump, vertical jump and during single-leg stance. The group with instability showed more variability of center of pressure in anterior-posterior direction (p=0.04) and variability of range of motion in ankle dorsiflexion/plantar flexion (p=0.04) compared to control in the single-leg stance test. For the within-group comparisons, the group with instability showed more variability of center of pressure in anterior-posterior direction in the drop jump higher than single-leg stance and vertical jump. The same pattern was seen for the control group. Thus, this study suggests that people with FAI have greater ankle range of motion variability and center of pressure variability in the anterior-posterior axis when compared to healthy individuals during single-leg stance. For those same two variables, preparation for a drop jump causes more postural instability when compared to the preparation for a vertical jump and to single-leg stance. PMID:27543811

  4. Effect of isotonic and isokinetic exercise on muscle activity and balance of the ankle joint

    OpenAIRE

    Kim, Mi-Kyoung; Yoo, Kyung-Tae

    2015-01-01

    [Purpose] This study was performed to examine how the balance of lower limbs and the muscle activities of the tibialis anterior (TA), the medial gastrocnemius (GCM), and the peroneus longus (PL) are influenced by isotonic and isokinetic exercise of the ankle joint. [Subjects] The subjects of this study were healthy adults (n=20), and they were divided into two groups (isotonic=10, isokinetic=10). [Methods] Isotonic group performed 3 sets of 10 contractions at 50% of MVIC and Isokinetic group ...

  5. Hydrocolonotherapy ankle joints after injuries

    Directory of Open Access Journals (Sweden)

    Volodymyr Muchin

    2016-02-01

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

  6. 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.

  7. Hydrocolonotherapy ankle joints after injuries

    OpenAIRE

    Volodymyr Muchin; Oleksandr Zviriaka

    2016-01-01

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

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

    OpenAIRE

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

    2008-01-01

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

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

    OpenAIRE

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

    2014-01-01

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

  10. Quality and Quantity of the Elbow Arthroscopy Literature: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Erickson, Brandon J; Chalmers, Peter N; Cvetanovich, Gregory L; Frank, Rachel M; Romeo, Anthony A; Harris, Joshua D

    2016-01-01

    The purpose of this article is to perform a systematic review and meta-analysis of elbow arthroscopy literature to answer the following questions: "Across the world, what demographic of patients are undergoing elbow arthroscopy, what are the most common indications for elbow arthroscopy, and how good is the evidence?" The authors hypothesized that patients who undergo elbow arthroscopy will be chiefly age evidence regarding elbow arthroscopy will be poor. Also, no significant differences will exist in elbow arthroscopy publications, subjects, outcomes, and techniques based on continent/country of publication. A systematic review was registered with the International Prospective Register of Ongoing Systematic Reviews (PROSPERO) and performed with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using 3 publicly available databases. Therapeutic clinical outcome investigations reporting arthroscopic elbow outcomes with levels of evidence I-IV were eligible for inclusion. All study, subject, and surgical technique demographics were analyzed and compared between continents and countries. Statistics were calculated using 1-way analysis of variance (ANOVA) to compare between continents and Pearson's correlation coefficients to evaluate changes over time. In total, 112 studies were included (3093 subjects; 3168 elbows; 64% male; mean 34.9 ± 14.68 years. Mean 33.4 ± 26.02 months follow-up. Most studies were level IV evidence (94.6%) and had a low Modified Coleman Methodology Score (MCMS) (mean 28.1 ± 8.06). From 1985 through 2013, the number of publications significantly increased with time (P = .004) in all continents. The 3 most common indications for elbow arthroscopy were osteochondritis dissecans (OCD), lateral epicondylitis, and release and débridement. The number of reported cases for the 3 most common indications significantly increased over time but did not differ between regions (P > .05 in all cases). Thirty-two studies

  11. Three-dimensional magnetic resonance imaging for ruptures of the lateral ligaments of the ankle

    International Nuclear Information System (INIS)

    The accuracy has been determined of three-dimensional MRI in visualizing the anterior talofibular and the calcaneofibular ligament in young athletes with an acute severe sprain of the lateral ligaments of the ankle by comparing these findings with those found at operation and evaluating three-dimensional fast imaging with steady state precession (3D FISP) as a diagnostic aid to operative planning for tears of both the anterior talofibular and the calcaneofibular ligament in younger competitive athletes. (author). 20 refs.; 2 figs

  12. Predicting Functional Recovery after Acute Ankle Sprain

    OpenAIRE

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

    2013-01-01

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

  13. Ankle reconstruction in type II fibular hemimelia

    OpenAIRE

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

    2012-01-01

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

  14. Glanzmann’s Thrombasthenia Diagnosed following Knee Arthroscopy

    Directory of Open Access Journals (Sweden)

    John E. Zvijac

    2015-01-01

    Full Text Available A 41-year-old man with an unremarkable medical history presented with a painful knee after a sports injury. He was diagnosed with a medial meniscal tear. Symptoms did not abate after 6 months of physical therapy, and he underwent arthroscopic partial medial meniscectomy. A week after beginning physical therapy he experienced a knee effusion, decreased ROM, and inability to flex his quadriceps. His knee was aspirated. Blood tests were ordered and his complete blood count, liver functions tests, and INR/PTT were normal. The patient had recurrent effusions requiring three additional joint aspirations. Ten weeks after the initial surgery, the patient underwent a second arthroscopy, during which a hematoma was removed and a synovectomy performed. The patient continued bleeding from the incisions after portals were sutured, and he was admitted to the hospital. A hematologist was consulted and comprehensive platelet aggregation testing revealed previously undiagnosed Glanzmann’s thrombasthenia. The patient began treatment with platelet infusions and desmopressin and progressed to a full recovery. Clinical suspicion for surgical patients with unusual repetitive postoperative bleeding should include previously undetected rare bleeding disorders even in adults.

  15. Retrograde interlocking intramedullary nailing under arthroscopy for supracondylar femoral fracture

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To evaluate the therapeutic effects of retrograde interlocking intramedullary nailing under arthroscopy on supracondylar femoral fractures.   Methods: From June 1999 to December 2000, 17 patients with supracondylar femoral fracture were treated with arthroscopically assisted implantation of retrograde interlocking intramedullary nail and close reduction.   Results: More than 6-month follow-up study after operation in 11 patients revealed that the average healing time was 3 months. Average range of the knee motion for all the patients was more than 90 degrees. There was no implant breakage and infection.   Conclusions: This new method, combining the advantage of arthroscope and retrograde interlocking intramedullary nail, can provide a stable and reliable fixation, and meanwhile is less invasive to the soft tissue and knee, less operative time and blood loss, minimal disruption of the blood supply in fracture site. It is conducive to the fracture healing and the functional recovery of the knee joint and worthwhile to be recommended.

  16. Find an Orthopaedic Foot and Ankle MD/DO

    Science.gov (United States)

    ... page. Home Contact Us FootCareMD Currently selected About Us Overview of Foot & Ankle Glossary of Foot & Ankle Terms Adult Foot Health ... Map American Orthopaedic Foot & Ankle Society ® Orthopaedic Foot ... US) Copyright © 2016 All Rights Reserved

  17. How to Stretch Your Ankle After a Sprain

    Science.gov (United States)

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

  18. Diagnostic Efficiency of MR Imaging of the Knee. Relationship to time Interval between MR and Arthroscopy

    International Nuclear Information System (INIS)

    To evaluate the efficiency of magnetic resonance (MR) in the diagnosis of knee lesions and how the results are influenced by the time interval between MR and arthroscopy. 248 knees studied by MR were retrospectively analyzed, as well as those which also underwent arthroscopy. Arthroscopy was considered to be the gold standard, MR diagnostic capacity was evaluated for both meniscal and cruciate ligament lesions. Sensitivity, specificity and Kappa index were calculated for the set of all knees included in the study (248), for those in which the time between MR and arthroscopy was less than or equal to three months (134) and for those in which the time between both procedures was less than or equal to one month. Sensitivity, specificity and Kappa index of the MR had global values of 96.5%, 70% and 71%, respectively. When the interval between MR and arthroscopy was less than or equal to three months, sensitivity, specificity and Kappa index were 95.5%, 75% and 72%, respectively. When it was less than or equal to one month, sensitivity was 100%, specificity was 87.5% and Kappa index was 91%. MR is an excellent tool for the diagnosis of knee lesions. Higher MR values of sensitivity, specificity and Kappa index are obtained when the time interval between both procedures is kept to a minimum. (Author) 11 refs

  19. Evaluation of the symptomatic supraspinatus tendon - a comparison of ultrasound and arthroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Venu, K.M.; Howlett, D.C.; Garikipati, R.; Anderson, H.J.; Bonnici, A.V

    2002-11-01

    Purpose: A prospective study was undertaken to determine the accuracy of ultrasound compared with arthroscopy in the evaluation of the symptomatic supraspinatus tendon, and to identify whether ultrasound diagnosis was helpful in pre-operative planning. Methods: A total of 276 consecutive patients with shoulder impingement symptoms underwent ultrasound examination of the supraspinatus tendon. Of these patients, 41 proceeded to open or arthroscopic surgical procedure on clinical grounds, and in this group direct comparison with ultrasound findings was made. Results: There was full correlation between ultrasound and arthroscopy in the diagnosis of a normal supraspinatus tendon, full-thickness tear, tendinopathy and tendon rupture. There was some discrepancy between the two techniques. Two patients with partial thickness tear on ultrasound had a full thickness tear at arthroscopy. Ultrasound was able to identify intra-substance partial thickness tears in three patients with supraspinatus tendon said to be normal at arthroscopy. Ultrasound helped plan the surgical approach and operative time needed in cases of supraspinatus tendon rupture and full thickness tear. Conclusion: In this study ultrasound was effective in the evaluation of the symptomatic supraspinatus tendon, and was also able to diagnose intra-tendinous lesions not visible at arthroscopy.

  20. Evaluation of the symptomatic supraspinatus tendon - a comparison of ultrasound and arthroscopy

    International Nuclear Information System (INIS)

    Purpose: A prospective study was undertaken to determine the accuracy of ultrasound compared with arthroscopy in the evaluation of the symptomatic supraspinatus tendon, and to identify whether ultrasound diagnosis was helpful in pre-operative planning. Methods: A total of 276 consecutive patients with shoulder impingement symptoms underwent ultrasound examination of the supraspinatus tendon. Of these patients, 41 proceeded to open or arthroscopic surgical procedure on clinical grounds, and in this group direct comparison with ultrasound findings was made. Results: There was full correlation between ultrasound and arthroscopy in the diagnosis of a normal supraspinatus tendon, full-thickness tear, tendinopathy and tendon rupture. There was some discrepancy between the two techniques. Two patients with partial thickness tear on ultrasound had a full thickness tear at arthroscopy. Ultrasound was able to identify intra-substance partial thickness tears in three patients with supraspinatus tendon said to be normal at arthroscopy. Ultrasound helped plan the surgical approach and operative time needed in cases of supraspinatus tendon rupture and full thickness tear. Conclusion: In this study ultrasound was effective in the evaluation of the symptomatic supraspinatus tendon, and was also able to diagnose intra-tendinous lesions not visible at arthroscopy

  1. Chronic ankle instability: evaluation with stress radiography, CT and CT arthrography

    International Nuclear Information System (INIS)

    We retrospectively evaluated the anterior talo-fibular ligament and the tarsal sinus of 17 patients who had complained of chronic ankle external instability. This study based on both surgery and CT-arthrography findings shows the pathologic or normal aspects of the talo-fibular anterior ligament (normal, lax, fibrosis residue, ruptured). It confirms the good anatomic analysis of the tarsal sinus, i particular the anterior talo-calcaneal interosseous ligament and the search for fibrosis. We underline that capsular distension due to subtalar laxity is not detected with medical imaging. Compared with surgery (all patients), CT arthrography demonstrated the different aspects of the anterior talo fibular ligament injuries (normal, lax, discontinuous). (authors)

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

    Science.gov (United States)

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

    2016-01-01

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

  3. Surgical treatment of the arthritic varus ankle.

    Science.gov (United States)

    Easley, Mark E

    2012-12-01

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

  4. 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.

  5. 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.

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

    OpenAIRE

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

    2010-01-01

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

  7. Low incidence of deep vein thrombosis after knee arthroscopy without thromboprophylaxis - A prospective cohort study of 335 patients

    NARCIS (Netherlands)

    M.R. Hoppener; H.B. Ettema; C.P. Henny; C.C.P.M. Verheyen; H.R. Buller

    2006-01-01

    Background There is little data on the risk of deep vein thrombosis after knee arthroscopy. Patients and methods We performed a prospective cohort study to establish the incidence of venous thrombo-embolic (VTE) complications after knee arthroscopy in daycare, as detected by bilateral complete compr

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

    Science.gov (United States)

    Lynch, S A; Renström, P A

    1999-01-01

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

  9. Anterior process calcaneal fractures: a systematic evaluation of associated conditions

    Energy Technology Data Exchange (ETDEWEB)

    Petrover, David [NYU Hospital for Joint Disease, Radiology Department, New York, NY (United States); Hopital Beaujon, Service de Radiologie, Paris (France); Schweitzer, Mark E. [NYU Hospital for Joint Disease, Radiology Department, New York, NY (United States); Laredo, J.D. [Hopital Lariboisiere, Service de Radiologie, Paris (France)

    2007-07-15

    The objective was to evaluate the association, by MRI, of anterior calcaneal process fractures with tarsal coalitions, ankle sprains, and bifurcate ligament abnormalities. A retrospective review of 1,479 foot and ankle MR images was performed, over a period of 5 years, for isolated anterior process fractures of the calcaneus. Fifteen 1.5-T MR examinations were systematically evaluated by two radiologists in consensus. Marrow edema patterns, presence of a calcaneonavicular coalition, as well as bifurcate and anterior talofibular ligaments, were evaluated. There were 15 fractures of the anterior calcaneal process with an incidence of 1%. The average patient age was 51 years (range 25-82). Twelve patients were women and 3 were men. The majority of the fractures (14 out of 15) presented as an edema pattern on T2-weighted images, either diffuse (9 out of 15), or vertical (5 out of 15). One case did not show marrow edema, but rather a hypointense line. Nine patients (60%) demonstrated calcaneonavicular coalition and anterior calcaneal process fracture. In 6 patients (50%) the anterior talofibular ligament (ATFL) was thickened. Three patients did not have axial images, and were classified as non-conclusive for the ATFL evaluation. The bifurcate ligament was thickened with hyperintense signal demonstrating a sprain in 9 out of 13 (69%). Only 2 patients (16.5%) had an anterior calcaneal process fracture without any associated abnormality. We believe that there is a probable association of anterior process fractures and calcaneonavicular coalitions. We also feel, based on our results and the prior literature that there is likely also an association with both ATFL injuries and bifurcate ligament injuries. (orig.)

