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Sample records for chronic ankle instability

  1. 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 ( ...

  2. 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

  3. 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…

  4. 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

  5. Systematic review of chronic ankle instability in children

    OpenAIRE

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

    2014-01-01

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

  6. 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

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

    OpenAIRE

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

    2013-01-01

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

  8. 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

  9. 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.)

  10. 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.

  11. Brostrom-Gould procedure for the treatment of chronic lateral ankle instability

    OpenAIRE

    Asik, Mehmet; Sen, Cengiz; Dikici, Fatih; Taser, Omer F.

    2004-01-01

    Objectives: We evaluated the results in 10 patients who underwent surgery using the Brostrom-Gould method for chronic lateral ankle instability. Methods: Brostrom-Gould procedure was performed in 11 ankles of 10 patients (4 females, 6 males; age range 14-32 years) with chronic lateral ankle instability. Ankle injury was localized to the right (n=6) and left (n=3) ankles. One patient had bilateral instability. The average period between the time of injury and that of operation was 38 months...

  12. Minimum reporting standards for copers in chronic ankle instability research.

    Science.gov (United States)

    Wikstrom, Erik A; Brown, Cathleen N

    2014-02-01

    Lateral ankle sprains (LASs) are among the most common sports-related injuries and a high percentage of individuals who sprain their ankle go on to develop chronic ankle instability (CAI). The condition of CAI is often classified as having pain, loss of function, and a restriction of, or failure to, return to levels of previous activity. Historically, uninjured healthy controls are used as a comparison group to study the biomechanical and neuromuscular consequences of CAI. However, this model is not ideal to determine why a portion of the population experiencing an ankle sprain does not recover. A more appropriate comparison may be individuals who had an ankle sprain, and thus the exposure, but did not go on to develop CAI (i.e., copers). Thus, the purpose of this review was to determine the existing discrepancies and common standards in definitions of, terminology used for, and the inclusionary/exclusionary criteria used to describe copers within the CAI literature. Multiple databases were searched by keywords and specific authors. Potential studies were screened independently by both authors. Inclusion criteria consisted of an explicit definition of copers and explicit inclusionary/exclusionary criteria. A total of 21 studies were included in the current study and had four outcomes extracted: (1) the definition of copers; (2) the terminology used; (3) specific inclusionary/exclusionary criteria; and (4) injury characteristics of the copers. Based on the included operational definitions, it is recommend that future operational definitions of copers include three key components: (1) an initial LAS; (2) subsequent lack of CAI symptoms (i.e., no complaints of disability or giving way); and (3) a time since injury component. The term coper was overwhelming used within the existing literature (n = 15) and is thus recommended to be used in future studies when describing individuals who have suffered an LAS but failed to develop CAI. Minimal inclusionary criteria should

  13. 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.

  14. 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.

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

    Science.gov (United States)

    Mattacola, Carl G.; Dwyer, Maureen K.

    2002-01-01

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

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

    OpenAIRE

    Mattacola, Carl G.; Dwyer, Maureen K.

    2002-01-01

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

  17. 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

  18. 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

  19. Selection criteria for patients with chronic ankle instability in controlled research: a position statement of the International Ankle Consortium

    NARCIS (Netherlands)

    Gribble, P.A.; Delahunt, E.; Bleakley, C.; Caulfield, B.; Docherty, C.; Fourchet, F.; Fong, D.T.; Hertel, J.; Hiller, C.; Kaminski, T.; McKeon, P.; Refshauge, K.; Wees, P.J. van der; Vincenzino, B.; Wikstrom, E.

    2014-01-01

    While research on chronic ankle instability (CAI) and awareness of its impact on society and health care systems has grown substantially in the last 2 decades, the inconsistency in participant/patient selection criteria across studies presents a potential obstacle to addressing the problem properly.

  20. Selection criteria for patients with chronic ankle instability in controlled research: a position statement of the International Ankle Consortium

    NARCIS (Netherlands)

    Gribble, P.A.; Delahunt, E.; Bleakley, C.M.; Caulfield, B.; Docherty, C.L.; Fong, D.T.; Fourchet, F.; Hertel, J.; Hiller, C.E.; Kaminski, T.W.; McKeon, P.O.; Refshauge, K.M.; Wees, P.J. van der; Vicenzino, W.; Wikstrom, E.A.

    2014-01-01

    While research on chronic ankle instability (CAI) and awareness of its impact on society and health care systems has grown substantially in the last 2 decades, the inconsistency in participant or patient selection criteria across studies presents a potential obstacle to addressing the problem proper

  1. Efficacy of the Star Excursion Balance Tests in Detecting Reach Deficits in Subjects With Chronic Ankle Instability

    OpenAIRE

    Olmsted, Lauren C.; Carcia, Christopher R; Hertel, Jay; Shultz, Sandra J

    2002-01-01

    Objective: Chronic instability after lateral ankle sprain has been shown to cause balance deficits during quiet standing. Although static balance assessment in those with ankle instability has been thoroughly examined in the literature, few researchers have studied performance on more dynamic tasks. Our purpose was to determine if the Star Excursion Balance Tests (SEBTs), lower extremity reach tests, can detect deficits in subjects with chronic ankle instability.

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

    Science.gov (United States)

    Simon, Janet; Hall, Emily; Docherty, Carrie

    2014-01-01

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

  3. 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...

  4. Chronic ankle instability. Which tests to assess the lesions? Which therapeutic options?

    OpenAIRE

    TOURNE, Yves; Besse, Jean-Luc; MABIT, Christian

    2010-01-01

    This paper purpose is to suggest an in-depth approach to diagnose the causes and lesions associated with and consecutive to chronic ankle instability due to ankle collateral ligament laxity. The different therapeutic and medicosurgical options adapted to this diagnostic approach are identified. The diagnostic aim is to precisely locate the ligamentous injuries of the tibiofibular, subtalar, talar and calcanean system, to identify the predisposing factors such as the hindfoot morphology, and a...

  5. The effect of kinesiotape on dynamic balance following muscle fatigue in individuals with chronic ankle instability.

    Science.gov (United States)

    Kodesh, Einat; Dar, Gali

    2015-01-01

    This study aimed to evaluate the effect of kinesiotape (KT) on dynamic stability following ankle muscle fatigue among individuals with chronic ankle instability (CAI). Twenty participants with CAI participated in the study. Participants were tested under three conditions: KT, non-elastic tape, and no tape pre- and post-fatigue of the ankle muscles. Ankle muscles fatigue was induced using an isokinetic apparatus, activity of the fibularis muscle was recorded using one-channel vibromyography (VMG), and dynamic balance and neuromuscular control were assessed using the Y-Balance Test. Following fatigue exercises, the VMG signal significantly decreased in all groups (p < 0.01), without differences between groups. No significant difference in dynamic balance test scores was found between the pre- and post-fatigue condition for each group and between groups. Our results demonstrate that KT had no significant effects on dynamic balance and muscle activity following ankle muscle fatigue among individuals with CAI. PMID:26279271

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

    Institute of Scientific and Technical Information of China (English)

    Songning; Zhang

    2012-01-01

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

  7. 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

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

    Directory of Open Access Journals (Sweden)

    Asman Sara

    2007-01-01

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

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

    Science.gov (United States)

    Kim, Kewwan; Jeon, Kyoungkyu

    2016-05-01

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

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

    NARCIS (Netherlands)

    Levin, O.; Vanwanseele, B.; Thijsen, J.R.; Helsen, W.F.; Staes, F.F.; Duysens, J.E.J.

    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 contr

  11. Hemi-Castaing ligamentoplasty for the treatment of chronic lateral ankle instability: a retrospective assessment of outcome

    NARCIS (Netherlands)

    T. Schepers (Tim); L.M.M. Vogels (Lucas); E.M.M. van Lieshout (Esther)

    2011-01-01

    textabstractPurpose: In the treatment of chronic ankle instability, most non-anatomical reconstructions use the peroneus brevis tendon. This, however, sacrifices the natural ankle stabilising properties of the peroneus brevis muscle. The aim of this study was to evaluate the functional outcome of pa

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

    Directory of Open Access Journals (Sweden)

    Busconi Brian D

    2009-12-01

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

  13. Application of ankle finite element model in chronic ankle instability%足踝有限元模型在踝关节失稳中的应用

    Institute of Scientific and Technical Information of China (English)

    徐菲

    2014-01-01

    踝关节力学机制复杂,各种损伤都可能打破其力学平衡而导致踝关节不稳定,诱发创伤性关节炎。人体足踝有限元模型能够量化内部组织的受力信息,对足踝临床医学和康复医学有重要意义。本文介绍了踝关节解剖结构以及慢性失稳的发生机制,分析了足踝有限元模型及其在踝关节慢性失稳中的应用,总结了其不足、研究方向及发展趋势。%Mechanics mechanism of ankle joint is complex.All kinds of damages on it may destroy the balance so that the ankle joint may lose its stability and induce traumatic arthritis.Finite element model of ankle can quantify the stress state of ankle ’s internal organization which is important to clinical medicine and rehabilitation medicine in ankle study.This paper introduces the anatomical structure in the ankle and the mechanism of chronic instability.The paper also analyzes ankle’s finite element model and the application in the chronic ankle instability,and summarizes the shortcomings and the development trend.

  14. 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

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

    Institute of Scientific and Technical Information of China (English)

    刘欣; 黄真

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    刘欣; 黄真

    2015-01-01

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

  17. 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)

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

    OpenAIRE

    Kim, Kewwan; Jeon, Kyoungkyu

    2016-01-01

    [Purpose] The aim of the present study was to construct an integrated rehabilitation exercise program to prevent chronic pain and improve motor ability in cases of ankle injury and re-injury. [Subjects and Methods] Twenty-six male soccer players who required functional strength exercises due to repeated ankle injury were the subjects. A 12-week rehabilitation exercise program was constructed with the aim of improving muscle strength in the ankle and dynamic coordination of the lower limb. Mus...

  19. A ligament reattachment technique for high-demand athletes with chronic ankle instability.

    Science.gov (United States)

    Cho, Byung-Ki; Kim, Yong-Min; Shon, Hyun-Chul; Park, Kyoung-Jin; Cha, Jung-Kwon; Ha, Yoon-Won

    2015-01-01

    The present prospective study was conducted to evaluate the clinical outcomes of the new ligament reattachment procedure for chronic lateral ankle instability in high-demand athletes. A total of 24 athletes 2 years after undergoing the modified Brostrom procedure using the suture bridge technique. The clinical evaluation included the Karlsson score, the Sefton grading system, and the period to return to exercise. As an evaluation of mechanical stability, the talar tilt angle and anterior talar translation were measured on stress radiographs. The Karlsson score had improved significantly from a preoperative average of 43.5 points to 92.2 points. Using the Sefton grading system, 22 (91.7%) patients achieved satisfactory results. The period to return to exercise was as follows: a mean of 8.4 weeks for jogging, 12.5 weeks for spurt running, 10.5 weeks for jumping, 9.2 weeks for 1 leg standing for >1 minute, 10.6 weeks for walking on uneven ground, and 11.2 weeks for going downstairs. The talar tilt angle and anterior talar translation had improved significantly from the preoperative average of 15.4° and 13.3 mm to 3.8° and 4.2 mm at 2 months postoperatively and 4.9° and 4.8 mm at the final follow-up visit, respectively. The modified Brostrom procedure using the suture bridge technique resulted in satisfactory clinical outcomes comparable to those with conventional ligament reattachment techniques. The suture bridge technique appears to be an effective treatment option for chronic ankle instability in high-demand athletes. PMID:25441285

  20. 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.

  1. Postural control systems in two different functional movements: a comparison of subjects with and without chronic ankle instability.

    Science.gov (United States)

    Choi, Ho-Suk; Shin, Won-Seob

    2016-01-01

    [Purpose] The aim of this study was to evaluate postural control during two different movements of the Functional Movement Screen in patients with chronic ankle instability compared with healthy subjects. [Subjects] This study was a cross-sectional survey of 50 participants comprised of 25 chronic ankle instability patients and 25 healthy subjects. [Methods] All subjects were subjected to measurement of the Foot and Ankle Disability Index and center of pressure and Functional Movement Screen testing. The deep squat and hurdle step were performed for the lower extremities in Functional Movement Screen testing. Then, the center of pressure was measured with balance assessment software using a Nintendo Wii Balance Board. The center of pressure path length, velocity, and area of the 95% confidence ellipse and Functional Movement Screen scores were evaluated for all subjects. [Results] The results showed significant differences in center of pressure path length, velocity, and area of the 95% confidence ellipse between the groups for the hurdle step with the non-affected limb. However, there were no significant differences between groups for the deep squat and hurdle step with the affected limb. [Conclusion] The results of this study showed that there was a difference in the hurdle step with the non-affected limb in chronic ankle instability patients compared with normal subjects. PMID:26957738

  2. Spatiotemporal postural control deficits are present in those with chronic ankle instability

    Directory of Open Access Journals (Sweden)

    McKeon Patrick O

    2008-06-01

    Full Text Available Abstract Background Postural control deficits have been purported to be a potential contributing factor in chronic ankle instability (CAI. Summary forceplate measures such as center of pressure velocity and area have not consistently detected postural control deficits associated with CAI. A novel measurement technique derived from the dynamical systems theory of motor control known as Time-to-boundary (TTB has shown promise in detecting deficits in postural control related to chronic ankle instability (CAI. In a previous study, TTB deficits were detected in a sample of females with CAI. The purpose of this study was to examine postural control in sample of males and females with and without CAI using TTB measures. Methods This case-control study was performed in a research laboratory. Thirty-two subjects (18 males, 14 females with self-reported CAI were recruited and matched to healthy controls. All subjects performed three, ten-second trials of single-limb stance on a forceplate with eyes open and eyes closed. Main outcome measures included the TTB absolute minimum (s, mean of TTB minima (s, and standard deviation of TTB minima (s in the anteroposterior and mediolateral directions. A series of group by gender analyses of variance were conducted to evaluate the differences in postural control for all TTB variables separately with eyes open and eyes closed. Results There were no significant group by gender interactions or gender main effects for any of the measures. There, however, significant group main effects for 4 of the 6 measures with eyes closed as the CAI group demonstrated significant deficits in comparison to the control group. There were no significant differences between groups in any of the TTB measures with eyes open. Conclusion TTB deficits were present in the CAI group compared to the control group. These deficits were detected with concurrent removal of visual input. CAI may place significantly greater constraints on the

  3. 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

  4. POSITION-SPECIFIC DEFICIT OF JOINT POSITION SENSE IN ANKLES WITH CHRONIC FUNCTIONAL INSTABILITY

    Directory of Open Access Journals (Sweden)

    Shigeki Yokoyama

    2008-12-01

    Full Text Available The present study was aimed to test a hypothesis that individuals with functional ankle instability (FAI underestimate the joint angle at greater plantarflexion and inversion. Seventeen males with unilateral FAI and 17 controls (males without FAI consented for participation in this IRB-approved, case-control study. Using a passive reproduction test, we assessed ankle joint position sense (JPS for test positions between 30 and -10 degrees plantarflexion with an inclement of 10 degrees with or without 20° inversion at each plantarflexion angle. The constant error (CE was defined as the value obtained by subtracting the true angle of a test position from the corresponding perceived angle. At plantarflexed and inverted test positions, the CE values were smaller in negative with greater in the FAI group than in the control group. That is, in the FAI group, the FAI group underestimated the true plantarflexion angle at combined 30° plantarflexion and 20° inversion. We conclude that the ankle with FAI underestimate the amount of plantarflexion, which increases the chance of reaching greater planterflexion and inversion than patients' intention at high risk situations of spraining such as landing

  5. Diagnosis and repair of chronic ankle instability%慢性踝关节不稳的诊断与修复

    Institute of Scientific and Technical Information of China (English)

    杨珍; 胡亚哲

    2014-01-01

    背景:慢性踝关节不稳会对正常的生活造成严重的影响。因此,慢性踝关节不稳得到越来越多的专家重视,而慢性踝关节不稳患者早期合理有效的诊断和针对性的治疗方法的选择在临床上已经成为一个重要的课题。  目的:回顾近年来慢性踝关节不稳的诊断及治疗方法的文献研究,为临床实践中慢性踝关节不稳的诊断及合理有效的治疗提供参考和评价标准。  方法:计算机检索PubMed数据库、中国期刊全文数据库(CNKI)、万方和维普数据库有关慢性踝关节不稳的临床及基础实验研究,检索关键词分别为“慢性踝关节,不稳,诊断,康复锻炼,手术方法,研究进展”和“Chronic ankle,Instability,Diagnosis,Rehabilitation exercises,Surgical methods,Research”。共纳入40篇文献进行分析。  结果与结论:由于踝关节特殊的解剖结构特征和生物力学优点,在针对慢性踝关节不稳的患者应首先考虑早期的诊断和有效的治疗方法。而治疗方法应综合踝关节的解剖结构特点、生物力学特征、慢性踝关节的发病原因和诊断方法等各方面的因素决定。保守治疗和手术治疗后的康复锻炼对慢性踝关节不稳的恢复起着重大作用。平衡板、倾斜板、登山机的使用是慢性踝关节不稳康复锻炼的有效手段。AOFOS-踝后足和腓骨肌反应时间的应用对踝关节功能恢复的评定有重要意义。关节镜的出现是踝关节的手术治疗中重大的临床研究方向。这对于慢性踝关节不稳的治疗起着显著的效果。%BACKGROUND:Chronic ankle instability affects normal life severely. Therefore, chronic ankle instability causes more and more attention of experts, and choice of reasonable and effective diagnosis and targeted treatment method for chronic ankle instability in early stage has become an important issue in the clinic. OBJECTIVE

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Jaime Salom-Moreno

    2015-01-01

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

  9. 慢性踝关节外侧不稳定的治疗%Management of chronic lateral ankle instability

    Institute of Scientific and Technical Information of China (English)

    徐向阳; 刘津浩; 朱渊; 李鸿庆; 钱龙杰

    2009-01-01

    Objective To retrospectively analyze management of chronic lateral ankle instability and evaluate its clinical results. Methods There were 74 patients including 43 males and 31 females at age range of 15-63 years (mean 39 years). All patients had at least half year of disease history, more than twice repeated strains and over six weeks of conservative management. Of all, 41 patients were trea-ted with surgical operations including modified Brostrom in 12 patients, Myerson in eight and Chrisman-Snook in 21. The aasoeiated pathological problems should be treated at the same time, ie, tenedesis for the peroneal tendon subluxations in six patients, Achilles tendon lengthening in nine, lateral shift of cal-caneal osteotomies in eight and clearance and holes-making for the osteochondral lesions in 13. Results Of all, functional instability was alleviated in 21 patients through conservative treatment before surgery. Of 53 patients with either functional or mechanical instability, 10 patients showed symptomatic relief, two refused surgical operation and the remained 41 patients were treated surgically. Thirty-nine patients trea-ted surgically and 28 treated conservatively were followed up for 6-91 months. The Roos Functional Out-come Score was used for validating the results. The average value of the ankle functional outcome was 86.24 and 97.34 respectively following operation and conservative management. Conclusions The full examination is needed to remove any possible pathological factors for the patients with chronic lateral ankle instability. The surgical operation can obtain satisfactory functional recovery of the ankle if the conserva-tive management is failed.%目的 回顾慢性踝关节外侧不稳定的治疗,对其结果进行分析和评价.方法 74例患者,其中男43例,女31例;年龄15~63岁,平均39岁.患者至少有半年以上的病史,有两次以上的反复扭伤史.所有患者均行6周以上的保守治疗.41例患

  10. Cognitive loading-induced sway alterations are similar in those with chronic ankle instability and uninjured controls.

    Science.gov (United States)

    Burcal, Christopher J; Wikstrom, Erik A

    2016-07-01

    Performing a cognitive task while balancing can result in either increased or decreased sway depending on the nature of the cognitive task, and is commonly used in pathologic populations to evaluate postural performance. A total of 39 participants were recruited into two groups: uninjured controls (n=20, age: 21.9±2.1 years, height: 175.0±11.2cm, mass: 71.3±14.9kg) and chronic ankle instability (n=19, age: 22.1±5.6 years, height: 169.7±7.7cm, mass: 72.9±17.3kg). Participants were asked to perform one of three cognitive tasks while maintaining single limb balance. Cognitive tasks included backwards counting by 3 (BC), the manikin test (MAN), and random number generation (RNG). Time-to-boundary minima, mean, and standard deviations were calculated and compared between groups as pre to post change scores. Effect sizes and 95% confidence intervals were also calculated to test for group differences and the effect of task performance on sway. No significant main effects of Group or Group by Task interactions were identified (p>0.05). However, a significant multivariate main effect of Task was identified in BC (p=0.001, F(6, 32)=4.804) and RNG (ppostural-suprapostural interactions across multiple cognitive task domains. Both the BC and RNG tasks resulted in less sway for all participants. Our results suggest that dual-task interference in the CAI population may not be present as previous research would suggest. PMID:27477716

  11. 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

  12. 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.

  13. 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。

  14. 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.

  15. 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.

  16. Relationship of ankle joint proprioceptor injury with chronic ankle instability: a preliminary study%踝关节本体感受器损伤与慢性踝关节不稳定关系的初步研究

    Institute of Scientific and Technical Information of China (English)

    朱渊; 徐向阳; 刘津浩; 边海林

    2011-01-01

    Objective To analyze the effect of ankle joint proprioceptor injury on the functional ankle instability. Methods The study enrolled 18 ( 13 males) with chronic ankle instability treated with ligament reconstruction operation. The American Orthopaedic Foot and Ankle Surgeons (AOFAS)score was used for evaluation of the function before and after operation and the balance system evaluate the proprioception function. The two ankle ligament specimens from fresh frozen body and the tissue samples from operation were used for investigation of the structure and distribution of the sensory corpuscles by using histology and immunohistoehemical staining. Results The sections were evaluated with a microscope and an image analyzer. Labeled nerve endings were mapped, measured and categorized. Type Ⅰ ( Ruffini-like ending) , type Ⅱ ( Pacinin-like corpuscle ) and type Ⅳ- (noncorpuscular) nerve endings could be identified in all the lateral ankle ligaments, with majority of types Ⅰ and Ⅱ nerve endings.These receptors were distributed primarily over the superficial ligament and near the bony attachments.There was statistical difference between preoperative and postoperative sway distance as well as between preoperative and postoperative AOFAS score. Conclusions This study suggests that the longer history,severer symptoms and lower AOFAS score may lead to the severer injury of the mechanical proprioceptors.The proprioceptor injury is correlated with ankle joint instability and the ligament reconstruction is effective to avoid the repeated injury of the proprioceptor.%目的 从新鲜尸体和踝关节不稳患者手术中所切取的韧带周围组织入手,分析踝关节周围本体感受器的性质和分布,并进一步与临床病例的生物力学、本体感觉功能检验结果相比较,判断和分析本体感受器受损在功能性踝关节不稳定中的作用.方法18例踝关节不稳患者行韧带重建手术.术前、术后分别行功能评分[美国骨科

  17. Effects of Running Speed, Fatigue, and Bracing on Motor Control of Chronically Unstable Ankles

    OpenAIRE

    Webster, Courtney Ann

    2013-01-01

    Ankle sprains are among the most common injuries for participants in running and jumping sports. Following an initial sprain injury, many (30-40%) will develop chronic ankle instability (CAI), characterized by a perception of instability and repeated sprain injuries. Quasi-static test methods indicate poor postural stability and joint position sense (JPS) as associated motor control deficits. Little research, though, has investigated ankle motor control under dynamic (simulated sport) or fati...

  18. 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...

  19. Clinical application of anchoring nail in treating chronic anterolateral ankle instability%骨锚在慢性踝关节前外侧不稳手术中的临床应用

    Institute of Scientific and Technical Information of China (English)

    马骁; 刘成; 卡索; 李丹; 田勇; 刘守应

    2012-01-01

    目的 探讨和总结微型带线骨锚钉在治疗慢性踝关节前外侧不稳手术中的临床疗效和使用经验.方法 选择2008年4月~2010年4月我院收治的慢性踝关节前外侧不稳患者38例.所有病例均采用强生Fastin RC带线锚钉手术解剖重建外踝韧带.本组男性25例,女性13例;年龄19~32岁,平均(24.1±6.4)岁.结果 38例均获得随访13~25个月,平均(16.8±6.7)个月,术后所有踝关节活动度基本恢复正常,均未出现复发性踝关节不稳.关节功能根据美国足踝骨科协会(AOFAS)足踝评分进行评估.术前与术后AOFAS后足评分有极显著性差异(P<0.01).结论 运用微型带线骨锚钉解剖重建外踝韧带,有效恢复了踝关节外侧的稳定性,是治疗慢性踝关节前外侧不稳合理想有效的方法.%Objective To discuss and summarize the clinical effect and experience of anchoring nail in trealing chronic anlerolaleral ankle instability. Methods From Apr. 2008 to Apr. 2010, reconslruclion was used for surgical trealmenl of chronic anlerolaleral ankle instability with anchoring nail in 38 palienls. There were 25 males and 13 females,whose age ranged from 19 to 32 years old ( average 24. 1 ±6. 4 years old). Results Tolally 38 palienls were followed up for 13-25 months,averaging 16. 8 ±6. 7 monlhs. Functional slabilily was achieved and range of molion was generally recovered wilhoul recurrenl inslabilily. The therapeulic resulls were evaluated with grading scale developed by American Orthopaedic Foot and Ankle Society ( AOFAS). There were obvious differences between two groups in AOFAS values before and after operation. Conclusion With reconstruction technique and anchoring nail, lateral instability of ankle can be stabilized effectively. It is a reasonable and effective surgical method for the treatment of chronic anterolateral ankle instability.

  20. 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.

  1. Neuromuscular training to enhance sensorimotor and functional deficits in subjects with chronic ankle instability: a systematic review and best evidence synthesis

    LENUS (Irish Health Repository)

    O'Driscoll, Jeremiah

    2011-09-22

    Abstract Objective To summarise the available evidence for the efficacy of neuromuscular training in enhancing sensorimotor and functional deficits in subjects with chronic ankle instability (CAI). Design Systematic review with best evidence synthesis. Data Sources An electronic search was conducted through December 2009, limited to studies published in the English language, using the Pubmed, CINAHL, Embase, and SPORTDiscus databases. Reference screening of all included articles was also undertaken. Methods Studies were selected if the design was a RCT, quasi RCT, or a CCT; the patients were adolescents or adults with confirmed CAI; and one of the treatment options consisted of a neuromuscular training programme. The primary investigator independently assessed the risk of study bias and extracted relevant data. Due to clinical heterogeneity, data was analysed using a best-evidence synthesis. Results Fourteen studies were included in the review. Meta-analysis with statistical pooling of data was not possible, as the studies were considered too heterogeneous. Instead a best evidence synthesis was undertaken. There is limited to moderate evidence to support improvements in dynamic postural stability, and patient perceived functional stability through neuromuscular training in subjects with CAI. There is limited evidence of effectiveness for neuromuscular training for improving static postural stability, active and passive joint position sense (JPS), isometric strength, muscle onset latencies, shank\\/rearfoot coupling, and a reduction in injury recurrence rates. There is limited evidence of no effectiveness for improvements in muscle fatigue following neuromuscular intervention. Conclusion There is limited to moderate evidence of effectiveness in favour of neuromuscular training for various measures of static and dynamic postural stability, active and passive JPS, isometric strength, muscle onset latencies, shank\\/rearfoot coupling and injury recurrence rates. Strong

  2. Neuromuscular training to enhance sensorimotor and functional deficits in subjects with chronic ankle instability: A systematic review and best evidence synthesis

    Directory of Open Access Journals (Sweden)

    O'Driscoll Jeremiah

    2011-09-01

    Full Text Available Abstract Objective To summarise the available evidence for the efficacy of neuromuscular training in enhancing sensorimotor and functional deficits in subjects with chronic ankle instability (CAI. Design Systematic review with best evidence synthesis. Data Sources An electronic search was conducted through December 2009, limited to studies published in the English language, using the Pubmed, CINAHL, Embase, and SPORTDiscus databases. Reference screening of all included articles was also undertaken. Methods Studies were selected if the design was a RCT, quasi RCT, or a CCT; the patients were adolescents or adults with confirmed CAI; and one of the treatment options consisted of a neuromuscular training programme. The primary investigator independently assessed the risk of study bias and extracted relevant data. Due to clinical heterogeneity, data was analysed using a best-evidence synthesis. Results Fourteen studies were included in the review. Meta-analysis with statistical pooling of data was not possible, as the studies were considered too heterogeneous. Instead a best evidence synthesis was undertaken. There is limited to moderate evidence to support improvements in dynamic postural stability, and patient perceived functional stability through neuromuscular training in subjects with CAI. There is limited evidence of effectiveness for neuromuscular training for improving static postural stability, active and passive joint position sense (JPS, isometric strength, muscle onset latencies, shank/rearfoot coupling, and a reduction in injury recurrence rates. There is limited evidence of no effectiveness for improvements in muscle fatigue following neuromuscular intervention. Conclusion There is limited to moderate evidence of effectiveness in favour of neuromuscular training for various measures of static and dynamic postural stability, active and passive JPS, isometric strength, muscle onset latencies, shank/rearfoot coupling and injury recurrence

  3. 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.