  10. Anterior process calcaneal fractures: a systematic evaluation of associated conditions

    International Nuclear Information System (INIS)

    The objective was to evaluate the association, by MRI, of anterior calcaneal process fractures with tarsal coalitions, ankle sprains, and bifurcate ligament abnormalities. A retrospective review of 1,479 foot and ankle MR images was performed, over a period of 5 years, for isolated anterior process fractures of the calcaneus. Fifteen 1.5-T MR examinations were systematically evaluated by two radiologists in consensus. Marrow edema patterns, presence of a calcaneonavicular coalition, as well as bifurcate and anterior talofibular ligaments, were evaluated. There were 15 fractures of the anterior calcaneal process with an incidence of 1%. The average patient age was 51 years (range 25-82). Twelve patients were women and 3 were men. The majority of the fractures (14 out of 15) presented as an edema pattern on T2-weighted images, either diffuse (9 out of 15), or vertical (5 out of 15). One case did not show marrow edema, but rather a hypointense line. Nine patients (60%) demonstrated calcaneonavicular coalition and anterior calcaneal process fracture. In 6 patients (50%) the anterior talofibular ligament (ATFL) was thickened. Three patients did not have axial images, and were classified as non-conclusive for the ATFL evaluation. The bifurcate ligament was thickened with hyperintense signal demonstrating a sprain in 9 out of 13 (69%). Only 2 patients (16.5%) had an anterior calcaneal process fracture without any associated abnormality. We believe that there is a probable association of anterior process fractures and calcaneonavicular coalitions. We also feel, based on our results and the prior literature that there is likely also an association with both ATFL injuries and bifurcate ligament injuries. (orig.)

  11. Development and validation of a computer-based learning module for wrist arthroscopy.

    Science.gov (United States)

    Obdeijn, M C; Alewijnse, J V; Mathoulin, C; Liverneaux, P; Tuijthof, G J M; Schijven, M P

    2014-04-01

    The objective of this study was to develop and validate a computer-based module for wrist arthroscopy to which a group of experts could consent. The need for such a module was assessed with members of the European Wrist Arthroscopy Society (EWAS). The computer-based module was developed through several rounds of consulting experts on the content. The module's learning enhancement was tested in a randomized controlled trial with 28 medical students who were assigned to the computer-based module group or lecture group. The design process led to a useful tool, which is supported by a panel of experts. Although the computer based module did not enhance learning, the participants did find the module more pleasant to use. Developing learning tools such as this computer-based module can improve the teaching of wrist arthroscopy skills.

  12. Testing Basic Competency in Knee Arthroscopy Using a Virtual Reality Simulator

    DEFF Research Database (Denmark)

    Jacobsen, Mads Emil; Andersen, Morten Jon; Hansen, Claus Ol;

    2015-01-01

    was set at a total z-score of 15.5 points, resulting in two of the novices passing the test and a single experienced surgeon failing the test. CONCLUSIONS: By combining four procedures on a virtual reality arthroscopy simulator, it was possible to create a valid, reliable, and feasible test of basic......BACKGROUND: Diagnostic knee arthroscopy is a common procedure that orthopaedic residents are expected to learn early in their training. Arthroscopy requires a different skill set from traditional open surgery, and many orthopaedic residents feel less prepared for arthroscopic procedures. Virtual...... reality simulation training and testing provide an opportunity to ensure basic competency before proceeding to supervised procedures in patients. METHODS: Twenty-six physicians (thirteen novices and thirteen experienced arthroscopic surgeons) were voluntarily recruited to perform a test consisting of five...

  13. Optimizing the Use of an Artificial Tongue-Placed Tactile Biofeedback for Improving Ankle Joint Position Sense in Humans

    CERN Document Server

    Vuillerme, N; Fleury, A; Demongeot, J; Payan, Y; Vuillerme, Nicolas; Chenu, Olivier; Fleury, Anthony; Demongeot, Jacques; Payan, Yohan

    2006-01-01

    The performance of an artificial tongue-placed tactile biofeedback device for improving ankle joint position sense was assessed in 12 young healthy adults using an active matching task. The underlying principle of this system consists of supplying individuals with supplementary information about the position of the matching ankle relative to the reference ankle position through a tongue-placed tactile output device generating electrotactile stimulation on a 36-point (6 X 6) matrix held against the surface of the tongue dorsum. Precisely, (1) no electrodes were activated when both ankles were in a similar angular position within a predetermined "angular dead zone" (ADZ); (2) 12 electrodes (2 X 6) of the anterior and posterior zones of the matrix were activated (corresponding to the stimulation of the front and rear portion of the tongue) when the matching ankle was in a too plantarflexed and dorsiflexed position relative to the reference ankle, respectively. Two ADZ values of 0.5° and 1.5° were...

  14. [Anterior dislocation of the fibula resulting from surgical malreduction: a case report].

    Science.gov (United States)

    Wang, Z Y; Wu, X B

    2016-04-18

    Ankle joint fracture is one of the most common types of fracture. There are many researches on the injury mechanism, treatment principles and surgical techniques. A type of injury which combines posterior dislocation of fibula, known as the Bosworth injury, is relatively rare. In 1947, Bosworth first described this type of injury as an unusual ankle fracture dislocation with fixed posterior fracture dislocation of the distal part of the fibula. In this type of fracture, the proximal fibular shaft fragment locks behind the tibialis posterior tubercle. This rare ankle fracture variant is often not recognized in initial radiographs and requires a computed tomographic (CT) scan for verification. But there are already many reports, discussing the injury mechanism, treatment principles and surgical techniques. However, there are few reports of anterior dislocation of the fibula, caused by either injury or surgery. The mechanism of the injury is still not clear. This article reports a case of anterior dislocation of the fibula. We report a patient with left ankle open fracture (Lauge-Hansen pronation-external rotation stage III, Gustilo IIIA). Open reduction and internal fixation was done in the initial surgery, but ended up with poor reduction, resulting in fibula anterior dislocation, anterior dislocation of talus and tibia fibular dislocation. The fibula was dislocated anteriorly of the tibia, which rarely happened. The patient suffered severe ankle joint dysfunction. The second operation took out the original internal fixation, reduced the fracture, and reset the internal fixation. The function of ankle joint was improved obviously after operation. But because of the initial injury and the two operations, the soft tissue around the fracture was greatly damaged. 6 months after the second operation, and the fracture still not healed, so the bone graft was carried out in the third surgery. Two months after the third surgery, the function of the ankle was significantly

  15. Editorial Commentary: Role of Synovial Biomarkers in Patient Outcomes After Knee Arthroscopy.

    Science.gov (United States)

    Brand, Jefferson C

    2016-03-01

    Humans are notably poor at predicting event outcomes. In "Correlation of Synovial Fluid Biomarkers With Cartilage Pathology and Associated Outcomes in Knee Arthroscopy," Cuellar, Cuellar, Kirsch, and Strauss show that some synovial fluid biomarkers (20 were sampled for the investigation) may predict operative findings at the time of arthroscopy and patient-reported outcome measures at follow-up. Further research will clarify the role of synovial biomarkers in knee pathology and, hopefully, narrow the choices to one or two pertinent markers that can be used to improve our ability to predict outcomes from arthroscopic knee surgery.

  16. Arthroscopy of the temporomandibular joint. Examination of 2 patients with suspected disk derangement.

    Science.gov (United States)

    Hellsing, G; Holmlund, A; Nordenram, A; Wredmark, T

    1984-02-01

    2 patients with a history of reciprocal temporomandibular joint (TMJ) clicking were visually examined with arthroscopy of their right side TMJs. Clinical and radiographic examination revealed no signs of arthrosis deformans. One patient with significantly reduced opening ability combined with occasional disappearance of TMJ clicks showed advanced arthrotic changes of cartilage which were not visible radiographically. The other patient with unimpaired function also had a severe arthrotic lesion in the clicking joint. In neither case did the disk appear to be displaced. It is concluded that arthroscopy yields additional information for TMJ diagnosis which cannot be achieved by clinical and radiographic examination alone.

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

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

  18. Artroscopia diagnóstica e terapêutica em pacientes sintomáticos pós-artroplastia do joelho Diagnostic and therapeutic arthroscopy in symptomatic patients after knee arthroplasty

    Directory of Open Access Journals (Sweden)

    Fabricio Roberto Severino

    2009-01-01

    Full Text Available OBJETIVOS: Verificar o valor da artroscopia na investigação e no tratamento da dor no joelho pós-artroplastia não esclarecida por exames clínicos e subsidiários. MÉTODOS: Entre 402 pacientes submetidos à artroplastia total ou unicompartimental de setembro de 2001 a abril de 2007 num hospital universitário público, 17 deles apresentavam dor na articulação protética, sem diagnóstico clínico, radiográfico, laboratorial, cintilográfico ou por ressonância nuclear magnética. Todos foram submetidos à artroscopia e a sintomatologia foi avaliada pela escala de Lysholm, comparando-se os períodos pré e pós-artroscopia. Os achados intraoperatórios foram registrados. RESULTADOS: O procedimento foi eficaz para alívio do sintoma doloroso em 14 dos 17 pacientes (82,35%. A mediana do escore de Lysholm subiu de 36 pontos antes da artroscopia para 94 pontos após (p OBJECTIVES: Assess the worthiness of arthroscopy in investigating and treating knee pain after arthroplasty unexplained by clinical and subsidiary examinations. METHODS: Among 402 patients submitted to total or unicompartimental arthroplasty between September 2001 and April 2007 at a public university hospital, 17 presented with pain on prosthetic articulation, without clear diagnosis by clinical, X-ray, laboratory, scintiscan, or nuclear magnetic resonance tests. All patients were submitted to arthroscopy and symptoms were assessed by using the Lysholm scale, comparing pre- and post-arthroscopy periods. Peroperative findings have been recorded. RESULTS: The procedure was effective for pain relief in 14 of 17 patients (82.35%. The median for Lysholm scale climbed from 36 points before arthroscopy to 94 points after the procedure (p < 0.001. Most of the patients (12 were arthroscopically diagnosed with fibrosis known as "cyclop"; on the remaining five patients, anterior synovitis was found. All patients were treated by resection. CONCLUSIONS: Knee arthroscopy after arthroplasty

  19. 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.

  20. Clinical and Arthroscopic Findings of Acute Anterior Cruciate Ligament Tears of the Knee

    Directory of Open Access Journals (Sweden)

    Kenji Shirakura

    1995-01-01

    Full Text Available Clinical, arthrographic, and arthroscopic findings in 53 patients with acutely torn anterior cruciate ligaments (ACLs were documented. Arthroscopy and instability tests under anesthesia were performed on all patients within 2 weeks after the initial injury. Twenty-three patients complained of extension blocks, and localized tenderness on the medial side was revealed in 26 patients at the initial examination. Aspiration from joints exhibited hemarthrosis in 52 patients. Arthroscopy revealed ACL ruptures in all patients. Four Segond's fractures, 26 meniscus tears (8 medial and 18 lateral, 1 osteochondral fracture, and 19 medial collateral ligament ruptures were revealed. Arthroscopy detected only 1 of the 5 ruptures of the posteromedial corner of the medial meniscus, which were noted on arthrography. Three ACL stumps were protruding among the femorotibial joint, which seemed to be restricting full extension. Statistical analysis showed that tenderness on the medial side was not revealed more frequently in knees with medial collateral ligament injuries than in the others. The volume of aspirated fluids in knees with no leakage in arthrography significantly increased over those with leakages (p < 0.05. Diagnosis of ACL injuries should be completed by clinical, arthrographic, and arthroscopic examinations.

  1. Mucoid degeneration of the anterior cruciate ligament mistaken for ligamentous tears

    Energy Technology Data Exchange (ETDEWEB)

    McIntyre, J. [San Francisco Magnetic Resonance Center, CA (United States); Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH (United States); Moelleken, S.; Tirman, P. [San Francisco Magnetic Resonance Center, CA (United States)

    2001-06-01

    Objective. To describe the MR features of mucoid degeneration of the anterior cruciate ligament (ACL) in a series of patients with MRI findings that were mistaken for tears in the majority of cases but who were found to have an intact ligament at arthroscopy. We will suggest a pathologic entity corresponding to this finding and describe some characteristic features that can be used to identify this entity on MRI.Design. A retrospective analysis of 10 MRI examinations of the knee was performed after arthroscopic evaluation. Prearthroscopic MRI findings had been interpreted as a tear in six patients prospectively and in the remaining four the diagnosis of mucoid degeneration was suggested and ultimately proven. All patients had an intact ACL by preoperative clinical examination, examination under anesthesia, and at arthroscopy.Results. MRI examinations demonstrated an ill-defined ACL, greater in girth than the normal ligament and characterized by increased signal on all sequences. The high-signal ligament was oriented in the normal direction of the ACL. The overall appearance of the ligament was retrospectively described as like a celery stalk. Arthroscopy demonstrated mechanically intact ligaments with a normal to expanded external appearance. Probing of three of the ligaments caused a material to be expressed and pathologic evaluation resulted in the diagnosis of cystic, mucoid degeneration.Conclusion. Mucoid degeneration and an intact ACL can be suspected when an apparently thickened and ill-defined ligament with increased signal intensity on all sequences is identified in a patient with a clinically intact ligament. (orig.)

  2. 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.

  3. Chinese Massage Therapy for Ankle Injury

    Institute of Scientific and Technical Information of China (English)

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

    2003-01-01

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

  4. Ankle and shoulder joint reconstruction using soft tissue allografts

    International Nuclear Information System (INIS)

    Full text: Lateral Collateral Ligament Insufficiency is a common complication of injury to the ankle joint. This needs reconstruction of the torn ligament as the joint instability gives rise to frequent giving way at the ankle joint. It can be reconstructed using autologous peroneus brevis tendon. The authors prefer to reconstruct using deep frozen (-80 degree C) non-gamma irradiated tibialis anterior or tibialis posterior tendon allograft procured by NUH Tissue Bank. The graft must be at least between 18-22 cm long. The procedure employed is a first stage Brostrom Procedure repairing the anterior talo-fibula ligament using Mitek sutures. In the second stage the Calcaneofibular ligament is reconstructed using a figure of eight tendon reconstruction via drill holes in the fibular above and the calcaneum below. Twelve cases have been reconstructed this way with good results. When injury is sustained to the Acromia-clavicular (AC) Joint, for type 3 to 5 AC Joint Dislocation and in manual labourers, reconstruction is needed. The author's preferred method is a 2 stage procedure using deep frozen (-80 degree C), non gamma-irradiated fascia lata allografts procured by NUH Tissue Bank. In the first stage the dislocated AC Joint is reduced and held in position by transfixation using 2 baby Steinmann Pins and repair of torn corac clavicular ligaments. The second stage consisted of reconstruction with rolled-up fascia lata figure of eight allograft tendon between the clavicle and the coracoid process. The 2 pins are removed after 6 weeks and the shoulder mobilised. 10 cases have been done with good results. Two cases showed mild subluxation of the AC joint due to slight loss of the reduction performed during the operation. (Author)

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

    Science.gov (United States)

    Gross, Michael T; Liu, Hsin-Yi

    2003-10-01

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

  6. Absence of sensory function in the reconstructed anterior cruciate ligament

    DEFF Research Database (Denmark)

    Krogsgaard, Michael R; Fischer-Rasmussen, Torsten; Dyhre-Poulsen, Poul

    2011-01-01

    Cruciate ligaments provide sensory information that cause excitatory as well as inhibitory effects to the activity of the muscles around the knee. The aim of the study was to determine whether these muscular reflexes are reestablished after anterior cruciate ligament (ACL) re-construction. Wire...... electrodes were inserted during arthroscopy into the normal posterior cruciate ligament (PCL) and the reconstructed ACL in 11 patients who had a successful ACL re-construction 8 months to 12 years earlier. After the anesthesia had subsided, the PCL was stimulated electrically through the electrodes...... and the sensory threshold was determined. Stimulus amplitudes were increased to 1.5-2.0 times the sensory threshold, and inhibitory reflexes could be elicited from PCL in the quadriceps during active extension and in the hamstrings muscles during active flexion in all patients. Subsequently the ACL re-constructions...