  4. Curative Effect of Semitendinosus Tendon Transplantation on Chronic Lateral Instability of the Ankle%半腱肌肌腱移植治疗慢性踝关节外侧不稳疗效观察

    Institute of Scientific and Technical Information of China (English)

    邓勇; 徐杨博; 鲁晓波

    2015-01-01

    Objective To explore the curative effect of semitendinosus tendon transplantation on chronic lateral instability of the an-kle. Methods Semitendinosus tendon transplantation was performed on 26 patients with chronic lateral instability of the ankle and plas-ter external fixation was made after surgery, and rehabilitation was applied;follow-up was performed 6 months after surgery and the cu-rative effect was analyzed. Results The follow-up of the 26 patients lasted from 8months to 3 years with the average of 1.8 years;ac-cording to AOFAS, the effect was excellent in 8 cases, good in 14 cases and fair in 4 cases, the total effective rate reached 84.6%, and the average AOFAS score went up from 61.3 before surgery to 86.54 after surgery. Conclusions Semitendinosus tendon transplantation plus suitable rehabilitation is of reliable effect on chronic lateral instability of the ankle and the function of ankle joint can have a satis-factory recovery.%目的:观察半腱肌肌腱移植治疗慢性踝关节外侧不稳的手术疗效。方法用半腱肌肌腱移植治疗26例慢性踝关节外侧不稳的患者,术后石膏外固定,康复锻炼,6个月后进行随访、分析治疗效果。结果26例患者均获得随访观察,随访时间8个月~3年,平均1.8年。按AOFAS标准评定,术后结果优8例,良14例,中4例,优良率为84.6%。AOFAS评分从术前平均61.3分提高到术后平均86.54分。结论半腱肌肌腱移植治疗慢性踝关节外侧不稳,结合良好康复治疗,踝关节功能恢复满意,疗效可靠。

  5. 高频超声评估慢性踝关节不稳定的诊断价值%Diagnostic value of high frequency ultrasound in chronic ankle instability

    Institute of Scientific and Technical Information of China (English)

    陈征; 李建国; 田辉; 车东东; 朱家安

    2015-01-01

    目的:应用高频超声测量中立位和前抽屉应力位下距腓前韧带(ATFL)的长度变化,探讨应力位超声检查对慢性踝关节不稳定(CAI)的诊断价值。方法:将80例受检者(共134个踝关节)分为两组:无踝扭伤病史的健康对照组(共80个踝关节)和CAI患者组(共54个踝关节)。通过声像图测量ATFL在中立位和前抽屉应力位下的长度变化。受检者通过Cumberland踝关节不稳定评定问卷自我定量评估日常活动和体育运动中的踝关节功能,用前抽屉试验评定踝关节的松弛程度,统计两组间应力位超声检查结果差异有无统计学意义,并分析其与前抽屉试验的相关性。结果:健康对照组双侧ATFL长度变化差异无统计学意义。健康对照组与CAI患者组ATFL长度变化差异有显著统计学意义(P<0.001)。应力位超声检查结果与前抽屉试验呈显著正相关。结论:应力位超声检查与前抽屉试验具有良好的相关性,可定性和定量评估踝关节的松弛程度,并可作为踝关节陈旧扭伤所致慢性机械性不稳定的客观有效的诊断依据。%Objective:To use high frequency ultrasonography to measure the changes in anterior taloifbular ligament (ATFL) length in the neutral and anterior drawer stress positions and to discuss the value of stress ultrasonography in the diagnosis of chronic ankle instability (CAI). Methods:Eighty subjects (134 ankles) were divided into two groups:control subjects without ankle injury history (80 ankles) and subjects with CAI (54 ankles). The changes in ATFL length in the neutral and anterior drawer stress positions were measured from ultrasound images. The Cumberland ankle instability tool (CAIT) was used to quantify self-reported functional activities of daily living and sports. The manual anterior drawer test was performed to assess the ankle laxity. The statistical signiifcance of stress ultrasonography between the two groups was

  6. 犬踝关节外侧副韧带损伤后本体感觉的变化%Changes of the proprioceptors in the partly injuried lateral collateral ligament in canine ankle with chronic instability

    Institute of Scientific and Technical Information of China (English)

    李彬; 温昱

    2013-01-01

    [Objective]To observe the morphological and functional changes of the proprioceptors in the partly injuried lateral collateral ligament in canine ankle with chronic instability following time. [Method] The lateral collateral ligament in canine ankle was damaged to make chronic ankle instability animal model. At 1,3 and 6 month post-operatively separately, the tissue in the lateral collateral ligament was examined with gold chlorid staining method and electrophysiologic study (including SEPs and EMG) to judge the morphological and functional changes of the neuromechanism in the ligament tissue. [Result] The quantity of the proprioceptors in the injuried lateral collateral ligament gradually reduced following time, and the morphogenesis of the proprioeeptors changed, including the volume of proprioeeptors diminuted and part structure depleted. The incubation period and wave amplitude of the SEPs and EMG degraded gradually following time with electrophysiologic study to the injuried lateral collateral ligament. [ Conclusion ] The proprioceptors in the ligament can still have some function after lateral collateral ligament in injuried canine ankle,but the effect will weaken gradually following time.%[目的]观察慢性踝关节不稳时韧带内本体感受器的形态和功能变化.[方法]制造Beagle犬慢性踝关节不稳动物模型,分别于术后1、3、6个月对损伤的踝关节外侧副韧带进行氯化金染色光学显微镜检查和电生理检查(包括体感诱发电位和腓肠肌肌电图),评价损伤韧带内神经结构的形态功能情况.[结果]慢性踝关节不稳时损伤的外侧副韧带内本体感受器的数量逐渐减少,异形的本体感受器增多,体积缩小,部分结构缺失,体感诱发电位和腓骨肌肌电图的潜伏期逐渐延长、波幅逐渐降低.[结论]慢性踝关节不稳时,损伤的外侧副韧带内的本体感受器短期内仍能发挥一定的作用,但是随着时间的延长,其作用逐渐减弱.

  7. Chronic ankle instability: evaluation with stress radiography, CT and CT arthrography; Instabilite chronique externe de la cheville. Apport des radiographies dynamiques, de la tomodensitometrie et de l`arthro-tomodensitometrie

    Energy Technology Data Exchange (ETDEWEB)

    Faure, Ch.; Deplus, F.; Bochu, M. [Hopital Edouard-Herriot, 69 - Lyon (France); Besse, J.L.; Moyen, B. [Centre Hospitalier Lyon-Sud, 69 -Pierre-Benite (France)

    1997-09-01

    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). 12 refs.

  8. 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

  9. 同种异体肌腱解剖重建修复慢性踝关节不稳%Anatomical reconstruction with allogeneic tendon graft for chronic ankle instability

    Institute of Scientific and Technical Information of China (English)

    沙勇; 唐辉; 丁晶; 徐永清; 李福兵; 阮默; 李春晓

    2014-01-01

    BACKGROUND:There is little evidence on the use of al ogeneic tendon graft in the reconstruction of ankle joint. OBJECTIVE:To explore the clinical outcome of anatomical reconstruction of the lateral ligaments with cryopreserved al ogeneic tendon graft in patients with chronic ankle instability. METHODS:Twenty-six patients with chronic lateral instability underwent anatomical reconstruction of the lateral ligaments with cryopreserved al ogeneic tendon. There were 18 cases of simultaneous injury or chalasia in calcaneofibular ligament and anterior talofibular ligament, and 8 cases of anterior talofibular ligament injury or chalasia. The ankle joint function was evaluated according to AOFAS scale and Good classification. The affect ankle and healthy ankle were compared in the extension, plantar flexion activity, and metaleg activity. RESULTS AND CONCLUSION:Al the 26 patients were fol owed up for 9-24 months with a mean of 15 months. No cases appeared recurrent ankle lateral instability. The mean AOFAS score in the group of calcaneofibular ligament and anterior talofibular ligament was improved from (48.4±3.7) points preoperatively to (88.2±3.8) postoperatively, while that in the group of anterior talofibular ligament was improved from (50.0±6.4) points preoperatively to (89.5±3.4) points postoperatively. According to Good score, there were excellent in 19 feet, good in 6 feet, fair in 1 foot, with an excellent and good rate up to 96%. No serious complication was occurred in this group. Anatomical reconstruction of the lateral ligaments with cryopreserved al ogeneic tendon graft can increase the tendon-bone contact area, improve the rate of tendon healing, and enhance the stability of ankle joint in patients with chronic ankle instability. Further studies are needed to verify its long-term efficacy.%背景:同种异体肌腱解剖重建应用于踝关节修复重建的报道目前较少。  目的:分析运用深低温冷冻保存同种异体肌腱解剖重

  10. 带线锚钉结合改良Brostr(o)m法修复慢性踝关节外侧不稳%Suture anchors in treatment of chronic lateral ankle instability using modified Brostr(o)m technique

    Institute of Scientific and Technical Information of China (English)

    陈刚; 陈封明; 任鹏; 李兵兵; 陈立; 周阳

    2012-01-01

    Objective To discuss the application of suture anchors in the treatment of chronic lateral ankle instability using the modified Brostr(o)m technique.Methods From May 2009 to May 2011,we admitted 16 patients with ankle sprain of degree Ⅲ who had had little improvement after conservative treatment for more than 6 months and deteriorated into chronic lateral ankle instability.They were 7 men and 9 women,aged from 19 to 31 years (average,23.6 years).They all had mild swelling,pain and instability at the lateral ankle.We treated them with suture anchors using the modified Brostr(o)m technique.The pre-and post-operative ankle functions were evaluated by American Orthopaedic Foot and Ankle Society(AOFAS) scores.The patients' subjective feeling after operation was evaluated by the Good grading system.Results The patients were followed up for 6 to 24 months (average,16 months).The AOFAS ankle and hindfoot score improved significantly from preoperative 65.00 ± 6.65 points to postoperative 92.06 ± 3.13 points,the talar antedisplacement from preoperative 11.38 ±2.23 mm to postoperative 3.19 ± 1.1 mm,and the talar tilt angle from preoperative 13.44° ± 2.25° to postoperative 4.69° ± 1.35° (P < 0.05).By the Good grading system for postoperative symptoms,there were 8 cases of grade Ⅰ,6 cases of grade Ⅱ,2 cases of grade Ⅲ and no case of grade Ⅳ,giving a good to excellent rate of 87.5%.Conclusion Suture anchors and modified Brostr(o)m technique is a reasonable and effective surgical method for the treatment of chronic lateral ankle instability.%目的 探讨带线锚钉结合改良Brostr(o)m法修复慢性踝关节外侧不稳的方法和疗效.方法 对2009年5月至2011年5月间收治16例慢性踝关节不稳患者进行回顾性分析,其中男7例,女9例;年龄19 ~31岁,平均23.6岁;均有踝关节外侧轻度肿胀、疼痛、不稳感,均为6个月以上的陈旧性损伤,而且经过3~6个月康复训练无改善,反复扭伤.均采用

  11. Instrumentos de avaliação para limitações funcionais associadas à instabilidade crônica de tornozelo: uma revisão sistemática da literatura Assessment instruments for chronic ankle instability: a systematic review of literature

    Directory of Open Access Journals (Sweden)

    Eneida Yuri Suda

    2012-03-01

    patients with chronic ankle instability. A computerized literature search was performed in the databases of PubMed, Embase, VHL, LILACS and SciELO to identify eligible instruments. Five studies were included and presented five different instruments - Foot and Ankle Disability Index (FADI, Ankle Joint Functional Assessment Tool (AJFAT, Foot and Ankle Ability Measure (FAAM, Ankle Joint Functional Assessment Tool (AII e Cumberland Ankle Instability Tool (CAIT. There were instruments that can detect functional limitations in subjects with functional ankle instability but that are not reliable to detect this condition. There is still a need for further clinimetric studies in order to validate these tools to obtain an effective and complete evaluation of the functional instability of the ankle.

  12. 半腱肌移植重建外侧副韧带治疗慢性踝关节不稳的临床研究%Clinical Study of Transplantation and Reconstruction of Semitendinosus into Lateral Collateral Ligament for Treatment of Chronic Ankle Instability

    Institute of Scientific and Technical Information of China (English)

    张新雄

    2015-01-01

    Objective To observe the clinical effect of transplantation and reconstruction of semitendinosus into lateral collateral ligament for treatment of chronic ankle instability.Method 21 patients with lateral ankle instability were given treatment of transplantation and reconstruction of semitendinosus into lateral collateral ligament. Difference of ankle function before and after operation was observed and compared.Result Scores of ankle function after operation was obviously higher than before operation (P<0.05). Excellent and good rate of ankle function score after operation was 95.2% (excellent 12 cases, good 8 cases, and normal 1 case). Within 6 months follow-up visit, ankle function recovered regularly and no ankle instability occurred.Conclusion Transplantation and reconstruction of semitendinosus into lateral collateral ligament for treatment of chronic ankle instability can facilitate improvement of ankle function and lessen repeated attack, so it is worth of being adopted in clinical work.%目的 观察半腱肌移植重建外侧副韧带治疗慢性踝关节不稳的疗效.方法 将我院收治的21例踝关节外侧不稳患者进行半腱肌移植重建外侧副韧带.观察和比较手术前后踝关节功能状态的差异.结果 踝关节功能状态手术后评分显著高于手术前评分,比较有统计学差异(P<0.05).手术后踝关节功能评分优秀12例,良好8例,一般1例,优良率为95.2%.进行6个月随访,踝关节功能恢复正常且无踝关节不稳复发情况.结论 半腱肌移植重建外侧副韧带治疗慢性踝关节不稳,有利于踝关节功能的改善,减少反复发作,值得临床选择.

  13. 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.

  14. 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

  15. Anatomical reconstruction of ligaments with chronic lateral ankle instability%自体肌腱移植解剖重建慢性踝关节外侧不稳定

    Institute of Scientific and Technical Information of China (English)

    王雪松; 冯华; 王满宜

    2010-01-01

    Objective To evaluate the clinical results of an anatomical reconstruction technique for the lateral ligaments with semitendinosus autografts in treatment of chronic lateral ankle instability.Methods From October 2008 to October 2009, 16 patients with lateral instability of the ankle underwent surgery using the proposed methods. They were 8 men and 8 women, with a mean age of 28.2 years (range,19 to 47 years) . Nine patients received only the anterior talofibular ligament reconstruction. Seven patients received both the anterior talofibular ligament and the calcaneofibular ligament reconstruction. Standard stress radiographs under anesthesia were taken to determine which ligament would be reconstructed. The semitendinosus autografts were secured to the fibular insertion site with suture anchors and to the talar or calcaneus insertion site with interference screws. The American Orthopaedic Foot and Ankle Society (AOFAS) scores and standard stress radiographs were used to assess the patients preoperation and at the last follow-up.Results We had a mean follow-up of 12. 1 months (range, 6 to 18 months). In the 16 patients, the average preoperative AOFAS score was 70. 50 ± 3.98, and the final average AOFAS score increased to 93.06 ± 4. 78 ( t = - 24. 010, P = 0. 000). Their average anterior drawer sign improved from 8. 75 ± 3.38 mm to 3.51 ±1.63 mm ( t = 7. 028, P = 0. 000). In the 7 patients who had received both lateral ligaments reconstruction,their average talar tilt improved from 16. 18° ± 7.30° to 5.57° ± 2. 99° ( t = 5. 661, P = 0. 001 ). No significant complications were found in all but one patient who had a 10° limitation of dorsal flexion of the ankle.Conclusions Our short-term results reveal that anatomical reconstruction of the ligaments with chronic lateral ankle instability using the above-mentioned methods may be effective and have the advantages of precise anatomical reconstruction, firm fixation of the grafts, mini-invasive procedure for the

  16. 慢性踝关节外侧不稳合并骨软骨损伤术后中期随访报告%Postoperative Mid-term Outcomes of Chronic Lateral Ankle Instability Combined with Osteochondral Lesions

    Institute of Scientific and Technical Information of China (English)

    江东; 胡跃林; 焦晨; 郭秦炜; 谢兴; 陈临新; 高士基

    2015-01-01

    Objective To investigate the postoperative 2 -4 year clinical outcomes of the chronic lateral ankle instability combined with chondral lesions . Methods The study was performed with 38 patients with chronic lateral instability combined with chondral lesions .Those patients underwent arthroscopic cartilage repair or debridement and insertion site reconstruction of the lateral ankle ligament from August 2010 to March 2012.There were 20 males and 18 females, with a mean age of (31.7 ±10.6) years old. The preoperative and postoperative VAS scores , AOFAS scores, Tegner scores, ankle stability, and the range of motion (ROM) were followed up and compared . Results The follow-up duration was 28 -45 (36.6 ±4.3) months.The median postoperative VAS scores [4.0 (0-7) vs.0 (0-7), Z=-4.210, P=0.000], AOFAS scores [74.0 (30 -92) vs.95.0 (52 -100), Z=-5.203, P=0.000], and Tegner scores [4.0 (1-8) vs.5.0 (1-8), Z=-2.631, P=0.009] were significantly improved from the preoperative levels.The ratio of recurrence and the ROM restriction were 28.9% (11/38) and 23.7% (9/38), respectively. Conclusion The postoperative mid-term outcomes are good in patients with chronic ankle instability combined with chondral lesions , with pain relieved and the joint function improved obviously .However, the ROM restriction is common.%目的:探讨慢性踝关节外侧不稳合并骨软骨损伤患者术后2~4年临床效果。方法2010年8月~2012年3月,38例慢性踝关节外侧不稳合并软骨损伤患者在我所行踝关节镜检、软骨修复或清理、外侧副韧带止点重建术,男20例,女18例,年龄(31.7±10.6)岁。随访并分析术前和术后疼痛VAS评分、AOFAS评分、Tegner评分、踝关节稳定性及关节活动度等。结果随访时间28~45个月,(36.6±4.3)月,AOFAS评分优27例,良8例,中3例,优良率91.2%。与术前相比,末次随访时VAS评分[中位数4.0(0~7) vs.0(0~7),Z=-4.210

  17. 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.

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

    Directory of Open Access Journals (Sweden)

    Mahmut Komurcu

    2003-09-01

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

  19. 带线锚钉在11例慢性踝关节外侧不稳韧带重建中的应用%With wire anchors application in the ligament reconstruction of 11 pa-tients with chronic lateral ankle instability

    Institute of Scientific and Technical Information of China (English)

    王波; 武亚娟; 侯勇

    2014-01-01

    Objective To investigate the value of with wire anchors in the treatment of cable anchors with chronic lat-eral ankle instability. Methods Selected 11 patients with chronic lateral ankle instability from January 2009 to Decem-ber 2012,7 males and 4 females,average age were(24.8±6.5) years,all implemented with wire anchors surgery to anatomi-cal reconstruction lateral ligaments,follow-up of 3 to 12 months postoperative,used a modified American Orthopaedic Foot and Ankle Society(AOFAS) scale to evaluate ankle function. Results Modified AOFAS ankle score excellent in 6 cases,good in 3 cases, fine in 1 case, poor in 1 case,good rate was 81.82%.AOFAS ankle scores were higher than preoperative after 3 months (P<0.05 or P<0.01); postoperative talar tilt angle,talar shift distance,ankle medial joint space was less than before(P<0.01). Conclusion With wire anchors application in the anatomical reconstruction of lat-eral ankle ligaments,the ligaments can restore the stability of the ankle, joint function recovered well, worthy of pro-motion apply.%目的:探讨带线锚钉在慢性踝关节外侧不稳治疗中的应用价值。方法选取2009年1月~2013年12月收治的慢性踝关节外侧不稳定患者11例,男7例,女4例;平均年龄(24.8±6.5)岁;均实施带线锚钉手术解剖重建外侧韧带,术后随访3~12个月,采用改良美国足踝骨科协会(AOFAS)足踝评分评价踝关节功能。结果改良AOFAS足踝评分优6例,良3例,可1例,差1例,优良率为81.82%。术后3个月改良AOFAS足踝评分均高于术前(P<0.05或P<0.01);术后距骨倾斜角度、距骨移位距离、踝关节内侧间隙均小于术前(P<0.01)。结论带线锚钉解剖重建踝关节外侧韧带能恢复韧带稳定性,踝关节功能恢复良好,值得临床推广适用。

  20. Surgical Reconstruction with the Remnant Ligament Improves Joint Position Sense as well as Functional Ankle Instability: A 1-Year Follow-Up Study

    Directory of Open Access Journals (Sweden)

    Kamizato Iwao

    2014-01-01

    Full Text Available Introduction. Chronic functional instability—characterized by repeated ankle inversion sprains and a subjective sensation of instability—is one of the most common residual disabilities after an inversion sprain. However, whether surgical reconstruction improves sensorimotor control has not been reported to date. The purpose of this study was to assess functional improvement of chronic ankle instability after surgical reconstruction using the remnant ligament. Materials and Methods. We performed 10 cases in the intervention group and 20 healthy individuals as the control group. Before and after surgical reconstruction, we evaluated joint position sense and functional ankle instability by means of a questionnaire. Results and Discussion. There was a statistically significant difference between the control and intervention groups before surgical reconstruction. Three months after surgery in the intervention group, the joint position sense was significantly different from those found preoperatively. Before surgery, the mean score of functional ankle instability in the intervention group was almost twice as low. Three months after surgery, however, the score significantly increased. The results showed that surgical reconstruction using the remnant ligament was effective not only for improving mechanical retensioning but also for ameliorating joint position sense and functional ankle instability.

  1. 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

    目的:探讨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.方法:自2005年9月至2010年3月,采用解剖重建距腓前韧带及跟腓韧带手术治疗慢性外踝不稳29例,男24例,女5例;年龄15~35岁,平均24岁;病史7个月~10年,平均10个月.主要临床表现为踝关节反复扭伤.查体时29例均有踝关节的内翻增加以及距骨前移增加,内翻活动度比健侧平均增加(12.5±3.2)°.术中先在踝关节镜下处理关节内病变.移植物为自体股薄肌腱,距骨止点以锚钉在骨表面固定,移植物通过腓骨远端的骨隧道,跟骨止点以挤压钉在骨隧道内固定.术后通过观察患者症状的变化、距骨内翻和前移的程度改变以及影像学变化来评价疗效,并以AOFAS后足功能评分评价踝关节功能.结果:所有患者手术成功,无骨折及感染发生.所有患者获得随访,时间16~60个月,平均28个月.终末随访时无踝关节不稳定或活动受限.术后踝关节内翻角度比对侧增加值为(2.5±0.8)°,低于术前(t=12.3,P=0.012);距骨前移距离(3.5±0.8)mm,较术前(16.3±4.0)mm下降(t=18.6,P=0.002);距骨倾斜角(4.5±1.0)°,较术前(17.5±3.6)°下降(t=9.7,P=0.035);AOFAS后足功能评分(92.8±6.2)分,较术前(48.0±6.7)分升高(t=25.3,P=0.001).所有患者无严重并发症出现,对疗效满意.结论:自体股薄肌腱移植解剖重建踝关节外侧韧带复合体的手术方式符合解剖学重建理念,手术创伤小,术后恢复快,无严重并发症.该手术临床效果可靠,术后踝关节稳定性恢复良好,踝关节功能明显改善.%Objective: To investigate the clinical and radiological results of lateral stabilization with reconstruction of the lateral ligaments for the treatment of chronic lateral instability of the ankle. Methods: From September 2005 to March 2010,29 patients with chronic lateral instability of the ankle were reviewed. There were 24 males and 5 females with

  2. Reconstruction of the lateral ankle ligaments with autograft of semitendinosus & bio-interference screws in chronic lateral instability of the ankle%自体半腱肌肌腱结合界面螺钉修复慢性踝关节外侧副韧带损伤

    Institute of Scientific and Technical Information of China (English)

    赵立来; 徐向阳; 刘津浩

    2011-01-01

    drilled on the lateral ankle, where the tendon of semitendinosus was permeated through, both ends of semitendinosus tendons were fixed with bio-interference screws on talus of at the end of anterior talofibular ligament and calcaneus of at the end of calcaneofibular ligament, maintaining ankle neutral and moderate valgus position. Following operation, the ankle was fixed in neutral position and slightly valgus position with plaster cast. The wound healing, the outcomes of American Orthopaedic Foot and Ankle Society (AOFAS) score, Foot and Ankle Outcome Score (FAOS), and stress radiographic evaluation were assessed at the follow-up. Results All 12 patients showed no infection and the wound healed well at the primary stage. At 3, 6, 12, 24 months after operation, all patients were followed-up. According to AOFAS and FAOS of preoperation and final follow-up postoperation, function of ankle in all patients was significantly improved (P<0.01), the scores of Chrisman-Snook group were more lower than this approach. No patients complained of instability of the ankle, and stress radiograph confirmed this improvement. Conclusion Reconstruction of lateral ligaments of the ankle with autograft of semilendinosus & biointerference screws is a practical and reliable treatment, which restores stability and function of the ankle.

  3. 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...

  4. 体校少年运动员慢性踝关节不稳定调查研究%The Incidence of Chronic Ankle Instability in Adolescent Athletes

    Institute of Scientific and Technical Information of China (English)

    李淑媛; 王俊清; 杨江飞; 马腾; 刘玉杰; 张亚楠; 杨辰辰

    2013-01-01

    目的:调查体校少年运动员功能性踝关节不稳定和机械性踝关节不稳定的发病情况.方法:以某市体校7个项目293名少年运动员为对象.采用Cumberland踝关节不稳定问卷(Cumberland Ankle Instability Tool,CAIT)调查功能性踝关节不稳定情况.每个项目随机抽取3名CAIT值为20分以下的运动员,共计21名运动员进行病史调查、专科查体(寻找压痛点、测量踝关节活动度、前抽屉试验、内翻应力试验)以及踝关节MRI检查,调查机械性踝关节不稳定的发病情况.结果:7个项目293例受试者中,CAIT最高分为30分,最低分为9分,左踝平均(23.93±4.63)分,右踝(24.09±4.81)分.以27.5分作为功能性踝关节不稳定的分界点,仅19.45%受试者踝关节稳定性正常,其余80.55%存在单侧或双侧踝关节功能性不稳定的因素.随机抽取的CAIT值为20分以下的21名运动员42踝中,21.43%存在机械性不稳定.结论:功能性踝关节不稳定和机械性踝关节不稳定在体校少年运动员中较普遍存在,与训练时自我防护意识淡薄以及踝关节扭伤后处理不够正规有关.

  5. 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

  6. Effect of strength and proprioception training on eversion to inversion strength ratios in subjects with unilateral functional ankle instability

    OpenAIRE

    Kaminski, T.; Buckley, B.; Powers, M.; Hubbard, T; Ortiz, C.; Mattacola, C

    2003-01-01

    Objectives: To examine the effect of six weeks of strength and proprioception training on eversion to inversion isokinetic strength ratios (E/I ratios) in subjects with unilateral functional ankle instability.

  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. 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

  9. 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

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

    Science.gov (United States)

    Konradsen, Lars; Voigt, Michael

    2002-12-01

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

  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. 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

  13. Increased calf and plantar muscle fibrotic contents in obese subjects may cause ankle instability.

    Science.gov (United States)

    Zhu, Junwei; Zhang, Lei; Chen, Yong; Zhao, Jianning

    2016-08-01

    Obesity is strongly associated with musculoskeletal disorders of the lower limb, including ankle instability and resulting gait problems. In the present study, we aimed to examine, using paired comparisons of subjects, whether moderate duration of obesity in patients with mild to moderate elevations of body mass index (BMI), changes the fibrous contents of muscles that support the ankle mortices, namely calf and plantar muscles. We attempted to examine these parameters because this shall provide direct evidence of whether obesity directly impacts myoarchitecture and support of the adjoining joints. MRI image segmentation and pixel correlations by grey level co-occurrence matrix (GLCM) and entropy were used to analyse the changes. The differences in the means between groups (both GLCM and entropy) were significant from control lean populations (Pcalf and the plantar muscles. Reduction in weight should thus be a first-line approach in preventing these changes that may significantly affect quality of life due to gait disturbances. PMID:27380952

  14. 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

  15. 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...

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

    OpenAIRE

    Yoshida, Takaki; Tanino, Yoshitsugu; Suzuki, Toshiaki

    2015-01-01

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

  17. Reliability of the identification of functional ankle instability (Idfai scale across different age groups in adults

    Directory of Open Access Journals (Sweden)

    Reshma S Gurav

    2014-01-01

    Full Text Available Background: Functional ankle instability (FAI is the tendency of the foot to ′give way′. Identification of Functional Ankle Instability questionnaire (IdFAI is a newly developed questionnaire to detect whether individuals meet the minimum criteria necessary for inclusion in an FAI population. However, the reliability of the questionnaire was studied only in a restricted age group. Aim: The purpose of this investigation was to examine the reliability of IdFAI across different age groups in adults. Materials and Methods: One hundred and twenty participants in the age group of 20-60 years consisting of 30 individuals in each age group were asked to complete the IdFAI on two occasions. Test-retest reliability was evaluated by intraclass correlation coefficient (ICC 2,1 . Results: The study revealed that IdFAI has excellent test-retest reliability when studied across different age groups. The ICC 2,1 in the age groups 20-30 years, 30-40 years, 40-50 years and 50-60 years was 0.978, 0.975, 0.961 and 0.922, respectively with Cronbach′s alpha >0.9 in all the age groups. Conclusion: The IdFAI can accurately predict if an individual meets the minimum criterion for FAI across different age groups in adults. Thus, the questionnaire can be applied over different age groups in clinical and research set-ups.

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

    OpenAIRE

    O'Driscoll Jeremiah; Kerin Fearghal; Delahunt Eamonn

    2011-01-01

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

  19. 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

  20. Peroneal muscle weakness in female basketballers following chronic ankle sprain.

    Science.gov (United States)

    Rottigni, S A; Hopper, D

    1991-01-01

    Female A-grade basketballers were examined for invertor and evertor muscle strength. Two test groups participated. The injured group were players who had persisting disability following ankle sprains. The control group were players who had never sustained an ankle sprain. Test apparatus was the Orthotron isokinetic dynamometer at contraction speed of 180° per second. Trends towards higher invertor and evertor strength in uninjured group when compared with the injured group found in the present study have been supported by one other report. Invertors were found to be significantly stronger than evertors in both injured and uninjured groups, with the exception of the dominant leg of the uninjured group. A significant weakness in non-dominant evertors of the uninjured group was detected. Dominance did not significantly alter strength differences in the invertor or evertor muscle groups within the uninjured population. The clinical importance of strengthening the peroneal muscles in ankle sprain rehabilitation is discussed, and further research considerations provided. PMID:25025187

  1. Physiotherapists' compliance with ankle injury guidelines is different for patients with acute injuries and patients with functional instability: an observational study.

    NARCIS (Netherlands)

    Kooijman, M.K.; Swinkels, I.C.S.; Veenhof, C.; Spreeuwenberg, P.; Leemrijse, C.J.

    2011-01-01

    QUESTIONS: What are the characteristics of patients with acute ankle injuries or functional instability of the ankle? Do physiotherapists treat these patients according to evidence-based guidelines? What are the determinants of adherence to the guidelines? DESIGN: Observational study using multi-lev

  2. Research Progress of Functional Ankle Instability%功能性踝关节不稳的研究进展

    Institute of Scientific and Technical Information of China (English)

    李男; 檀志宗

    2012-01-01

    By the method of literature study,the mechanism of functional ankle instability is discussed from the aspects of strength,proprioception and postural control,and the effect of methods used in rehabilitation is summarized.This may offer reference for the prevention and treatment of functional ankle instability.%通过文献资料法,对功能性踝关节不稳的形成机制分别从力量、本体感觉、姿势控制等方面进行了分析讨论,并且归纳了目前康复中所采用方法的效果,为功能性踝关节不稳的预防和治疗提供参考。

  3. 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 ...

  4. Chronic lateral instability of the foot

    NARCIS (Netherlands)

    J.W.K. Louwerens

    1996-01-01

    textabstractInjmy to the ligaments on the lateral side of the ankle and foot, caused by a sudden excessive inversion andlor torsion of the foot in relation to the leg, is probably the most common everyday injury of the locomotory system. Most of these injuries are sustained during sport, but with in

  5. Radiology of chronic diseases of the ankle joint; Chronische Krankheitsbilder am Sprunggelenk

    Energy Technology Data Exchange (ETDEWEB)

    Rand, T. [Vienna Univ. (Austria). Einrichtung fuer Magnetresonanztomographie]|[Universitaetsklinik fuer Radiodiagnostik, Vienna (Austria); Trattnig, S.; Breitenseher, M.; Imhof, H. [Vienna Univ. (Austria). Einrichtung fuer Magnetresonanztomographie; Kreuzer, S. [Universitaetsklinik fuer Radiodiagnostik, Vienna (Austria); Wagesreither, S. [Vienna Univ. (Austria). Klinik fuer Zahn-, Mund- und Kieferheilkunde

    1999-01-01

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

  6. 以踝关节解剖结构及生物力学特征分析慢性踝关节不稳%Chronic ankle instability:an analysis based on anatomical structure and biomechanical characteristics of the ankle joint

    Institute of Scientific and Technical Information of China (English)

    苏应军; 童新延; 胡力

    2015-01-01

    背景:长期慢性踝关节不稳可引起创伤性关节病及继发粘连关节囊炎,甚至成为永久性功能障碍。  目的:分析踝关节的生物力学,明确慢性踝关节不稳的形成原因,探讨慢性踝关节不稳的诊断方法及治疗方案。  方法:检索1990年1月至2014年12月PubMed数据库和万方医学网,选取与慢性踝关节不稳有关解剖、生物力学、诊治等相关方面的综述及基础实验研究的文章。检索词:“慢性踝关节不稳,踝关节解剖,生物力学,治疗方法,研究进展”和“Chronic ankle instability,Anatomy of ankle joint,Biomechanics,Therapy, Research”。经过筛选后纳入40篇文献,对踝关节解剖学结构、慢性踝关节外侧不稳机制及分级、诊断方法、治疗方法等内容的总结。  结果与结论:慢性踝关节不稳的诊断方法包括踝关节内翻应力试验、踝关节前抽屉试验、超声检测、现代影像学检测;慢性踝关节不稳的治疗方法分为保守治疗和手术治疗,手术可分为非解剖学重建和受损韧带解剖修复。慢性踝关节不稳患者应进行早期的诊断和有效的治疗,应综合踝关节解剖结构、生物力学特征、发病原因、诊断结果等因素决定治疗方案。%BACKGROUND:Chronic ankle instability can cause traumatic joint disease and secondary adhesive capsulitis, and even result in permanent dysfunction. OBJECTIVE: To explicit the forming reason of chronic ankle instability and to investigate the diagnosis and treatment methods of chronic ankle instability based on the biomechanical analysis of the ankle joint. METHODS: PubMed and Wanfang databases were retrieved for review and basic research papers about the anatomy, biomechanics, diagnosis and treatment of chronic ankle instability published from January 1990 to December 2014. The keywords were “chronic ankle instability, anatomy of ankle joint, biomechanics

  7. Gait Biomechanics in Participants, Six Months after First-time Lateral Ankle Sprain.

    Science.gov (United States)

    Doherty, C; Bleakley, C; Hertel, J; Caulfield, B; Ryan, J; Delahunt, E

    2016-06-01

    No research currently exists predicating a link between the injury-affiliated sensorimotor deficits of acute ankle sprain and those of chronic ankle instability during gait. This analysis evaluates participants with a 6-month history of ankle sprain injury to affirm this link. 69 participants with a 6-month history of acute first-time lateral ankle sprain were divided into subgroups ('chronic ankle instability' and 'coper') based on their self-reported disability and compared to 20 non-injured participants during a gait task. Lower extremity kinematic and kinetic data were collected from 200 ms pre- to 200 ms post-heel strike (period 1) and from 200 ms pre- to 200 ms post-toe off (period 2). The 'chronic ankle instability' subgroup (who reported greater disability) displayed increased knee flexion during period 1. During period 2, this subgroup exhibited greater total displacement at their ankle joint and greater extensor dominance at their knee. That many of these features are present, both in individuals with acute ankle sprain and those with chronic ankle instability may advocate a link between acute deficits and long-term outcome. Clinicians must be aware that the sensorimotor deficits of ankle sprain may persevere beyond the acute stage of injury and be cognizant of the capacity for impairments to pervade proximally. PMID:27136507

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

    Directory of Open Access Journals (Sweden)

    Alfonso Vargas-Macías

    2012-05-01

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

  9. Ankle sprain

    OpenAIRE

    Struijs, Peter AA; Kerkhoffs, Gino MMJ

    2010-01-01

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

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

    OpenAIRE

    van Mechelen Willem; Verhagen Evert ALM; Hupperets Maarten DW

    2008-01-01

    Abstract Background There is strong evidence that athletes have a twofold risk for re-injury after a previous ankle sprain, especially during the first year post-injury. These ankle sprain recurrences could result in disability and lead to chronic pain or instability in 20 to 50% of these cases. When looking at the high rate of ankle sprain recurrences and the associated chronic results, ankle sprain recurrence prevention is important. Objective To evaluate the effect of a proprioceptive bala...

  11. Physiotherapy Treatment in Patients with Hemophilia and Chronic Ankle Arthropathy: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Rubén Cuesta-Barriuso

    2013-01-01

    Full Text Available Haemophilic arthropathy of the ankle causes pain and deterioration in gait, causing disability. Although some physiotherapy modalities are effective in the management of acute bleeding, the results are unknown in chronic arthropathy. Our objective was to determine the most effective physiotherapy procedures for treating the haemophilic arthropathy of the ankle and to assess the methodological quality of the studies. A systematic review was carried out in the Cochrane Database, PubMed, MEDLINE, ISI Web of Knowledge, PEDro, TESEO, and specialized journals (Haemophilia and Haematologica. It included articles with at least one group undergoing any kind of physiotherapy treatment and with pretest and posttest evaluation, published before April 2013. An analysis of variables was performed and assessed the methodological quality of studies. Five studies met the criteria for inclusion. Hydrotherapy treatments, strength training and balance strength, balance training, and sports therapy, have improved range of movement, pain, balance, and subjective physical performance. The proposed methodological analysis was not possible due to the low quality of the studies. Although the results are positive, they lack rigorous evidence on the effects of treatments. Studies are needed to establish the efficacy of the various forms of physiotherapy in the haemophilic arthropathy of the ankle.

  12. The effectiveness of mobilisation with movement for chronic medial ankle pain: a case study

    Directory of Open Access Journals (Sweden)

    M. Penso

    2008-02-01

    Full Text Available Introduction and Purpose: It has been shown that approximatelythirty percent of those sustaining an ankle sprain are likely to develop chronicfunctional limitations. Mulligan has developed mobilisation with movement (MWMfor treatment of joint dysfunction and suggests that it is a positional fault of the jointthat causes pain and movement restriction. Method: This single case reports on the effects of a MWM technique on chronicmedial ankle pain. The patient was a 25-year-old female runner who had experiencedpain since an initial ankle sprain at 8 years of age. The main findings of the subjective and physical examinations were decrease in active and passive dorsiflexion and eversion range of motion (ROM, shortening of gastrocnemiusand soleus muscles and the functional limitation of pain when running. The patient was treated twice with the MWMtechnique.Results: Outcomes of immediate reduction in pain, restoration of full dorsiflexion and eversion ROM, increase in calfmuscle length and pain free running were observed. This was maintained over a four-month follow up period.Conclusion: This case concurs with previous studies detailing increases in range of motion and restoration of painfree movement as well as adding new support for the resolution of chronic pain with MWM.

  13. PREVALENCE OF PERIPHERAL VASCULAR DISEASE IN CHRONIC ALCOHOLICS AS MEASURED BY ANKLE TO BRACHIAL INDEX

    Directory of Open Access Journals (Sweden)

    Raj Bahadur

    2015-08-01

    Full Text Available The ankle - brachial pressure index (ABI, which is the ratio of ankle to brachial systolic blood pressure, is the golden standard for the diagnosis of peripheral arterial disease (PAD and is a highly specific method for the assessment of vascular risk in otherwise asymptomatic patients . ABI value of individual with daily alcohol level >60g/d was significantly lower consumption of less than 60g/d had an inverse association with peripheral atherosclerosis whereas consumption of 60 g/d or more had a positive association. Studies have shown the sensitivity of ABPI is 90% with a corresponding 98% specificity for detecting hemodynamically significant (Serious stenosis >50% in major leg arteries, defined by angiogram. AIMS AND OBJECTIVES : To determine the prevalence of peripheral vascular disease in chronic alcoholics using ankle to brachial index and to compare the values of ankle brachial index in chronic alcoholics with age and sex matched healthy controls. MATERIALS AND METHODS : In the present study, 50 cases consuming more than 60gm of absolute alcohol per day for more than 12 months attending out p atient department and admitted were enrolled. 50 age and sex matched healthy controls who have never consumed alcohol (never drinkers were also enrolled . After taking detailed history using Doppler ultrasound blood flow detector mean systolic pressure in upper limb and lower limb was calculated and then the mean ABI was calculated. This value was then compared with variables like LDL levels, Triglycerides levels, age, clinical symptoms of PVD, alcohol consumption amount and duration. RESULTS: It was observed that mean ABI was significantly lower (<0.9 in 11(22% cases and majority of them were between age group of 41 - 50 years. Of these only 7(14% showed clinical symptoms of PVD. The prevalence of PVD was 66% in those who consumed 61 - 70 grams alcohol per day for around 6 - 10 years. Results were found to be statistically significant. CONCLUSION

  14. Accuracy of MRI findings in chronic lateral ankle ligament injury: Comparison with surgical findings

    Energy Technology Data Exchange (ETDEWEB)

    Park, H.-J. [Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Department of Radiology, Kangwon National University, School of Medicine, Chuncheon (Korea, Republic of); Cha, S.-D. [Department of Orthopedic Surgery, Myongji Hospital, Kwandong University, College of Medicine, Koyang (Korea, Republic of); Kim, S.S. [Department of Radiology, Kangwon National University, School of Medicine, Chuncheon (Korea, Republic of); Rho, M.-H., E-mail: parkhiji@kangwon.ac.kr [Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kwag, H.-J. [Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Park, N.-H. [Department of Radiology, Myongji Hospital, Kwandong University, College of Medicine, Koyang (Korea, Republic of); Lee, S.-Y. [Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2012-04-15

    Aim: To evaluate the accuracy of magnetic resonance imaging (MRI) findings in chronic lateral ankle ligament injury in comparison with that of surgical findings. Materials and methods: Forty-eight cases (25 men, 23 women, mean age 36 years) of clinically suspected chronic ankle ligament injury underwent MRI studies and surgery. Sagittal, coronal, and axial, T1-weighted, spin-echo, proton density and T2-weighted, fast spin-echo images with fat saturation were obtained in all patients. MRI examinations were read in consensus by two fellowship-trained academic musculoskeletal radiologists who evaluated the lateral ankle ligaments, including the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) without clinical information. The results of the MRI studies were then compared with the surgical findings. Results: The MRI findings of ATFL injury showed a sensitivity of detection of complete tears of 75% and specificity of 86%. The sensitivity of detection of partial tears was 75% and the specificity was 78%. The sensitivity of detection of sprains was 44% and the specificity was 88%. Regarding the MRI findings of CFL injury, the sensitivity of detection of complete tears was 50% and the specificity was 98%. The sensitivity of detection of partial tear was 83% and the specificity was 93%. The sensitivity of detection of sprains was 100% and the specificity was 90%. Regarding the ATFL, the accuracies of detection were 88, 58, 77, and 85% for no injury, sprain, partial tear, and complete tear, respectively, and for the CFL the accuracies of detection were 90, 90, 92, and 96% for no injury, sprain, partial tear, and complete tear, respectively. Conclusions: The diagnosis of a complete tear of the ATFL on MRI is more sensitive than the diagnosis of a complete tear of the CFL. MRI findings of CFL injury are diagnostically specific but are not sensitive. However, only normal findings and complete tears were statistically significant between ATFL and CFL (p

  15. Accuracy of MRI findings in chronic lateral ankle ligament injury: Comparison with surgical findings

    International Nuclear Information System (INIS)

    Aim: To evaluate the accuracy of magnetic resonance imaging (MRI) findings in chronic lateral ankle ligament injury in comparison with that of surgical findings. Materials and methods: Forty-eight cases (25 men, 23 women, mean age 36 years) of clinically suspected chronic ankle ligament injury underwent MRI studies and surgery. Sagittal, coronal, and axial, T1-weighted, spin-echo, proton density and T2-weighted, fast spin-echo images with fat saturation were obtained in all patients. MRI examinations were read in consensus by two fellowship-trained academic musculoskeletal radiologists who evaluated the lateral ankle ligaments, including the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) without clinical information. The results of the MRI studies were then compared with the surgical findings. Results: The MRI findings of ATFL injury showed a sensitivity of detection of complete tears of 75% and specificity of 86%. The sensitivity of detection of partial tears was 75% and the specificity was 78%. The sensitivity of detection of sprains was 44% and the specificity was 88%. Regarding the MRI findings of CFL injury, the sensitivity of detection of complete tears was 50% and the specificity was 98%. The sensitivity of detection of partial tear was 83% and the specificity was 93%. The sensitivity of detection of sprains was 100% and the specificity was 90%. Regarding the ATFL, the accuracies of detection were 88, 58, 77, and 85% for no injury, sprain, partial tear, and complete tear, respectively, and for the CFL the accuracies of detection were 90, 90, 92, and 96% for no injury, sprain, partial tear, and complete tear, respectively. Conclusions: The diagnosis of a complete tear of the ATFL on MRI is more sensitive than the diagnosis of a complete tear of the CFL. MRI findings of CFL injury are diagnostically specific but are not sensitive. However, only normal findings and complete tears were statistically significant between ATFL and CFL (p

  16. THERAPEUTIC EFFECTS OF ELECTROACUPUNCTURE PLUS POINT-PENETRATION FOR CHRONIC ANKLE JOINT SPRAIN

    Institute of Scientific and Technical Information of China (English)

    ZHAO Yi-zao

    2005-01-01

    Objective: To observe clinical therapeutic effects of electroacupuncture plus point-penetration for chronic ankle joint sprain. Methods: 76 patients were randomly divided into treatment group (n=43) and control group (n=33).In teatment group, penetration needling from Qiuxu (丘墟 GB 40) to Zhaohai (照海 KI 6) was performed, combined with electrical stimulation for 30 min. Patients of control group were ordered to take Antinfan (50 mg,b.I.d.),supplemented with local external application of Votalin cream (b.I.d.).After 14 treatments (two courses), the therapeutic effect was assessed. Results: Following two courses of treatment, of the 43 cases and 33 cases in treatment and control groups,33 (76.7%) and 15 (45.5%) were cured, 4 (9.3%) and 7 (21.2%) had marked improvement in their symptoms, 3 (7.0%) and 2 (6.1%) had improvement, and 3 (7.0%) and 9(27.3%) failed, with the effective rates being 93.0% and 72.7% respectively. The therapeutic effect of treatment group was significantly superior to that of control group (P<0.05). Conclusion: Penetrative needling plus EA is significantly superior to medication in relieving chronic ankle spain patient's clinical symptoms and signs.

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

    OpenAIRE

    Terrier P.; Luthi F.; Dériaz O.

    2013-01-01

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

  18. 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

  19. 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...

  20. Can pre-operative axial CT imaging predict syndesmosis instability in patients sustaining ankle fractures? Seven years' experience in a tertiary trauma center

    Energy Technology Data Exchange (ETDEWEB)

    Yeung, Tsz Wai; Chan, Chung Yan Grace; Chan, Wun Cheung Samuel; Yuen, Ming Keung [Tuen Mun Hospital, Department of Radiology, Tuen Mun (China); Yeung, Yuk Nam [Tune Mun Hospital, Department of Orthopaedics and Traumatology, Tuen Mun (China)

    2015-06-01

    The purpose of this study is to explore the diagnostic accuracy of CT measurements in predicting syndesmosis instability of injured ankle, with correlation to operative findings. From July 2006 to June 2013, 123 patients presented to a single tertiary hospital who received pre-operative CT for ankle fractures were retrospectively reviewed. All patients underwent open reduction and internal fixation for fractures and intra-operative syndesmosis integrity tests. The morphology of incisura fibularis was categorized as deep or shallow. The tibiofibular distance (TFD) between the medial border of the fibula and the nearest point of the lateral border of tibia were measured at anterior (aTFD), middle (mTFD), posterior (pTFD), and maximal (maxTFD) portions across the syndesmosis on axial CT images at 10 mm proximal to the tibial plafond. Statistical analysis was performed with independent samples t test and ROC curve analysis. Intraobserver reproducibility and inter-observers agreement were also evaluated. Of the 123 patients, 39 (31.7 %) were operatively diagnosed with syndesmosis instability. No significant difference of incisura fibularis morphology (deep or shallow) and TFDs was demonstrated respective to genders. The axial CT measurements were significantly higher in ankles diagnosed with syndesmosis instability than the group without (maxTFD means 7.2 ± 2.96 mm vs. 4.6 ± 1.4 mm, aTFD mean 4.9 ± 3.7 mm vs. 1.8 ± 1.4 mm, mTFD mean 5.3 ± 2.4 mm vs. 3.2 ± 1.6 mm, pTFD mean 5.3 ± 1.8 mm vs. 4.1 ± 1.3 mm, p < 0.05). Their respective cutoff values with best sensitivity and specificity were calculated; the aTFD (AUC 0.798) and maxTFD (AUC 0.794) achieved the highest diagnostic accuracy. The optimal cutoff levels were aTFD = 4 mm (sensitivity, 56.4 %; specificity, 91.7 %) and maxTFD = 5.65 mm (sensitivity, 74.4 %; specificity, 79.8 %). The inter-observer agreement was good for all aTFD, mTFD, pTFD, and maxTFD measurements (ICC 0.959, 0.799, 0.783, and 0.865). The ICC

  1. EFFECT OF ATHLETIC TAPING AND KINESIOTAPING® ON MEASUREMENTS OF FUNCTIONAL PERFORMANCE IN BASKETBALL PLAYERS WITH CHRONIC INVERSION ANKLE SPRAINS

    Science.gov (United States)

    Karatas, Nihan; Baltaci, Gul

    2012-01-01

    Background: Chronic inversion ankle sprains are common in basketball players. The effect of taping on functional performance is disputed in the literature. Kinesiotaping® (KT®) is a new method that is being used as both a therapeutic and performance enhancement tool. To date, it appears that no study has investigated the effect of ankle KT® on functional performance. Purpose: To investigate the effects of different types of taping (KT® using Kinesio Tex®, athletic taping) on functional performance in athletes with chronic inversion sprains of the ankle. Study Design: Crossover Study Design Methods: Fifteen male basketball players with chronic inversion ankle sprains between the ages of 18 and 22 participated in this study. Functional performance tests (Hopping test by Amanda et al, Single Limb Hurdle Test, Standing Heel Rise test, Vertical Jump Test, The Star Excursion Balance Test [SEBT] and Kinesthetic Ability Trainer [KAT] Test) were used to quantify agility, endurance, balance, and coordination. These tests were conducted four times at one week intervals using varied conditions: placebo tape, without tape, standard athletic tape, and KT®. One-way ANOVA tests were used to examine difference in measurements between conditions. Bonferroni correction was applied to correct for repeated testing. Results: There were no significant differences among the results obtained using the four conditions for SEBT (anterior p=0.0699; anteromedial p=0.126; medial p=0.550; posteromedial p=0.587; posterior p=0.754; posterolateral p=0.907; lateral p=0.124; anterolateral p=0.963) and the KAT dynamic measurement (p=0.388). Faster performance times were measured with KT® and athletic tape in single limb hurdle test when compared to placebo and non-taped conditions (Athletic taping- placebo taping: p=0.03; athletic taping- non tape p=0.016;KT®- Placebo taping p=0.042; KT®-Non tape p=0.016). In standing heel rise test and vertical jump test, athletic taping led to decreased

  2. 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 ...

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

    LENUS (Irish Health Repository)

    O'Driscoll, Jeremiah

    2011-06-09

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

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

    Directory of Open Access Journals (Sweden)

    O'Driscoll Jeremiah

    2011-06-01

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

  5. Managing ankle ligament sprains and tears: current opinion

    Directory of Open Access Journals (Sweden)

    McGovern RP

    2016-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Sanjay Mattam

    2015-06-01

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

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

    Science.gov (United States)

    McGovern, Ryan P; Martin, RobRoy L

    2016-01-01

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

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

    Science.gov (United States)

    Lee, Sun-Min; Lee, Jung-Hoon

    2016-01-01

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

  9. 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...

  10. 功能性踝关节不稳者的静态平衡能力*%Static balance ability of functional ankle instability patients

    Institute of Scientific and Technical Information of China (English)

    张阳; 张秋霞

    2013-01-01

    BACKGROUND:At present, the study to balance ability of functional ankle instability patients is less. The balance ability deficiency may also be one of the important reasons for ankle repeated injury, so the research can effectively reduce the damage probability. OBJECTIVE:To explore the static balance ability characteristics of functional ankle instability patients. METHODS:Ten male subjects with unilateral functional ankle instability were enrol ed as the experimental group in the study, and other 10 healthy match-paired subjects were served as the control group. Their static balance ability was measured under double feet standing and single foot standing using win-pod system, the double feet testing lasted for 30 seconds and the single foot testing lasted for 10 seconds. Evaluation parameters of balance ability were obtained. RESULTS AND CONCLUSION:During double feet testing, there were no significant differences in balance ability parameters between the experimental group and the control group whether eyes be opened or closed (P>0.05), but the index values of double feet testing were obviously less than those of single foot testing. So we concluded that in the double feet standing, there was no significant difference in the static balance ability between functional ankle instability patients and normal persons. Moreover, the static balance ability of double feet was better than that of single feet. In the single foot standing of the affected foot, the static balance ability of functional ankle instability patients was slightly worse than that of the normal persons, especial y with eyes closed. Comparison of the average swing between the X-axis and Y-axis found that in the process of maintaining balance posture, the swing direction of the body center of gravity was mainly in the anteroposterior direction.%  背景:目前国内对功能性踝关节不稳者平衡能力的研究较少,并且其平衡能力的缺失也可能是导致踝关节反复损伤

  11. 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

  12. 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...

  13. [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.

  14. [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

  15. 临床护理人员踝关节的稳定性调查与防护研究%Investigation of functional ankle instability in nurses and exploration of its preventive and protective methods

    Institute of Scientific and Technical Information of China (English)

    李振香; 秦发伟; 卢凤娟; 李淑媛

    2013-01-01

    Objective To investigate the functional ankle instability in nurses,and provide references for increase preventive and protective awareness and establishment of preventive measures.Methods 100 nurses recruited from 10 wards of Provincial Hospital Affiliated to Shandong University were included into this study.Chinese version of the Cumberland Ankle Instability Tool (CAIT) was used to investigate the condition of functional ankle instability of these nurses.A self-designed questionnaire was used to investigate cognitive degree of ankle sprain prevention and treatment knowledge.Results Only 16% of these nurses had no unstable problems in both of their two ankles.There were functional ankle instable problems in either single or both of the two ankles of the other 84% nurses.And most of the nurses had little knowledge of how to prevent or treat ankle sprain properly.Conclusions There is a high rote of functional ankle instability in nurses.It is necessary to pay great attention to the prevention of ankle sprain and instability in nurses,which is of great importance to health and occupational safety assurance of nurses.%目的 对护理人员功能性踝关节不稳定情况进行调查分析,为提高防护意识、制订预防措施提供依据.方法 自我院10个病房中随机抽取共计100名护理人员,采用中文版cumberland踝关节不稳定问卷(CAIT)进行踝关节不稳定情况调查,同时采用自行设计的踝关节扭伤防治常规认知情况量表,调查受试者对踝关节扭伤防护及诊疗常规的了解程度.结果 仅有16%的受试者双侧踝关节稳定性正常,剩余84%的受试者存在单侧或双侧踝关节功能性不稳定的因素.大多数护理人员对踝关节扭伤的防治知识了解较少.结论 护理人员中功能性踝关节不稳定现象较为严重,增强对踝关节功能的重视,积极防治踝关节扭伤和踝关节不稳定,对于保证护士健康,提高职业安全性、稳定性具有重要意义.

  16. 动静态平衡训练治疗慢性踝关节不稳的疗效研究%Effect of dynamic and static balance training on ankle instability

    Institute of Scientific and Technical Information of China (English)

    梁英; 高敏; 王萍芝; 薛燕萍; 李鹏; 刘强

    2015-01-01

    ObjectiveTo observe the clinical effect of proprioception and stability in patients with chronic ankle instability (CAI) using dynamic and static balance training.Methods32 CAI patients between December 2013 and March 2015 were enrolled prospectively according to inclusive criteria and randomly divided into control group (n=16) and treatment group (n=16). Both group were processed with ankle pump exercises as physical therapy, in addition, treatment group took extra static balance training as well. After following participants for 4 weeks, differences between the two groups in terms of cumberland ankle instability tool (CAIT) score, average trace error (ATE) and average load power were compared. ResultsAll of32 cases were followed-up after postoperative 4-8 weeks, with an average of 5 weeks, and all cases obtained satisfactory results. There was no significant differences in CAIT score between control group (12.88±7.37) and treatment group (10.69±5.62) before training (P>0.05). The CAIT score of training group (16.38±7.23) was higher than that of control group (11.56±5.37) after training, and the difference was statistically significant (P0.05). Both ATE and average load power scores of treatment group were lower than that of control group after training, and the difference was statistically significant (P<0.05). In the treatment group after training, the CAIT score showed a 53.22% increase, the ATE score reduced by 33.41%, and the average load power reduced by 24.27%.ConclusionDynamic and static balance training can significantly improve the proprioception and stability of patients with CAI.%目的:观察动静态平衡训练对慢性踝关节不稳(chronic ankle instability,CAI)患者的本体感觉功能及稳定性的影响。方法前瞻性收集2013年12月至2015年3月收治的符合纳入及排除标准的CAI患者32例,随机分为对照组(n=16)和试验组(n=16)。对照组患者行踝泵运动训练;试验组在此基础上增

  17. 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...