  7. Ultrasound arthroscopy of human knee cartilage and subchondral bone in vivo.

    Science.gov (United States)

    Liukkonen, Jukka; Lehenkari, Petri; Hirvasniemi, Jukka; Joukainen, Antti; Virén, Tuomas; Saarakkala, Simo; Nieminen, Miika T; Jurvelin, Jukka S; Töyräs, Juha

    2014-09-01

    Arthroscopic ultrasound imaging enables quantitative evaluation of articular cartilage. However, the potential of this technique for evaluation of subchondral bone has not been investigated in vivo. In this study, we address this issue in clinical arthroscopy of the human knee (n = 11) by determining quantitative ultrasound (9 MHz) reflection and backscattering parameters for cartilage and subchondral bone. Furthermore, in each knee, seven anatomical sites were graded using the International Cartilage Repair Society (ICRS) system based on (i) conventional arthroscopy and (ii) ultrasound images acquired in arthroscopy with a miniature transducer. Ultrasound enabled visualization of articular cartilage and subchondral bone. ICRS grades based on ultrasound images were higher (p < 0.05) than those based on conventional arthroscopy. The higher ultrasound-based ICRS grades were expected as ultrasound reveals additional information on, for example, the relative depth of the lesion. In line with previous literature, ultrasound reflection and scattering in cartilage varied significantly (p < 0.05) along the ICRS scale. However, no significant correlation between ultrasound parameters and structure or density of subchondral bone could be demonstrated. To conclude, arthroscopic ultrasound imaging had a significant effect on clinical grading of cartilage, and it was found to provide quantitative information on cartilage. The lack of correlation between the ultrasound parameters and bone properties may be related to lesser bone change or excessive attenuation in overlying cartilage and insufficient power of the applied miniature transducer. PMID:25023111

  8. Prospective, double-blind comparison of shoulder MR imaging, US, arthrography, and arthroscopy

    International Nuclear Information System (INIS)

    To determine the efficacy of diagnostic imaging modalities in the evaluation of shoulder pain, magnetic resonance (MR) imaging, ultrasonography (US) and arthrography were prospectively compared in a double-blind experimental protocol. Thirty consecutive patients were studied by these modalities, which received separate, blinded interpretations. The images and interpretations were sealed in an envelope and blinded from the arthroscopist for initial arthroscopy, but second-look arthroscopy, and in some cases open surgery, was performed after the envelopes were unsealed. To avoid selection bias, negative MR and/or US examinations never affected confirmation by arthrography and/or arthroscopy, so negatives and positives were equivalently tested. To date, MR imaging and US are equally sensitive in the detection of rotator cuff tears, but the combination is more sensitive. Both MR imaging and US demonstrated tears not diagnosed by means of arthrography, and MR imaging distinguished hemorrhagic muscle tears from rotator cuff tears, which arthrography and arthroscopy did not. Both MR imaging and US showed characteristic appearances of biceps tendonitis, but neither demonstrated adhesive capsulitis. The authors conclude that all three imaging modalities have a role in shoulder diagnosis

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

    OpenAIRE

    Wilson, Erin Lawall

    2005-01-01

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

  10. MRI of anterior cruciate ligament healing

    Energy Technology Data Exchange (ETDEWEB)

    Ihara, Hidetoshi; Miwa, Megumi; Deya, Keizo; Torisu, Kenji [Kyushu Rosai Hospital, Kitakyushu (Japan)

    1996-03-01

    The purpose of this study was to evaluate using MRI the natural healing of the anterior cruciate ligament (ACL) when treated conservatively by early protective motion. Consecutive acute complete intraligamentous ruptures of the ACL in 50 cases that were allowed to heal without surgery were evaluated before and after 3 month treatment by MRI, arthroscopy, and stress radiographs. Twenty-nine of the 50 patients were also reevaluated 11 months from the initial injury, of which 7 were reevaluated again 24 months from the initial injury by MRI. The MR appearance of the treated ACL was categorized into four grades depending on homogeneity, straight band, and size. MR assessment of the ACL after 3 month treatment demonstrated a well defined normal-sized straight band in 37 cases (74%). There was a significant relationship between the 3 and 11 month MR evaluations (r. = 0.801, p < 0.0001). There were also significant relationships between the MR and arthroscopic evaluations (r, = 0.455, p < 0.005) and between the MR and stress radiographic evaluations (r, = 0.348, p < 0.025) after the 3 month treatment. MRI can demonstrate ACL healing when treated conservatively with early protective mobilization. 40 refs., 3 figs., 2 tabs.

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

    Science.gov (United States)

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

    2016-02-01

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

  12. 踝关节骨关节炎治疗方法的临床回顾%Clinical review of treatment of ankle joint osteoarthritis

    Institute of Scientific and Technical Information of China (English)

    王玉光; 陆芸

    2016-01-01

    Ankle osteoarthritis is a common disease of which the incidence was lower than hip or knee osteoarthritis;however , the patients are progressively increasing .Treatments traditionally consist of the measures relieving pain such as analgesia , physiotherapy , and injections .Operative fusion of the ankle is required for the mid and late phases of the ankle osteoarthritis .Rerecently, interest has increased in ankle arthroscopy and new arthroplasty designs .This is a review of the treatment methods and research progress of ankle joint osteoarthritis .%踝关节骨关节炎在临床中是很常见的慢性退行性疾病,其发病率要低于膝关节骨关节炎与髋关节骨关节炎,然而,在临床中发现患者数在逐年增多。许多传统的治疗方法仅仅能够缓解其引起的疼痛等临床症状,例如,热敷理疗、药物关节内注射等等。虽然踝关节融合术是治疗中晚期踝关节骨关节炎的首选手术方式,但近年来,关节镜技术以及踝关节置换术的日渐成熟也给踝关节骨关节炎带来了新的思路。本文对有关踝关节骨关节炎的治疗进展进行综述。

  13. Effects of Preventative Ankle Taping on Planned Change-of-Direction and Reactive Agility Performance and Ankle Muscle Activity in Basketballers

    Science.gov (United States)

    Jeffriess, Matthew D.; Schultz, Adrian B.; McGann, Tye S.; Callaghan, Samuel J.; Lockie, Robert G.

    2015-01-01

    This study investigated the effects of preventative ankle taping on planned change-of-direction and reactive agility performance and peak ankle muscle activity in basketballers. Twenty male basketballers (age = 22.30 ± 3.97 years; height = 1.84 ± 0.09 meters; body mass = 85.96 ± 11.88 kilograms) with no ankle pathologies attended two testing sessions. Within each session, subjects completed six planned and six reactive randomized trials (three to the left and three to the right for each condition) of the Y-shaped agility test, which was recorded by timing lights. In one session, subjects had both ankles un-taped. In the other, both ankles were taped using a modified subtalar sling. Peak tibialis anterior, peroneus longus (PL), peroneus brevis (PB), and soleus muscle activity was recorded for both the inside and outside legs across stance phase during the directional change, which was normalized against 10-meter sprint muscle activity (nEMG). Both the inside and outside cut legs during the change-of-direction step were investigated. Repeated measures ANOVA determined performance time and nEMG differences between un-taped and taped conditions. There were no differences in planned change-of-direction or reactive agility times between the conditions. Inside cut leg PL nEMG decreased when taped for the planned left, reactive left, and reactive right cuts (p = 0.01). Outside leg PB and soleus nEMG increased during the taped planned left cut (p = 0.02). There were no other nEMG changes during the cuts with taping. Taping did not affect change-of-direction or agility performance. Inside leg PL activity was decreased, possibly due to the tape following the line of muscle action. This may reduce the kinetic demand for the PL during cuts. In conclusion, ankle taping did not significantly affect planned change-of-direction or reactive agility performance, and did not demonstrate large changes in activity of the muscle complex in healthy basketballers. Key points Ankle

  14. 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.

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

    Science.gov (United States)

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

    2016-09-01

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

  16. 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.

  17. Outcome of arthroscopy in patients with advanced osteoarthritis of the hip.

    Directory of Open Access Journals (Sweden)

    Sachin Daivajna

    Full Text Available Hip arthroscopy has continued to expand its horizons in treating many conditions other than femoroacetabular impingement (FAI. However, the results of hip arthroscopy are known to be poor if the degree of articular cartilage damage is significant. We wanted to assess, whether the procedure might have a role in the management of young and active patients with advanced osteoarthritis (OA and whether it should be offered as a treatment modality. 77 consecutive patients with Tönnis grade 2 and 3 osteoarthritis of the hip who had undergone hip arthroscopy were included in the study. Patients' medical notes, plain radiographs and outcome scores (modified Harris hip score (mHHS, non-arthritic hip score (NAHS preoperatively and postoperatively at six weeks, six months, one year and annually thereafter, were analysed. 77 patients consisted of 63 men and 14 women with mean follow-up of 2.8 years (2.2 to 4.2 and mean age at surgery of 43 years (19 to 64. The mean preoperative mHHS and NAHS scores were 58 (28 to 87 and 64 (27 to 93 respectively. The mean improvements in both the mHHS and NAHS scores were significant (p = 0.003 and p = 0.0001 for mHHS at one and two years, p = 0.002 and p = 0.0003 for NAHS at one and two years, respectively. There were 34 patients (44% who required a total hip replacement at mean of 18 months (6 to 48 after hip arthroscopy. We conclude that hip arthroscopy improves outcome scores in 56% of patients with severe OA of the hip (Tönnis grade 2 and 3 for at least two years after surgery. We thus consider the procedure to be a reasonable option for patients with hip OA, although success of the procedure will be less than if undertaken for certain other conditions.

  18. 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.

  19. Foot and Ankle Injuries in Runners.

    Science.gov (United States)

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

    2016-02-01

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

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

    OpenAIRE

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

    2013-01-01

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

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

    OpenAIRE

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

    2015-01-01

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

  2. Clinical Outcomes Following Revision Anterior Shoulder Stabilization

    Science.gov (United States)

    Frank, Rachel M.; Mellano, Chris; Shin, Jason J.; Feldheim, Terrence F.; Mascarenhas, Randhir; Yanke, Adam Blair; Cole, Brian J.; Nicholson, Gregory P.; Romeo, Anthony A.; Verma, Nikhil N.

    2015-01-01

    Objectives: The purpose of this study was to determine the clinical outcomes following revision anterior shoulder stabilization performed either via all-arthroscopic soft tissue repair or via Latarjet coracoid transfer. Methods: A retrospective review of prospectively collected data on 91 shoulders undergoing revision anterior shoulder stabilization was performed. All patients underwent prior soft tissue stabilization; those with prior open bone grafting procedures were excluded. For patients with 25% glenoid bone loss, Latarjet was performed (n=28). Patients were queried regarding recurrent instability (subluxation or dislocation). Clinical outcomes were evaluated using validated patient reported outcome questionnaires including the American Shoulder and Elbow Surgeons (ASES) score, Simple Shoulder Test (SST), visual analog scale (VAS) for pain, and Western Ontario Shoulder Instability Index (WOSI). Results: A total of 63 shoulders in 62 patients (46 males, 16 females) with an average age of 23.2 ± 6.9 years were included in the revision arthroscopy group. At an average follow-up of 46.9 ± 16.8 months (range, 15 to 78), the mean WOSI score was 80.1 (range, 15.0 to 100), and there were significant improvements (pLatarjet group. Thirteen (46%) had more than one previous stabilization attempt. ), the average WOSI score was 71.9, and there were significant improvements (pLatarjet. Conclusion: Both arthroscopic revision stabilization and Latarjet coracoid transfer result in satisfactory outcomes in patients who have failed previous arthroscopic capsulolabral repair. Recurrent instability rates were higher in the all-arthroscopic group (19% versus 7%). Longer-term studies are required to determine whether similar results are maintained over time, and to provide guidance on focused clinical indications for this challenging patient population.

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

    LENUS (Irish Health Repository)

    Thomason, Katherine

    2014-07-01

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

  4. Anterior labral tear: diagnostic value of MR arthrography of the shoulder

    International Nuclear Information System (INIS)

    To assess the accuracy of magnetic resonance(MR) arthrography in the diagnosis of anterior labral tear of the shoulder Between september 1996 and February 2000, MR arthrography of the shoulder was performed in 281 patients with a history of shoulder pain or instability. Among this total, only 157 shoulders in 154 patients who underwent arthroscopy or open surgery 0 to 230 (average, 20.9) days after MR arthrography were included in this study; the subjects comprised of 150 males and 4 females with an average age of 23.3 years. MR arthrographs of these 154 patients were analyzed for the presence of anterior labral tears, and the findings were correlated with the arthroscopic and surgical findings. Anterior labral tear was classified as A to D according to its location, as determined by arthroscopy and surgery. (A=4 to 6 o'clock direction, anteroinferior; B=2 to 4 o'clock direction, central; C=12 to 2 o'clock direction, anterosuperior; D= SLAP lesion). The retrospective analysis of MR arthrographs showing false-positive and negative findings was also underthken.. In the diagnosis of anterior labral tear, MR arthrography showed a sensitivity of 94%, a specificity of 90% and an accuracy of 91%. Anterior labral tears were confirmed by arthroscopy or surgery in 62 of the 157 shoulders (39%). Among 62 lesion, two (3%) were observed in area A, 32(52%) in area A+B, nine (15%) in area A+B+C, one(2%) in area A+B+D,13(21%) in area A+B+C+D, two (3%) in area B+C, one(2%) in area B+D, and two(3%) in area C. Among ten false-positive cases, seven were focal lessions (two, three and two lesions in area A, B and C, respectively), and in the remaining three cases, lacated in area A+B, MR arthrography revealed thickening and deformation. All four false negatives were focal lesions (two in area A and two in area C). Other than in focal lesions, in which accuracy was relatively low, MR arthrography showed high sensitivity, specificity and accuracy in the diagnosis of anterior labral tear

  5. Osteoarthritis of the Foot and Ankle

    Science.gov (United States)

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

  6. A novel dynamic ankle-supinating device.

    Science.gov (United States)

    Gutierrez, Gregory M; Kaminski, Thomas

    2010-02-01

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

  7. Intraarticular Entrapment of Os Subfibulare Following a Severe Inversion Injury of the Ankle: A Case Report

    Science.gov (United States)

    Kose, Ozkan; Kilicaslan, Omer Faruk; Guler, Ferhat; Aktan, Cemil

    2015-01-01

    Introduction: Anterior Talofibular Ligament (ATFL) rupture is the most commonly injured anatomic structure in lateral ankle sprain. In some cases, ATFL avulsion fracture from the lateral malleolus may occur instead of purely ligamentous injuries. The ATFL avulsion fracture is detected as a small ossicle at the tip of lateral malleolus on direct radiographs, which is called os subfibulare in chronic cases. Case Presentation: Severe displacement of this ossicle to the tibiotalar joint space is an extremely rare injury. Herein, a case of intra-articular entrapment of os subfibulare following a severe inversion injury of the ankle, which caused a diagnostic challenge was presented. Conclusions: To the best of our knowledge, this is the first case of entrapment of os subfibulare in the talotibial joint space. Fixation of the os subfibulare to lateral malleolus resulted in union and excellent functional results. PMID:26101763

  8. The diagnosis of ligament injuries of the ankle joint using pressure during exposures

    International Nuclear Information System (INIS)

    Pressure exerted against the ankle joint during lateral exposures shows a typical form of subluxation of the talus in respect of the tibia if there has been rupture of the anterior fibulo-talar ligament. This displacement can be quantified by using the standard technique of Seiler and Holzrichter. Retrospective evaluation of exposures carried out with pressure in 206 patients with stretching or rupture of the ligaments of the ankle joint have shown that stretching can be diagnosed if the joint space reaches 7 mm, and a rupture can be diagnosed with a joint space of 11 mm. If there is a difference of more than 5 mm in the joint space of the two joints, a rupture is present. With these criteria, 85% of all ligament injuries can be correctly diagnosed. In the remaining 15%, early arthrography provides the necessary information. (orig.)