  18. Subintimal angioplasty for below-the-ankle arterial occlusion in diabetic patients with chronic critical limb ischemia

    International Nuclear Information System (INIS)

    Objective: To assess the feasibility and efficacy of subintimal angioplasty (SA) for the treatment of below-the-arterial occlusion in diabetic patients with chronic critical limb ischemia (CLI). Methods: SA was adopted for 57 diseased lower limbs in 37 diabetic patients with chronic CLI and occlusive disease of the dorsalis pedis artery (DPA) and/or planter artery (PA), who were not suitable candidates for intraluminal angioplasty or bypass surgery. Of the total 57 diseased lower limbs, tissue loss was seen in 31 (54.4%) and pain was reported in 51 (89.5%). SA was carried out to create continuous arterial flow to the foot for limb salvage. Both before and after the procedure the clinical symptoms, DPA or PA pulse volume scores and ankle-brachial indexes (ABI) were determined in all patients, the results were compared and statistically analysed. During the follow-up period, the healing of the wound, the salvage of the diseased limb and the re-stenosis occurrence of the target vessels were evaluated. Kaplan-Meier curves were constructed to evaluate limb salvage, survival rate and freedom from amputation. Results: A total of 66 below-the-ankle arterial lesions were detected in 57 affected limbs. Of the 66 lesions, SA was successfully performed in 55 (83.3%). Before SA the median pulse volume scores and ABIs were 0.33±0.54 and 0.31±0.19 respectively, which became 2.04±1.05 and 0.80±0.14 respectively after SA, the differences in both median pulse volume scores and ABI were statistically significant (P<0.01 for both). One patient (2.7%) died within 30 days after the procedure. Mild complications, such as bleeding, thrombosis or angiospasm etc. occurred in five patents (13.5%). Twelve months after SA. Kaplan-Meier analysis showed that the limb salvage rate was 94.6%, the freedom from amputation was 89.2% and the survival rate was 97.3%. Conclusion: SA of the dorsalis pedis artery and/or planter artery is an effective technique for lower limb salvage in diabetic

  19. The clinical observation for the effect of the peroneus brevis tendon transposition to repair the injury of lateral ligament of ankle instability%腓骨短肌腱转位修复踝关节外侧副韧带损伤及踝关节不稳的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    王春生; 孙焕伟; 钟怡鸣; 张洪权; 杨卫东; 高斌; 苏毅; 何明达; 徐媛媛

    2015-01-01

    Objective To investigate the peroneus brevis tendon transposition for repairment of ankle lateral ligament damage and instability of the ankle joint. Methods A retrospective analysis from 2007 July to 2013 December treated 116 patients with ankle joint lateral collateral ligament injury data, all patients underwent peroneus brevis tendon transposition, Johnson strip anchor fixation with reconstruction of the lateral ligament of ankle joint, ankle postoperative patients with plaster fixation in flexion and neutral a mild valgus, and guarantee, and the patients were observed the effects of short-term and long-term. This group included 51 male patients, 65 female patients; age ranges from 16 to 61 years old, average 38.5 years old. Results A total of 116 patients were followed up, follow up time was 9 months to 5.5 years, average 2 years and 8 months. All patients were stage I operation incision healing; and the risk of foot and no local swelling and pain, walking normal, ankle active and passive activities are good, good ankle active and passive activities; the positive rate of foot from the anterior drawer test is only 1.7%; visual assessment of pain tenderness and pain after operation (VAS) score and range of motion (ROM) compared with the preoperative evaluation, analysis by T test statistics, with significant difference (P<0.05);preoperative USA foot & Ankle Society (AOFAS) score (41.81+3.21), postoperative (88.21+2.53), the results by T test statistical analysis, with a significant difference (P< 0.05). Conclusion (1) ankle lateral ligament injury is the result of chronic ankle instability, common cause even ankle osteoarthritis; (2) peroneus brevis tendon transposition, the belt line anchor fixing method is effective and simple treatment of ankle joint lateral collateral ligament injury, for the treatment of ankle instability to prevent the occurrence, plays an important role in osteoarthritis of the ankle.%目的:探讨腓骨短肌腱转位修复踝关节

  20. Análise da performance funcional em indivíduos com instabilidade do tornozelo: uma revisão sistemática da literatura Functional performance assessment in individuals with ankle instability: a systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Eneida Yuri Suda

    2009-06-01

    study was to systematically review the literature in order to identify the existence of clinical procedures to assess functional performance of individuals with chronic ankle instability, and to identify the existence of studies that objectively assess the presence of functional performance deficits in these subjects. METHOD: A database search was conducted in MEDLINE, EMBASE, LILACS. This review included studies that described tools that evaluated functional performance in individuals with chronic ankle instability. Two reviewers conducted the research and independently assessed the methodological quality and extracted relevant data of each included study. RESULTS: A total of six studies were included, from which three were considered of high quality. The tests described in the literature for performance evaluation in unstable individuals were "Cocontraction test", "Shuttle run test", "Agility hop test", "Triple-hop crossover for distance", "6-m shuttle run" , "Figure-of-8-hop," "Side hop," "Up-down-hop," "Single hop," "Multiple hop test" and "Star excursion balance test." Only the two last tests were able to detect functional performance deficits in individuals with ankle instability. CONCLUSION: It was observed that until the present time, only the "Multiple Hop Test" and "SEBT" tests were valid and reliable as instruments able to detect deficits of performance in individuals with chronic ankle instability.

  1. 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. ...

  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. 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

  4. Ankle-Brachial Index Is a Powerful Predictor of Renal Outcome and Cardiovascular Events in Patients with Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Fu-An Chen

    2012-01-01

    Full Text Available Ankle-brachial index (ABI is an accurate tool to diagnose peripheral arterial disease. The aim of this study was to evaluate whether ABI is also a good predictor of renal outcome and cardiovascular events in patients with chronic kidney disease (CKD. We enrolled 436 patients with stage 3–5 CKD who had not been undergoing dialysis. Patients were stratified into two groups according to the ABI value with a cut point of 0.9. The composite renal outcome, including doubling of serum creatinine level and commencement of dialysis, and the incidence of cardiovascular events were compared between the two groups. After a median follow-up period of 13 months, the lower ABI group had a poorer composite renal outcome (OR=2.719, P=0.015 and a higher incidence of cardiovascular events (OR=3.260, P=0.001. Our findings illustrated that ABI is a powerful predictor of cardiovascular events and renal outcome in patients with CKD.

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

    Science.gov (United States)

    Moreira, Vítor; Antunes, Filipe

    2008-01-01

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

  6. Ankle sprain: pathophysiology, predisposing factors, and management strategies

    Directory of Open Access Journals (Sweden)

    Tricia J Hubbard

    2010-07-01

    Full Text Available Tricia J Hubbard, Erik A WikstromUNC Charlotte, Department of Kinesiology, CharlotteAbstract: With the high percentage (up to 75% of initial lateral ankle sprains (LAS leading to repetitive sprains and chronic symptoms, it is imperative to better understand how best to treat and rehabilitate LAS events. The purpose of this paper is to review LAS pathophysiology, predisposing factors, and the current evidence regarding therapeutic modalities and exercises used in the treatment of LAS. Functional rehabilitation, early mobilization with support, is the current standard of care for LAS. However, the high percentage of reinjury occurrence and development of chronic symptoms (up to 75% after a LAS, suggests the current standard of care may not be effective. Recent evidence has shown the need for more stringent immobilization to facilitate ligament healing and restoration of joint stability and function after a LAS. Additionally, the importance of adding adjunctive therapies, specifically joint mobilizations and balance training have been shown to improve function and decrease the incidence of reinjury after a LAS. Modifying current rehabilitation protocols to include protecting the ankle joint with stringent immobilization, and including joint mobilizations and balance training may be the first step to decreasing the incidence of short and long term ankle joint dysfunction.Keywords: rehabilitation, recurrent sprains, chronic ankle instability (CAI

  7. 机械性踝关节不稳定患者中腓骨肌功能的表面肌电研究%Surface Electromyographic Study of the Peroneal Tendons in Patients with Mechanical Ankle Instability

    Institute of Scientific and Technical Information of China (English)

    汪嘉鸿; 封旭华; 华英汇

    2011-01-01

    评价机械性踝关节不稳定中腓骨肌的功能变化.20名单侧机械性踝关节不稳定患者的双侧踝关节在行走过程中模拟内翻动作时接受表面肌电测试,以患侧踝关节作为不稳定组,以同一患者的对侧无症状踝关节作为正常对照组.计算并比较两组踝关节腓骨长肌和腓骨短肌的标化平均波幅和激发时间的差异.在模拟内翻动作中,不稳定组的腓骨长肌和腓骨短肌的标化平均波幅减小(1.8±0.9;1.9±0.7),腓骨长肌和腓骨短肌的激发时间延迟(73.45±13.92 ms;71.57±11.24 ms),与正常对照组(3.5±2.1;3.8±1.5;59.12±9.15 ms;63.79±10.21 ms)相比,差别均有显著性意义.机械性踝关节不稳定中存在模拟内翻动作时腓骨肌的标化平均波幅下降,激发延迟,这可能导致踝关节习惯性不稳定,并使踝关节更容易扭伤.%To evaluate the function of peroneal tendons in patients with mechanical ankle instability (MAI). A controlled laborato-ry study was done in twenty patients with unilateral MAI (Group Instability, twenty ankles with MAI; and group control, the contralat-eral twenty asymptomatic ankles). All ankles experienced the test as patients underwent a sudden ankle inversion perturbation during walking. Surface electromyography (sEMG) of the bilateral peroneal longus and peroneal brevis were recorded during the test. The standardized average EMG amplitudes and on set time in two groups were calculated and compared. During the sudden ankle inversion perturbation, the instability group had lower standardized average EMG amplitudes of peroneal longus (1.8 ± 0.9) and peroneal brevis (1.9±0.7), longer on set time of peroneal longus (73.45± 13.92ms) and peroneal brevis (71.57± 11.24ms) than those of con-trol group (3.5 ±2.1 ;3.8 ± 1.5;59.12 ± 9.15ms;63.79 ± 10.21ms). Significant differences were seen in all the differences. Low-er standardized average EMG amplitudes and delayed on set time are seen in ankles with

  8. Lateral collateral ligament reconstruction for chronic varus instability of the hallux interphalangeal joint.

    Science.gov (United States)

    Cho, Jaeho

    2014-01-01

    Chronic varus instability of the hallux interphalangeal joint is a rare injury, and only a few reports of this injury have been published. In some studies, this injury has been related to taekwondo. Taekwondo is an essential martial art in the Korean military. We have described a case of varus instability of the hallux interphalangeal joint in a professional soldier who had practiced taekwondo for 5 years and the surgical outcome after reconstruction of the lateral collateral ligament with the fourth toe extensor tendon.

  9. 贴扎对患踝关节不稳的男橄榄球运动员下肢运动素质的影响%Effect of Ankle Taping on the Athletic Constitution of Lower Limb of Male Players with Ankle Instability from the National Rugby Team

    Institute of Scientific and Technical Information of China (English)

    罗强; 胡晨; 冯晓琪; 马泽兵

    2015-01-01

    To exam the lower limbs athletic constitution of the national rugby team's athlets suffering from the functional ankle instability in order to learn about the protection for the ankle and the impact on the athletic constitution. Results: 1) the effect of Lower limbs' explosive power and coordination before and after ankle taping is at the level of 0.05; 2)the effect of speed and balanced capacity before and after ankle taping is not at the level of 0.05. Conclusions: ankle taping can improve athletes' part of athletic constitution but it has negative impact on lower limbs' explosive power.%通过实验法测试踝关节贴扎前后患有功能性踝关节不稳的国家男子橄榄球队(15人制)运动员的下肢运动素质,了解踝关节贴扎给运动员带来踝关节保护的同时,踝关节贴扎对运动员下肢运动素质的具体影响。结果:贴扎对七人制橄榄球运动员的下肢爆发力和灵敏性有显著性影响(P0.05)。结论:踝关节贴扎对患有功能性踝关节不稳的男性橄榄球运动员下肢运动素质有一定的促进作用,但是对下肢爆发力有一定的负面影响。

  10. Effect of Ankle Taping on the Athletic Constitution of Lower Limb of Male Players with Ankle Instability from the National Rugby Team%贴扎对患踝关节不稳的男橄榄球运动员下肢运动素质的影响

    Institute of Scientific and Technical Information of China (English)

    罗强; 胡晨; 冯晓琪; 马泽兵

    2015-01-01

    通过实验法测试踝关节贴扎前后患有功能性踝关节不稳的国家男子橄榄球队(15人制)运动员的下肢运动素质,了解踝关节贴扎给运动员带来踝关节保护的同时,踝关节贴扎对运动员下肢运动素质的具体影响。结果:贴扎对七人制橄榄球运动员的下肢爆发力和灵敏性有显著性影响(P0.05)。结论:踝关节贴扎对患有功能性踝关节不稳的男性橄榄球运动员下肢运动素质有一定的促进作用,但是对下肢爆发力有一定的负面影响。%To exam the lower limbs athletic constitution of the national rugby team's athlets suffering from the functional ankle instability in order to learn about the protection for the ankle and the impact on the athletic constitution. Results: 1) the effect of Lower limbs' explosive power and coordination before and after ankle taping is at the level of 0.05; 2)the effect of speed and balanced capacity before and after ankle taping is not at the level of 0.05. Conclusions: ankle taping can improve athletes' part of athletic constitution but it has negative impact on lower limbs' explosive power.

  11. 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 ...

  12. 功能性踝关节不稳者姿势稳定性的研究进展%Research Advancement on Postural Stability of Subjects with Functional Ankle Instability

    Institute of Scientific and Technical Information of China (English)

    尹彦; 罗冬梅; 刘卉; 于冰

    2016-01-01

    姿势稳定性可以从整体上反映人体的姿势控制能力,对姿势稳定性进行评价是功能性踝关节不稳者损伤预防的重要方面。明确了姿势稳定性比平衡更适合作为反映人体姿势控制能力的专业术语,详细综述了功能性踝关节不稳者静态和动态姿势稳定性的主观和客观评价方法,概括分析了现有评价方法的局限性,为今后功能性踝关节不稳者姿势控制能力测量与评价的方法研究提供理论依据。%Postural stability can reflect the human’ s ability to control posture .Evaluation of postural stability is an important aspect of the prevention from injury of subjects wity function‐al ankle instability .Firstly ,this paper advanced that postural stability was more appropriate as a terminology to reflect the ablity to control posture than balance .Secondly ,the subjective and objective methods of evaluating the static and dynamic postural stability of subjects with func‐tional ankle instability were reviewed .Thirdly ,the limitations of the existing methods were an‐alyzed and summarized .It can provide a theoretical basis for the future research on methods of mearsuring and evaluating the postural stability of subjects wity functional ankle instability .

  13. 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.

  14. 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 ...

  15. 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 ...

  16. Colville手术治疗慢性踝关节外侧不稳%Reconstruction of lateral ankle ligaments (Colville's technique) for chronic lateral instability of the ankle

    Institute of Scientific and Technical Information of China (English)

    沙勇; 丁晶; 徐永清; 李春晓; 李军; 师继红

    2008-01-01

    内翻应力导致的外踝扭伤是一种常见外伤,而大约10%~15%的损伤导致距腓前韧带和跟腓韧带断裂。然而经过治疗后,仍然有部分患者出现慢性踝关节外侧不稳,需要进行外科手术治疗。1999年8月至2004年2月,我们应用Colville术式重建踝关节外侧韧带,治疗踝关节慢性外侧不稳26例,取得了良好的疗效,报告如下。

  17. Repairing ankle lateral collateral ligament chronic injury using different methods:A stability assessment%不同方法修复踝关节外侧副韧带慢性损伤的稳定性评价☆

    Institute of Scientific and Technical Information of China (English)

    焦晨; 胡跃林; 郭秦炜; 王成; 梅宇; 谢兴; 杨渝平; 陈临新; 江东

    2013-01-01

    BACKGROUND: There are many repair and reconstruction methods to restore the stability of lateral ankle joint. OBJECTIVE: To compare the mechanical changes of modified Karlsson procedure and modified Broström procedure for the treatment of lateral chronic ankle instability. METHODS: Seventy-three patients with lateral chronic ankle instability were enrol ed, among whom, 43 consecutive patients were treated with modified Broström procedure and fol owed-up for average (50.8±26.5) months, and 30 consecutive patients underwent modified Karlsson procedure and fol owed-up for (49.5±11.1) months. Chondral lesions, American Orthopaedic Foot and Ankle Society score, Mazur score, Tegner score, satisfaction score and re-injury situation were recorded before and after treatment. Objective examinations including drawer test and inversion stress test were also done for assessment. RESULTS AND CONCLUSION: 38.4% patients had chondral lesions, and 40.5% lesions occurred in the anteromedial facet of the talocrural joint (talus zone I and tibia region I). Mazur score and Tegner score were significantly improved postoperatively in modified Broström group and modified Karlsson group. There were no significant differences on Mazur score and Tegner score between two groups. The improved American Orthopaedic Foot and Ankle Society score in the modified Karlsson group was significantly higher than that in the modified Broström group. The drawer test and inversion stress test were negative in two groups, except positive in one patient in modified Broström group. The treatment time in the modified Karlsson group was significantly shorter than that in the modified Broström group, and there was no significant difference in satisfaction score between two groups. There were two cases of re-injury in modified Broström group while one case in modified Karlsson group. Modified Karlsson procedure has the treatment effect similar to modified Broström procedure, but it is easier to operate.%

  18. 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

    -free, whereas surgery had serious, though infrequent, complications. Functional treatment produced no more sequelae than casting with or without surgical repair. Secondary surgical repair, even years after an injury, has results comparable to those of primary repair, so even competitive athletes can receive initial conservative treatment. Sequelae of lateral ligament injuries are common. After conservative or surgical treatment, 10 to 30% of patients have chronic symptoms, including persistent synovitis or tendinitis, ankle stiffness, swelling, pain, muscle weakness and 'giving-way'. Well-designed physical therapy programmes usually reduce instability. For individuals with chronic instability refractory to conservative measures, surgery may be needed. Subtalar instability should be carefully evaluated when considering surgery. PMID:10028133

  19. Effectiveness of functional ankle taping for judo athletes: a comparison between judo bandaging and taping.

    OpenAIRE

    Yamamoto, T; Kigawa, A; Xu, T

    1993-01-01

    This study was conducted to compare the effectiveness of the traditional method of ankle bandaging and the new method of ankle taping for judo athletes in Japan, and to introduce a functionally effective taping method for judo players. Four university judo athletes with ankle instability were selected to undertake radiography of the ankles before and after exercise, with bandaging at one time and taping at the other. Talar tilt (TT) angles were measured in order to compare the ankle-supportin...

  20. Chronic lateral instability of the ankle%慢性踝关节外侧不稳定

    Institute of Scientific and Technical Information of China (English)

    王金辉; 蒋协远; 武勇; 王满宜

    2006-01-01

    慢性踝关节外侧不稳定是一种常见的疾病,国内对于此病的研究和报告不多,一方面是由于患者本身要求不高,另一方面临床医生对它也不够重视.结合国内外有关文献报道,探讨了有关诊断问题,描述和比较了几种常见手术重建方法,以期能对慢性踝关节外侧不稳定的诊断和治疗有更深入和全面的认识.

  1. 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

  2. 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.)

  3. Biceps tenodesis with Clancy method for chronic posterolateral rotary instability of the knee

    Directory of Open Access Journals (Sweden)

    Motamedi M.

    2008-03-01

    Full Text Available Background: Posterolateral rotatory instability is one of the most complex problems in ligamentous injuries of the knee. It represents a challenging diagnostic and therapeutic problem for the orthopaedic surgeon. We present the results of biceps tenodesis in chronic posterolateral rotatory instabilily of the knee.Methods: In this case series we included all of the patients with positive reverse pivot shift test and prone external rotation test at least 3 weeks after their trauma. We excluded the patients with varus malalignment of the knee and concomitant anterior cruciate ligament (ACL rupture. Biceps tenodesis (Clancy method was performed. We did not reconstruct posterior cruciate ligament (PCL if its insufficiency was diagnosed in addition to posterolateral rotatory instability. Knee scoring scale of Lysholm was used during and after follow ups. The results were statistically compared using Wilcoxon signed rank test (WSRT, paired samples t-test and friedman test. Data analysis was done using SPSS (version 11.5 and Stata (version 8 computer softwares.Results: Our series consists of 13 patients (12 male and one female. 31% of the patients had isolated posterolateral injury and 69% of the patients had combined posterolateral and PCL injuries. The patients were between 17 to 45 years old (mean 30.25 years. Follow up was between 4 to 44 months (mean: 31 months. At the end of follow up 85% of patients had negative reverse pivot shift test. Prone external rotation test at 30° of knee flexion was negative in 92% of patients. In 92% of patients giving way was negative and in 77% of patients pain was decreased. Before operation the average Knee scoring scale of Lysholm was 73 and at the end of the follow up it increased to 85 (p value<0.001.Conclusions: Biceps tenodesis using Clancy method is a safe, effective and reliable method in management of chronic posterolateral rotatory instability of the knee. During surgery careful exploration of the common

  4. 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

  5. Acute Tibialis Posterior Tendon Rupture With Pronation-Type Ankle Fractures.

    Science.gov (United States)

    Bernstein, Derek T; Harris, Joshua D; Cosculluela, Pedro E; Varner, Kevin E

    2016-09-01

    Tibialis posterior tendon rupture in the setting of pronation-type ankle fractures can lead to long-term debility as a result of chronic tendon dysfunction. This rare injury pattern presents a diagnostic challenge because thorough preoperative examination of the function of the tendon is limited by pain, swelling, and inherent instability of the fracture. As such, a high index of suspicion is necessary in ankle fractures with radiographs showing a medial malleolus fracture with an associated suprasyndesmotic fibula fracture. This report describes 3 cases of tibialis posterior tendon rupture associated with pronation-type ankle fractures treated acutely with open reduction and internal fixation and primary tendon repair. Additionally, common features of this injury pattern are discussed based on the current literature. In accordance with this report, the typical mechanism of injury is high energy and includes forced pronation, external rotation, and dorsiflexion of the ankle, which places maximal stress on the tibialis posterior tendon. Rupture most commonly occurs in a relatively hypovascular area of the tendon located at the posteromedial extent of the medial malleolus fracture. In the operative treatment of pronation-type ankle fractures, direct inspection of the tibialis posterior tendon allows for timely diagnosis and treatment of associated ruptures. [Orthopedics.2016; 39(5):e970-e975.]. PMID:27248337

  6. 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...

  7. 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.

  8. 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 ...

  9. The Position Sense and Muscle Force Sense of the Ankle Joint with Functional Instability%功能性不稳踝关节位置觉和肌肉力觉特征

    Institute of Scientific and Technical Information of China (English)

    张秋霞; 张林; 王国祥; 王国栋

    2012-01-01

    Objective To examine the difference in proprioception of the ankle joint with functional instability through analyzing the joint position sense and force sense, in order to provide the basis for the prevention from and treatment on the sprained ankle. Methods Fourteen males subjects with unilateral functional ankle instability (FAD were enrolled in the study, and other 14 healthy matched-paired subjects were served as controls. The target angle of the ankle passively reposition was set at 5° plantar flexion for measuring joint position sense and the target force of the muscle at 25% maximal voluntary isometric contraction for measuring muscle force sense. 2×2 mixed model ANOVA was used to compare the difference in proprioception between two the groups with and without FAI. Results The VEJPS (variable error of joint position sense) and AEJPS (absolute error of joint position sense) of FAI group were not significantly different from those of the control group (P>0.05) .However, there was significant difference in the RVEFS (relative variable error of force sense) and RAEFS (relative absolute error of force sense) between the two groups (P 0.05).. Conclusion The difference between FAI group and the control group was found not in the joint position sense, but in themuscle force sense. The ability of neuromuscular control for the FAI group was impaired. There was only one subject whose proprioception appeared to be normal.%目的:探讨功能性不稳踝关节的位置觉和肌肉力觉特征及其发生机制,为踝关节损伤防治和康复训练提供依据.方法:选取14名有单侧踝关节功能性不稳的受试者为实验组(FAI组),匹配14名无踝关节伤病的受试者作为对照组.测试受试者踝关节跖屈5°的被动定位并被动复位能力作为踝关节位置觉,计算位置觉的可变误差(VEJPS)和绝对误差(AEJPS).测试受试者踝关节跖屈肌群对25%最大等长峰值力矩值的复制能力作为肌肉力觉,计

  10. 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

  11. 康复指导在功能性踝关节不稳康复中的意义%Effect of Comprehensive Rehabilitation Direction on Functional Ankle Instability

    Institute of Scientific and Technical Information of China (English)

    刘欣; 张云鹏; 王磊; 卢占斌; 陈先; 黄玉国; 郁冰

    2014-01-01

    目的:探讨正规康复指导对功能性踝关节不稳(FAI)患者踝关节功能的影响。方法32例FAI患者随机分为两组,治疗组(n=16)在物理治疗师的指导下,在医院内行4周下肢功能及姿势控制训练;对照组(n=16)在家中按照康复计划自行训练。训练前后进行单腿站立试验(OLST)及足踝功能障碍指数(FADI)评定。结果训练后,治疗组OLST评分明显减低(P0.05)。训练后,治疗组FADI评分明显提高(P0.05)。结论正规指导下的综合康复训练有助于恢复FAI患者踝关节本体感觉及踝关节稳定控制能力。%Objective To investigate the effect of comprehensive rehabilitation direction on functional ankle instability (FAI). Methods 32 consecutive patients with FAI were divided into 2 groups. The rehabilitation group (n=16) finished their rehabilitation program under the instruction of physiotherapists in the hospital, and the control group (n=16) exercised at home by written instruction. All the patients were tested with One Leg Standing Test (OLST) and Foot and Ankle Disability Index (FADI) for the injured ankle before and 4 weeks after train-ing. Results The scores of both OLST and FADI improved after training in the rehabilitation group (P0.05);and improved more in the rehabilitation group than in the control group (P<0.05). Conclusion The comprehensive rehabili-tation direction is effctive on FAI.

  12. Ankle-brachial blood pressure index predicts cardiovascular events and mortality in Japanese patients with chronic kidney disease not on dialysis.

    Science.gov (United States)

    Yoshitomi, Ryota; Nakayama, Masaru; Ura, Yoriko; Kuma, Kazuyoshi; Nishimoto, Hitomi; Fukui, Akiko; Ikeda, Hirofumi; Tsuchihashi, Takuya; Tsuruya, Kazuhiko; Kitazono, Takanari

    2014-12-01

    The ankle-brachial blood pressure index (ABPI) has been recognized to have a predictive value for cardiovascular (CV) events and mortality in general or dialysis populations. However, the associations between ABPI and those outcomes have not been fully investigated in predialysis patients. The present study aimed to clarify the relationships between ABPI and both CV events and mortality in Japanese chronic kidney disease (CKD) patients not on dialysis. In this prospective observational study, we enrolled 320 patients with CKD stages 3-5 who were not on dialysis. At baseline, ABPI was examined and a low ABPI was defined as ABPI were risk factors for CV events. It was demonstrated that age, a history of cerebrovascular disease and low ABPI were determined as independent risk factors for CV mortality. In addition, age, body mass index and low ABPI were independently associated with all-cause mortality. In patients with CKD, low ABPI during the predialysis period is independently associated with poor survival and CV events, suggesting the usefulness of measuring ABPI for predicting CV events and patient survival in CKD. PMID:25056682

  13. Transcutaneous oximetry but not arterial toe blood pressure or ankle-brachial index is related to macular thickness in patients with chronic diabetic foot ulcers

    Directory of Open Access Journals (Sweden)

    Per Katzman

    2013-04-01

    Full Text Available Objectives: Diabetes related vascular complications of the lower extremity could be classified as micro- and macrovascular. Ankle-brachial index (ABI and toe blood pressure (TBP measurements evaluate macro-circulation, whereas transcutaneous oximetry (TcPO2 is considered to be a composite measure of vascular function, thereby also reflecting microcirculation. Microvascular disease in the eye involves abnormal capillary permeability and possibly thereby increased macular thickness. The aim of the present clinical study was to evaluate if microvascular disease in the eye was related to measures of foot ischemia in patients with diabetes mellitus. Methods: Twenty consecutive patients with diabetes and chronic full-thickness foot ulcers were included. Peripheral ischemia was diagnosed using TcPO2, TBP and ABI. Macular thickness was measured with optical coherence tomography technique. Results: Based on TcPO2, TBP and ABI measurements 14, 13 and 13 patients, respectively, were classified as ischemic. Patients with ischemic TcPO2 levels at the dorsum of the foot had significantly higher macular thicknesses. This was not the case in patients with ischemic TBP or ABI levels. Conclusion: TcPO2, unlike TBP and ABI, seems to be a clinically relevant measure of peripheral microvascular disease in patients with diabetes mellitus and may, if low, indicate an increased risk of macular edema. [J Exp Integr Med 2013; 3(2.000: 81-85

  14. Total ankle joint replacement.

    Science.gov (United States)

    2016-02-01

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

  15. 功能性踝关节不稳者动态平衡能力及等速肌力特征研究%Examination of dynamic balance ability and isokinetic strength in participants with functional ankle instability

    Institute of Scientific and Technical Information of China (English)

    赵丽; 李翠; 顾博雅; 熊开宇

    2012-01-01

    目的 分析功能性踝关节不稳者动态平衡能力和不同速度、不同收缩模式下跖屈、背屈等速肌力特征.方法 应用Biodex Balance System测试系统对FAI组(19例)和对照组(19例)分别进行姿势稳定性测试和60°/s、180°/s跖屈肌群、背屈肌群等速向心、离心肌力测试分析.结果 FAI组健侧、患侧的稳定指数和前后方向稳定指数大于对照组,而左右方向稳定指数无差异;双脚站立姿势稳定性测试结果FAI组和对照组无差异;FAI组跖屈肌群低速离心肌力和高速向心、离心肌力不足;FAI组跖屈肌群的向心、离心峰值力矩差值比在不同速度下均大于10%,背屈肌群均小于10%.结论 功能性踝关节不稳者单脚站立时健侧和患侧都存在动态平衡能力下降,双脚站立时动态平衡能力与常人无异;功能性踝关节不稳者跖屈肌群高速工作能力较差;功能性踝关节不稳者随角速度增加离心力量增加越小者,其跖屈肌群的弹性组织损伤的可能性越大.%Objective To investigate dynamic balance ability and isokinetic strength of plantar flexion or dorsiflexion under different velocity and contraction modes in the participants with the functional ankle instability (FAI). Methods The participants (including 19 participants with a history of unilateral FAI and 19 participants with stable ankles) were tested in both postural stability (PS) and plantar-flexion-dorsiflexion movements at the speed of 60°/s and 180°/s using Biodex Balance System. The injured ankle of the FAI group was matched by side and limb dominance to an ankle in the control group. The order of the test side and movement was counterbalanced for all participants. Results Significant differences were noted for the anterior/posterior stability between FAI group and control group, but medial/lateral stability difference was not significant; two leg standing PS test result showed no significant difference between FAI group and

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

    Directory of Open Access Journals (Sweden)

    van Mechelen Willem

    2008-05-01

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

  17. Progress in Application of Soft Tissue Taping Techniques for Ankle Sprains (review)%软组织贴扎技术预防及治疗踝关节扭伤的临床应用进展

    Institute of Scientific and Technical Information of China (English)

    柴松; 余波; 陈文华

    2015-01-01

    The ankle sprain is very common in clinic. It will be sprained again if it is not handled properly, and even develop into chron-ic ankle instability which will affect people's daily life and exercise. This paper discussed the soft tissue techniques, especially kinesio tap-ing, applied for ankle sprain in clinical. As a non-invasive therapy, soft tissue taping can relieve the symptoms of ankle sprains, stable ankle, improve ankle function and prevent recurrent ankle sprain, which is worthy of further research and application.%踝关节扭伤临床极为常见,如处理不当很容易再次扭伤,甚至发展成慢性踝关节不稳,影响人们的日常生活与运动。本文对以肌内效贴为代表的软组织贴扎技术预防及治疗踝关节扭伤的临床应用进展进行综述。作为一种非侵入性治疗手段,软组织贴扎技术可缓解踝关节扭伤症状,稳定关节,改善功能,预防踝关节扭伤反复发作,值得临床进一步研究与应用。

  18. 软组织贴扎技术预防及治疗踝关节扭伤的临床应用进展%Progress in Application of Soft Tissue Taping Techniques for Ankle Sprains (review)

    Institute of Scientific and Technical Information of China (English)

    柴松; 余波; 陈文华

    2015-01-01

    踝关节扭伤临床极为常见,如处理不当很容易再次扭伤,甚至发展成慢性踝关节不稳,影响人们的日常生活与运动。本文对以肌内效贴为代表的软组织贴扎技术预防及治疗踝关节扭伤的临床应用进展进行综述。作为一种非侵入性治疗手段,软组织贴扎技术可缓解踝关节扭伤症状,稳定关节,改善功能,预防踝关节扭伤反复发作,值得临床进一步研究与应用。%The ankle sprain is very common in clinic. It will be sprained again if it is not handled properly, and even develop into chron-ic ankle instability which will affect people's daily life and exercise. This paper discussed the soft tissue techniques, especially kinesio tap-ing, applied for ankle sprain in clinical. As a non-invasive therapy, soft tissue taping can relieve the symptoms of ankle sprains, stable ankle, improve ankle function and prevent recurrent ankle sprain, which is worthy of further research and application.