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

    International Nuclear Information System (INIS)

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

  10. Tibiofibular syndesmosis in acute ankle fractures: additional value of an oblique MR image plane

    Energy Technology Data Exchange (ETDEWEB)

    Hermans, John J.; Ginai, Abida Z. [Erasmus University Medical Center, Department of Radiology, Rotterdam (Netherlands); Beumer, Annechien; Moonen, Adrianus F.C.M. [Amphia Hospital, Department of Orthopaedics, Breda (Netherlands); Hop, Wim C.J. [Erasmus University Medical Center, Department of Biostatistics, Rotterdam (Netherlands)

    2012-02-15

    To evaluate the additional value of a 45 oblique MRI scan plane for assessing the anterior and posterior distal tibiofibular syndesmotic ligaments in patients with an acute ankle fracture. Prospectively, data were collected for 44 consecutive patients with an acute ankle fracture who underwent a radiograph (AP, lateral, and mortise view) as well as an MRI in both the standard three orthogonal planes and in an additional 45 oblique plane. The fractures on the radiographs were classified according to Lauge-Hansen (LH). The anterior (ATIFL) and posterior (PTIFL) distal tibiofibular ligaments, as well as the presence of a bony avulsion in both the axial and oblique planes was evaluated on MRI. MRI findings regarding syndesmotic injury in the axial and oblique planes were compared to syndesmotic injury predicted by LH. Kappa and the agreement score were calculated to determine the interobserver agreement. The Wilcoxon signed rank test and McNemar's test were used to compare the two scan planes. The interobserver agreement ({kappa}) and agreement score [AS (%)] regarding injury of the ATIFL and PTIFL and the presence of a fibular or tibial avulsion fracture were good to excellent in both the axial and oblique image planes ({kappa} 0.61-0.92, AS 84-95%). For both ligaments the oblique image plane indicated significantly less injury than the axial plane (p < 0.001). There was no significant difference in detection of an avulsion fracture in the axial or oblique plane, neither anteriorly (p=0.50) nor posteriorly (p=1.00). With syndesmotic injury as predicted by LH as comparison, the specificity in the oblique MR plane increased for both anterior (to 86% from 7%) and posterior (to 86% from 48%) syndesmotic injury when compared to the axial plane. Our results show the additional value of an 45 oblique MR image plane for detection of injury of the anterior and posterior distal tibiofibular syndesmoses in acute ankle fractures. Findings of syndesmotic injury in the oblique

  11. Tibiofibular syndesmosis in acute ankle fractures: additional value of an oblique MR image plane

    International Nuclear Information System (INIS)

    To evaluate the additional value of a 45 oblique MRI scan plane for assessing the anterior and posterior distal tibiofibular syndesmotic ligaments in patients with an acute ankle fracture. Prospectively, data were collected for 44 consecutive patients with an acute ankle fracture who underwent a radiograph (AP, lateral, and mortise view) as well as an MRI in both the standard three orthogonal planes and in an additional 45 oblique plane. The fractures on the radiographs were classified according to Lauge-Hansen (LH). The anterior (ATIFL) and posterior (PTIFL) distal tibiofibular ligaments, as well as the presence of a bony avulsion in both the axial and oblique planes was evaluated on MRI. MRI findings regarding syndesmotic injury in the axial and oblique planes were compared to syndesmotic injury predicted by LH. Kappa and the agreement score were calculated to determine the interobserver agreement. The Wilcoxon signed rank test and McNemar's test were used to compare the two scan planes. The interobserver agreement (κ) and agreement score [AS (%)] regarding injury of the ATIFL and PTIFL and the presence of a fibular or tibial avulsion fracture were good to excellent in both the axial and oblique image planes (κ 0.61-0.92, AS 84-95%). For both ligaments the oblique image plane indicated significantly less injury than the axial plane (p < 0.001). There was no significant difference in detection of an avulsion fracture in the axial or oblique plane, neither anteriorly (p=0.50) nor posteriorly (p=1.00). With syndesmotic injury as predicted by LH as comparison, the specificity in the oblique MR plane increased for both anterior (to 86% from 7%) and posterior (to 86% from 48%) syndesmotic injury when compared to the axial plane. Our results show the additional value of an 45 oblique MR image plane for detection of injury of the anterior and posterior distal tibiofibular syndesmoses in acute ankle fractures. Findings of syndesmotic injury in the oblique MRI plane were

  12. Postoperative infection in the foot and ankle.

    LENUS (Irish Health Repository)

    Chan, Victoria O

    2012-07-01

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

  13. 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...

  14. 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

  15. Proactive and reactive neuromuscular control in subjects with chronic ankle instability: evidence from a pilot study on landing.

    Science.gov (United States)

    Levin, Oron; Vanwanseele, Benedicte; Thijsen, Jo R J; Helsen, Werner F; Staes, Filip F; Duysens, Jacques

    2015-01-01

    To understand why subjects with chronic ankle instability (CAI) have frequent sprains, one must study the preparation/reactions of these subjects to situations related to ankle inversion in real life. In the present pilot study, we examined whether subjects with CAI altered their neuromuscular control and reflex responses during and after ankle perturbations in landing. EMG signals were collected from the tibialis anterior (TA), peroneus longus (PL), medial gastrocnemius (MG), and gluteus medius (GLM) of both legs in 9 subjects with CAI and 9 subjects with intact ankles (control). A trapdoor was used to produce an ankle inversion of 25° with the left leg (control) or the affected leg (CAI) in 0%, 50% or 100% of the landing trials. As compared to controls, subjects with CAI had increased proactive activity in the contralateral side prior to touchdown during landing trials with 50% (PL) and 100% (PL and MG) chance of inversion (all, p proactive control on the contralateral side could be part of a strategy to smooth the impact of landing on the affected side in subjects with CAI. Following touchdown, the CAI group showed decreased ipsilateral short latency reflex (SLR) responses in all test conditions both in distal (PL and MG) and in proximal muscles (GLM) on the affected side (all, p strategies from controls while landing. PMID:25439444

  16. Diagnosis of knee injuries: comparison of the physical examination and magnetic resonance imaging with the findings from arthroscopy

    Directory of Open Access Journals (Sweden)

    Nilton Orlando Júnior

    2015-12-01

    Full Text Available ABSTRACT OBJECTIVES: To ascertain the sensitivity, specificity, accuracy and concordance of the physical examination (PE and magnetic resonance imaging (MRI in comparison with arthroscopy, in diagnosing knee injuries. METHODS: Prospective study on 72 patients, with evaluation and comparison of PE, MRI and arthroscopic findings, to determine the concordance, accuracy, sensitivity and specificity. RESULTS: PE showed sensitivity of 75.00%, specificity of 62.50% and accuracy of 69.44% for medial meniscal (MM lesions, while it showed sensitivity of 47.82%, specificity of 93.87% and accuracy of 79.16% for lateral meniscal (LM lesions. For anterior cruciate ligament (ACL injuries, PE showed sensitivity of 88.67%, specificity of 94.73% and accuracy of 90.27%. For MM lesions, MRI showed sensitivity of 92.50%, specificity of 62.50% and accuracy of 69.44%, while for LM injuries, it showed sensitivity of 65.00%, specificity of 88.46% and accuracy of 81.94%. For ACL injuries, MRI showed sensitivity of 86.79%, specificity of 73.68% and accuracy of 83.33%. For ACL injuries, the best concordance was with PE, while for MM and LM lesions, it was with MRI ( p < 0.001. CONCLUSIONS: Meniscal and ligament injuries can be diagnosed through careful physical examination, while requests for MRI are reserved for complex or doubtful cases. PE and MRI used together have high sensitivity for ACL and MM lesions, while for LM lesions the specificity is higher. Level of evidence II - Development of diagnostic criteria on consecutive patients (with universally applied reference "gold" standard.

  17. Assessment of Intraoperative Intra-articular Morphine and Clonidine Injection in the Acute Postoperative Period After Hip Arthroscopy

    OpenAIRE

    Cogan, Charles J.; Knesek, Michael; Tjong, Vehniah K.; Nair, Rueben; Kahlenberg, Cynthia; Dunne, Kevin F.; Mark C. Kendall; Terry, Michael A.

    2016-01-01

    Background: Previous authors have suggested that intra-articular morphine and clonidine injections after knee arthroscopy have demonstrated equivocal analgesic effect in comparison with bupivacaine while circumventing the issue of chondrotoxicity. There have been no studies evaluating the effect of intra-articular morphine after hip arthroscopy. Purpose: To evaluate the efficacy of intra-articular morphine in combination with clonidine on postoperative pain and narcotic consumption after hip ...

  18. Ankle flexibility and injury patterns in dancers.

    Science.gov (United States)

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

    1996-01-01

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

  19. 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

  20. 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

  1. Evaluation of anterior cruciate ligament ruptures by three dimension MR imaging

    International Nuclear Information System (INIS)

    Objective: To compare the diagnostic performance of conventional 2D and 3D Cube MR imaging to identify complete and partial tears of anterior cruciate ligament (ACL). Methods: Forty patients suspected of having tears of anterior cruciate ligament were prospectively studied by 3.0 T conventional 2D and 3D Cube MR imaging and arthroscopy. MR images were interpreted in consensus by two experienced radiologists, and the ACL was diagnosed as being normal, partially torn, or completely torn. Diagnostic accuracy of 2D and 3D Cube MR for the detection of both complete and partial tears of ACL was calculated using arthroscopy as the standard of reference. Area under curve (AUC) of both methods were calculated using ROC curves and were compared using Hanley and McNeil curve comparison. Results: Sixteen patients had intact ACL, 12 had complete tear, and 12 had partial tear of the ACL at arthroscopy. For complete ACL tear, AUC of 2D MR and 3D Cube was 0.839 and 0.923 respectively, and there was no significant difference on ROC curves (Z=1.245, P=0.213). For partial ACL tears, AUC of 2D and 3D Cube MR were 0.643 and 0.881 respectively, and there was significant difference on ROC curves (Z=2.384, P=0.017). Conclusions: Both 2D MR and 3D Cube MR have high sensitivity and specificity for identifying the complete ruptures of ACL. 3D Cube MRI appears to be superior identifying partial rupture of ACL. (authors)

  2. Injuries of the lateral collateral ligaments of the ankle: assessment with MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kreitner, K.F.; Ferber, A.; Grebe, P.; Thelen, M. [Department of Radiology, Johannes Gutenberg University Mainz (Germany); Runkel, M. [Department of Traumatologic and Reconstructive Surgery, Johannes Gutenberg University Mainz (Germany); Berger, S. [Department of Pediatric Surgery, Johannes Gutenberg University Mainz (Germany)

    1999-04-01

    The aim of this study was to evaluate the ability of MRI to display injuries of the lateral collateral ligamentous complex in patients with an acute ankle distorsion trauma. The MR examinations of 36 patients with ankle pain after ankle distorsion were evaluated retrospectively without knowledge of clinical history, outcome and/or operative findings. The examinations were performed on a 1.5-T whole-body imager using a flexible surface coil. The signs for ligamentous abnormality were as follows: complete or partial discontinuity, increased signal within, and irregularity and waviness of the ligament. The results were compared with operative findings in 18 patients with subsequent surgical repair. Eighteen patients with conservative therapy had a follow-up MR examination after 3 months. There was 1 sprain, 3 partial and 32 complete tears of the anterior talofibular ligament, and 5 sprains, 5 partial, and 7 complete tears of the calcaneofibular ligament. There were no lesions of the posterior talofibular ligament. Compared with surgery, MRI demonstrated in 18 of 18 cases the exact extent of anterior talofibular ligament injuries and underestimated the extent in 2 of 8 cases of calcaneofibular ligament injury. In patients with follow-up MRI after conservative therapy, a thickened band-like structure was found along the course of the injured ligament in 17 of 18 cases. The absence of ligament repair after conservative treatment was confirmed during operative revision in one case. The MRI technique allows for grading of the extent of injury of the lateral collateral ligamentous complex after acute ankle strain. It seems to be suitable for monitoring the healing process after conservative-functional treatment of ligament tears. (orig.) With 5 figs., 2 tabs., 26 refs.

  3. Injuries of the lateral collateral ligaments of the ankle: assessment with MR imaging

    International Nuclear Information System (INIS)

    The aim of this study was to evaluate the ability of MRI to display injuries of the lateral collateral ligamentous complex in patients with an acute ankle distorsion trauma. The MR examinations of 36 patients with ankle pain after ankle distorsion were evaluated retrospectively without knowledge of clinical history, outcome and/or operative findings. The examinations were performed on a 1.5-T whole-body imager using a flexible surface coil. The signs for ligamentous abnormality were as follows: complete or partial discontinuity, increased signal within, and irregularity and waviness of the ligament. The results were compared with operative findings in 18 patients with subsequent surgical repair. Eighteen patients with conservative therapy had a follow-up MR examination after 3 months. There was 1 sprain, 3 partial and 32 complete tears of the anterior talofibular ligament, and 5 sprains, 5 partial, and 7 complete tears of the calcaneofibular ligament. There were no lesions of the posterior talofibular ligament. Compared with surgery, MRI demonstrated in 18 of 18 cases the exact extent of anterior talofibular ligament injuries and underestimated the extent in 2 of 8 cases of calcaneofibular ligament injury. In patients with follow-up MRI after conservative therapy, a thickened band-like structure was found along the course of the injured ligament in 17 of 18 cases. The absence of ligament repair after conservative treatment was confirmed during operative revision in one case. The MRI technique allows for grading of the extent of injury of the lateral collateral ligamentous complex after acute ankle strain. It seems to be suitable for monitoring the healing process after conservative-functional treatment of ligament tears. (orig.)