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

    Directory of Open Access Journals (Sweden)

    Verhagen Evert ALM

    2011-09-01

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

  20. [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

  1. Subtalar joint instability: current clinical concepts.

    Science.gov (United States)

    Budny, Adam

    2004-07-01

    There has been extensive research and investigation into the subtalar joint (STJ), yet the biomechanics that relate to its anatomic function, especially instability after injury, are surrounded by controversy. With a mechanism of injury closely related to the classic inversion ankle sprain, chronic instability can result following trauma to the lateral ligamentous support network of either joint. Over the past decades there have been countless examples in the literature challenging the current standard of evaluation and treatment of the "subtalar sprain." New technologies have offered varied approaches to diagnostic capability, each with its own strengths and weaknesses, ranging from standard radiographs to CT and MRI. A review of the literature should aid in deciphering the controversy surrounding this aspect of podiatric medicine. PMID:15246150

  2. 单侧功能性踝关节不稳者的单足静态平衡能力%The single foot static balancing ability of people suffering from single side functional ankle joint instability

    Institute of Scientific and Technical Information of China (English)

    张阳; 张秋霞; 金超

    2014-01-01

    In order to probe into the characteristics of the single foot static balancing ability of people suffering from single side functional ankle joint instability, the authors used a WIN-POD balancing instrument to test the static balancing ability of 15 people suffering from single side functional ankle joint instability and 15 normal people in eyes opened and shut single foot standing conditions for 10, and revealed the following findings: 1) in an eyes opened left foot standing condition, the differences in envelop area and axisY shaking amplitude between the people in the experiment group and the people in the control group were statistically significant (P<0.05); in an eyes shut standing condition, except axesX andY shaking speeds, the differences in other indexes between the people in the experiment group and people in the control group were statistically significant (P<0.05); 2) in an eyes shut right foot standing condition, the differences in envelop area and axisY shaking amplitude between the people in the experi-ment group and the people in the control group were statistically significant (P<0.05); 3) for the people in the ex-periment group, in an eyes opened standing condition, the difference in envelop area between the ill foot and the healthy one was statistically significant (P<0.05), in an eyes shut standing condition, the differences in envelop area and average axisY shaking amplitude between the ill foot and the healthy one were statistically significant (P<0.05); 4) for the people in the control group, in an eyes shut standing condition, except axesX andY shaking speeds, the differences in other indexes between the left foot and the right one were all statistically significant (P<0.05). The said findings indicate the followings: for people suffering from single side functional ankle joint instability, the bal-ancing ability of the ill foot is slightly weaker than that of the corresponding foot of normal people, and also weaker than that of the

  3. 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 ( ...

  4. 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…

  5. 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.

  6. 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.)

  7. 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.)

  8. 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.

  9. Mini-open reconstruction of lateral collateral ligaments of ankle with partial tendon of its peroneus brevis%小切口取部分腓骨短肌腱重建踝关节外侧副韧带

    Institute of Scientific and Technical Information of China (English)

    陈前博; 唐康来; 吴雪晖; 徐格; 谭晓康; 周兵华; 周运平; 许建中

    2008-01-01

    Objective To describe a new technique with mini-open reconstruction of lateral ligaments of ankle with partial tendon of its peroneus brevis and evaluate its effect in treatment of chronic lateral ankle instability. Methods A total of 11 cases of chronic lateral ankle instability;at mean age of 27.6 years(16-42 years),were treated with mini-open reconstruction of the lateral ligaments of the ankle with partial tendon of its peroneus brevis.The mean delay between the initial episode of ankle sprain and the surgery was 10.3 months(4-32 months).Postoperatively,all cases were examined with MRI,stress X-rays and comparative stability of bilateral ankle inspection at clinical follow-up.The function of the ankle were evaluated bv American Orthopaedic Foot & Ankle Society (AOFAS)score and ankle-hind foot scale. Results The average duration of follow-up was 17.5 months(12-37 months).The mean AOFAS ankle-hindfoot score was 88.3 points(72-96 points)at the time of the latest follow-up,including excellent result in 6 cases(55%),good in 4(36%)and fair in 1(9%).MRI results showed that the ruptured lateral collateral ligaments of the ankle were repaired and remodeled very well in all patients.There was no recurrence of the ankle instability or other complications. Conclusion Mini-open reconstruction of the lateral ligaments of ankle with partial tendon of its peroneus brevis is safe and effective for treatment of chronic lateral ankle instability.%目的 介绍小切口取部分腓骨短肌腱解剖重建外侧副韧带治疗慢性踝关节外侧不稳的疗效.方法 11例慢性踝关节外侧不稳患者接受小切口取部分腓骨短肌腱解剖重建踝关节外侧副韧带的手术治疗,年龄16~42岁,平均27.6岁.术前病程4~32个月,平均10.3个月.术后定期行双侧踝关节对比稳定检查、应力位X线片及MRI检查,并按美国足踝外科协会(AOFAS)踝-后足功能评分表进行功能评分.结果 11例患者术后平均随访17.5个月(12~37

  10. Therapeutic Observation of Acupuncture-moxibustion plus Bloodletting for Chronic Ankle Sprain%针灸配合刺血疗法治疗陈旧性踝关节扭伤疗效观察

    Institute of Scientific and Technical Information of China (English)

    卢振中

    2016-01-01

    Objective To observe the clinical efficacy of acupuncture-moxibustion plus bloodletting in treating chronic ankle sprain.Method Sixty-six patients with chronic ankle sprain were randomized into a treatment group and a control group, 33 in each group. The treatment group was intervened by acupuncture with distal points plus warm needling and bloodletting method in the topical area; the control group was by warm needling plus ultrashort wave applied to the topical area. The ankle joint symptom and sign score was evaluated before and after intervention, and the clinical efficacies were compared between the two groups.Result The recovery-markedly-effective rate in the treatment group was 51.6%, 74.2%, and 93.5% respectively after 1, 2, and 3 treatment courses, versus 26.7%, 46.7%, and 70.0% in the control group, and the between-group differences were statistically significant (P<0.05).Conclusion Acupuncture-moxibustion is an effective method in treating chronic ankle sprain.%目的:观察针灸配合刺血疗法治疗陈旧性踝关节扭伤的临床疗效。方法将66例陈旧性踝关节扭伤患者随机分为治疗组和对照组,每组33例。治疗组采用针刺远端取穴配合局部温针灸及刺血疗法治疗,对照组采用局部温针灸配合超短波治疗。观察两组患者治疗前后踝关节症状体征评分,比较两组临床疗效。结果治疗组治疗1、2、3个疗程后愈显率分别为51.6%、74.2%和93.5%,对照组分别为26.7%、46.7%和70.0%,两组比较差异具有统计学意义(P<0.05)。结论针灸配合刺血疗法是一种治疗陈旧性踝关节扭伤的有效方法。

  11. Avulsion fracture of the coracoid process in a patient with chronic anterior shoulder instability treated with the Latarjet procedure: a case report

    OpenAIRE

    Schneider, Marco Michael; Balke, Maurice; Koenen, Paola; Bouillon, Bertil; Banerjee, Marc

    2014-01-01

    Introduction Shoulder dislocations can cause acute and chronic instabilities that need to be addressed in order to restore joint functioning. The transfer of the coracoid process has become a feasible surgical procedure in patients with shoulder instability. Several concomitant injuries after recurrent dislocations have been described. Case presentation A 32-year-old German man presented to our department with a history of recurrent shoulder dislocations. He was diagnosed with an avulsion fra...

  12. 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

  13. Proprioceptive exercises for ankle ligament injury: a CAT

    OpenAIRE

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2016-10-01

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

  15. 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)

  16. Foot, leg, and ankle swelling

    Science.gov (United States)

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

  17. How to Tape an Ankle

    Science.gov (United States)

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

  18. Proprioceptive exercises for ankle ligament injury: a CAT

    Directory of Open Access Journals (Sweden)

    Raúl Aguilera Eguía

    2013-06-01

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

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

    Science.gov (United States)

    2014-01-01

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

  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. The foot and ankle

    International Nuclear Information System (INIS)

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

  3. Ankle sprain - slideshow

    Science.gov (United States)

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

  4. A anquilose tíbio-társica e sua importância na insuficiência venosa crônica Ankle ankylosis and its importance in chronic venous insufficiency

    Directory of Open Access Journals (Sweden)

    Jorge Ribas Timi

    2009-09-01

    Full Text Available CONTEXTO: O desenvolvimento de anquilose em pacientes com insuficiência venosa crônica (IVC pode ser evidenciado em diversos estágios da patologia através de medidas da amplitude de movimento da articulação do tornozelo tomadas com a utilização de um goniômetro. OBJETIVO: Relacionar a diminuição da amplitude de movimento da articulação tíbio-társica na IVC dos membros inferiores (MMII medida por goniometria com a gravidade da IVC, utilizando-se a classificação CEAP. MÉTODOS: No período de março de 2003 a agosto de 2004, 86 pacientes (67 mulheres e 19 homens com média de idade de 50,6 anos foram submetidos à goniometria do tornozelo. Os indivíduos foram divididos conforme a gravidade da IVC de seus MMII (121 avaliados de acordo com a classificação CEAP. Quarenta membros foram caracterizados como C0 (grupo-controle, 40 como C3, e 41 como C4. As medidas obtidas nos diferentes grupos foram comparadas entre si. RESULTADOS: A média da amplitude de movimento da articulação tíbio-társica do grupo C0 foi de 42,4º (variação de 26-54; a do grupo C3 foi de 37,9º (variação de 10-61; e a do grupo C4 foi de 24,5º (variação de 8-50. A diferença das médias de C4 e C3 foi de 36%, e a de C3 comparada com o grupo-controle (C0, de 11%, caracterizando a maior diferença entre C3 e C4. CONCLUSÃO: A goniometria do tornozelo auxilia a graduar a hipertensão venosa crônica, pois demonstra a existência de correlação entre a gravidade da anquilose e a severidade da IVC.BACKGROUND: Development of ankylosis in patients with chronic venous insufficiency (CVI can be observed in different stages of the disease as the ankle range of motion is measured by a goniometer. OBJECTIVE: To relate a reduced ankle range of motion in patients with CVI of the lower limbs measured by goniometry and the severity of CVI according to the CEAP classification. METHODS: From March 2003 to August 2004, 86 patients (67 females and 19 males with a mean

  5. 中药洗药治疗陈旧性踝关节扭伤的临床疗效观察%Clinical observation on treating chronic ankle sprain in TCM medicine

    Institute of Scientific and Technical Information of China (English)

    刘照富; 张振南

    2014-01-01

    To observe clinical effects of TCM medicine on chronic ankle sprains. Methods:60 cases of chronic ankle sprains were randomly divided into the treatment group and the control group. The treatment group was given TCM form foot for 30 min, twice a day; The control group was given topical indomethacin papua cream. Clinical effects in two groups were recorded in 2 courses. Results: Clinical efficacy in two groups was 93.33% and 73.33% respectively, with significant difference (P<0.05). Conclusion: TCM medicine shows curative effects and was worthy of application.%目的:观察中药洗药治疗陈旧性踝关节扭伤的临床疗效。方法:选出符合条件的陈旧性踝关节扭伤病人60例,随机分成治疗组30例,对照组30例。治疗组用中药洗药泡足30min,2次/d;对照组外用吲哚美辛巴布膏,1片/次,1次/d;2个疗程后两组进行临床疗效评分。结果:治疗组和对照组有效率分别为93.33%、73.33%,差异具有显著性(P<0.05)。结论:中药洗药治疗陈旧性踝关节扭伤临床疗效显著,值得临床推广应用。

  6. Chronic p53-independent p21 expression causes genomic instability by deregulating replication licensing.

    Science.gov (United States)

    Galanos, Panagiotis; Vougas, Konstantinos; Walter, David; Polyzos, Alexander; Maya-Mendoza, Apolinar; Haagensen, Emma J; Kokkalis, Antonis; Roumelioti, Fani-Marlen; Gagos, Sarantis; Tzetis, Maria; Canovas, Begoña; Igea, Ana; Ahuja, Akshay K; Zellweger, Ralph; Havaki, Sofia; Kanavakis, Emanuel; Kletsas, Dimitris; Roninson, Igor B; Garbis, Spiros D; Lopes, Massimo; Nebreda, Angel; Thanos, Dimitris; Blow, J Julian; Townsend, Paul; Sørensen, Claus Storgaard; Bartek, Jiri; Gorgoulis, Vassilis G

    2016-07-01

    The cyclin-dependent kinase inhibitor p21(WAF1/CIP1) (p21) is a cell-cycle checkpoint effector and inducer of senescence, regulated by p53. Yet, evidence suggests that p21 could also be oncogenic, through a mechanism that has so far remained obscure. We report that a subset of atypical cancerous cells strongly expressing p21 showed proliferation features. This occurred predominantly in p53-mutant human cancers, suggesting p53-independent upregulation of p21 selectively in more aggressive tumour cells. Multifaceted phenotypic and genomic analyses of p21-inducible, p53-null, cancerous and near-normal cellular models showed that after an initial senescence-like phase, a subpopulation of p21-expressing proliferating cells emerged, featuring increased genomic instability, aggressiveness and chemoresistance. Mechanistically, sustained p21 accumulation inhibited mainly the CRL4-CDT2 ubiquitin ligase, leading to deregulated origin licensing and replication stress. Collectively, our data reveal the tumour-promoting ability of p21 through deregulation of DNA replication licensing machinery-an unorthodox role to be considered in cancer treatment, since p21 responds to various stimuli including some chemotherapy drugs. PMID:27323328

  7. 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.)

  8. 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.)

  9. 踝关节慢性不稳定的手术治疗%The Surgical Treatment of Chronical Ankle Instability

    Institute of Scientific and Technical Information of China (English)

    李仙彤

    2008-01-01

    目的:探讨治疗踝关节慢性不稳定的方法及其临床效果.方法:1999年1月~2006年12月,对36例踝关节慢性不稳定患者,通过手术进行外侧踝韧带修复与重建,经过1年~4年的随访,了解患踝疼痛、肿胀、活动度以及患肢整体功能康复情况.结果:术后平均随访3年,优32例,良2例,无变化1例,仅有1例失败(由于明显的再损伤),并进行了翻修,无严重的并发症发生.结论:通过手术对踝关节慢性不稳定进行踝外侧韧带修复与重建,手术创伤小,并发症少,能够最大程度恢复踝关节功能.

  10. 慢性外踝关节不稳定的影像学诊断%Radiology diagnosis of chronic instability of lateral ankle

    Institute of Scientific and Technical Information of China (English)

    何伟华; 原林; 黄昌林; 胡书鸿

    2005-01-01

    目的探讨应力位片在慢性外踝关节不稳定诊断中的意义,提出影像学的定量诊断方法.方法随机选择慢性外踝关节不稳的陆军士兵40人共42侧患踝,正常对照组40人共80侧踝.拍摄前抽屉试验侧位片及内翻应力正位片,分别测量距骨前移距离(ATT)及距骨斜角(TT).结果患侧ATT平均7.8mm,TT平均9.1°,而健侧分别为5.4mm及5.4°,对照组为6.1mm及4.9°,患侧与健侧及对照组比较均有显著性差异(P<0.01),健侧与对照组比较差异无显著性.患侧与健侧距骨前移距离差值(△ATT)平均2.4mm,距骨斜角差值(△TT)平均3.7°,而对照组分别为0.9mm及1.1°,与慢性外踝关节不稳的40例比较差异显著(P<0.01).118例正常踝关节ATT、TT的P95分别为8mm及9°.结论前抽屉试验侧位片及内翻应力正位片对于慢性外踝不稳诊断具有重要意义.前抽屉试验侧位片中ATT≥8mm、△ATT≥2mm,内翻应力正位片中TT≥9°、△ATT≥3°可作为衡量踝关节不稳定的标准.

  11. Surgical treatment for chronic anterolateral ankle instability%踝关节慢性前外侧不稳的手术治疗

    Institute of Scientific and Technical Information of China (English)

    叶伟雄; 张同仁; 梁伟国; 陈鸿辉

    2005-01-01

    目的:探讨治疗踝关节慢性前外侧不稳定(踝关节外侧不稳定合并距下关节不稳定)的合理而有效的手术方式.方法:自1999~2003年,应用Chrisman-Snook术式,以腓骨短肌腱前半部分重建距腓前韧带、跟腓韧带和距跟外侧韧带,治疗踝关节慢性前外侧不稳8例患者,共13例关节.结果:术后随诊6个月~5年,平均19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.以Good评级标准作为疗效评价,10例关节(77%)为优,2例关节(15%)为良,1例关节为中(7%),优良率达92%.结论:Chrisman-Snook术式重建了距腓前韧带、跟腓韧带和距跟外侧韧带,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.

  12. Surgical treatment for chronical lateral instability of the ankle joint%踝关节外侧不稳的手术修复

    Institute of Scientific and Technical Information of China (English)

    毛宾尧; 应忠追; 王毳; 李新春; 司全明

    2009-01-01

    目的 探讨踝关节外侧不稳手术治疗的效果.方法 自1994年6月至2007年7月采用Watson-Jones手术和改进的Chrisman-Snook手术治疗踝关节不稳24例(踝),其中11例采用Watson-Jones手术,13例采用Chrisman-Snook手术.结果 除8例失访外,余16例获平均5年9个月(2.5~9年)随访,踝关节功能采用踝关节稳定度(50分)、踝关节内翻试验(25分)和踝关节抽屉试验(25分)等来评价,疗效优(85~100分)14例,良2例(70~84分),无失败(<69分).还比较了Watson-Jones法与改进的Chrisman-Snook法疗效.术前、术后稳定度、踝内翻试验和抽屉试验两组数据的统计学分析(P<0.01)有显著意义.本组无并发症发生.结论 踝关节外侧不稳采用Watson-Jones手术和改进的Chrisman-Snook手术修复踝关节外侧韧带有良好疗效.

  13. 慢性踝关节不稳定治疗新进展%Advance of Treatment for Chronic Ankle Instability (review)

    Institute of Scientific and Technical Information of China (English)

    汤宇

    2008-01-01

    踝关节扭伤处理不当常导致慢性踝关节不稳定.随着足踝外科技术及认识的不断发展,对慢性踝关节不稳定的治疗也出现新的方法和临床长期随访结果,在改善症状、恢复踝关节功能方面显现出积极意义.本文就新的文献报道进行文献综述.

  14. 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.)

  15. 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 ...

  16. Ankle-brachial index as indicator of chronic arterial insufficiency of the lower extremities and renal artery stenosis CT/DS angiography

    International Nuclear Information System (INIS)

    Full text: The aim is to validate the measurements of ankle -brachial index (ABI), as part of routine examination algorithm in conducting CTA/DSA of the extremities in patients suffering from PAD. Correlations between ABI values and renal artery stenosis. The present study includes 200 patients (138 men and 62 women, aged between 60 and 75 years). 130 of them were examined by a computer- tomography angiography - 95 men and 32 women. 70 patients were examined by digital subtraction angiography - 50 men and 20 women. Measurements of ankle-brachial index (ABI) were performed on all patients by measuring the systolic blood pressure on both brachial arteries and determine the peak pressure in both aa. dorsalis pedis. Statistical data processing. There are no patients in the study with ABI values above 0.7 that have established renal artery stenosis. All patients with severe atherosclerotic changes have values of the ABI below 0.7, and those with the most severe changes below 0.5. This fully corresponds to global data showing that values below 0.9 ABI show mild engagement, below 0.7 average, and below 0.5 severe involvement. According to the results of this survey sensitivity of ABI for renal arteries below 0.7 equals 100% and its specificity = 67.5%. For values of ABI below 0.5: Sensitivity =100%; Specificity = 83.85%. By determining ABI values both symptomatic and asymptomatic form of a PAD can be diagnosed. the method is fast, non-invasive, inexpensive and applicable everywhere. No special preparation of the patient is needed. The method can be used not only to assess the degree of commitment of the vessels of the lower limbs, but also as an indicator for the state of renal arteries in those patients

  17. 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

  18. FUNCTIONAL OUTCOME FOLLOWING RECONSTRUCTION FOR CHRONIC ISOLATED DORSAL DISTAL RADIOULNAR JOINT INSTABILITY BY FULKERSON-WATSON METHOD-A PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Santhamoorthy

    2014-10-01

    Full Text Available BACKGROUND: Chronic isolated distal radioulnar joint instability is a relatively rare entity. Several methods of reconstruction were available to stabilize the joint and each method has some advantage over others. We proposed to assess the functional outcome following reconstruction of chronic dorsal distal radio ulnar instability using extra articular reconstruction by Fulkerson – Watson method. AIM: To assess the functional outcome following reconstruction for chronic isolated dorsal distal radio ulnar instability using Fulkerson –Watson method. METHODS: We conducted a prospective study in five patients over three years from 2010 to 2013 with chronic isolated dorsal distal radio ulnar instability who were treated by Fulkerson-Watson method of reconstruction. All patients underwent MRI evaluation before surgery to assess ligament pathology and for adequacy of sigmoid notch. Arthroscopy performed in all patients. Functional outcomes were assessed using VAS score, quick-DASH score and Mayo wrist score at every 6 months follow-up. Radiological assessment done using plain x-rays at each follow up. RESULTS: Three patients required Arthroscopic debridement for TFCC. All five patients had achieved stability at distal radio ulnar joint after surgery and remained so till their last follow up. One patient had persistent pain near ulnar styloid. The average loss of motion for pronation was 10 degrees and supination was 3 degrees in reference to the normal side. All except one patient achieved ulnar grip strength of >90 % compared to normal side. The mean pre and postoperative VAS score, quick-DASH score, Mayo wrist score were 76.6 and 17.2, 37.3 and 11.3, 45 and 77 respectively. CONCLUSION: Though extra articular reconstruction for DRUJ by Fulkerson-Watson method is non-anatomical, the procedure is simple than intra articular reconstruction and gives similar functional outcome like intra articular reconstructions as shown by our results.

  19. 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

  20. 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? ...

  1. Ankle Arthrodesis Following Trauma, a Useful Salvage Procedure – A Report on Three Cases

    OpenAIRE

    Oboirien, Muhammad

    2011-01-01

    Open musculoskeletal injuries remain a difficult problem to manage especially in resource-poor regions. They are complicated by prolonged morbidity and chronic osseous infections and sometimes gangrene. Our objective was to look at ankle arthrodesis as a primary and useful salvage procedure through simple technique for cases of severe open ankle injuries. Three patients with severe open ankle injuries between January 2007 and December 2009 were seen and had wound debridement done and compress...

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

    OpenAIRE

    Baumbach Sebastian Felix; Fasser Mariette; Polzer Hans; Sieb Michael; Regauer Markus; Mutschler Wolf; Schieker Matthias; Blauth Michael

    2013-01-01

    Abstract Background Ankle sprains often result in ankle instability, which is most likely caused by damage to passive structures and neuromuscular impairment. Whole body vibration (WBV) is a neuromuscular training method improving those impaired neurologic parameters. The aim of this study is to compare the current gold standard functional treatment to functional treatment plus WBV in patients with acute unilateral unstable inversion ankle sprains. Methods/Design 60 patients, aged 18–40 years...

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

    OpenAIRE

    M.S. Patil; S.M.G. Raza; Md. Nayeem Ali

    2012-01-01

    Background: Ankle injuries are unique as they are not only intra-articular of weight bearing joint, but also caused by a variety of mechanism, each resulting in different pattern with ankle fractures. The primary concern is residual instability of the joint as malalignment or residual displacement can adversely affect the biomechanical behaviour of ankle and resulting loss of function, due to non restoration of normal anatomy. Therefore essential of proper anatomical parameters for assessment...

  4. 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

  5. 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 ...

  6. 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.

  7. 推拿配合中药熏蒸治疗陈旧性踝关节扭伤疗效观察%Efficacy observation of combining tuina and Chinese herbal fumigation for chronic ankle sprain

    Institute of Scientific and Technical Information of China (English)

    陈斌; 张峻峰; 李艳; 吴耀持

    2015-01-01

    目的:观察推拿配合中药熏蒸治疗陈旧性踝关节扭伤的临床疗效。方法:将纳入的93例患者根据随机数字表随机分为2组,观察组47例,给予经筋理论指导下推拿配合中药熏蒸治疗;对照组46例,予口服活血止痛药物配合中药熏蒸治疗。推拿和中药熏蒸均隔日1次,10次为1个疗程,治疗1个疗程后观察两组踝关节功能评分(Baird-Jackson)及临床疗效。结果:治疗后,除放射线检查结果外,两组治疗前后Baird-Jackson各项评分均有统计学差异(P<0.05,P<0.01);除踝关节活动度量(range of motion, ROM)外,两组间各项评分及总分差异亦有统计学意义(P<0.01)。观察组优良率为76.6%,对照组优良率为54.4%,两组优良率差异有统计学意义(P<0.05)。结论:经筋理论指导下推拿配合中药熏蒸治疗陈旧性踝关节扭伤的临床效果优于口服活血止痛药物配合中药熏蒸治疗。%Objective:To observe the clinical efficacy of combining tuina and Chinese herbal fumigation for chronic ankle sprain. Methods:A total of 93 cases were randomly allocated into an observation group (n=47) and a control group (n=46) according to the table of random number. Cases in the observation group received tuina combining with Chinese herbal fumigation, whereas cases in the control group received oral blood-circulating and pain-alleviating capsules combining with Chinese herbal fumigation. Both tuina and Chinese herbal fumigation were done once every other day and 10 times made up a course of treatment. The Baird-Jackson ankle scoring system and clinical efficacy were observed after 1 course of treatment. Results:After treatment, except for radiographic findings, there were significant intra-group differences in individual item scores of Baird-Jackson (P Conclusion:Combining Chinese herbal fumigation and tuina based on the muscle region theory can obtain better effect than combining oral blood-circulating and pain

  8. 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 ...

  9. Endobutton elastic fixation for treatment of chronic syndesmotic instability%Endobutton纽扣钢板弹性固定治疗陈旧性下胫腓联合不稳

    Institute of Scientific and Technical Information of China (English)

    田竞; 周大鹏; 解冰; 刘欣伟; 项良碧

    2014-01-01

    Objective To observe the clinical efficacy of Endobutton elastic fixation for treatment of chronic syndesmotic instability.Methods From January 2011 to January 2013,13 cases of chronic syndesmotic instability were treated by Endobutton elastic fixation in our department.They were 9 men and 4 women,aged from 32 to 46 years (average,37.5 years).The duration from injury to the operative treatment ranged from 3 to 6 months (average,3.8 months).After debridement of the medial gutter and the inferior tibiofibular space,2 Endobutton plates instead of traditional metal screws were used to stabilize the syndesmosis.Follow-up included clinical evaluation,X-ray and CT examination and image-based PACS 5.0 system measurement at 3 days,8 weeks and 6 months postoperation.The American Orthopaedic Foot and Ankle Society (AOFAS) score system was used for postoperative efficacy evaluation at 6 months postoperation.Results The patients were followed for 6 to 28 months,with an average of 16.0 months.All the malleolus fractures healed after an average of 11.5 weeks (from 10 to 17 weeks).No infection,faulty wound healing or phlebothrombosis happened in this group.Reduction of the syndesmosis was confirmed by X-ray and CT scan 3 days,8 weeks and 6 months after the surgery.The mean AOFAS score improved significantly from 49.5 points to 71.6 points,with 7 excellent cases,5 fine cases and one fair case.Conclusions Endobutton elastic fixation for chronic syndesmotic instability can preserve physiological fretting of the syndesmosis and avoid removal of hardware and further separation of the syndesmosis.It may also lead to fine functional recovery of the ankle,absence of significant complications and satisfactory outcomes in a short-term.%目的 探讨Endobutton纽扣钢板弹性固定治疗陈旧性下胫腓联合不稳的疗效. 方法 回顾性分析2011年1月至2013年1月采用Endobutton纽扣钢板弹性固定13例陈旧性下胫腓联合不稳的患者资料,男9例,女4例;年龄32

  10. 正骨手法结合正骨散外用治疗陈旧性踝关节扭伤的疗效观察%Bone-setting manipulation combined with Zhenggu powder treatment of chronic ankle joint sprain of curative effect observation

    Institute of Scientific and Technical Information of China (English)

    张红川; 王法利

    2014-01-01

    目的:探讨和分析应用正骨手法结合正骨散治疗陈旧性踝关节扭伤的疗效。方法自2011年6月~2012年5月,采用正骨手法结合正骨散外用治疗陈旧性踝关节共38例,男20例,女18例。年龄21~55岁,平均38岁,病程平均63天。按照Baird-Jackson踝关节评分,治疗3周后比较患者的治疗前后踝关节功能评分。结果38例患者治疗前Baird-Jackson踝关节评分为64.36±4.26,经手法结合正骨散治疗后评分为90.22±5.13,治疗前后存在显著性差异(P<0.01)。结论正骨手法结合正骨散外用是治疗陈旧性踝关节扭伤的一种有效的方法。%Abastract:ObjectiveTo discussion and analysis of the application of Bone-setting manipulation combined with Zhenggu powder in the treatment of chronic ankle joint sprain effect.Methods From 2011 June to 2012 May, with Bone-setting manipulation combined with Zhenggu powder for the treatment of chronic ankle in 38 cases, male 20 cases, female 18 cases. The age ranged from 21 to 55 years old, average 38 years old, average duration was 63 days. According to Baird-Jackson ankle function score, ankle joint function score were compared before and after treatment and 3 weeks after treatment. Results In 38 cases of patients before treatment ,Baird-Jackson ankle function score was 64.36 ± 4.26, by manipulation combined with Zhenggu powder after treatment was 90.22 ± 5.13 .Before and after treatment, there were significant differences(P<0.01). Conclusion Bone-setting manipulation combined with Zhenggu powder is an effective method for treatment of chronic ankle joint sprain.

  11. 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.

  12. Correlation between radiological assessment of acute ankle fractures and syndesmotic injury on MRI

    International Nuclear Information System (INIS)

    Owing to the shortcomings of clinical examination and radiographs, injury to the syndesmotic ligaments is often misdiagnosed. When there is no indication requiring that the fractured ankle be operated on, the syndesmosis is not tested intra-operatively, and rupture of this ligamentous complex may be missed. Subsequently the patient is not treated properly leading to chronic complaints such as instability, pain, and swelling. We evaluated three fracture classification methods and radiographic measurements with respect to syndesmotic injury. Prospectively the radiographs of 51 consecutive ankle fractures were classified according to Weber, AO-Mueller, and Lauge-Hansen. Both the fracture type and additional measurements of the tibiofibular clear space (TFCS), tibiofibular overlap (TFO), medial clear space (MCS), and superior clear space (SCS) were used to assess syndesmotic injury. MRI, as standard of reference, was performed to evaluate the integrity of the distal tibiofibular syndesmosis. The sensitivity and specificity for detection of syndesmotic injury with radiography were compared to MRI. The Weber and AO-Mueller fracture classification system, in combination with additional measurements, detected syndesmotic injury with a sensitivity of 47% and a specificity of 100%, and Lauge-Hansen with both a sensitivity and a specificity of 92%. TFCS and TFO did not correlate with syndesmotic injury, and a widened MCS did not correlate with deltoid ligament injury. Syndesmotic injury as predicted by the Lauge-Hansen fracture classification correlated well with MRI findings. With MRI the extent of syndesmotic injury and therefore fracture stage can be assessed more accurately compared to radiographs. (orig.)

  13. Correlation between radiological assessment of acute ankle fractures and syndesmotic injury on MRI

    Energy Technology Data Exchange (ETDEWEB)

    Hermans, J.J. [Radboud University Nijmegen Medical Center, Department of Radiology, P.O. Box 9101, Nijmegen (Netherlands); Wentink, N. [Atrium Medisch Centrum, Department of Surgery, PO Box 4446, Heerlen (Netherlands); Beumer, A.; Moonen, A.F.C.M. [Amphia Ziekenhuis Hospital, Department of Orthopaedics, PO Box 90158, Breda (Netherlands); Hop, W.C.J. [Erasmus University Medical Center Rotterdam, Department of Biostatistics, PO Box 2040, Rotterdam (Netherlands); Heijboer, M.P. [Erasmus University Medical Center Rotterdam, Department of Orthopaedics, PO Box 2040, Rotterdam (Netherlands); Ginai, A.Z. [Erasmus University Medical Center Rotterdam, Department of Radiology, PO Box 2040, Rotterdam (Netherlands)

    2012-07-15

    Owing to the shortcomings of clinical examination and radiographs, injury to the syndesmotic ligaments is often misdiagnosed. When there is no indication requiring that the fractured ankle be operated on, the syndesmosis is not tested intra-operatively, and rupture of this ligamentous complex may be missed. Subsequently the patient is not treated properly leading to chronic complaints such as instability, pain, and swelling. We evaluated three fracture classification methods and radiographic measurements with respect to syndesmotic injury. Prospectively the radiographs of 51 consecutive ankle fractures were classified according to Weber, AO-Mueller, and Lauge-Hansen. Both the fracture type and additional measurements of the tibiofibular clear space (TFCS), tibiofibular overlap (TFO), medial clear space (MCS), and superior clear space (SCS) were used to assess syndesmotic injury. MRI, as standard of reference, was performed to evaluate the integrity of the distal tibiofibular syndesmosis. The sensitivity and specificity for detection of syndesmotic injury with radiography were compared to MRI. The Weber and AO-Mueller fracture classification system, in combination with additional measurements, detected syndesmotic injury with a sensitivity of 47% and a specificity of 100%, and Lauge-Hansen with both a sensitivity and a specificity of 92%. TFCS and TFO did not correlate with syndesmotic injury, and a widened MCS did not correlate with deltoid ligament injury. Syndesmotic injury as predicted by the Lauge-Hansen fracture classification correlated well with MRI findings. With MRI the extent of syndesmotic injury and therefore fracture stage can be assessed more accurately compared to radiographs. (orig.)

  14. 一期韧带修复联合拉力螺钉固定治疗踝关节不稳的疗效观察%Efficacy of phase Ⅰ ligament repair combined with lag screw fixation for ankle instability

    Institute of Scientific and Technical Information of China (English)

    罗静涛; 韩铭

    2015-01-01

    Objective To evaluate the clinical efficacy of phase Ⅰ ligament repair combined with lag screw fixation for ankle instability. Methods From Jan. 2011 to Jun. 2013, 34 patients with acute ankle sprain, including 18 males and 16 females, aged 28. 0 to 69. 0 years (mean 49. 3 years), were randomly divid-ed into external fixation group and screw fixation group (n=17 each), given external fixation with plaster or brace, and phase Ⅰ line of rivets in-situ repair combined with lag screw, respectively. All lesion limbs were not weight-bearing and followed up for 3 months. Hospital costs and complications were observed. Therapeutic effect was evaluated by AOFAS and VAS score. Results The cost of hospitalization was (1. 72±0. 30) ten thousand yuan in screw fixation group, and (0. 68±0. 20) ten thousand yuan in external fixation group (P<0. 05). AOFAS scores at 1st, 2nd, and 3rd month during the followed-up period were (66. 2±1. 3), (88. 5±2. 1) and (97. 2 ±1. 9) in screw fixation group, and (46. 8±1. 6), (53. 5±2. 7) and (75. 6±1. 2) in external fixation group (P<0. 05), respectively. VAS scores at 1st, 2nd, and 3rd month during the followed-up period were (3. 2 ± 0. 8), (2. 5±0. 6) and (1. 2±0. 2) in screw fixation group, and (4. 0±0. 7), (3. 1±0. 6) and (2. 6±0. 4) in external fixation group (P<0. 05), respectively. There was no screw cut out, nails broken, traumatic arthritis, inferior tibiofibular instability and other complications in screw fixation group. In external fixation group, 2 patients complained of ankle stiffness that eased after exercise and physiotherapy, and 4 patients administered phase Ⅱ ankle ligament reconstruction due to pain and instability in the knee. Conclusion Phase Ⅰ ligament repair combined with lag screw fixation for acute ankle instability manifests excellent postop-erative ankle function and fewer complications, although the cost of hospitalization is higher. It is a practicable procedure for ankle sprains.%目的:

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

    Directory of Open Access Journals (Sweden)

    Eneida Yuri Suda

    2008-08-01

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

  16. 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.)

  17. Closure of chronic non healing ankle ulcer with low level laser therapy in a patient presenting with thalassemia intermedia: Case report

    Directory of Open Access Journals (Sweden)

    Snehil Dixit

    2014-01-01

    Full Text Available In this single case study, the possible effect of low-level laser therapy (LLLT was explored in the form of light emitting diodes on a chronic non-healing wound of 6 months duration in an 18-year-old male patient suffering from thalassemia intermedia. After irradiation, with LLLT dosage of 17.3 J/cm 2 for 8 min for 2 weeks duration followed by proliferative dosage of 8.65-4.33 J/cm 2 for 4 min from 3 rd week to 6 th week for 2 min along with antibiotics vancomycin (15 mg/kg and a combination of amoxicillin and clavulanic acid (1 g. Proliferation of healthy granulation tissue was observed with decrease in score of pressure ulcer scale with complete re-epithelialization eventually LLLT irradiation could be a novel method of treatment for chronic non-healing wound in a thalassemia intermedia patient and an useful adjunct to standard care of treatment of pressure ulcers. It is postulated that LED irradiation augments wound healing with an early closure and no recurrence at the irradiated site even after follow up of 6 months.

  18. The Effect of Fatigue and Instability on Postural Control Parameters in Standing Posture in Healthy Adults and Patients with Chronic Low Back Pain

    Directory of Open Access Journals (Sweden)

    Amir Hosein Kahlaee

    2012-06-01

    Full Text Available Background: This study aims at analyzing the effect of fatigue and instability on postural control parameters in both healthy people and patients with the chronic nonspecific low-back pain.Materials and Methods: In this non-experimental case-control study, oscillations of center of pressure were statistically analyzed in 16 healthy people and 15 patients with the chronic nonspecific low back pain. The analysis was conducted through two stages: before and after fatigue and under both stable and unstable surfaces. Results: Under the pre-fatigue, stable condition, there was not any difference between the two groups. Both fatigue and unstable surface changed our variables (sway area, range, velocity, frequency and total power of the signal. All the changes in variables were significant in the low-back pain group; while changes in the healthy group only covered the time-domain variables. The effect of instability was higher than that of fatigue. Conclusion: The postural control system for patients with low-back pain before fatigue and under stable condition, revealed sufficient competence to provide postural stability and its function cannot be differentiated from that in healthy people. Meanwhile, different mechanisms were used by these patients to confront stability challenging factors and further neural activity was required to counteract such factors.

  19. Effect of kidney damage indicators on ankle-brachial index of patients with chronic kidney disease%慢性肾脏病患者肾脏损伤指标对踝臂指数的影响

    Institute of Scientific and Technical Information of China (English)

    牛福坤; 阎磊; 邵凤民

    2012-01-01

    目的:探讨慢性肾脏病(CKD)患者肾脏损伤指标对踝臂指数(ABI)的影响.方法:收集295例CKD患者及体检中心170例无CKD的对照人群的资料,对2组尿白蛋白/肌酐比值(ACR)、估计肾小球滤过率(eGFR)与ABI进行logistic回归分析.结果:对CKD患者进行的多变量logistic回归分析显示,在校正了传统的心血管危险因素后,ACR与eGFR<60 mL/(min·1.73m2)均是低ABI的独立危险因素,OR(95%CI)分别为1.065(1.022~1.105)和1.122(1.032~2.577).结论:高ACR与低 eGFR可能导致CKD患者ABI降低.%Aim:To explore the effect of kidney damage indicators on abnormal ankle-brachial index( ABI ) of patients with chronic kidney disease( CKD ). Methods:A total of 295 patients with CKD and 170 non-CKD participants were enrolled. Association between kidney damage indicators, including estimated glomerular filtration rate ( eGFR ) and urinary albumin to creatinine ratio( ACR ) and abnormal ABI were analyzed by multivariable logistic regression model. Results: After adjusting for traditional cardiovascular risk factors among patients with CKD, ACR and eGFR were both independently associated with low ABI,OR( 95% CI) was 1.065( 1.022 ~ 1. 105 ) and 1. 122( 1.032~2.577 ),respectively. Conclusion: High ACR and low eGFR may induce low ABI of CKD patients.

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

    OpenAIRE

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

    2012-01-01

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

  1. 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.)

  2. 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.)

  3. 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 ...

  4. 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

  5. Simultaneous surgical management of chronic grade-2 valgus instability of the knee and anterior cruciate ligament deficiency in athletes.

    Science.gov (United States)

    Osti, Leonardo; Papalia, Rocco; Del Buono, Angelo; Merlo, Franco; Denaro, Vincenzo; Maffulli, Nicola

    2010-03-01

    We report on 22 patients with chronic grade-2 valgus laxity of the knee combined with chronic anterior cruciate ligament (ACL) insufficiency, in whom the two lesions were addressed at the same surgical setting. At a minimum follow-up of 24 months, clinical and functional variables had improved significantly (P pre-injury level. There were no operative complications in this series. In selected athletes with chronic symptomatic valgus laxity of the knee combined with ACL insufficiency, surgical repair of the MCL in association with ACL reconstruction is a suitable and reliable option to restore knee stability and allow return to pre-injury activity level.

  6. Effects of virtual reality-based ankle exercise on the dynamic balance, muscle tone, and gait of stroke patients

    OpenAIRE

    Yom, Changho; Cho, Hwi-young; Lee, Byounghee

    2015-01-01

    [Purpose] The purpose of this study was to investigate the therapeutic effects of virtual reality-based ankle exercise on the dynamic balance, muscle tone, and gait ability of stroke subjects. [Subjects and Methods] Twenty persons who were in the chronic stroke subjects of this study and they were included and assigned to two groups: experimental (VRAE; Virtual Reality-based Ankle Exercise group) (n=10) and control groups (n=10). The VRAE group performed virtual environment system ankle exerc...

  7. 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.)

  8. 跖板修补联合Weil截骨治疗慢性跖趾关节不稳%Plantar plate repair with Weil osteotomy for chronic instability of the lesser metatarsophalangeal joint

    Institute of Scientific and Technical Information of China (English)

    薛剑锋; 梅国华; 施忠民; 柴益民; 张长青

    2014-01-01

    Objective To evaluate the clinical outcome of plantar plate repair with Weil osteotomy for chronic instability of the lesser metatarsophalangeal joint.Methods From February 2012 to January 2013,19 patient with chronic instability of the lesser metatarsophalangeal joint were treated in our department.They were 18 females and one male with an average age o f 57 years (from 51 to 65 years).By the Coughlin's classification,3 cases were grade 1,5 cases grade 2,9 cases grade 3 and 2 cases grade 4.Except for one case involving both the second and the third metatarsophalangeal joints,all lesions were located at the second metatarsophalangeal joint.Weil osteotomy was used to shorten and elevate the affected metatarsal head.Injury to the plantar plate was detected before directly repaired in 17 cases and with transfer of the flexor digitorum longus in 2 cases.American Orthopaedic Foot and Ankle Society (AOFAS) and visual analogue scale (VAS) scores were used to assess the clinical outcome.Results The 2 patients who underwent tendon transfer were excluded from the final analysis.The mean follow-up period was 18 months (from 12 to 24 months).The symptoms were alleviated in all the patients.The dislocated metatarsophalangeal joints were reduced,and postoperative Lachman tests were negative.Radiological exams showed corrected alignment of the lesser metatarsophalangeal joint.At the last follow-up,the AOFAS score (83.4 ± 8.7) and VAS score (1.3 ± 0.9) were significantly improved compared to the preoperative ones (40.7 ± 6.9 and 6.8 ± 1.2,respectively) (P < 0.05).Conclusions For chronic instability of the lesser matatarsophalangeal joint,anatomical plantar plate repair with Weil osteotomy can restore the alignment of the metatarsophalangeal joint,diminish the pain and improve the functional recovery.Its short term clinical outcome is promising.%目的 评价跖板修补联合Weil截骨治疗慢性跖趾关节不稳的临床疗效.方法 回顾性分析2012年2月至2013年1

  9. 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

  10. 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

  11. Late diagnosis of lateral meningocele syndrome in a 55-year-old woman with symptoms of joint instability and chronic musculoskeletal pain.

    Science.gov (United States)

    Castori, Marco; Morlino, Silvia; Ritelli, Marco; Brancati, Francesco; De Bernardo, Carmelilia; Colombi, Marina; Grammatico, Paola

    2014-02-01

    Lateral meningocele syndrome (LMS) is a rare hereditary connective tissue disorder characterized by pan-spinal meningoceles, specific facial dysmorphism, skeletal and soft tissue abnormalities, and hypotonia and/or muscle weakness. LMS has been observed in eleven patients with two instances of vertical transmission, and seven sporadic cases with an age at diagnosis ranging from 25 months to 33 years. We report on a further observation of LMS in a 55-year-old woman presenting with a long history of joint instability, chronic musculoskeletal pain, and iatrogenic bladder and anorectal dysfunction due to irreversible nerve damage after surgical excision of a meningeal cyst. Her clinical characteristics are compared with those of previously reported patients, as well as two further cases originally diagnosed with Hajdu-Cheney and Ehlers-Danlos syndromes, but displaying typical features of LMS. PMID:24311540

  12. Avaliação da circulação arterial pela medida do índice tornozelo/braço em doentes de úlcera venosa crônica Evaluation of arterial circulation using the ankle/brachial blood pressure index in patients with chronic venous ulcers

    Directory of Open Access Journals (Sweden)

    Fabiane Noronha Bergonse

    2006-03-01

    Full Text Available FUNDAMENTOS: As úlceras venosas dos membros inferiores são freqüentes e têm grande impacto na qualidade de vida e produtividade do indivíduo, além de alto custo para a saúde pública. OBJETIVOS: Detecção de alterações arteriais em pacientes de úlcera venosa crônica dos membros inferiores com emprego de método não invasivo, de modo a discriminar aqueles em que estaria contra-indicado o tratamento compressivo. MÉTODOS: Foram estudados 40 doentes portadores de úlcera venosa crônica, com o intuito de se avaliar a presença de doença arterial periférica pela medida do índice tornozelo/braço por doppler-ultra-som. RESULTADOS: O índice tornozelo/braço mostrou-se alterado (menor que 1 em 9/22 (40,9% doentes com úlcera venosa crônica e hipertensão arterial concomitante, e apenas em 1/13 (7,7% doentes de úlcera venosa crônica sem hipertensão arterial. CONCLUSÕES: Doentes de úlcera venosa crônica e hipertensão arterial concomitantes devem ser submetidos rotineiramente à medida do índice tornozelo/braço para detecção de possível insuficiência arterial periférica associada.BACKGROUND: Chronic venous ulcers are extremely frequent and have a significant impact on quality of life and work productivity of individuals, in addition to high costs to public health. OBJECTIVES: Detection of arterial circulation alterations in chronic venous ulcer legs using a non-invasive method to discriminate patients not indicated to have compressive treatment. METHODS: Forty patients with chronic venous ulcers were investigated for the presence of peripheral arterial disease with measurement of the ankle/brachial index by Doppler ultrasound. RESULTS: The resting ankle/brachial pressure index was abnormal (lower than 1 in 9/22 (40.9% patients with concomitant chronic venous ulcers and hypertension and only in one out of 13 (7.7% patients with chronic venous ulcers and no hypertension. CONCLUSIONS: Patients with concomitant chronic venous

  13. 10-year survival of total ankle arthroplasties

    Science.gov (United States)

    2011-01-01

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

  14. 针灸、超短波联合肌内效贴治疗慢性踝关节扭伤的临床疗效观察%Observation of clinical efficacy of acupuncture, ultrashort wave combined with kinesio taping in the treatment of chronic ankle sprain

    Institute of Scientific and Technical Information of China (English)

    宋瑞军; 董莉莉; 李明阳; 张明; 尚明臣; 梁海龙

    2015-01-01

    目的:探讨针灸、超短波联合肌内效贴治疗慢性踝关节扭伤的疗效,以供临床参考。方法80例慢性踝关节扭伤患者随机分为对照组和治疗组,对照组采用针灸、超短波治疗,治疗组在针灸、超短波基础上加入肌内效贴治疗,以7 d为一个疗程,连续治疗2个疗程,共14 d,观察两组患者的临床疗效。治疗前后采用视觉模拟评分法(VAS)、《实用骨伤科手册》进行评定。结果两组患者VAS评分和治疗有效率均改善,治疗组较对照组改善更明显(P<0.01)。结论运用针灸、超短波联合肌内效贴治疗慢性踝关节扭伤能更有效缓解疼痛,改善踝关节功能。%Objective To explore the curative effects of acupuncture, ultrashort wave combined with kinesio taping in the treatment of chronic ankle sprain for clinical references. Methods All 80 patients with chronic ankle sprain were randomly assigned to the control group and the treatment group. The control group was given the treatment of acupunc-ture and ultrashort wave, and the treatment group was further given the treatment of kinesio taping on the basis of acupuncture and ultrashort wave. One course of treatment lasted for seven days,and the treatment lasted for two courses of 14 days in total. The differences of clinical efficacy were observed between the two groups of patients. VAS and A Modern Practical Handbook of Orthopedics were applied for evaluation before and after the treatment. Results VAS scores and curative effective rate in the two groups all improved,and the improvement in the treatment group was more significant than that in the control group (P<0.01). Conclusion The application of acupuncture, ultrashort wave com-bined with kinesio taping in the treatment of chronic ankle sprain is effective in alleviating pain and improving ankle function.

  15. Observation of clinical efficacy of acupuncture, ultrashort wave combined with kinesio taping in the treatment of chronic ankle sprain%针灸、超短波联合肌内效贴治疗慢性踝关节扭伤的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    宋瑞军; 董莉莉; 李明阳; 张明; 尚明臣; 梁海龙

    2015-01-01

    Objective To explore the curative effects of acupuncture, ultrashort wave combined with kinesio taping in the treatment of chronic ankle sprain for clinical references. Methods All 80 patients with chronic ankle sprain were randomly assigned to the control group and the treatment group. The control group was given the treatment of acupunc-ture and ultrashort wave, and the treatment group was further given the treatment of kinesio taping on the basis of acupuncture and ultrashort wave. One course of treatment lasted for seven days,and the treatment lasted for two courses of 14 days in total. The differences of clinical efficacy were observed between the two groups of patients. VAS and A Modern Practical Handbook of Orthopedics were applied for evaluation before and after the treatment. Results VAS scores and curative effective rate in the two groups all improved,and the improvement in the treatment group was more significant than that in the control group (P<0.01). Conclusion The application of acupuncture, ultrashort wave com-bined with kinesio taping in the treatment of chronic ankle sprain is effective in alleviating pain and improving ankle function.%目的:探讨针灸、超短波联合肌内效贴治疗慢性踝关节扭伤的疗效,以供临床参考。方法80例慢性踝关节扭伤患者随机分为对照组和治疗组,对照组采用针灸、超短波治疗,治疗组在针灸、超短波基础上加入肌内效贴治疗,以7 d为一个疗程,连续治疗2个疗程,共14 d,观察两组患者的临床疗效。治疗前后采用视觉模拟评分法(VAS)、《实用骨伤科手册》进行评定。结果两组患者VAS评分和治疗有效率均改善,治疗组较对照组改善更明显(P<0.01)。结论运用针灸、超短波联合肌内效贴治疗慢性踝关节扭伤能更有效缓解疼痛,改善踝关节功能。

  16. 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.

  17. 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)

  18. 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)

  19. 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.

  20. 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 ...

  1. 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.

  2. 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...

  3. Open Reduction Internal Fixation of a Bimalleolar Ankle Fracture With Syndesmotic Injury.

    Science.gov (United States)

    Ostrum, Robert F; Avery, Matthew C

    2016-08-01

    Rotational ankle fractures are incredibly common, resulting in a wide spectrum of bony and ligamentous injury patterns. After open reduction of an ankle fracture, the treating surgeon must always evaluate syndesmotic stability. If the syndesmosis is determined to be unstable, a reduction of the distal tibiofibular joint should be performed. Failure to adequately identify and treat injuries to the syndesmosis may result in continued ankle instability and poor patient outcomes. Lateral fluoroscopic images are necessary to assess a closed reduction of the syndesmosis before stabilization, although the accuracy of this tool has been questioned in several studies. Significant controversy surrounds many aspects of this injury and its treatment, including methods of diagnosis, ideal reduction clamp positioning, diameter and number of syndesmotic screws, and number of tibial cortices to be engaged. In the accompanying video, we describe our approach for the treatment of a bimalleolar ankle fracture with syndesmotic injury, using a posterior fibular plate and single tricortical syndesmotic screw. PMID:27441940

  4. 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

  5. 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...

  6. 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...

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

    Directory of Open Access Journals (Sweden)

    Baumbach Sebastian Felix

    2013-01-01

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

  8. 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

  9. 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.

  10. Strategies and Efficacy Analysis of Surgical Treatment of Unstable Ankle Fractures%不稳定踝关节骨折38例手术治疗分析

    Institute of Scientific and Technical Information of China (English)

    吴建红; 林鹏; 赖松军

    2012-01-01

    and presence or absence of associated ligament injury, and appropriate choice of fixation methods are the most effective measures to prevent secondary chronic ankle instability which may lead to traumatic arthritis.

  11. Reconstruction of the anterior cruciate ligament with the iliotibial band autograft in patients with chronic knee instability.

    Science.gov (United States)

    Jørgensen, U; Bak, K; Ekstrand, J; Scavenius, M

    2001-05-01

    We performed combined internal and external anterior cruciate ligament (ACL) reconstruction with the iliotibial band autograft in 169 consecutive patients with chronic ACL insufficiency who were followed up for 24-61 months. Of these, 155 (91%) agreed to an additional independent observer follow-up after 24-92 months. Eight patients (5%) had sustained a rerupture/elongation of the graft and were operated on again; nine (6%) had sustained a tear of the contralateral ACL. Knee function and activity increased after the reconstruction. Lysholm scores improved from median 81 preoperatively to 99 at follow-up and Tegner scores from median 4 to 7. At follow-up 97 (71%) were active at the same level as prior to injury. In 17 of the 40 patients (12%) dropping to a lower activity level this was due to knee problems. The side-to-side difference in anterior-posterior knee laxity was more than 3 mm in 18 knees (13%) and more than 5 mm in 3 knees (2%). Including eight reruptures, this results in a "stability" failure rate of 8.8%. The overall IKCD rating showed normal knee function in 88 (73%) and nearly normal knee function in 30 (25%). Anterior knee pain was present in 14 (10%) of the patients at follow-up. Patients with isolated ACL injury had higher Lysholm scores and Tegner scores than patients with associated injuries. No clinical signs of varus knee development were seen. Of the 155 patients 94% would have the procedure repeated if necessary with the knowledge that they have today. The combined internal and external iliotibial band procedure can restore knee stability and function in the majority of chronic ACL-insufficient knees. PMID:11420786

  12. Ankle sprain: pathophysiology, predisposing factors, and management strategies

    OpenAIRE

    Hubbard, Tricia J.; Wikstrom, Erik A.

    2010-01-01

    Tricia J Hubbard, Erik A WikstromUNC Charlotte, Department of Kinesiology, CharlotteAbstract: With the high percentage (up to 75%) of initial lateral ankle sprains (LAS) leading to repetitive sprains and chronic symptoms, it is imperative to better understand how best to treat and rehabilitate LAS events. The purpose of this paper is to review LAS pathophysiology, predisposing factors, and the current evidence regarding therapeutic modalities and exercises used in the treatment of LAS. Functi...

  13. 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

  14. 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.

  15. Shoulder Instability

    Science.gov (United States)

    ... Risk Factors Is shoulder instability the same as shoulder dislocation? No. The signs of dislocation and instability might ... the same to you--weakness and pain. However, dislocation occurs when your shoulder goes completely out of place. The shoulder ligaments ...

  16. 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.

  17. 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 ( ...

  18. 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.

  19. 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

  20. 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...

  1. Minimally invasive soft tissue release of foot and ankle contracture secondary to stroke.

    Science.gov (United States)

    Boffeli, Troy J; Collier, Rachel C

    2014-01-01

    Lower extremity contracture associated with stroke commonly results in a nonreducible, spastic equinovarus deformity of the foot and ankle. Rigid contracture deformity leads to gait instability, pain, bracing difficulties, and ulcerations. The classic surgical approach for stroke-related contracture of the foot and ankle has been combinations of tendon lengthening, tendon transfer, osteotomy, and joint fusion procedures. Recovery after traditional foot and ankle reconstructive surgery requires a period of non-weightbearing that is not typically practical for these patients. Little focus has been given in published studies on minimally invasive soft tissue release of contracture. We present the case of a 61-year-old female with an equinovarus foot contracture deformity secondary to stroke. The patient underwent Achilles tendon lengthening, posterior tibial tendon Z lengthening, and digital flexor tenotomy of each toe with immediate weightbearing in a walking boot, followed by transition to an ankle-foot orthosis. The surgical principles and technique tips are presented to demonstrate our minimally invasive approach to release of foot and ankle contracture secondary to stroke. The main goal of this approach is to improve foot and ankle alignment for ease of bracing, which, in turn, will improve gait, reduce the risk of falls, decrease pain, and avoid the development of pressure sores. PMID:23890795

  2. 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…

  3. 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

  4. 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

  5. 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...