  4. An Acute Lateral Ankle Sprain Significantly Decreases Physical Activity across the Lifespan

    Directory of Open Access Journals (Sweden)

    Tricia Hubbard-Turner, Erik A. Wikstrom, Sophie Guderian, Michael J. Turner

    2015-09-01

    Full Text Available We do not know the impact an ankle sprain has on physical activity levels across the lifespan. With the negative consequences of physical inactivity well established, understanding the effect of an ankle sprain on this outcome is critical. The objective of this study was to measure physical activity across the lifespan after a single ankle sprain in an animal model. Thirty male mice (CBA/J were randomly placed into one of three groups: the transected calcaneofibular ligament (CFL group, the transected anterior talofibular ligament (ATFL/CFL group, and a SHAM group. Three days after surgery, all of the mice were individually housed in a cage containing a solid surface running wheel. Physical activity levels were recorded and averaged every week across the mouse’s lifespan. The SHAM mice ran significantly more distance each day compared to the remaining two running groups (post hoc p = 0.011. Daily duration was different between the three running groups (p = 0.048. The SHAM mice ran significantly more minutes each day compared to the remaining two running groups (post hoc p=0.046 while the ATFL/CFL mice ran significantly less minutes each day (post hoc p = 0.028 compared to both the SHAM and CFL only group. The SHAM mice ran at a faster daily speed versus the remaining two groups of mice (post hoc p = 0.019 and the ATFL/CFL mice ran significantly slower each day compared to the SHAM and CFL group (post hoc p = 0.005. The results of this study indicate that a single ankle sprain significantly decreases physical activity across the lifespan in mice. This decrease in physical activity can potentially lead to the development of numerous chronic diseases. An ankle sprain thus has the potential to lead to significant long term health risks if not treated appropriately.

  5. Experience with peroneus brevis muscle flaps for reconstruction of distal leg and ankle defects

    Directory of Open Access Journals (Sweden)

    Babu Bajantri

    2013-01-01

    Full Text Available Objective: Peroneus brevis is a muscle in the leg which is expendable without much functional deficit. The objective of this study was to find out its usefulness in coverage of the defects of the lower leg and ankle. Patients and Methods: A retrospective analysis of the use of 39 pedicled peroneus brevis muscle flaps used for coverage of defects of the lower leg and ankle between November 2010 and December 2012 was carried out. The flaps were proximally based for defects of the lower third of the leg in 12 patients and distally based for reconstruction of defects of the ankle in 26 patients, with one patient having flaps on both ankles. Results: Partial flap loss in critical areas was found in four patients requiring further flap cover and in non-critical areas in two patients, which were managed with a skin graft. Three of the four critical losses occurred when we used it for covering defects over the medial malleolus. There was no complete flap loss in any of the patients. Conclusion: This flap has a unique vascular pattern and fails to fit into the classification of the vasculature of muscles by Mathes and Nahai. The unusual feature is an axial vessel system running down the deep aspect of the muscle and linking the perforators from the peroneal artery and anterior tibial artery, which allows it to be raised proximally or distally on a single perforator. The flap is simple to raise and safe for the reconstruction of small-to moderate-sized skin defects of the distal third of the tibia and all parts of the ankle except the medial malleolus, which is too far from the pedicle of the distally based flap. The donor site can be closed primarily to provide a linear scar. The muscle flap thins with time to provide a good result aesthetically at the primary defect.

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

    Science.gov (United States)

    Kunz, R I; Coradini, J G; Silva, L I; Bertolini, G R F; Brancalhão, R M C; Ribeiro, L F C

    2014-10-01

    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. PMID:25140815

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

    Institute of Scientific and Technical Information of China (English)

    Scott; Ross; Brent; Arnold

    2012-01-01

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

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  9. 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.

  10. 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.

  11. CONGENITAL ANTERIOR TIBIOFEMURAL SUBLUXATION

    Directory of Open Access Journals (Sweden)

    A. Shahla

    2008-06-01

    Full Text Available Congenital anterior tibiofemoral subluxation is an extremely rare disorder. All reported cases accompanied by other abnormalities and syndromes. A 16-year-old high school girl referred to us with bilateral anterior tibiofemoral subluxation as the knees were extended and reduced at more than 30 degrees flexion. Deformities were due to tightness of the iliotibial band and biceps femuris muscles and corrected by surgical release. Associated disorders included bilateral anterior shoulders dislocation, short metacarpals and metatarsals, and right calcaneuvalgus deformity.

  12. Bilateral anterior shoulder dislocation

    OpenAIRE

    Meena, Sanjay; Saini, Pramod; Singh, Vivek; Kumar, Ramakant; Trikha, Vivek

    2013-01-01

    Shoulder dislocations are the most common major joint dislocations encountered in the emergency departments. Bilateral shoulder dislocations are rare and of these, bilateral posterior shoulder dislocations are more prevalent than bilateral anterior shoulder dislocations. Bilateral anterior shoulder dislocation is very rare. We present a case of 24-year-old male who sustained bilateral anterior shoulder dislocation following minor trauma, with associated greater tuberosity fracture on one side...

  13. Intraligamentous ganglion cysts of the anterior cruciate Ligament: MR findings with clinical and arthroscopic correlations

    Energy Technology Data Exchange (ETDEWEB)

    Do-Dai, D.D.; Youngberg, R.A.; Lanchbury, F.D.; Pitcher, J.D. Jr.; Garver, T.H. [Madigan Army Medical Center, Tacoma, WA (United States)

    1996-01-01

    Magnetic resonance findings with clinical and arthroscopic correlation of intraligamentous cysts of the anterior cruciate ligament (ACL) are presented. Three cases of intraligamentous cysts of the ACL were identified out of 681 knee MRI examinations over a 2-year period. Arthroscopy and postoperative MRI were performed in all three patients, each of whom experienced knee pain with extreme flexion and extension. In all three cases the intraligamentous cyst was homogeneously hypointense on T1-weighted imaging and hyperintense on T2-weighted imaging relative to the ACL. Two of the three ACL cysts required a 70{degrees} scope for adequate visualization and establishment of posteromedial and posterolateral portals for arthroscopic treatment. One cyst could not be visualized arthroscopically and probing of the ACL from the anterior portal resulted in drainage of the cyst. No patient had presence of ACL cyst on follow-up MRI or recurrence of symptoms at a mean of 24 months. Intraligamentous cyst of ACL is a rare cause of knee pain. It should be suspected in patients having chronic pain with extremes of motion. Magnetic resonance findings are diagnostic and help to guide arthroscopy. 14 refs., 3 figs.

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

    Directory of Open Access Journals (Sweden)

    Xin Wang

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

  15. ARTHROSCOPY AND HIGH RESOLUTION ULTRASOUND CORRELATION IN INTERNAL DERANGEMENT OF KNEE: A STUDY

    Directory of Open Access Journals (Sweden)

    Timma Reddy

    2015-10-01

    Full Text Available BACK GROUND : Internal derangement of Knee is a serious injury with a high morbidity for the patient. It is imperative that this condition should be identified as early as possible and correct treatment instituted at the earliest. High resolution Ultrasound ( HRUS is a viable alternative to Arthroscopy in diagnosing this serious condition. MATERIALS & METHODS : In a prospective study we investigated internal derangement of knee (IDK with High resolution ultrasound (HRUS, in 189 patients, over a period of 4 years i.e . , from august 2011 to august 2015, in the department of Orthopedics, and Traumatology, Osmania Medical College/ Hospital, Hyderabad. Aim was to d etermine effectiveness of ultrasound in diagnosing IDK and to compare with Arthroscopy. Ultrasound showed good sensitivity (91.3% and specificity (90.6% and the figures were comparable to arthroscopic findings. CONCLUSIONS : We conclude that ultrasound is a simple, accurate, inexpensive and non - invasive way of diagnosing knee disorders with a learning curve.

  16. Dry arthroscopy with a retraction system for matrix-aided cartilage repair of patellar lesions.

    Science.gov (United States)

    Sadlik, Boguslaw; Wiewiorski, Martin

    2014-02-01

    Several commercially available cartilage repair techniques use a natural or synthetic matrix to aid cartilage regeneration (e.g., autologous matrix-induced chondrogenesis or matrix-induced cartilage implantation). However, the use of matrix-aided techniques during conventional knee joint arthroscopy under continuous irrigation is challenging. Insertion and fixation of the matrix can be complicated by the presence of fluid and the confined patellofemoral joint space with limited access to the lesion. To overcome these issues, we developed a novel arthroscopic approach for matrix-aided cartilage repair of patellar lesions. This technical note describes the use of dry arthroscopy assisted by a minimally invasive retraction system. An autologous matrix-induced chondrogenesis procedure is used to illustrate this novel approach.

  17. Arthroscopie robotisée de la hanche dans l'anatomie humaine

    OpenAIRE

    Kather, Jens

    2013-01-01

    Contexte: Les spécificités de la technologie robotique pourraient permettre d'explorer de nouvelles solutions pour l'arthroscopie de la hanche, soumise pour l'instant à quelques restrictions. Méthodes: Deux arthroscopies de la hanche ont été réalisées sur des cadavres humains avec le système chirurgical da Vinci. Une caméra robotisée et des trocarts da Vinci de 5 ou 8 mm munis d’instruments ont été introduits dans l'articulation de la hanche en vue d'une manipulation. Résultats: L'introductio...

  18. Magnetic resonance evaluation of anterior cruciate ligament repair using the patellar tendon double bone block technique

    Energy Technology Data Exchange (ETDEWEB)

    Autz, G.; Singson, R.D. (St. Luke' s Roosevelt Hospital Center, New York, NY (United States). Dept. of Radiology); Goodwin, C. (St. Luke' s Roosevelt Hospital Center, New York, NY (United States). Dept. of Orthopedics)

    1991-11-01

    The magnetic resonance (MR) appearance of the anterior cruciate ligament reconstruction was determined in 20 clinically stable and 2 clinically unstable knees for a total of 22 examinations. All patients studied had undergone knee reconstruction using the patellar tendon as graft material. The reconstructed anterior cruciate ligament varies in appearance. It appeared as a thick, well-defined, low signal band on T1- and T2-weighted sagittal and coronal images in 14 of 22 examinations. The remaining 8 knees showed a graft having one or more thin and attenuated, low signal intensity bands in the sagittal and/or coronal plane. Arthroscopy confirmed an intact but lax graft in the clinically unstable knees. (orig.).

  19. An Acute Lateral Ankle Sprain Significantly Decreases Physical Activity across the Lifespan.

    Science.gov (United States)

    Hubbard-Turner, Tricia; Wikstrom, Erik A; Guderian, Sophie; Turner, Michael J

    2015-09-01

    We do not know the impact an ankle sprain has on physical activity levels across the lifespan. With the negative consequences of physical inactivity well established, understanding the effect of an ankle sprain on this outcome is critical. The objective of this study was to measure physical activity across the lifespan after a single ankle sprain in an animal model. Thirty male mice (CBA/J) were randomly placed into one of three groups: the transected calcaneofibular ligament (CFL) group, the transected anterior talofibular ligament (ATFL)/CFL group, and a SHAM group. Three days after surgery, all of the mice were individually housed in a cage containing a solid surface running wheel. Physical activity levels were recorded and averaged every week across the mouse's lifespan. The SHAM mice ran significantly more distance each day compared to the remaining two running groups (post hoc p = 0.011). Daily duration was different between the three running groups (p = 0.048). The SHAM mice ran significantly more minutes each day compared to the remaining two running groups (post hoc p=0.046) while the ATFL/CFL mice ran significantly less minutes each day (post hoc p = 0.028) compared to both the SHAM and CFL only group. The SHAM mice ran at a faster daily speed versus the remaining two groups of mice (post hoc p = 0.019) and the ATFL/CFL mice ran significantly slower each day compared to the SHAM and CFL group (post hoc p = 0.005). The results of this study indicate that a single ankle sprain significantly decreases physical activity across the lifespan in mice. This decrease in physical activity can potentially lead to the development of numerous chronic diseases. An ankle sprain thus has the potential to lead to significant long term health risks if not treated appropriately. Key pointsA single ankle significantly decreased physical activity levels in mice across the lifespan.Decreased physical activity could significantly negatively impact overall health if not modified

  20. Ketofol for monitored anesthesia care in shoulder arthroscopy and labral repair: a case report

    OpenAIRE

    Lee KC; Shi H.; Lee BC

    2016-01-01

    Kevin C Lee,1 Hanyuan Shi,2 Brian C Lee3 1Columbia University College of Dental Medicine, New York, NY, 2Vanderbilt University School of Medicine, Nashville, TN, 3Department of Anesthesiology, Columbia University Medical Center, New York, NY, USA Abstract: A 21-year-old male (body mass index: 28.3) with a history of asthma and reactive airway disease since childhood underwent left shoulder arthroscopy and labral repair surgery under monitored anesthesia care. Because the procedure was perform...

  1. Cytokines as a predictor of clinical response following hip arthroscopy: minimum 2-year follow-up.

    Science.gov (United States)

    Shapiro, Lauren M; Safran, Marc R; Maloney, William J; Goodman, Stuart B; Huddleston, James I; Bellino, Michael J; Scuderi, Gaetano J; Abrams, Geoffrey D

    2016-08-01

    Hip arthroscopy in patients with osteoarthritis has been shown to have suboptimal outcomes. Elevated cytokine concentrations in hip synovial fluid have previously been shown to be associated with cartilage pathology. The purpose of this study was to determine whether a relationship exists between hip synovial fluid cytokine concentration and clinical outcomes at a minimum of 2 years following hip arthroscopy. Seventeen patients without radiographic evidence of osteoarthritis had synovial fluid aspirated at time of portal establishment during hip arthroscopy. Analytes included fibronectin-aggrecan complex as well as a multiplex cytokine array. Patients completed the modified Harris Hip Score, Western Ontario and McMaster Universities Arthritis Index and the International Hip Outcomes Tool pre-operatively and at a minimum of 2 years following surgery. Pre and post-operative scores were compared with a paired t-test, and the association between cytokine values and clinical outcome scores was performed with Pearson's correlation coefficient with an alpha value of 0.05 set as significant. Sixteen of seventeen patients completed 2-year follow-up questionnaires (94%). There was a significant increase in pre-operative to post-operative score for each clinical outcome measure. No statistically significant correlation was seen between any of the intra-operative cytokine values and either the 2-year follow-up scores or the change from pre-operative to final follow-up outcome values. No statistically significant associations were seen between hip synovial fluid cytokine concentrations and 2-year follow-up clinical outcome assessment scores for those undergoing hip arthroscopy.

  2. Dry Arthroscopy With a Retraction System for Matrix-Aided Cartilage Repair of Patellar Lesions

    OpenAIRE

    Sadlik, Boguslaw; Wiewiorski, Martin

    2014-01-01

    Several commercially available cartilage repair techniques use a natural or synthetic matrix to aid cartilage regeneration (e.g., autologous matrix–induced chondrogenesis or matrix-induced cartilage implantation). However, the use of matrix-aided techniques during conventional knee joint arthroscopy under continuous irrigation is challenging. Insertion and fixation of the matrix can be complicated by the presence of fluid and the confined patellofemoral joint space with limited access to the ...

  3. Role of Arthroscopy in Disorder of Knee Joints:Analysis of 30 Cases.

    Directory of Open Access Journals (Sweden)

    R.K.Gupta , Ravi Mittal

    2001-07-01

    Full Text Available Thirty cases of various disorders of knee joint were subjected to an arthroscopic examination inorder to confirm/alter the diagnosis and simultaneously correctthe pathology detected. Torn menisciand ACL tear constitured the large percentage ofcases. Partial menisectomy was the most commonlyperformed procedure accounting for 47% of cases. The superiority of arthroscopy in diagnosingand treating various disorders of knee joint was proved beyond doubt.

  4. Three tesla magnetic resonance imaging of the anterior cruciate ligament of the knee: can we differentiate complete from partial tears?

    Energy Technology Data Exchange (ETDEWEB)

    Dyck, Pieter van; Gielen, Jan L.; Parizel, Paul M. [University Hospital Antwerp and University of Antwerp, Department of Radiology, Antwerp (Edegem) (Belgium); Vanhoenacker, Filip M. [University Hospital Antwerp and University of Antwerp, Department of Radiology, Antwerp (Edegem) (Belgium); AZ St-Maarten Duffel/Mechelen, Department of Radiology, Duffel (Belgium); Dossche, Lieven; Gestel, Jozef van [University Hospital Antwerp and University of Antwerp, Department of Orthopedics, Antwerp (Edegem) (Belgium); Wouters, Kristien [University Hospital Antwerp and University of Antwerp, Department of Scientific Coordination and Biostatistics, Antwerp (Edegem) (Belgium)

    2011-06-15

    To determine the ability of 3.0T magnetic resonance (MR) imaging to identify partial tears of the anterior cruciate ligament (ACL) and to allow distinction of complete from partial ACL tears. One hundred seventy-two patients were prospectively studied by 3.0T MR imaging and arthroscopy in our institution. MR images were interpreted in consensus by two experienced reviewers, and the ACL was diagnosed as being normal, partially torn, or completely torn. Diagnostic accuracy of 3.0T MR for the detection of both complete and partial tears of the ACL was calculated using arthroscopy as the standard of reference. There were 132 patients with an intact ACL, 17 had a partial, and 23 had a complete tear of the ACL seen at arthroscopy. Sensitivity, specificity, and accuracy of 3.0T MR for complete ACL tears were 83, 99, and 97%, respectively, and, for partial ACL tears, 77, 97, and 95%, respectively. Five of 40 ACL lesions (13%) could not correctly be identified as complete or partial ACL tears. MR imaging at 3.0T represents a highly accurate method for identifying tears of the ACL. However, differentiation between complete and partial ACL tears and identification of partial tears of this ligament remains difficult, even at 3.0T. (orig.)

  5. 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

    Objective: To assess the value of ankle fusion with a retrograde locked intramedullary nail in the treatment of sequela of lower extremity compartment syndrome.Methods:Thirty-five cases of equinus deformity following tibiofibular compartment syndrome treated by means of ankle fusion with a retrograde locked intramedullary nail from January 2001 to December 2010 were retrospectively reviewed.The complications,the time needed for bony fusion of the ankle joint assessed by anteroposterior and lateral X-ray photographs as well as patients' subjective evaluation were recorded and analysed.Results: Among the 35 patients,15 had previously undergone surgical treatment twice on the same limb,13 had thrice and 7 had to be operated on four times before ankle fusion.An anterior midpoint approach to the ankle joint was adopted in 29 cases,while anterior midpoint approach plus a small incision on the posterior ankle joint was made in 17 cases,whereas lateral approach in 6 cases.Tarsus joint fusion was performed on 4 cases.The follow-up period ranged 6-124 months,averaged 40.6 months.Bone grafting was not performed in this series.Preoperative tibial shaft fracture occurred in one patient and was healed after conservative treatment.Incision dehiscence located at previous Achilles tendon incision was found in two patients.As a result,one received an intramedullary nail emplacement at calcaneoplantar part while the wound at anterosuperior part of the other one was healed by dressing change.Two patients failed to bony union 5 months postoperatively,in which one healed 10 weeks after retrieval of proximal tibial nail and another by iliac grafting.Terminal necrosis of the toe due to blood supply dysfunction was not found in this series.All the patients were satisfied with the ankle joint function postoperatively.The time for bony union on X-rays was 9.8 weeks on average.Except for one patient who demanded removal of intramedullary nail,all the intramedullary nails were not retrieved at

  6. Acute injury of the ankle joint

    International Nuclear Information System (INIS)

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

  7. 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.

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

    Science.gov (United States)

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

  9. [Palmar wrist arthroscopy for evaluation of concomitant carpal lesions in operative treatment of distal intraarticular radius fractures].

    Science.gov (United States)

    Hohendorff, B; Eck, M; Mühldorfer, M; Fodor, S; Schmitt, R; Prommersberger, K-J

    2009-10-01

    Fractures of the distal radius, which currently are treated with palmar locking plates, are often accompanied by carpal lesions. Tears of the scapholunate interosseus ligament (SL) can affect the outcome. Between January 2007 and May 2008, 28 patients with distal intraarticular fractures of the radius were included in a prospective study. Preoperative CT-arthrography was performed. SL tears were found in 11 patients, with 10 partial and one complete rupture observed. A tear of the triangular fibrocartilage complex (TFCC) was detected in 16 patients. Every patient was operated with a palmar locking plate through a palmar approach between the flexor carpi radialis tendon and the radial artery. Then, a palmar wrist arthroscopy using a palmar portal was performed. Eleven SL tears with 9 partial and two total ruptures were diagnosed by arthroscopy. Ten lesions were associated with a C1-fracture with a fracture line projected onto the scapholunate interval. The TFCC was appraisable by palmar wrist arthroscopy only in 4 patients. Three of the SL tears detected by CT-arthrography could not be confirmed by palmar wrist arthroscopy. One complete rupture and one partial lesion confirmed by palmar wrist arthroscopy were found by CT-arthrography to be intact. Palmar wrist arthroscopy affords certainty when assessing the SL ligament. In this study, an assessment of ulnocarpal structures was not possible. For assessment of the ulnocarpal structures, CT-arthrography was superior to palmar wrist arthroscopy. However, the latter is an alternative during emergency treatment or when CT-arthrography is not available. PMID:19790024

  10. Anterolateralni utesnitveni sindrom gležnja: Ankle impingement syndrome:

    OpenAIRE

    Frangež, Igor; Senekovič, Vladimir; Žnidaršič, Marta

    2011-01-01

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

  11. Validation of the Ottawa ankle rules in children.

    OpenAIRE

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

    1999-01-01

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

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

    Science.gov (United States)

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

    2013-12-01

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

  13. Development and Reliability of the Ankle Instability Instrument

    OpenAIRE

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

    2006-01-01

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

  14. Ultrasonographic test for complete anterior cruciate ligament injury

    Directory of Open Access Journals (Sweden)

    Piotr Grzelak

    2015-01-01

    Full Text Available Background: Although ultrasound (US has a wide range of applications in orthopedic diagnostics, sonographic evaluation of traumatic anterior cruciate ligament (ACL insufficiency is still inadequate. There is a growing need for diagnostic tests that allow for simple and reliable assessment of ACL instability. This investigation aims to evaluate feasibility of sonographic technique for diagnosing complete ACL insufficiency. Materials and Methods: Eighty three consecutive patients suspected of ACL injury were examined with sonographic, dynamic test of anterior instability. The translation of the intercondylar eminence against the patellar tendon was measured in the injured and opposite (injured knee. Subsequent magnetic resonance imaging was performed on all patients. Forty-seven of them underwent a further arthroscopy. Five patients have been examined for the 2 nd time to evaluate interclass and intraclass agreement and bias. Results: Complete ACL insufficiency has been confirmed in 37 patients. In those individuals, the total anterior knee translation and the difference between two joints (side-to-side difference were significantly increased (8.67 mm standard deviation [SD] 2.65 mm in the affected knee versus 2.88 mm SD 1.26 mm in uninjured joint; P < 0.001. Based on a threshold of 2.0 mm for the side-to-side difference and 5.0 mm for the absolute translation, the sonographic test was found to have a sensitivity and specificity of 91.9% and 95.6%, respectively. Conclusions: The present technique supports the clinician with additional fast and noninvasive diagnostic procedure that can facilitate the evaluation of anterior knee instability.

  15. Anterior cruciate ligament remnants nodule: potential factor causing extension loss

    Institute of Scientific and Technical Information of China (English)

    WANG Jian; AO Ying-fang

    2013-01-01

    Background Extension loss caused by anterior cruciate ligament (ACL) remnants nodule was usually reported by case reports.There is no systematic report analyzing ACL remnants nodule.The purpose of this study was to investigate the characteristics of extension loss caused by remnants of ACL after injury.Methods From June 2008 to December 2011,ACL remnants were observed by atthroscopy in 1012 cases with ACL injuries at the time of primary reconstruction.ACL remnants nodules were recorded.The time of extension loss occurrence caused by ACL remnants nodule,associated symptom and sign,magnetic resonance imaging (MRI),and arthroscopic findings were observed.Histological examination was performed on the lesion resected.Results Twenty-four cases with ACL remnants nodules were found by arthroscopy.Among them extension loss caused by remnants of ACL happened in 19 cases (male 13; female 6).The average extension loss were 9.1° (range,5°-20°).The average time from injury to operation was 8.9 weeks (range,3-26 weeks).The remnants of ACL depressed in the inter-condylar notch were found on MRI in 15 cases with extension loss.The rupture locations of ACL were all close to the upper insertion of ACL.The microscopic examination of the resected remnants of ACL revealed disorganized fibrous connective tissue and tissue of ACL ligament.Conclusions Among 1012 ACL injury cases,24 ACL remnants nodules were found with arthroscopy and 19 nodules could cause knee extension loss.ACL remnants nodule should be paid attention to as a potential cause of extension loss.

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

    Directory of Open Access Journals (Sweden)

    Brown Cathleen N

    2007-12-01

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

  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...... 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...

  18. Evidence-based treatment of open ankle fractures

    NARCIS (Netherlands)

    C.C.C. Hulsker; S. Kleinveld; C.B.L. Zonnenberg; M. Hogervorst; M.P.J. van den Bekerom

    2011-01-01

    Fractures of the ankle are fairly common injuries. Open ankle fractures are much less common and associated with severe injuries to surrounding tissues. We have performed a systematic review of the literature concerning the clinical results and complication rates in the treatment of open ankle fract

  19. 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

  20. 半腱肌移植重建踝关节外侧副韧带及踝关节不稳%Treatment of lateral ankle ligament injuries and ankle instability with semitendinosus tendon graft

    Institute of Scientific and Technical Information of China (English)

    张振宇; 毕龙; 宋扬; 黄兆松; 孙鹏霄; 卢旭; 韩一生

    2010-01-01

    Objective To explore the effectiveness of ipsilateral autologous semitendinosus ten don graft in treatment of lateral ankle ligament injuries and ankle instability. Methods Two patients including one male (25 years old) and one female (17 years old) with chronic lateral instability of the ankle were enrolled in the study. Both patients had the history of repeated ankle sprain in supination position and had grade Ⅲ injury of the lateral ankle ligament according to the American College of Foot and Ankle Surgeons Grading System. Anterior drawer test and talar tilt test were all positive. The stress-inversion radiograph demonstrated the average inclination of the talus for 21 ° and the lateral radiograph demonstrated anterior dislocation of the talus. The chronic ankle instabilities in two patients were treated by using the ipsilateral autologous semitendinosus tendon graft to reconstruct the lateral ankle ligament. Results The two patients were followed up for mean eight months, which revealed that the active and passive range of motion was good, with no pain or swelling. The anterior drawer test and talar tilt test were all negative. The stress-inversion radiograph demonstrated that the average inclination of the talus was less than 5°, with no anterior dislocation of the talus. According to the Mazur grading system, the clinical outcome was excellent in one patient and good in one. The two patients were satisfied with the stability of the ankle. Conclusions ( 1 ) Lateral ankle ligament injury is a common cause of chronic ankle instability,even the ankle osteoarthritis. ( 2 ) Brostr(o)m method can attain satisfactory result for fresh lateral injury of the ankle, but not for the old injuries. ( 3 ) Ipsilateral autologous semitendinosus tendon graft is simpleand effective for treatment of lateral ankle ligament injuries and chronic ankle instability and may play an important role in the treatment of lateral ankle instability and prevention of the occurrence of

  1. Secondary signs of anterior cruciate ligament tear at MR imaging

    International Nuclear Information System (INIS)

    The value of secondary signs of anterior cruciate ligament (ACL) tear was evaluated. MR images of 47 knees, 15 with normal, 6 with acutely torn and 26 with chronically torn ACLs confirmed at arthroscopy, were reviewed. Lateral and medial anterior tibial translocations (ATT), posterior cruciate ligament (PCL) bowing ratio and depth of lateral femoral notch (LFN) were measured. The degrees of lateral and medial ATTs and the PCL bowing ratio of the chronically torn ACLs were significantly higher than those of normal ACLs. With cutoff values of 5-mm lateral ATT, 2.5-mm medial ATT and 0.35-PCL bowing ratio, torn ligaments were distinguished from intact ligaments with accuracies of over 80%. Depth of LFN was less sensitive and less accuracies. All knees with lateral ATT of 6.4 mm medial ATT of 3.5 mm, PCL bowing ratio of 0.43 and LFN depth of 1.5 mm or more had torn ACLs. Higher correlations were revealed between lateral ATT and medial ATT, and also between lateral ATT and PCL bowing ratio. Combined criteria of lateral ATT and PCL bowing ratio indicated the highest diagnostic value as a reliable secondary sign of torn ACLs. (author)

  2. Anterior cruciate ligament (ACL) injury

    Science.gov (United States)

    Cruciate ligament injury - anterior; ACL injury; Knee injury - anterior cruciate ligament (ACL) ... knee. It prevents the knee from bending out. Anterior cruciate ligament (ACL) is in the middle of the knee. ...