  6. Shoulder instability

    International Nuclear Information System (INIS)

    In the shoulder, the advantages of range of motion are traded for the disadvantages of vulnerability to injury and the development of instability. Shoulder instability and the lesion it produces represent one of the main causes of shoulder discomfort and pain. Shoulder instability is defined as a symptomatic abnormal motion of the humeral head relative to the glenoid during active shoulder motion. Glenohumeral instabilities are classified according to their causative factors as the pathogenesis of instability plays an important role with respect to treatment options: instabilities are classified in traumatic and atraumatic instabilities as part of a multidirectional instability syndrome, and in microtraumatic instabilities. Plain radiographs ('trauma series') are performed to document shoulder dislocation and its successful reposition. Direct MR arthrography is the most important imaging modality for delineation the different injury patterns on the labral-ligamentous complex and bony structures. Monocontrast CT-arthrography with use of multidetector CT scanners may be an alternative imaging modality, however, regarding the younger patient age, MR imaging should be preferred in the diagnostic work-up of shoulder instabilities. (orig.)

  7. 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

  8. 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.

  9. Hip instability.

    Science.gov (United States)

    Smith, Matthew V; Sekiya, Jon K

    2010-06-01

    Hip instability is becoming a more commonly recognized source of pain and disability in patients. Traumatic causes of hip instability are often clear. Appropriate treatment includes immediate reduction, early surgery for acetabular rim fractures greater than 25% or incarcerated fragments in the joint, and close follow-up to monitor for avascular necrosis. Late surgical intervention may be necessary for residual symptomatic hip instability. Atraumatic causes of hip instability include repetitive external rotation with axial loading, generalized ligamentous laxity, and collagen disorders like Ehlers-Danlos. Symptoms caused by atraumatic hip instability often have an insidious onset. Patients may have a wide array of hip symptoms while demonstrating only subtle findings suggestive of capsular laxity. Traction views of the affected hip can be helpful in diagnosing hip instability. Open and arthroscopic techniques can be used to treat capsular laxity. We describe an arthroscopic anterior hip capsular plication using a suture technique. PMID:20473129

  10. 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.)

  11. 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...

  12. 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

  13. 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 __________________________________________________________________ ...

  14. 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

  15. 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.

  16. 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.

  17. 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.

  18. 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...

  19. 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...

  20. 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...

  1. 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 ...

  2. 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...

  3. 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...

  4. 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

  5. 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 ...

  6. 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

  7. 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.

  8. 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.

  9. Collective instabilities

    Energy Technology Data Exchange (ETDEWEB)

    K.Y. Ng

    2003-08-25

    The lecture covers mainly Sections 2.VIII and 3.VII of the book ''Accelerator Physics'' by S.Y. Lee, plus mode-coupling instabilities and chromaticity-driven head-tail instability. Besides giving more detailed derivation of many equations, simple interpretations of many collective instabilities are included with the intention that the phenomena can be understood more easily without going into too much mathematics. The notations of Lee's book as well as the e{sup jwt} convention are followed.

  10. 腓骨骨膜-筋膜瓣移位治疗慢性踝关节不稳的临床应用%Clinical application of fibular periosteal-fascial flap in treatment of chronic ankle instability

    Institute of Scientific and Technical Information of China (English)

    覃伟明; 刘伯泉; 瞿东滨

    2004-01-01

    目的:报道自体腓骨骨膜-筋膜瓣移位治疗慢性踝关节不稳的方法及疗效.方法:5例慢性踝照关节外侧不稳患者接受手术治疗,将腓骨骨膜-筋膜的中下1/3向下游离至近关节囊部,保留下端血供,分成两瓣,分别修复距腓前韧带和跟腓韧带.结果:随访6~18个月,5例患者临床症状明显改善,摄X线片检查踝关节稳定性恢复良好,临床疗效满意.结论:采用自体腓骨骨膜-筋膜瓣移位治疗慢性踝关节不稳方法简便,疗效确切.

  11. The Relationship between the Chronic Instability of the Lateral Ankle And the Talar Tilt Angle%慢性外踝不稳与距骨斜角关系探讨

    Institute of Scientific and Technical Information of China (English)

    严敦尧; 王永明; 许光旭

    2002-01-01

    探讨距骨斜角与慢性外踝不稳的关系,拟提供一种慢性外踝不稳的定量诊断方法.方法随机选择慢性外踝不稳青年患者62人,共64例外踝不稳踝关节(男37人39例,女25人25例)与外踝无损伤者224人共445例踝关节(男118人235例,女106人210例),用"踝关节加压内翻拍片架"进行踝跖屈内翻固定,拍摄踝关节跖屈内翻应力正位片.结果患者组距骨斜角平均9.3°,对照组距骨斜角平均4.2°,P9°, 则可考虑慢性外踝不稳; 患踝距骨斜角≤9°但比健侧大2°或以上,也应考虑慢性外踝不稳的可能性.

  12. 动静态平衡仪评定踝关节稳定性的信效度研究%Validity and reliability of balance instrument for chronic ankle instability patients

    Institute of Scientific and Technical Information of China (English)

    高敏; 梁英; 王萍芝; 武俊英; 许志强

    2015-01-01

    目的:探讨应用动静态平衡仪评定踝关节稳定程度的信度与效度,为临床应用提供客观依据.方法:慢性踝关节不稳(CAI)患者32例(CAI组)和正常人群30例(正常组),对CAI患者的患侧踝关节和正常人群单侧踝关节进行3次Pro-kin动静态平衡仪的本体感觉预评估、多轴本体感觉评估和Cumberland踝关节不稳定评价问卷评定,并将32例3次慢性踝关节不稳患者的本体感觉预评估指标和多轴本体感觉评估指标的均值分别与Cumber-land不稳定评价问卷评分进行相关性分析,以检验动静态平衡仪的效度.收集62例受试者的3次评估指标采用等级相关系数(ICC)检验Pro-kin动静态平衡仪的信度.对正常组与CAI组多轴本体感觉评估结果采用两独立样本t检验来检验Pro-kin动静态平衡仪的灵敏度.结果:Pro-kin动静态平衡仪多轴本体感觉评估指标:平均轨迹差,平均负重力量差与Cumberland踝关节不稳定评价问卷评分呈中度负相关(r=-0.421,-0.419,P<0.05);本体感觉预评估指标:前后稳定指数、左右稳定指数、A2-A6稳定指数、A4 A8稳定指数、圆周稳定指数与Cumber-land踝关节不稳定评价问卷评分相关性弱(r=-0.057,-0.003,-0.013,-0.129,-0.164,P<0.05).Pro-kin动静态平衡仪的重复测量信度ICC为0.831~0.959,95%可信区间集中;测量者间信度为0.798~0.961,95%可信区间集中.正常组与CAI组多轴本体感觉评估指标比较,差异具有统计学意义(均P<0.05).结论:Pro-kin动静态平衡仪多轴本体感觉评估检测指标平均轨迹差和平均负重力量差可用来评估踝关节稳定性且具有较高的灵敏度,并且Pro-kin动静态平衡仪测量踝关节稳定性具有较高的信度.

  13. Study of Treatment for Chronic Lateral Instability of Ankle in Military Training Injury%军训伤导致慢性外踝关节不稳的手术治疗探讨

    Institute of Scientific and Technical Information of China (English)

    叶添生; 张平; 孙洪体; 张寅权; 张玉贵; 朱玉明; 洪梅

    2007-01-01

    目的 探讨军训伤导致慢性外踝关节不稳的手术治疗方法及其疗效.方法 2002年7月-2006年11月,采用腓骨短肌腱重建修复踝关节外侧韧带的方法手术治疗14例慢性外踝不稳,术后踝关节应力位石膏外固定6周.结果 经4~12个月的随访复查,优9例,良3例,中2例,总优良率85.7%.结论 采用腓骨短肌腱重建外侧韧带治疗慢性外踝关节不稳疗效满意,可减少慢性外踝关节不稳导致创伤性关节炎的发生.

  14. Research Progress of Distribution Features of Plantar Pressure of People with Chronic Ankle Joint Instability%慢性踝关节不稳者足底压力分布特征研究进展

    Institute of Scientific and Technical Information of China (English)

    毛晓锟; 张秋霞; 嵇洁; 孙普庆

    2015-01-01

    慢性踝关节不稳者的踝关节容易反复损伤,而其足底压力特征还不甚明了.通过查阅大量资料并进行分析总结,对慢性踝关节不稳者足底压力特征的研究现状进行综述.足底压力测试研究能够反映人体在安静和运动状态下的足部动作结构变化,有助于踝足损伤诊断和康复评定.关于慢性踝关节不稳者足底压力的分布特征还没有定论,因此慢性踝关节不稳对足底压力分布的影响有待于进一步深入研究,为慢性踝关节不稳的诊断以及康复评定提供实验依据.

  15. 前抽屉试验侧位片对慢性外踝关节不稳的诊断意义%The application of anterior drawer stress roentgenogram in diagnosis of chronic lateral instability of ankle

    Institute of Scientific and Technical Information of China (English)

    何伟华; 黄昌林; 李珂; 齐玉增; 姚朝峰

    2005-01-01

    目的探讨前抽屉试验应力位片在慢性外踝关节不稳定诊断中的意义,提出影像学的定量诊断方法.方法随机选择慢性外踝关节不稳患者40例,共42侧患踝;正常对照组40名,共80侧踝.拍摄前抽屉试验应力位片,测量距骨前移距离.结果患侧距骨前移距离(ATT)平均7.8mm,健侧5.4mm,对照组为6.1mn,患侧与健侧及对照组相比存在显著性差异(P<0.01),健侧与对照组相比,无显著性差异.患侧与健侧距骨前移距离差值(△ATT)平均2.4mm,对照组△ATT平均0.9mm(P<0.01).结论前抽屉试验应力位片对于慢性外踝关节不稳诊断具有重要意义.ATT≥8mm,△ATT≥2 mm可作为衡量踝关节不稳定的标准.

  16. Baroclinic instabilities

    OpenAIRE

    Joly, Laurent; Chassaing, Patrick; Chapin, Vincent; Reinaud, Jean; Micallef, J; Suarez, Juan; Bretonnet, L

    2003-01-01

    1. Introduction - Illustrative examples from experiments and simulations 2. The baroclinic torque in high Froude number flows, its organization, scale and order of magnitude 3. Stability of the inhomogeneous mixing-layer 4. Transition of the inhomogeneous mixing-layer and the 2D secondary baroclinic instability 5. The strain field of 2D light jets 6. Transition to three-dimensionality in light jets and the question of side-jets 7. Baroclinic instability of heavy vortices and...

  17. Carpal instability

    Energy Technology Data Exchange (ETDEWEB)

    Schmitt, R.; Froehner, S.; Coblenz, G.; Christopoulos, G. [Institut fuer Diagnostische und Interventionelle Radiologie, Herz- und Gefaessklinik GmbH, Bad Neustadt an der Saale (Germany)

    2006-10-15

    This review addresses the pathoanatomical basics as well as the clinical and radiological presentation of instability patterns of the wrist. Carpal instability mostly follows an injury; however, other diseases, like CPPD arthropathy, can be associated. Instability occurs either if the carpus is unable to sustain physiologic loads (''dyskinetics'') or suffers from abnormal motion of its bones during movement (''dyskinematics''). In the classification of carpal instability, dissociative subcategories (located within proximal carpal row) are differentiated from non-dissociative subcategories (present between the carpal rows) and combined patterns. It is essential to note that the unstable wrist initially does not cause relevant signs in standard radiograms, therefore being ''occult'' for the radiologic assessment. This paper emphasizes the high utility of kinematographic studies, contrast-enhanced magnetic resonance imaging (MRI) and MR arthrography for detecting these predynamic and dynamic instability stages. Later in the natural history of carpal instability, static malalignment of the wrist and osteoarthritis will develop, both being associated with significant morbidity and disability. To prevent individual and socio-economic implications, the handsurgeon or orthopedist, as well as the radiologist, is challenged for early and precise diagnosis. (orig.)

  18. 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.

  19. 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.

  20. Shoulder instability

    International Nuclear Information System (INIS)

    Shoulder instability is a common clinical feature leading to recurrent pain and limitated range of motion within the glenohumeral joint. Instability can be due a single traumatic event, general joint laxity or repeated episodes of microtrauma. Differentiation between traumatic and atraumatic forms of shoulder instability requires careful history and a systemic clinical examination. Shoulder laxity has to be differentiated from true instability followed by the clinical assessment of direction and degree of glenohumeral translation. Conventional radiography and CT are used for the diagnosis of bony lesions. MR imaging and MR arthrography help in the detection of soft tissue affection, especially of the glenoid labrum and the capsuloligamentous complex. The most common lesion involving the labrum is the anterior labral tear, associated with capsuloperiostal stripping (Bankart lesion). A number of variants of the Bankart lesion have been described, such as ALPSA, SLAP or HAGL lesions. The purpose of this review is to highlight different forms of shoulder instability and its associated radiological findings with a focus on MR imaging. (orig.)

  1. 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

  2. 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

  3. Are low-energy open ankle fractures in the elderly the new geriatric hip fracture?

    Science.gov (United States)

    Toole, William P; Elliott, Mark; Hankins, David; Rosenbaum, Corey; Harris, Anthony; Perkins, Christopher

    2015-01-01

    As the geriatric population in the United States continues to increase, ankle fractures in the elderly are predicted to exponentially increase in the future. As such, these injuries will become a common injury seen by physicians in various fields. Currently, no studies discussing low-energy open ankle fractures in the elderly and/or the mortality rate associated with these devastating injuries have been published. The purpose of the present study was to retrospectively review the morality rate associated with low-energy open ankle fractures in the elderly. We retrospectively identified 11 patients >60 years old who had sustained low-energy open ankle fractures and been treated at our institution. The patient demographics, mechanism of injury, wound size, medical comorbidities, treatment, follow-up data, and outcomes were recorded. Low-energy falls were defined as ground level falls from sitting or standing. The mean age of the patients was 70.72 years, with a mean body mass index of 35.93 ± 10.24. Of the 11 patients, 9 (81.81%) had ≥3 comorbidities (i.e., hypertension, diabetes, coronary artery disease, congestive heart failure, and/or chronic obstructive pulmonary disease). The mean size of the medially based ankle wound was 14.18 ± 4.12 cm; 10 (90.90%) were Gustilo and Anderson grade IIIA open ankle fractures. In our study, low-energy open ankle fractures in the elderly, very similar to hip fractures, were associated with a high mortality incidence (27.27%) at a mean of 2.67 ± 2.02 months, and 81.81% of our patients had ≥3 medical comorbidities. PMID:25488597

  4. 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

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

    Directory of Open Access Journals (Sweden)

    Costa Christopher R

    2012-07-01

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

  6. Beam Instabilities

    CERN Document Server

    Rumolo, G

    2014-01-01

    When a beam propagates in an accelerator, it interacts with both the external fields and the self-generated electromagnetic fields. If the latter are strong enough, the interplay between them and a perturbation in the beam distribution function can lead to an enhancement of the initial perturbation, resulting in what we call a beam instability. This unstable motion can be controlled with a feedback system, if available, or it grows, causing beam degradation and loss. Beam instabilities in particle accelerators have been studied and analysed in detail since the late 1950s. The subject owes its relevance to the fact that the onset of instabilities usually determines the performance of an accelerator. Understanding and suppressing the underlying sources and mechanisms is therefore the key to overcoming intensity limitations, thereby pushing forward the performance reach of a machine.

  7. 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

  8. 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...

  9. Recombination instability

    DEFF Research Database (Denmark)

    D'Angelo, N.

    1967-01-01

    A recombination instability is considered which may arise in a plasma if the temperature dependence of the volume recombination coefficient, alpha, is sufficiently strong. Two cases are analyzed: (a) a steady-state plasma produced in a neutral gas by X-rays or high energy electrons; and (b...

  10. 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.

  11. 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

  12. 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.

  13. 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.

  14. 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

  15. 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...

  16. 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

  17. [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.

  18. 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.

  19. Effects of ankle joint mobilization with movement and weight-bearing exercise on knee strength, ankle range of motion, and gait velocity in patients with stroke: a pilot study.

    Science.gov (United States)

    An, Chang-Man; Won, Jong-Im

    2016-01-01

    [Purpose] The purpose of this study was to investigate the effects of ankle joint mobilization with movement on knee strength, ankle range of motion, and gait velocity, compared with weight-bearing exercise in stroke patients. [Subjects and Methods] Thirty subjects with chronic stroke were divided into three groups: MWM (n = 12), WBE (n = 8), and control (n = 10). All groups attended physical therapy sessions 3 times a week for 5 weeks. Subjects in the MWM group performed mobilization with movement exercises, whilst participants in the WBE group performed weight-bearing exercises. Knee peak torque, ankle range of motion, and spatiotemporal gait parameters were evaluated before and after the interventions. [Results] Knee extensor peak torque increased significantly in both MWM and WBE groups. However, only the MWM group showed significant improvement in passive and active ankle range of motion and gait velocity, among the three groups. [Conclusion] Ankle joint mobilization with movement intervention is more effective than simple weight-bearing intervention in improving gait speed in stroke patients with limited ankle motion.

  20. 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 ...

  1. 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.

  2. 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...

  3. 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

  4. POSTTRAUMATIC SHOULDER INSTABILITY IN CHILDREN: CLINICAL PRESENTATION, DIAGNOSIS AND TREATMENT

    Directory of Open Access Journals (Sweden)

    Ярослав Николаевич Прощенко

    2014-09-01

    Full Text Available The article presents an analysis of the treatment of 15 patients with posttraumatic shoulder instability aged 11-17 years, as a result of primary traumatic dislocation and chronic instability. We identified the following causes of chronic shoulder instability: Bankart injury, SLAP-injury; Hill-Sachs defect; fracture of the glenoid, type 3 humeral head-glenoid relation, and retroversion of the humeral head, as well as defects in the treatment of primary shoulder dislocation. Surgical treatment is performed in 7 patients with chronic instability (7 joints. Unsatisfactory result was detected in 1 patient (1 joints, which is caused by a type 3 humeral head-glenoid relation.

  5. [Carpal instability].

    Science.gov (United States)

    Redeker, J; Vogt, P M

    2011-01-01

    Carpal instability can be understood as a disturbed anatomical alignment between bones articulating in the carpus. This disturbed balance occurs either only dynamically (with movement) under the effect of physiological force or even statically at rest. The most common cause of carpal instability is wrist trauma with rupture of the stabilizing ligaments and adaptive misalignment following fractures of the radius or carpus. Carpal collapse plays a special role in this mechanism due to non-healed fracture of the scaphoid bone. In addition degenerative inflammatory alterations, such as chondrocalcinosis or gout, more rarely aseptic bone necrosis of the lunate or scaphoid bones or misalignment due to deposition (Madelung deformity) can lead to wrist instability. Under increased pressure the misaligned joint surfaces lead to bone arrosion with secondary arthritis of the wrist. In order to arrest or slow down this irreversible process, diagnosis must occur as early as possible. Many surgical methods have been thought out to regain stability ranging from direct reconstruction of the damaged ligaments, through ligament replacement to partial stiffening of the wrist joint.

  6. 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

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

    Science.gov (United States)

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

    2010-01-01

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

  8. Can textured insoles improve ankle proprioception and performance in dancers?

    Science.gov (United States)

    Steinberg, Nili; Waddington, Gordon; Adams, Roger; Karin, Janet; Begg, Rezaul; Tirosh, Oren

    2016-08-01

    With the aim of determining both the acute and the chronic effects of textured insoles on the ankle discrimination and performance ability of dancers, 60 ballet dancers from the Australian Ballet School, aged 14-19 years, were divided into three groups (two intervention groups and a control group), age- and level-matched. In the first 5 weeks (weeks 1 to 5), the first intervention group (GRP1) was asked to wear textured insoles in their ballet shoes and the second intervention group (GRP2) was not given textured insoles to wear. In the next 5 weeks (weeks 6 to 10), GRP2 was asked to wear the same type of textured insoles and GRP1 did not wear the textured insoles. The control group (CTRL) did not wear textured insoles during the whole 10 weeks. All participants were tested preintervention, after 5 weeks and after 10 weeks for ankle discrimination score (AUC scores). Dance performance was assessed by 5-7 dance teachers. Pre-to-post change in AUC scores was significantly greater for the groups wearing insoles than for the controls (P = .046) and the size of pre-to-post changes did not differ between the two intervention groups (P = .834). Significant correlation was found between ankle discrimination score and performance scores, using the textured insoles (r = .412; P = .024). In conclusion, the stimulation to the proprioceptive system arising from textured insoles worn for five weeks was sufficient to improve the proprioceptive ability and performance ability of ballet dancers. PMID:26618395

  9. Can textured insoles improve ankle proprioception and performance in dancers?

    Science.gov (United States)

    Steinberg, Nili; Waddington, Gordon; Adams, Roger; Karin, Janet; Begg, Rezaul; Tirosh, Oren

    2016-08-01

    With the aim of determining both the acute and the chronic effects of textured insoles on the ankle discrimination and performance ability of dancers, 60 ballet dancers from the Australian Ballet School, aged 14-19 years, were divided into three groups (two intervention groups and a control group), age- and level-matched. In the first 5 weeks (weeks 1 to 5), the first intervention group (GRP1) was asked to wear textured insoles in their ballet shoes and the second intervention group (GRP2) was not given textured insoles to wear. In the next 5 weeks (weeks 6 to 10), GRP2 was asked to wear the same type of textured insoles and GRP1 did not wear the textured insoles. The control group (CTRL) did not wear textured insoles during the whole 10 weeks. All participants were tested preintervention, after 5 weeks and after 10 weeks for ankle discrimination score (AUC scores). Dance performance was assessed by 5-7 dance teachers. Pre-to-post change in AUC scores was significantly greater for the groups wearing insoles than for the controls (P = .046) and the size of pre-to-post changes did not differ between the two intervention groups (P = .834). Significant correlation was found between ankle discrimination score and performance scores, using the textured insoles (r = .412; P = .024). In conclusion, the stimulation to the proprioceptive system arising from textured insoles worn for five weeks was sufficient to improve the proprioceptive ability and performance ability of ballet dancers.

  10. 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...

  11. 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.

  12. 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.

  13. 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 ...

  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. Midcarpal instability: a radiological perspective

    Energy Technology Data Exchange (ETDEWEB)

    Toms, Andoni Paul [Norfolk and Norwich University Hospital NHS Trust, Department of Radiology, Norwich, Norfolk (United Kingdom); Radiology Academy, Cotman Centre, Norwich, Norfolk (United Kingdom); Chojnowski, Adrian [Norfolk and Norwich University Hospital NHS Trust, Department of Orthopaedic Surgery, Norwich, Norfolk (United Kingdom); Cahir, John G. [Norfolk and Norwich University Hospital NHS Trust, Department of Radiology, Norwich, Norfolk (United Kingdom)

    2011-05-15

    Midcarpal instability (MCI) is the result of complex abnormal carpal motion at the midcarpal joint of the wrist. It is a form of non-dissociative carpal instability (CIND) and can be caused by various combinations of extrinsic ligament injuries that then result in one of several subtypes of MCI. The complex patterns of injury and the kinematics are further complicated by competing theories, terminology and classifications of MCI. Palmar, dorsal, ulna midcarpal instability, and capitolunate or chronic capitolunate instability are all descriptions of types of MCI with often overlapping features. Palmar midcarpal instability (PMCI) is the most commonly reported type of MCI. It has been described as resulting from deficiencies in the ulna limb of the palmar arcuate ligament (triquetrohamate-capitate) or the dorsal radiotriquetral ligaments, or both. Unstable carpal articulations can be treated with limited carpal arthrodesis or the ligamentous defects can be treated with capsulorrhaphy or ligament reconstruction. Conventional radiographic abnormalities are usually limited to volar intercalated segment instability (VISI) patterns of carpal alignment and are not specific. For many years stress view radiographs and videofluoroscopy have been the methods of choice for demonstrating carpal instability and abnormal carpal kinematics respectively. Dynamic US can be also used to demonstrate midcarpal dyskinesia including the characteristic triquetral ''catch-up'' clunk. Tears of the extrinsic ligaments can be demonstrated with MR arthrography, and probably with CT arthrography, but intact yet redundant ligaments are more difficult to identify. The exact role of these investigations in the diagnosis, categorisation and management of midcarpal instability has yet to be determined. (orig.)

  16. Suture anchors for the repair of deltoid ligament injury:restore the stability of ankle joint%带线锚钉修复三角韧带损伤:恢复踝关节稳定性

    Institute of Scientific and Technical Information of China (English)

    田勇; 马骁

    2015-01-01

    BACKGROUND:Ankle fractures combined with deltoid ligament injury are not uncommon in clinical practice, prone to misdiagnosis and missed diagnosis, resulting in ankle instability, chronic pain and traumatic arthritis. In recent years, because of the research and development of anatomy and biomechanical characteristics of deltoid ligament, the treatment and surgical methods of ankle fracture combined with deltoid ligament injury have progress and development, but it remains controversial. OBJECTIVE:To evaluate the clinical effect of suture anchor repair in the treatment of ankle fracture combined with deltoid ligament injury. METHODS: Twenty-seven patients with ankle fracture combined with deltoid ligament injury were selected between January 2010 and January 2013. The lateral maleolus and posterior maleolus fracture patients were treated with open reduction and internal fixation, and al the deltoid ligament injury patients were treated with anchor repair. The tibiofibular syndesmosis isolated patients received internal fixation with a cancelous bone screw. RESULTS AND CONCLUSION:Al 27 patients were folowed-up for 11-35 months, averagely 23 months. The evaluation according to the American Orthopaedic Foot and Ankle Society score system showed that the excelent and good rate was 74.1%. The results indicate that anchor could perfectly restore the stability of ankle joint.%背景:踝关节骨折合并三角韧带损伤在临床上并不少见,容易发生漏诊及误诊,从而导致踝关节不稳、踝部慢性疼痛及创伤性关节炎。近年来对三角韧带解剖结构和生物力学特征的研究发展,踝关节骨折合并三角韧带损伤的治疗理念和手术方法都有了进步和发展,但仍存在争议。目的:评价带线锚钉治疗踝关节骨折合并三角韧带损伤的临床治疗效果。方法:于2010年1月至2013年1月利用带线锚钉治疗踝关节骨折合并三角韧带损伤27例,对外踝、后踝骨折均行切

  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. Acute injury of the ankle joint

    International Nuclear Information System (INIS)

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

  19. 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.

  20. 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," ...

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

    Energy Technology Data Exchange (ETDEWEB)

    Capen, D.; Scheck, M.

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

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

    Science.gov (United States)

    Tantivesruangdet, Nopmanee

    2016-02-01

    Acupuncture is an ancient medical treatment that is increasingly attracting the interest of the public. It is a complementary therapy that is widely used for management of pain, especially chronic discomfort caused by migraine, low-back pain and osteoarthritis of the knee(¹⁻³). The evidence base for the effectiveness of acupuncture and its clinical applications is controversial, and although its efficacy and safety in the management of acute pain have been demonstrated, the quality of this modality is still questionable. The present study reports a case of acute ankle injury, which was treated with acupuncture. A 33-year-old man presented with acute twisted ankle injury. He had pain with swelling around the ankle, and he was experiencing difficulty in walking. His clinical diagnosis was acute ankle sprain with severe pain. Several drug treatments are used for pain control, but in this case, we used acupuncture. After treatment, his pain diminished significantly with a decrease in VAS pain level from 8 to 4 in 20 minutes. At follow-up after one month, we found no skin infection in this case. PMID:27266242

  3. 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)

  4. 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...

  5. 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...

  6. 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

  7. Association between improved trunk stability and walking capacity using ankle-foot orthosis in hemiparetic patients with stroke: evidence from three-dimensional gait analysis

    Institute of Scientific and Technical Information of China (English)

    LAN Yue; XU Guang-qing; HUANG Dong-feng; MAO Yu-rong; CHEN Shao-zhen; PEI Zhong; ZENG Jin-sheng

    2013-01-01

    Background Restoration of both normal movement of the pelvis and centre of mass is a primary goal of walking rehabilitation in post-stroke patients because these movements are essential components of effective gait.The aim of this study is to quantitatively analyze the effect of ankle-foot orthosis on walking ability,and to investigate the correlation between improvements in trunk motion and walking capacity.Methods Walking speed,centre of mass displacement,and pelvic movements were examined in 20 post-stroke hemiparetic patients with and without ankle-foot orthosis using three-dimensional motion analysis.Results Using ankle-foot orthosis improved walking speed,pelvic rotation and tilt,and lateral and vertical displacements of the centre of mass (P <0.01).Moreover,the gait asymmetry index was significantly decreased (P <0.01),and the Functional Ambulation Categories score improved significantly when patients used an anklefoot orthosis (P <0.05).There was significant correlation between improvements in the walking capacity and the displacement of the centre of mass in both vertical and lateral directions (P <0.01).Conclusions Using ankle-foot orthosis improves the walking capacity by improving the stability and concordant of the trunk in hemiplegic patients.The improvement in the walking capacity from using an ankle-foot orthosis may be attributed to its prevention of foot drop and compensation for the instability of the ankle joint.

  8. 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...

  9. 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

  10. 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

  11. 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.

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

    Institute of Scientific and Technical Information of China (English)

    徐向阳; 刘津浩; 朱渊; 王碧菠

    2010-01-01

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

  13. 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

  14. Anterolateral Ankle Impingement Syndrome (review)%踝关节前外侧撞击综合征的研究进展

    Institute of Scientific and Technical Information of China (English)

    闵红巍; 刘克敏

    2014-01-01

    临床将踝关节扭伤后无骨折脱位,反复出现踝关节前外侧肿痛称为踝关节前外侧撞击综合征,为慢性踝关节疼痛的主要病因之一,受到广泛关注。本文就其发病机制、临床表现、诊断及治疗进行综述。%Ankle sprain without fracture or dislocation, accompanied by repeated ankle swelling is called as Anterolateral Ankle Im-pingement Syndrome. It is a major reason of chronic ankle pain and received extensive attention. This paper summarized its pathogenesis, clinical manifestations, diagnosis and treatment.

  15. 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

  16. 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 ...

  17. 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...

  18. 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.