  3. Uncommon causes of anterior knee pain: a case report of infrapatellar contracture syndrome.

    Science.gov (United States)

    Ellen, M I; Jackson, H B; DiBiase, S J

    1999-01-01

    The uncommon causes of anterior knee pain should always be considered in the differential diagnosis of a painful knee when treatment of common origins become ineffective. A case is presented in which the revised diagnosis of infrapatellar contracture syndrome was made after noting delayed progress in the rehabilitation of an active female patient with a presumed anterior horn medial meniscus tear and a contracted patellar tendon. The patient improved after the treatment program was augmented with closed manipulation under arthroscopy and infrapatellar injection of both corticosteroids and a local anesthetic. Infrapatellar contraction syndrome and other uncommon sources of anterior knee pain, including arthrofibrosis, Hoffa's syndrome, tibial collateral ligament bursitis, saphenous nerve palsy, isolated ganglions of the anterior cruciate ligament, slipped capital femoral epiphysis, and knee tumors, are subsequently discussed. Delayed functional advancement in a rehabilitation program requires full reassessment of the patient's diagnosis and treatment plan. Alternative diagnoses of knee pain are not always of common origins. Ample knowledge of uncommon causes of anterior knee pain is necessary to form a full differential diagnosis in patients with challenging presentations. PMID:10418845

  4. An unusual cause of an ankle mass

    Science.gov (United States)

    Prinja, Aditya; Roberts, Catherine; Doherty, Tom; Oddy, Michael J

    2014-01-01

    We report the case of a patient who presented with a 7-year history of a mass over the medial aspect of his right ankle, which had been gradually increasing in size. He had given up his occupation as a bus driver due to decreased movement of his ankle. An initial diagnosis of endemic syphilis was made after treponemal antibody and treponema pallidum particle agglutination tests were positive. However, following surgical debulking, cultures grew Fusarium solani and the diagnosis was changed to eumycetoma. He received prolonged treatment with antifungal agents and at 18 months follow-up remains well. PMID:25260425

  5. Comparison of impact forces, accelerations and ankle range of motion in surfing-related landing tasks.

    Science.gov (United States)

    Lundgren, Lina E; Tran, Tai T; Nimphius, Sophia; Raymond, Ellen; Secomb, Josh L; Farley, Oliver R L; Newton, Robert U; Sheppard, Jeremy M

    2016-01-01

    This study aimed to describe the impact forces, accelerations and ankle range of motion in five different landing tasks that are used in training and testing for competitive surfing athletes, to assist coaches in the prescription of landing task progression and monitoring training load. Eleven competitive surfing athletes aged 24 ± 7 years participated, and inertial motion sensors were fixed to the anterior aspect of the feet, mid-tibial shafts, sacrum and eighth thoracic vertebrae on these athletes. Three tasks were performed landing on force plates and two tasks in a modified gymnastics set-up used for land-based aerial training. Peak landing force, resultant peak acceleration and front and rear side ankle dorsiflexion ranges of motion during landing were determined. The peak acceleration was approximately 50% higher when performing aerial training using a mini-trampoline and landing on a soft-density foam board, compared to a similar landing off a 50 cm box. Furthermore, the ankle ranges of motion during the gymnastic type landings were significantly lower than the other landing types (P ≤ 0.05 and P ≤ 0.001), for front and rear sides, respectively. Conclusively, increased task complexity and specificity of the sport increased the tibial peak acceleration, indicating greater training load.

  6. Comparison of impact forces, accelerations and ankle range of motion in surfing-related landing tasks.

    Science.gov (United States)

    Lundgren, Lina E; Tran, Tai T; Nimphius, Sophia; Raymond, Ellen; Secomb, Josh L; Farley, Oliver R L; Newton, Robert U; Sheppard, Jeremy M

    2016-01-01

    This study aimed to describe the impact forces, accelerations and ankle range of motion in five different landing tasks that are used in training and testing for competitive surfing athletes, to assist coaches in the prescription of landing task progression and monitoring training load. Eleven competitive surfing athletes aged 24 ± 7 years participated, and inertial motion sensors were fixed to the anterior aspect of the feet, mid-tibial shafts, sacrum and eighth thoracic vertebrae on these athletes. Three tasks were performed landing on force plates and two tasks in a modified gymnastics set-up used for land-based aerial training. Peak landing force, resultant peak acceleration and front and rear side ankle dorsiflexion ranges of motion during landing were determined. The peak acceleration was approximately 50% higher when performing aerial training using a mini-trampoline and landing on a soft-density foam board, compared to a similar landing off a 50 cm box. Furthermore, the ankle ranges of motion during the gymnastic type landings were significantly lower than the other landing types (P ≤ 0.05 and P ≤ 0.001), for front and rear sides, respectively. Conclusively, increased task complexity and specificity of the sport increased the tibial peak acceleration, indicating greater training load. PMID:26383823

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

    Science.gov (United States)

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

    2012-09-01

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

  8. Cold water immersion of the ankle decreases neuromuscular response of lower limb after inversion movement

    Directory of Open Access Journals (Sweden)

    Christiane S. G. Macedo

    2014-03-01

    Full Text Available BACKGROUND: Cryotherapy has been associated with a significant decrease in nerve conduction velocity and muscle contraction with possible effects on exercise and physical training. OBJECTIVES: To quantify the electromyographic response of the lateral gastrocnemius, tibialis anterior, fibularis longus, rectus femoris and gluteus medius to ankle inversion following cold water immersion. METHOD: The peak values of the root mean square (RMS were obtained from 35 healthy and active university subjects after the use of a tilt platform to force the ankle into 30° of inversion before, immediately after, and 10, 20, and 30 minutes after water immersion at 4±2°C, for 20 minutes. The Shapiro-Wilk test, repeated measures analysis, Bonferroni's post-hoc, and linear regression analysis provided the results. RESULTS: Peak RMS was significantly lower at all times after cold water immersion, with residual effect of up to 30 minutes, when compared to pre-immersion for all muscles, except for immediate post-immersion for the gluteus medius. CONCLUSIONS: After cold water immersion of the ankle, special care should be taken in activities that require greater neuromuscular control.

  9. Effects of virtual reality programs on balance in functional ankle instability.

    Science.gov (United States)

    Kim, Ki-Jong; Heo, Myoung

    2015-10-01

    [Purpose] The aim of present study was to identify the impact that recent virtual reality training programs used in a variety of fields have had on the ankle's static and dynamic senses of balance among subjects with functional ankle instability. [Subjects and Methods] This study randomly divided research subjects into two groups, a strengthening exercise group (Group I) and a balance exercise group (Group II), with each group consisting of 10 people. A virtual reality program was performed three times a week for four weeks. Exercises from the Nintendo Wii Fit Plus program were applied to each group for twenty minutes along with ten minutes of warming up and wrap-up exercises. [Results] Group II showed a significant decrease of post-intervention static and dynamic balance overall in the anterior-posterior, and mediolateral directions, compared with the pre-intervention test results. In comparison of post-intervention static and dynamic balance between Group I and Group II, a significant decrease was observed overall. [Conclusion] Virtual reality programs improved the static balance and dynamic balance of subjects with functional ankle instability. Virtual reality programs can be used more safely and efficiently if they are implemented under appropriate monitoring by a physiotherapist. PMID:26644652

  10. MR imaging of anterior cruciate ligament injury: associated findings

    International Nuclear Information System (INIS)

    Authors investigated the associated findings and their value in the diagnosis of anterior cruciate ligament (ACL) injury in MR image. The knee MR images of 47 patients with ACL injury (complete;24, partial;23) and 61 patients with normal ACL confirmed by the knee arthroscopy or operation were reviewed retrospectively. The degree of anterior translocation of tibia and the degree of posterior cruciate ligament (PCL) buckling were evaluated. The prevalence and pattern of associated adjacent bone, ligament and meniscus injuries were studied. The means(± 2 standard errors) of anterior translocation were different significantly in statistical analysis (ρ < 0.001, student t-test) between injury group (7.51 ± 1.16 mm) and normal group (-0.56 ± 0.92mm). In the level of 5mm of anterior translocation for the criteria of ACL injury, the sensitivity, specificity, accuracy were 78.7%, 89.5%, 84.3% for each. The means of PCL buckling ratio were also different statistically between injury group(0.23 ± 0.02) and normal group(0.17 ± 0.01)(ρ < 0.001). In the level of 0.20 for diagnostic criteria of ACL injury, the sensitivity, specificity, accuracy were 71.4%, 83.6%, 78.4% for each. Thirty one medial meniscus tear (66%), thirteen lateral meniscus tear (28%), ten medial collateral ligament injury (28%), one PCL injury(2%) were associated with ACL injury. The twenty nine bone marrow changes were found in twenty patients (43%) which included acutely injured seven patients. In acute cases, the bone marrow changes were depicted as diffuse or focal high signal intensity lesions in lateral femoral or tibial condyles in contrast to the changes in chronic cases depicted as focal low signal intensity lesions in variable location. Lateral femoral condylar notch depression were found in nine patients (19%) and avulsion fractures of anterior tibial spine in four patients(9%). The associated findings with ACL injury (anterior translocation, buckling of PCL, associated bone, ligament and

  11. The role of arthroscopy in the management of low-velocity gunshot wounds of the knee joint.

    Science.gov (United States)

    Parisien, J S; Esformes, I

    1984-05-01

    Eight patients with low-velocity civilian gunshot wounds of the knee were examined and evaluated by arthroscopy. Three of these patients were also treated by surgical arthroscopy and underwent limited arthrotomy for bullet removal. In two patients small arthrotomy incisions were made following arthroscopic exploration for removal of bullets. Two patients underwent diagnostic arthroscopy. One underwent internal fixation for a chondral fracture of the femoral condyle. The majority of patients sustained intra-articular damage and retained foreign materials (denim flecks and metallic shards) and osteochondral fragments. There were no postoperative infections after a minimum follow-up period of one year. Arthroscopy is highly effective in the diagnosis and surgical management of low-velocity gunshot wounds of the knee both alone and in combination with limited arthrotomy depending on the severity of the condylar damage. The length of the hospital stay is reduced (length of stay exceeded 3-4 days only as a result of intravenous antibiotic coverage). Physical therapy requirements are minimal. Active mobility and a full range of motion are regained more rapidly with arthroscopy than with surgical exposure of multiple exploratory incisions or conventional standard arthrotomy. PMID:6705381

  12. Evaluation of the foot and ankle outcome score in patients with osteoarthritis of the ankle.

    Science.gov (United States)

    Mani, S B; Do, H; Vulcano, E; Hogan, M V; Lyman, S; Deland, J T; Ellis, S J

    2015-05-01

    The foot and ankle outcome score (FAOS) has been evaluated for many conditions of the foot and ankle. We evaluated its construct validity in 136 patients with osteoarthritis of the ankle, its content validity in 37 patients and its responsiveness in 39. Data were collected prospectively from the registry of patients at our institution. All FAOS subscales were rated relevant by patients. The Pain, Activities of Daily Living, and Quality of Life subscales showed good correlation with the Physical Component score of the Short-Form-12v2. All subscales except Symptoms were responsive to change after surgery. We concluded that the FAOS is a weak instrument for evaluating osteoarthritis of the ankle. However, some of the FAOS subscales have relative strengths that allow for its limited use while we continue to seek other satisfactory outcome instruments. PMID:25922461

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

    OpenAIRE

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

    2009-01-01

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

  14. 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.

  15. 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.

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

    OpenAIRE

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

    2008-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    陈继铭; 钟环; 陈海聪; 冯柏淋

    2015-01-01

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

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

    Science.gov (United States)

    Cumps, Elke; Verhagen, Evert; Meeusen, Romain

    2007-01-01

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

  19. 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.

  20. 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.

  1. American Orthopaedic Foot and Ankle Society

    Science.gov (United States)

    ... QUALIFIED The Orthopaedic Distinction ​​​​​​​​​​​​​​​​​​ ​ The American Orthopaedic Foot & Ankle Society (AOFAS) is an organization of more than 2,200 orthopaedic surgeons from the US and abroad who specialize in the medical and ...

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

    Science.gov (United States)

    Pittaccio, S.; Viscuso, S.

    2011-07-01

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

  3. Algorithm for establishing the indication for knee arthroscopy in children: a comparison of adolescent and preadolescent children.

    Science.gov (United States)

    Irha, E; Vrdoljak, J

    2000-01-01

    The aim of this study was to select children with pathological lesions of the intra-articular structures from children with identical complaints but with no pathological intra-articular changes. The younger the child, the more difficult it is to make the diagnosis, and the expected distribution of pathology changes increasingly. This is particularly stressed in children aged younger than 13 years. Synovial inflammatory alterations are more frequent, and osteochondral and chondral fractures appear to be more problematic than meniscal and cruciate ligament lesions. Before establishing the indication for knee arthroscopy it is mandatory to implement the algorithm of diagnostic and conservative therapeutic procedures. The indication for knee arthroscopy is considered in cases when complaints persist after conservative treatment, a lesion of intra-articular segments is suspected, and the pathological condition is deemed arthroscopically treatable. Arthroscopy before conservative treatment is justified only in acute cases.

  4. The Effect of Velocity of Joint Mobilization on Corticospinal Excitability in Individuals With a History of Ankle Sprain.

    Science.gov (United States)

    Fisher, Beth E; Piraino, Andrew; Lee, Ya-Yun; Smith, Jo Armour; Johnson, Sean; Davenport, Todd E; Kulig, Kornelia

    2016-07-01

    Study Design Controlled laboratory study. Background Joint mobilization and manipulation decrease pain and improve patient function. Yet, the processes underlying these changes are not well understood. Measures of corticospinal excitability provide insight into potential mechanisms mediated by the central nervous system. Objectives To investigate the differential effects of joint mobilization and manipulation at the talocrural joint on corticospinal excitability in individuals with resolved symptoms following ankle sprain. Methods Twenty-seven participants with a history of ankle sprain were randomly assigned to the control, joint mobilization, or thrust manipulation group. The motor-evoked potential (MEP) and cortical silent period (CSP) of the tibialis anterior and gastrocnemius were obtained with transcranial magnetic stimulation at rest and during active contraction of the tibialis anterior. The slopes of MEP/CSP input/output curves and the maximal MEP/CSP values were calculated to indicate corticospinal excitability. Behavioral measures, including ankle dorsiflexion and dynamic balance, were evaluated. Results A repeated-measures analysis of variance of the MEP slope showed a significant group-by-time interaction for the tibialis anterior at rest (P = .002) and during active contraction (P = .042). After intervention, the thrust manipulation group had an increase in corticospinal excitability, while the corticospinal excitability decreased in the mobilization group. The thrust manipulation group, but not other groups, also demonstrated a significant increase in the maximal MEP amplitude of the tibialis anterior after intervention. Conclusion The findings suggest that joint manipulation and mobilization have different effects on corticospinal excitability. The increased corticospinal excitability following thrust manipulation may provide a window for physical therapists to optimize muscle recruitment and subsequently movement. The trial was registered at

  5. A portable powered ankle-foot orthosis for rehabilitation

    Directory of Open Access Journals (Sweden)

    K. Alex Shorter, PhD

    2011-05-01

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

  6. The use of navigation forces for assessment of wrist arthroscopy skills level.

    Science.gov (United States)

    Obdeijn, Miryam C; van Baalen, Sophie J; Horeman, Tim; Liverneaux, Philippe; Tuijthof, Gabrielle J M

    2014-05-01

    Purpose To provide an efficient learning process, feedback on performance is crucial. In skills laboratories, it is possible to measure the skills and progression of skills of the trainees objectively. This requires metrics that represent the learning curve of the trainee, which were investigated for wrist arthroscopy. The research questions were: What are the forces used by novices during wrist arthroscopy?What aspects of these navigation forces are discriminative for the wrist arthroscopy skills level?Methods A cadaver wrist was mounted in a custom-made distraction device mounted in front of a force platform (ForceTrap). Eleven novices were invited to perform two tasks on the wrist: Insertion of the scope through the 3-4 portal and the hook through the 6R portal, and visualization of the hook in the center of the imageNavigation through the wrist from radial to ulnar with probing and visualization of five predefined landmarksThe second task was repeated 10 times. The absolute force (F abs) and the direction of force were measured. The angle α is defined in the vertical plane, and the angle β in the horizontal plane. Results The median F abs used by novices remained below the force threshold as defined from the expert data (7.3 N). However, the direction of the applied forces by novices in both planes was not consistent with expert data and showed a wider range. Also, there was no improvement after more trials. Conclusion Our study suggests by the absence of a learning curve for the novices and a significant difference between novices and experts that novices can benefit from feedback on the magnitude and direction of forces to improve their performance.