  19. PA03.03. Effect of manjishtadi lepa in management of ankle sprain

    Science.gov (United States)

    Patil, S Suraj; Kumar, P Hemantha

    2013-01-01

    Purpose: To evaluate the effect of Manjisthadi Lepa in the Management of Ankle Sprain. To compare the effectiveness of Sheeta and Ushna Manjisthadi Lepa on Ankle Sprain. Method: Cases presenting with classical signs and symptoms of Ankle Sprain were selected from the outpatient and in patient department of Shalya Tantra. They were randomly allocated into two groups with 20 patients. Group – A / Sheeta Group– Sheeta Manjishtadi Lepa. Group – B / Ushna Group– Sheeta Manjishtadi Lepa. Lepa was applied twice daily for one week duration and daily assessment of the clinical parameters was done according to the proforma and weekly follow up for four weeks Result: Duration of one week treatment has provided significant relief with a value of 88.23% in pain, 85.71% in tenderness, 75% in swelling, 100% in loss of function and 100% in discoloration. 100% result is obtained in the movements of joint as dorsiflexion, plantarflexion, adduction, abduction, inversion and eversion after the application of Sheeta Manjisthadi Lepa. After the application of Ushna Manjisthadi Lepa pain reduced by 91.17%, tenderness by 86.%, swelling by 76.4%, loss of function by, discoloration and movements of the joints by 100% with P < 0.001 in both groups. On the second follow up only 100% relief was noted in all the parameters in both the groups. Conclusion: Group A / Sheeta group patients showed better improvement in the initial days of treatment i.e. in conditions of Acute Ankle Sprain, where as in Group B / Ushna group showed better improvement in later stage i.e. in Chronic Ankle Sprain. Complete remission was seen in 75% of patients, marked improvement in 17.5%, moderate improvement in 7% and no patient showed unchanged results after one week treatment.

  20. 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.

  1. 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.

  2. 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 ...

  3. [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

  4. 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

  5. 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

  6. 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

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

    Science.gov (United States)

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

    2016-01-01

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

  8. 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.

  9. Predicting functional recovery after acute ankle sprain.

    Directory of Open Access Journals (Sweden)

    Sean R O'Connor

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

  10. 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.

  11. 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.)

  12. 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.

  13. 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

  14. 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

  15. Optimal management of ankle syndesmosis injuries

    OpenAIRE

    Porter DA; Jaggers RR; Barnes AF; Rund AM

    2014-01-01

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

  16. The management of soft tissue ankle injuries.

    OpenAIRE

    Crean, D.

    1981-01-01

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

  17. 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.)

  18. 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

  19. 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

  20. 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.

  1. 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...

  2. 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...

  3. 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.)

  4. 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...

  5. Rehabilitation of Ankle and Foot Injuries in Athletes

    OpenAIRE

    Chinn, Lisa; Hertel, Jay

    2010-01-01

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

  6. 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...

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

    OpenAIRE

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

    2015-01-01

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

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

    OpenAIRE

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

    2013-01-01

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

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

    International Nuclear Information System (INIS)

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

  10. Kinematics and kinetics of an accidental lateral ankle sprain

    OpenAIRE

    Kristianslund, Eirik; Bahr, Roald; Krosshaug, Tron

    2011-01-01

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

  11. Influence on ankle taping on dynamic balance performance

    OpenAIRE

    Kenny, Ian; Wu, Can; McEvoy, Johnson

    2011-01-01

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

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

    OpenAIRE

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

    2015-01-01

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

  13. 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...

  14. MR imaging of the ankle. Magnetresonanztomographie des Sprunggelenks

    Energy Technology Data Exchange (ETDEWEB)

    Vestring, T.; Bongartz, G.; Vassallo, P.; Wiesmann, W.; Adlawan, C.; Adolph, J.; Peters, P.E. (Muenster Univ. (Germany). Radiologische Klinik und Poliklinik); Erlemann, R. (Muenster Univ. (Germany). Radiologische Klinik und Poliklinik Sankt-Johannes-Hospital, Duisburg (Germany, F.R.). Inst. fuer Radiologie); Sciuk, J. (Muenster Univ. (Germany, F.R.). Klinik und Poliklinik fuer Nuklearmedizin)

    1991-12-01

    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.).

  15. Effect of peroneal electrical stimulation versus an ankle-foot orthosis on obstacle avoidance ability in people with stroke-related foot drop.

    NARCIS (Netherlands)

    Swigchem, R. van; Duijnhoven, H.J.R. van; Boer, J. den; Geurts, A.C.H.; Weerdesteijn, V.G.

    2012-01-01

    BACKGROUND: Walking ability of people with foot drop in the chronic phase after stroke is better with functional electrical stimulation (FES) of the peroneal nerve than without an orthotic device. However, the literature is not conclusive on whether peroneal FES also is better than an ankle-foot ort

  16. Benign and malignant tumors of the foot and ankle

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

    Kulisić, Sandra Marinović

    2012-10-01

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

  18. Benign and malignant tumors of the foot and ankle

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-03-15

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

  19. Increased reward in ankle robotics training enhances motor control and cortical efficiency in stroke

    Directory of Open Access Journals (Sweden)

    Ronald N. Goodman, PhD

    2014-03-01

    Full Text Available Robotics is rapidly emerging as a viable approach to enhance motor recovery after disabling stroke. Current principles of cognitive motor learning recognize a positive relationship between reward and motor learning. Yet no prior studies have established explicitly whether reward improves the rate or efficacy of robotics-assisted rehabilitation or produces neurophysiologic adaptations associated with motor learning. We conducted a 3 wk, 9-session clinical pilot with 10 people with chronic hemiparetic stroke, randomly assigned to train with an impedance-controlled ankle robot (anklebot under either high reward (HR or low reward conditions. The 1 h training sessions entailed playing a seated video game by moving the paretic ankle to hit moving onscreen targets with the anklebot only providing assistance as needed. Assessments included paretic ankle motor control, learning curves, electroencephalograpy (EEG coherence and spectral power during unassisted trials, and gait function. While both groups exhibited changes in EEG, the HR group had faster learning curves (p = 0.05, smoother movements (p

  20. Increased reward in ankle robotics training enhances motor control and cortical efficiency in stroke.

    Science.gov (United States)

    Goodman, Ronald N; Rietschel, Jeremy C; Roy, Anindo; Jung, Brian C; Diaz, Jason; Macko, Richard F; Forrester, Larry W

    2014-01-01

    Robotics is rapidly emerging as a viable approach to enhance motor recovery after disabling stroke. Current principles of cognitive motor learning recognize a positive relationship between reward and motor learning. Yet no prior studies have established explicitly whether reward improves the rate or efficacy of robotics-assisted rehabilitation or produces neurophysiologic adaptations associated with motor learning. We conducted a 3 wk, 9-session clinical pilot with 10 people with chronic hemiparetic stroke, randomly assigned to train with an impedance-controlled ankle robot (anklebot) under either high reward (HR) or low reward conditions. The 1 h training sessions entailed playing a seated video game by moving the paretic ankle to hit moving onscreen targets with the anklebot only providing assistance as needed. Assessments included paretic ankle motor control, learning curves, electroencephalograpy (EEG) coherence and spectral power during unassisted trials, and gait function. While both groups exhibited changes in EEG, the HR group had faster learning curves (p = 0.05), smoother movements (p

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

    OpenAIRE

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

    2015-01-01

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

  2. Evaluating shoulder instability treatment

    OpenAIRE

    Linde, J. A.

    2016-01-01

    Shoulder instability common occurs. When treated nonoperatively, the resulting societal costs based on health care utilization and productivity losses are significant. Shoulder function can be evaluated using patient reported outcome measurements (PROMs). For shoulder instability, these include the Western Ontario Shoulder Instability index (WOSI) and the Oxford Shoulder Instability Score (OSIS). When translated and validated for the dutch population, both have good measurment properties. Sco...

  3. 55例踝关节外侧副韧带损伤合并外踝撕脱骨折的手术治疗分析%Surgical treatment for ankle lateral collateral ligament injury with avulsion fracture:a report of 55 cases

    Institute of Scientific and Technical Information of China (English)

    谢兴; 胡跃林; 焦晨; 江东; 陈临新; 梅宇; 郭秦炜

    2015-01-01

    Background:Injury of the lateral collateral ligament (LCL) is one of the most common ankle injuries. There are many stud-ies on isolated ankle LCL injury. However, few studies have been reported on combined injuries of the LCL and avulsion fracture in ankle joint. Objective:To evaluate clinical features and outcomes of ankle LCL injury combined with avulsion fracture. Methods:A total of 55 patients who suffered from ankle LCL injury combined with avulsion fracture and received modified Broström procedure and avulsion bone resection between January 2013 and January 2014 were enrolled in the study. Preop-erative X-ray and MRI were performed in all patients. AOFAS hindfoot functional evaluation system was used preoperative-ly and 6 months postoperatively. Results:Avulsion fracture was found in 51 patients by X-ray and in 4 by MRI. As compared with preoperative one, AOFAS score was significantly increased 6 months postoperatively (54.62±10.31 vs 87.70±3.22, P Conclusions:X-ray and MRI can accurately diagnose avulsion fractures of the lateral malleolus. The lateral ligament injury with avulsion fracture of ankle should be treated as soon as possible so as to prevent chronic instability. Modified Broström procedure and avulsion bone resection can achieve good clinical outcomes for the patients suffered from lateral collateral ligament injury with avulsion fracture of the ankle.%背景:踝关节外踝韧带损伤是最高发的踝关节损伤,目前针对外踝韧带损伤方面的研究较多,而对于外踝韧带损伤合并撕脱骨折的报道较少。  目的:评价踝关节外侧副韧带损伤合并外踝撕脱骨折的临床特点及手术治疗效果。  方法:2013年1月至2014年1月,55例踝关节外侧副韧带损伤合并外踝撕脱骨折患者接受了改良Broström法外踝韧带修复和撕脱骨块切除术。术前行X线片检查及MRI,术前及术后6个月随访时进行AOFAS踝-后足功能评分。  结果:55

  4. Foot and ankle injuries in child and adolescent athletes

    OpenAIRE

    Yildirim, Yakup; Esemenli, Tanil

    2004-01-01

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

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

    OpenAIRE

    Cummings, Robert Jay

    2008-01-01

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

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

    NARCIS (Netherlands)

    Kemler, H.J.

    2015-01-01

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

  7. 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.

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  9. Kinematics of ankle taping after a training session.

    Science.gov (United States)

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

    2008-01-01

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

  10. Dislocated ankle fracture complicated by near total distal ischaemia

    Science.gov (United States)

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

    2013-01-01

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

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

    Science.gov (United States)

    2011-01-01

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

  12. Total ankle prostheses in rheumatoid arthropathy

    Science.gov (United States)

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

    2009-01-01

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

  13. 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

  14. Robotic Ankle for Omnidirectional Rock Anchors

    Science.gov (United States)

    Parness, Aaron; Frost, Matthew; Thatte, Nitish

    2013-01-01

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

  15. Clinical assessment and management of ankle sprains.

    Science.gov (United States)

    Myrick, Karen M

    2014-01-01

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

  16. MRI of injuries of the lateral ankle ligaments

    International Nuclear Information System (INIS)

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

  17. Finite element analysis of a composite artificial ankle

    Science.gov (United States)

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

    1993-01-01

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

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

    Science.gov (United States)

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

    2016-04-01

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

  19. Total ankle replacement – surgical treatment and rehabilitation

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2013-11-01

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

  1. Shoulder instability; Schulterinstabilitaeten

    Energy Technology Data Exchange (ETDEWEB)

    Kreitner, Karl-Friedrich [Mainiz Univ. (Germany). Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie

    2014-06-15

    In the shoulder, the advantages of range of motion are traded for the disadvantages of vulnerability to injury and the development of instability. Shoulder instability and the lesion it produces represent one of the main causes of shoulder discomfort and pain. Shoulder instability is defined as a symptomatic abnormal motion of the humeral head relative to the glenoid during active shoulder motion. Glenohumeral instabilities are classified according to their causative factors as the pathogenesis of instability plays an important role with respect to treatment options: instabilities are classified in traumatic and atraumatic instabilities as part of a multidirectional instability syndrome, and in microtraumatic instabilities. Plain radiographs ('trauma series') are performed to document shoulder dislocation and its successful reposition. Direct MR arthrography is the most important imaging modality for delineation the different injury patterns on the labral-ligamentous complex and bony structures. Monocontrast CT-arthrography with use of multidetector CT scanners may be an alternative imaging modality, however, regarding the younger patient age, MR imaging should be preferred in the diagnostic work-up of shoulder instabilities. (orig.)

  2. A novel tool for measuring ankle dorsiflexion: A study of its reliability in patients following ankle fractures

    DEFF Research Database (Denmark)

    Larsen, Peter; Nielsen, Henrik; Lund, Christoffer;

    2016-01-01

    correlation coefficients (ICC). RESULTS: The study sample consisted of 24 patients: fifteen females and nine males post-immobilisation following surgery for ankle fractures. The mean age was 51.0 years, ranging from 22–92 years. All patients had sustained an AO classification 44- fracture of the ankle...

  3. Total ankle replacement: a population-based study of 515 cases from the Finnish Arthroplasty Register

    Science.gov (United States)

    Koivu, Helka; Eskelinen, Antti; Ikävalko, Mikko; Paavolainen, Pekka; Remes, Ville

    2010-01-01

    Background and purpose Although total ankle replacement (TAR) is a recognized procedure for treatment of the painful arthritic ankle, the best choice of implant and the long-term results are still unknown. We evaluated the survival of two TAR designs and factors associated with survival using data from the nationwide arthroplasty registry in Finland. Methods 573 primary TARs were performed during the period 1982–2006 because of rheumatic, arthritic, or posttraumatic ankle degeneration. We selected contemporary TAR designs that were each used in more than 40 operations, including the S.T.A.R. (n = 217) and AES (n = 298), to assess their respective survival rates. The mean age of the patients was 55 (17–86) years and 63% of operations were performed in women. Kaplan-Meier analysis and the Cox regression model were used for survival analysis. The effects of age, sex, diagnosis, and hospital volume were also studied. Results The annual incidence of TAR was 1.5 per 105 inhabitants. The 5-year overall survivorship for the whole TAR cohort was 83% (95% CI: 81–86), which agrees with earlier reports. The most frequent reasons for revision were aseptic loosening of one or both of the prosthesis components (39%) and instability (39%). We found no difference in survival rate between the S.T.A.R. and AES designs. Furthermore, age, sex, diagnosis, and hospital volume ( 100 replacements in each of 17 hospitals) did not affect the TAR survival. Interpretation Based on our findings, we cannot conclude that any prosthesis was superior to any other. A high number of technical errors in primary TARs suggests that this low-volume field of implant arthroplasty should be centralized to fewer units. PMID:20180720

  4. MR imaging in sports-related glenohumeral instability

    International Nuclear Information System (INIS)

    Sports-related shoulder pain and injuries represent a common problem. In this context, glenohumeral instability is currently believed to play a central role either as a recognized or as an unrecognized condition. Shoulder instabilities can roughly be divided into traumatic, atraumatic, and microtraumatic glenohumeral instabilities. In athletes, atraumatic and microtraumatic instabilities can lead to secondary impingement syndromes and chronic damage to intraarticular structures. Magnetic resonance (MR) arthrography is superior to conventional MR imaging in the diagnosis of labro-ligamentous injuries, intrinsic impingement, and SLAP (superior labral anteroposterior) lesions, and thus represents the most informative imaging modality in the overall assessment of glenohumeral instability. This article reviews the imaging criteria for the detection and classification of instability-related injuries in athletes with special emphasis on the influence of MR findings on therapeutic decisions. (orig.)

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

    International Nuclear Information System (INIS)

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

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

    NARCIS (Netherlands)

    Doets, Hendrik Cornelis

    2009-01-01

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

  7. Summary of Human Ankle Mechanical Impedance During Walking

    Science.gov (United States)

    Rouse, Elliott J.; Krebs, Hermano Igo

    2016-01-01

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

  8. Influence of distal tibiofibular synostosis on ankle function

    Institute of Scientific and Technical Information of China (English)

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

    2009-01-01

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

  9. X-ray image characteristics and related measurements in the ankles of 118 adult patients with Kashin-Beck disease

    Institute of Scientific and Technical Information of China (English)

    Zeng Yi; Zhou Zongke; Shen Bin; Yang Jing; Kang Pengde; Zhou Xuan; Zou Ling

    2014-01-01

    Background Kashin-Beck disease (KBD) is a chronic,degenerative osteoarthropathy that causes severe skeletal deformation.Although many researchers have proven that almost all KBD patients who showed an increaseing proximo-distal gradient had radiographic abnormalities of the ankle,few detailed description of radiographic changes in the ankles of patients with KBD has been reported,especially for variable measurements of ankle changes.The purpose of this study was to demonstrate the radiographic characteristics of the ankles of adult KBD patients.Methods One hundred and eighteen adult KBD patients from september to October 2010 in Rongtang county in China were examined with lateral radiographs of the right ankle.The morphological abnormalities in the talus,calcaneus,navicular bone,distal tibia,and joint space were analyzed,and the calcaneus length,height,length-height ratio,tuber angle,front angle,plantar angle,and distal tibia anteroposterior (AP) length were measured using Riepert's method.Results Eighty-one patients (68.6%) had abnormal ankle radiographs; 72 (88.9%) patients had talus changes,69 (85.2%) patients had calcaneus changes,28 (34.6%) patients had navicular bone changes,and 48 (59.2%) patients had distal tibia changes.For 118 KBD patients,the average calcaneus length was 7.4 cm,height was 4.3 cm,and the length-height ratio was 1.7.The calcaneus tuber angle was 28.2°,front angle was 38.0° and the plantar angle was 74.2°.The distal tibia anteroposterior length was 4.05 cm.Compared with 50 normal adults (control group),significant differences were found for the calcaneus length,the calcaneus length-height ratio,and the distal tibia AP length.Conclusions Patients with KBD have characteristic abnormalities on ankle radiographs; talus depression and deformity,calcaneus shortening deformity,and distal tibia deformity with AP length widening were the most typical changes.

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

    Directory of Open Access Journals (Sweden)

    Suresh

    2014-12-01

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

  11. Preoperative gait characterization of patients with ankle arthrosis.

    Science.gov (United States)

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

    2006-08-01

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

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

    OpenAIRE

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

    2015-01-01

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

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

    OpenAIRE

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

    2011-01-01

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

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

    OpenAIRE

    Gougoulias, Nikolaos; Khanna, Anil; Maffulli, Nicola

    2009-01-01

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

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

    OpenAIRE

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

    2009-01-01

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

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

    OpenAIRE

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

    2011-01-01

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

  17. 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

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

    Directory of Open Access Journals (Sweden)

    M.S. Patil

    2012-10-01

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

  19. Near-fatal infection following an elective ankle-fracture fixation: less risk should not mean less vigilance

    Institute of Scientific and Technical Information of China (English)

    Giada Bianchi; Dingxin Qin; Joseph A.Dearani; Qi Qian

    2011-01-01

    Surgical fixation of closed ankle fracture is traditionally viewed as having low risk for post-operative infection. Only a few cases of surgical-site confined infection have been reported. Because of the low infection risk, the necessity for perioperative prophylaxis has been questioned. We report a case of fulminant methicillin-resistant Staphylococcus aureus endocarditis occurring shortly after an elective ankle fixation surgery in an elderly woman with chronic rheumatoid arthritis. Because systemic infection was unexpected, she had been given antipyretics for postoperative fever until just before rapid clinical deterioration. A nearly fatal hematogenous infection occurred after such a procedure, indicating the necessity for being on high alert and considering the possibility of bloodstream infection.

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

    Science.gov (United States)

    Yablon, Corrie M

    2013-02-01

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

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

    Science.gov (United States)

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

    2016-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Yaniel Truffin Rodríguez

    2014-10-01

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

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

    Science.gov (United States)

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

    2016-07-01

    In our experience, complaints of ankle swelling are more common in summer, typically from patients with no obvious cardiovascular disease. Surprisingly, this observation has never been reported. To objectively establish this phenomenon, we sought evidence of seasonality in the public's Internet searches for ankle swelling. Our data, obtained from Google Trends, consisted of all related Google searches in the United States from January 4, 2004, to January 26, 2016. Consistent with our expectations and confirmed by similar data for Australia, Internet searches for information on ankle swelling are highly seasonal (highest in midsummer), with seasonality explaining 86% of search volume variability. PMID:27401424

  4. Multicenter follow-up study of ankle fracture surgery

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

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

    Science.gov (United States)

    Yablon, Corrie M

    2013-02-01

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

  6. Early intra-articular complement activation in ankle fractures

    DEFF Research Database (Denmark)

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

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Sophia Chui-Wai Ha

    2015-10-01

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

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

    Science.gov (United States)

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

    2014-03-01

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

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

    Science.gov (United States)

    2010-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  11. 影响不稳定性踝关节骨折手术疗效的相关因素分析%Factors affecting efficacy of surgical treatment of unstable ankle fractures

    Institute of Scientific and Technical Information of China (English)

    张殿英; 付中国; 徐海林; 张培训; 杨明; 郁凯; 姜保国

    2010-01-01

    type and treatments. Results Follow-ups lasted for an average time of 46. 3 months, ranging from 3. 5 months to 9 years. The mean AOFAS score was 90 (65 to 95).Univariate Logistic regression analysis found statistically significant differences in age, complications, and fracture type. Their P values, OR values and 95% CI respectively were: 0.005, 1.073, 1.017 to 1.203; 0.019,0.134, 0.063 to 0.351; 0.005, 1.274, 1. 171 to 1. 439. Multivariate Logistic regression analysis showed that only age and fracture type had significant differences. Their P values, OR values and 95% CI were respectively:0. 008, 1. 503, 1. 391 to 1. 701; 0. 007, 1. 247, 1. 153 to 1. 394. Conclusions Age and fracture type of the patients are the main prognostic factors affecting postoperative function of the ankle joint. Timely discovery of factors that might lead to ankle instability, correct diagnosis of the fracture type and presence or absence of associated ligament injury, and appropriate choice of fixation methods are the most effective measures to prevent secondary chronic ankle instability which may lead to traumatic arthritis.

  12. Instability in evolutionary games.

    Directory of Open Access Journals (Sweden)

    Zimo Yang

    Full Text Available BACKGROUND: Phenomena of instability are widely observed in many dissimilar systems, with punctuated equilibrium in biological evolution and economic crises being noticeable examples. Recent studies suggested that such instabilities, quantified by the abrupt changes of the composition of individuals, could result within the framework of a collection of individuals interacting through the prisoner's dilemma and incorporating three mechanisms: (i imitation and mutation, (ii preferred selection on successful individuals, and (iii networking effects. METHODOLOGY/PRINCIPAL FINDINGS: We study the importance of each mechanism using simplified models. The models are studied numerically and analytically via rate equations and mean-field approximation. It is shown that imitation and mutation alone can lead to the instability on the number of cooperators, and preferred selection modifies the instability in an asymmetric way. The co-evolution of network topology and game dynamics is not necessary to the occurrence of instability and the network topology is found to have almost no impact on instability if new links are added in a global manner. The results are valid in both the contexts of the snowdrift game and prisoner's dilemma. CONCLUSIONS/SIGNIFICANCE: The imitation and mutation mechanism, which gives a heterogeneous rate of change in the system's composition, is the dominating reason of the instability on the number of cooperators. The effects of payoffs and network topology are relatively insignificant. Our work refines the understanding on the driving forces of system instability.

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

    Science.gov (United States)

    Saltzman, Charles L.; Kadoko, Robert G.

    2010-01-01

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

  14. [Ankle fractures in the elderly patient].

    Science.gov (United States)

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

    2014-12-17

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

  15. Lateral elbow instability

    Directory of Open Access Journals (Sweden)

    Harry Dominic Stracey Clitherow

    2014-01-01

    Full Text Available Lateral elbow stability utilises a combination of bony and soft tissue constraints. Lateral elbow instability is usually associated with an episode of elbow dislocation. Isolated lateral ligament complex insufficiency results in posterolateral rotatory instability (PLRI, The most common presentation is lateral elbow discomfort and a sensation of instability, without recurrent dislocation. The lateral pivot shift test is unreliable for diagnosing PLRI when the patient is awake due to significant apprehension. Stress radiographs, fluoroscopy, computed tomography and arthroscopy are all useful investigations to confirm the diagnosis of lateral instability. Surgical treatment is indicated for functional instability. All associated fractures need to be addressed. In severe cases, the medial structures and the posterolateral capsule may also require reconstruction.

  16. Chronic sleep reduction, functioning at school and school achievement in preadolescents

    NARCIS (Netherlands)

    A.M. Meijer

    2008-01-01

    This study investigates the relationship between chronic sleep reduction, functioning at school and school achievement of boys and girls. To establish individual consequences of chronic sleep reduction (tiredness, sleepiness, loss of energy and emotional instability) the Chronic Sleep Reduction Ques

  17. Optimal management of ankle syndesmosis injuries

    Directory of Open Access Journals (Sweden)

    Porter DA

    2014-08-01

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

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    In this paper we show that exchanging curved feet and rigid ankles by at feet and compliant ankles improves the range of gait parameters for a bipedal dynamic walker. The new lower legs were designed such that they t to the old set-up, allowing for a direct and quantitative comparison. The dynamic...... walking robot RunBot, controlled by an reflexive neural network, uses only few sensors for generating its stable gait. The results show that at feet and compliant ankles extend RunBot's parameter range especially to more leaning back postures. They also allow the robot to stably walk over obstacles...

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

    OpenAIRE

    Crevoisier X.; Assal M.; Stankova K.

    2016-01-01

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

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

    Science.gov (United States)

    Shore, Benjamin J; Kramer, Dennis E

    2016-06-01

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

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

    Science.gov (United States)

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

    2008-01-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    OpenAIRE

    English, Edward

    1985-01-01

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

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

    OpenAIRE

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

    2012-01-01

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

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

    OpenAIRE

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

    2013-01-01

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

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

    OpenAIRE

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

    2014-01-01

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

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

    International Nuclear Information System (INIS)

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

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

    OpenAIRE

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

    2015-01-01

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

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

    OpenAIRE

    Cusimano, Michael; Faress, Ahmed; Luong, Wilson; Amin, Khizer; Eid, Joanne; Abdelshaheed, Tamer; Russell, Kelly

    2013-01-01

    This cross-sectional study explores factors affecting the decision of basketball players to wear ankle support devices (ASDs). A questionnaire regarding attitudes towards ASD usage was developed based on the Health Belief Model (HBM). The questionnaire assessed HBM perceptions (susceptibility, severity, benefits, and barriers) and modifying factors (demographic, personal history of ankle injury, influence of coach to preventive action) that may affect an athlete’s decision to wear ASDs. One h...

  11. Stress Fractures of the Foot and Ankle in Athletes

    OpenAIRE

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

    2014-01-01

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

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

    OpenAIRE

    Preetha R; John Solomon M

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Witjes Suzanne

    2012-02-01

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

  14. Mitotic Origins of Chromosomal Instability in Colorectal Cancer

    OpenAIRE

    Dalton, W. Brian; Yang, Vincent W.

    2007-01-01

    Mitosis is a crucial part of the cell cycle. A successful mitosis requires the proper execution of many complex cellular behaviors. Thus, there are many points at which mitosis may be disrupted. In cancer cells, chronic disruption of mitosis can lead to unequal segregation of chromosomes, a phenomenon known as chromosomal instability. A majority of colorectal tumors suffer from this instability, and recent studies have begun to reveal the specific ways in which mitotic defects promote chromos...

  15. Nonlinear helical MHD instability

    Energy Technology Data Exchange (ETDEWEB)

    Zueva, N.M.; Solov' ev, L.S.

    1977-07-01

    An examination is made of the boundary problem on the development of MHD instability in a toroidal plasma. Two types of local helical instability are noted - Alfven and thermal, and the corresponding criteria of instability are cited. An evaluation is made of the maximum attainable kinetic energy, limited by the degree to which the law of conservation is fulfilled. An examination is made of a precise solution to a kinematic problem on the helical evolution of a cylindrical magnetic configuration at a given velocity distribution in a plasma. A numerical computation of the development of MHD instability in a plasma cylinder by a computerized solution of MHD equations is made where the process's helical symmetry is conserved. The development of instability is of a resonance nature. The instability involves the entire cross section of the plasma and leads to an inside-out reversal of the magnetic surfaces when there is a maximum unstable equilibrium configuration in the nonlinear stage. The examined instability in the tore is apparently stabilized by a magnetic hole when certain limitations are placed on the distribution of flows in the plasma. 29 references, 8 figures.

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

    Directory of Open Access Journals (Sweden)

    Alireza Manafi Rasi

    2013-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Alireza Manafi Rasi

    2013-12-01

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

  18. Reflex responses to combined hip and knee motion in human chronic spinal cord injury

    OpenAIRE

    Ming Wu, PhD; Brian D. Schmit, PhD

    2010-01-01

    The relative contributions of hip and knee proprioceptors to the origination of extensor spasms were examined in 11 subjects with chronic spinal cord injury (SCI). Ramp and hold extension and combined hip and knee oscillation movements were imposed to the right leg while the ankle was held in a static position by a custom-designed robot. Isometric joint torques of the hip, knee, and ankle and surface electromyograms (EMGs) from seven leg muscles were recorded following controlled hip and knee...

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

    Science.gov (United States)

    Fan, Ka Yuk; Lui, Tun Hing

    2014-01-01

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

  20. Chronic pancreatitis

    Science.gov (United States)

    Chronic pancreatitis - chronic; Pancreatitis - chronic - discharge; Pancreatic insufficiency - chronic; Acute pancreatitis - chronic ... abuse over many years. Repeated episodes of acute pancreatitis can lead to chronic pancreatitis. Genetics may be ...