  7. The Use of Navigation Forces for Assessment of Wrist Arthroscopy Skills Level

    Science.gov (United States)

    Obdeijn, Miryam C.; van Baalen, Sophie J.; Horeman, Tim; Liverneaux, Philippe; Tuijthof, Gabrielle J. M.

    2014-01-01

    Purpose To provide an efficient learning process, feedback on performance is crucial. In skills laboratories, it is possible to measure the skills and progression of skills of the trainees objectively. This requires metrics that represent the learning curve of the trainee, which were investigated for wrist arthroscopy. The research questions were: What are the forces used by novices during wrist arthroscopy? What aspects of these navigation forces are discriminative for the wrist arthroscopy skills level? Methods A cadaver wrist was mounted in a custom-made distraction device mounted in front of a force platform (ForceTrap). Eleven novices were invited to perform two tasks on the wrist: Insertion of the scope through the 3–4 portal and the hook through the 6R portal, and visualization of the hook in the center of the image Navigation through the wrist from radial to ulnar with probing and visualization of five predefined landmarks The second task was repeated 10 times. The absolute force (F abs) and the direction of force were measured. The angle α is defined in the vertical plane, and the angle β in the horizontal plane. Results The median F abs used by novices remained below the force threshold as defined from the expert data (7.3 N). However, the direction of the applied forces by novices in both planes was not consistent with expert data and showed a wider range. Also, there was no improvement after more trials. Conclusion Our study suggests by the absence of a learning curve for the novices and a significant difference between novices and experts that novices can benefit from feedback on the magnitude and direction of forces to improve their performance. PMID:25077049

  8. The use of navigation forces for assessment of wrist arthroscopy skills level.

    Science.gov (United States)

    Obdeijn, Miryam C; van Baalen, Sophie J; Horeman, Tim; Liverneaux, Philippe; Tuijthof, Gabrielle J M

    2014-05-01

    Purpose To provide an efficient learning process, feedback on performance is crucial. In skills laboratories, it is possible to measure the skills and progression of skills of the trainees objectively. This requires metrics that represent the learning curve of the trainee, which were investigated for wrist arthroscopy. The research questions were: What are the forces used by novices during wrist arthroscopy?What aspects of these navigation forces are discriminative for the wrist arthroscopy skills level?Methods A cadaver wrist was mounted in a custom-made distraction device mounted in front of a force platform (ForceTrap). Eleven novices were invited to perform two tasks on the wrist: Insertion of the scope through the 3-4 portal and the hook through the 6R portal, and visualization of the hook in the center of the imageNavigation through the wrist from radial to ulnar with probing and visualization of five predefined landmarksThe second task was repeated 10 times. The absolute force (F abs) and the direction of force were measured. The angle α is defined in the vertical plane, and the angle β in the horizontal plane. Results The median F abs used by novices remained below the force threshold as defined from the expert data (7.3 N). However, the direction of the applied forces by novices in both planes was not consistent with expert data and showed a wider range. Also, there was no improvement after more trials. Conclusion Our study suggests by the absence of a learning curve for the novices and a significant difference between novices and experts that novices can benefit from feedback on the magnitude and direction of forces to improve their performance. PMID:25077049

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

    Science.gov (United States)

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

    2016-03-01

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

  10. 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.

  11. 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

  12. Visualization of torn anterior cruciate ligament using 3-dimensional computed tomography

    Directory of Open Access Journals (Sweden)

    Hiroaki Uozumi

    2013-07-01

    Full Text Available Recently, a remnant-preserving anterior cruciate ligament (ACL reconstruction technique has been developed. However, the pre-operative condition of remnant ACL is occasionally difficult to evaluate by magnetic resonance imaging. The purpose of this study is to evaluate the accuracy of pre-operative visualization of remnant ACL using three-dimensional computed tomography (3D-CT. The remnant ACL in 25 patients was examined by 3D-CT before ACL reconstruction surgery. Findings on 3D-CT images and arthroscopy were compared. The 3D-CT images were classified into 4 groups: Group A, remnant fibers attached to the posterior cruciate ligament (PCL; Group B, those located between the PCL and the lateral wall; Group C, those attached to the lateral wall; and Group D, no identifiable remnant fibers on the tibial side. These groups were made up of 4, 3, 9 and 9 patients, respectively. Findings on 3D-CT images were identical to those during arthroscopy in 20 of 25 cases (80%. Remnant ACL can be accurately evaluated using 3D-CT in 80% of cases of torn ACL. This novel method is a useful technique for pre-operative assessment of remnant ACL.

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

    Directory of Open Access Journals (Sweden)

    Дмитрий Степанович Буклаев

    2013-03-01

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

  14. Failure of normal development of central drive to ankle dorsiflexors relates to gait deficits in children with cerebral palsy

    DEFF Research Database (Denmark)

    Petersen, Tue Hvass; Farmer, Simon F; Kliim-Due, Mette;

    2013-01-01

    affected TA muscles were unrelated to differences in the magnitude of EMG in the two muscles but positively correlated with ankle dorsiflexion velocity and joint angle during gait. Time and frequency domain analysis of on-going EMG recruited during behaviourally relevant lower limb tasks provides a non......Neurophysiological markers of the central control of gait in children with cerebral palsy (CP) are used to assess developmental response to therapy. Here we measure the central common drive to a leg muscle in children with CP. We recorded EMGs from the Tibialis Anterior (TA) muscle of 40 children...... with hemiplegic CP and 42 typically-developing age-matched controls during static dorsiflexion of the ankle and during the swing phase of treadmill walking. The common drive to TA motoneurones was identified through time and frequency domain cross-correlation methods. In control subjects, the common drive...

  15. 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

  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. Congenital anterior urethral diverticulum.

    Science.gov (United States)

    Singh, Sanjeet Kumar; Ansari, Ms

    2014-09-01

    Congenital anterior urethral diverticulum (CAUD) may be found all along the anterior urethra and may present itself at any age, from infant to adult. Most children with this condition present with difficulty in initiating micturition, dribbling of urine, poor urinary stream, or urinary tract infection. A careful history will reveal that these children never had a good urinary stream since birth, and the telltale sign is a cystic swelling of the penile urethra. In this paper, we present two cases of CAUD that were managed by excision of the diverticulum with primary repair. PMID:26328174

  18. 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.

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

    Science.gov (United States)

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

    2015-11-01

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

  20. MR for assessing anterior cruciate ligament reconstructions by tendon grafts. Die Kernspintomographie zur Beurteilung des vorderen Kreuzbandersatzes mit Sehnentransplantaten

    Energy Technology Data Exchange (ETDEWEB)

    Allgayer, B.; Lehner, K.; Gewalt, Y. (Klinikum rechts der Isar, Muenchen (Germany). Inst. fuer Roentgendiagnostik); Gradinger, R.; Flock, K. (Klinikum rechts der Isar, Muenchen (Germany). Orthopaedische Klinik und Poliklinik)

    1991-10-01

    150 patients were examined via magnetic resonance (MR) after anterior cruciate (ACL) ligament reconstruction (76 patellar tendon grafts, 53 semitendinosous tendon grafts and 21 sutures). The results of MR were compared with clinical tests (Lachman, pivot-shift and anterior drawer test), in 2 cases with the operative findings, and in one case with arthroscopy findings. In 91% of patients with a clinically stable knee we found a continuous low-intensity ligamental structure. 10 patients were examined twice or more between 8 days and 6 months after surgery. Ligamental structures of low signal intensity did not significantly change their MR characteristics. MR is a valuable noninvasive method for evaluating ligament reconstructions. (orig./GDG).

  1. MR arthrography of the ankle joint

    International Nuclear Information System (INIS)

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

  2. Sensitivity and specificity of vertically oriented lateral collateral ligament as an indirect sign of anterior cruciate ligament tear on magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Palle, Lalitha; Reddy, Balaji; Reddy, Jagannath [Focus Diagnostics, Sai Baba Temple Lane, Dwarakapuri Colony, Hyderabad, Andhra Pradesh (India)

    2010-11-15

    To evaluate the correlation between anterior cruciate ligament (ACL) tear and straightened, vertically oriented lateral collateral ligament (LCL). This study included 556 patients who underwent MRI of the knee and were divided into three subsets based on ACL morphology. Subset 1 included patients with unequivocal normal ACL. Subset 2 included patients with unequivocal ACL tears. Subset 3 included patients with doubtful ACL who underwent arthroscopy. MR images were reviewed and sensitivity and specificity of vertically oriented LCL as an indirect sign of ACL tear were calculated. The MRI results were as follows: subset 1, out of 282 patients, 270 had oblique LCL and 12 demonstrated vertical LCL; subset 2, out of 212 patients, 189 demonstrated vertical LCL and 23 revealed oblique LCL; subset 3, out of 62 patients, 28 patients with vertical orientation of LCL had a possible ACL tear. Patients with oblique LCL orientation (34) were reported as probably having normal ACL. On comparison with arthroscopy, in 28 patients who we reported as having possible ACL tears, there were 17 patients with torn ACL. The rest of the 11 patients revealed no ACL tears. In the group of 34 patients in whom we reported possible normal, arthroscopy-confirmed tear in 5 patients. Sensitivity and specificity of vertical LCL as an indirect sign of ACL tear was found to be 88% and the specificity 92.85%. Vertically oriented LCL is a useful indirect MRI sign of ACL tear and aids in making a diagnosis, when ACL appearance is equivocal. (orig.)

  3. 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.

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

    Science.gov (United States)

    Zhao, Yong; Wang, Gang

    2015-04-01

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

  5. 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

  6. Pediatric Ankle Fractures: Concepts and Treatment Principles.

    Science.gov (United States)

    Su, Alvin W; Larson, A Noelle

    2015-12-01

    Current clinical concepts are reviewed regarding the epidemiology, anatomy, evaluation, and treatment of pediatric ankle fractures. Correct diagnosis and management relies on appropriate examination, imaging, and knowledge of fracture patterns specific to children. Treatment is guided by patient history, physical examination, plain film radiographs and, in some instances, computed tomography. Treatment goals are to restore acceptable limb alignment, physeal anatomy, and joint congruency. For high-risk physeal fractures, patients should be monitored for growth disturbance as needed until skeletal maturity. PMID:26589088

  7. Optimal management of ankle syndesmosis injuries

    OpenAIRE

    Porter DA; Jaggers RR; Barnes AF; Rund AM

    2014-01-01

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

  8. The management of soft tissue ankle injuries.

    OpenAIRE

    Crean, D.

    1981-01-01

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

  9. Osteoarthritis after osteosynthesis of ankle injuries

    International Nuclear Information System (INIS)

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

  10. Diagnostic dilemmas in foot and ankle injuries

    International Nuclear Information System (INIS)

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

  11. Detection of radiographically occult-ankle fractures. Positive predictive value of post-traumatic soft-tissue swelling

    International Nuclear Information System (INIS)

    The objective of this study was to assess the value of soft-tissue swelling on plain radiographs as a predictor of radiographically occult fracture, after acute ankle injury (trauma). Patients with acute ankle trauma and plain radiographic evidence of soft-tissue swelling were included in this study. Patients were excluded if ankle trauma was sustained more than 48 hours previously or if fracture was visible on plain radiographs. All subjects (n=25) underwent computed tomography (CT) of the ankle in sagittal and coronal planes. Size of soft-tissue swelling was measured from initial Antero-posterior (AP) radiographs. The subjects in the study were placed into two groups according to whether a fracture was identified on CT or not. The results identified that those subjects without a fracture demonstrated by CT, had a soft-tissue swelling of less than 12.6 mm, while those with over 17.1mm swelling, showed a fracture on CT. Twelve patients (48 per cent) had radiographically occult fractures identified with CT. Fracture sites included: Talus/Talar Dome (n=9), posterior or lateral malleolos (n=2), distal tibia/fibula (n=1). CT detected significant soft-tissue injuries in six patients (24 per cent), composed of damaged anterior talo-fibular ligament (n=4), torn flexor tendons (n=1), and damaged fibular calcaneal ligament (n=1). One patient also showed gas in the talar dome. This study concludes that presence of a large soft-tissue swelling on plain radiographs after acute ankle trauma suggests an underlying fracture. A soft-tissue swelling of >15 mm is a reasonable threshold to prompt further imaging. Helical computed tomography provides good visualisation of subtle bone injuries and may detect clinically important soft-tissue injuries. While the study has a small sample, there is clear evidence that there is a trend worth investigating. Future research will seek to investigate a larger sample. Copyright (1999) Australian Institute of Radiography

  12. MRI evaluation of the knee post double bundle ACL reconstruction: Association of graft findings and comparison with arthroscopy

    Directory of Open Access Journals (Sweden)

    Mohammed Farghally Amin

    2016-06-01

    Conclusion: Increased signal intensity within the anteromedial or posterolateral bundles of a double bundle ACL reconstruction is frequently associated with a partial tear. Impingement of the anteromedial graft is frequently associated with partial tear and increased signal intensity which is proved by arthroscopy/surgery. A low incidence of other complications is seen.

  13. Forces predicted at the ankle during running.

    Science.gov (United States)

    Burdett, R G

    1982-01-01

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

  14. 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.

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

    OpenAIRE

    Khor, Yuet Peng; Tan, Ken Jin

    2013-01-01

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

  16. Neuromuscular control and rehabilitation of the unstable ankle

    OpenAIRE

    Hung, You-jou

    2015-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-11-15

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

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

    OpenAIRE

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

    1983-01-01

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

  19. Rehabilitation of Ankle and Foot Injuries in Athletes

    OpenAIRE

    Chinn, Lisa; Hertel, Jay

    2010-01-01

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

  20. MRI in acute ligamentous injuries of the ankle.

    Science.gov (United States)

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

    2016-01-01

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