Influence of syndesmotic injuries and posterior malleolar ankle fractures on fibula position in the ankle joint: a cadaveric study

2020 ◽  
Author(s):  
Sven Y. Vetter ◽  
Nora Palesche ◽  
Nils Beisemann ◽  
Marc Schnetzke ◽  
Holger Keil ◽  
...  
Keyword(s):  
Ankle Joint ◽  
Cadaveric Study ◽  
Ankle Fractures

Examination of the Origin and Branching Direction of the Anterior Medial Malleolar Artery From the Anterior Tibial Artery: A Cadaveric Study

2018 ◽  
Vol 12 (2) ◽  
pp. 167-171 ◽  
Author(s):  
Ichiro Tonogai ◽  
Fumio Hayashi ◽  
Yoshihiro Tsuruo ◽  
Koichi Sairyo
Keyword(s):  
Ankle Joint ◽  
Sagittal Plane ◽  
External Iliac Artery ◽  
Longitudinal Axis ◽  
Cadaveric Study ◽  
Ankle Arthroscopy ◽  
Anterior Tibial Artery ◽  
Tibial Artery ◽  
Anterior Tibial ◽  
Branching Point

Background. This study characterized the anterior medial malleolar artery (AMMA) branching from the anterior tibial artery (ATA) to identify problems in anterior ankle arthroscopy possibly contributing to injury to the AMMA. Methods. Barium was injected into 12 adult cadaveric feet via the external iliac artery and the origin and branching direction of the AMMA were identified on computed tomography. Results. The AMMA originated from the level of the ankle joint and below and above the ankle joint line (AJL) in 4 (33.3%), 6 (50.0%), and 1 (8.3%) specimen, respectively. Mean distance from the AJL to the branching point of the AMMA on the sagittal plane was 2.5 mm distal to the AJL. Mean angle between the distal longitudinal axis of the ATA and AMMA was 83.2°. Conclusions. This study established the origin and branching of the AMMA from the ATA. The AMMA should be examined carefully during ankle arthroscopy. Levels of Evidence: Level IV: Cadaveric study

The fate of the syndesmosis in type C ankle fractures: a cadaveric study

Injury ◽  
1997 ◽  
Vol 28 (4) ◽  
pp. 275-277 ◽  
Author(s):  
I.A. Harris ◽  
H.P. Jones
Keyword(s):  
Cadaveric Study ◽  
Ankle Fractures ◽  
Type C

Traumatic osteoarthrosis of the ankle joint secondary to ankle fractures

1991 ◽  
Vol 81 (8) ◽  
pp. 399-405 ◽  
Author(s):  
JH Walter ◽  
A Spector
Keyword(s):  
Ankle Joint ◽  
Ankle Fractures ◽  
Common Finding ◽  
Joint Cartilage ◽  
The One

Arthritis, in one form or another, is one of the most common disorders that affect man. Whether the etiology is systemic, neurologic, or traumatic, the one common finding is the destruction of joint cartilage. Although there have been massive amounts of literature concerning osteoarthritis, little has been written about arthritis of the ankle joint. Current concepts in the pathology, terminology, symptomatology, and treatment of the arthritic ankle are discussed.

Vascularity of the ankle joint after arthrodesis: a cadaveric study

The Foot ◽  
1995 ◽  
Vol 5 (3) ◽  
pp. 127-131 ◽  
Author(s):  
G.P. Paremain ◽  
M.S. Myerson
Keyword(s):  
Ankle Joint ◽  
Cadaveric Study

Supination-Eversion Fractures of the Ankle Joint: Changes in Incidence over 30 Years

Foot & Ankle ◽  
1987 ◽  
Vol 8 (1) ◽  
pp. 26-28 ◽  
Author(s):  
Mats Bauer ◽  
Urban Bengnér ◽  
Olof Johnell ◽  
Inga Redlund-Johnell
Keyword(s):  
Ankle Joint ◽  
Fragility Fracture ◽  
Elderly Women ◽  
Stage Iv ◽  
Ankle Fractures ◽  
Time Interval ◽  
Skeletal Involvement ◽  
Incidence Pattern ◽  
The 1950S

The sex- and age-specific incidence has been calculated for ankle fractures from the first part of the 1950s and compared with the 1980s, a 30-year interval. The fractures were also classified according to Lauge-Hansen. Altogether 1784 fractures were found. During that time interval ankle fractures had become more common, particularly those with extensive skeletal involvement, such as the stage IV supination-eversion fractures, which today have an incidence pattern more typical of a fragility fracture in elderly women.

scholarly journals The Role of Deep Deltoid Ligament in Ankle Fracture Stability: A Biomechanical Cadaveric Study

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0035
Author(s):  
Daniel McCormack ◽  
Sayyied J. Kirmani ◽  
Sheweidin Aziz ◽  
Radwane Faroug ◽  
Jitendra Mangwani
Keyword(s):  
Ankle Fracture ◽  
Dynamic Stress ◽  
Cadaveric Study ◽  
Ankle Fractures ◽  
Deltoid Ligament ◽  
Lateral Side ◽  
Posterior Portion ◽  
Stage 4 ◽  
Talar Tilt

Category: Ankle; Basic Sciences/Biologics; Trauma Introduction/Purpose: Supination-external rotation (SER) injuries make up 80% of all ankle fractures. SER stage 2 injuries (AITFL and Weber B) are considered stable. SER stage 3 injury includes disruption of the posterior malleolus (or PITFL). In SER stage 4 there is either medial malleolus fracture or deltoid injury. SER 4 injuries have been considered unstable, requiring surgery. The deltoid ligament is a key component of ankle stability, but clinical tests to assess deltoid injury have low specificity. This biomechanical cadaveric study specifically investigates the role of the components of the deep deltoid ligament in the stabillity of SER ankle fractures. Methods: In the first phase of the study, three specimens were utilised to standardise dissection of the deltoid ligament and creation and fixation of SER ankle fracture. In phase two, four matched pairs (8 specimens) were tested using this standardised protocol (Figure1). Specimens were sequentially tested for stability when axially loaded with a custom rig with up to 750N. Specimens were tested with: ankle intact; lateral injury (AITFL and Weber B); additional posterior injury (PITFL); additional anterior deep deltoid; additional posterior deep deltoid; lateral side ORIF. Clinical photographs and radiographs were recorded at each stage. In addition, dynamic stress radiographs were performed after sectioning the deep deltoid and following fracture fixation to assess talar tilt in eversion. Results: All specimens behaved in an identical manner when subjected to this standardised protocol. When the posterior deep deltoid ligament was intact, the ankle remained stable when loaded and showed no talar tilt on dynamic stress test. Once the posterior deep deltoid ligament was sectioned, there was demonstrable instability in all specimens. Surgical stabilisation of the lateral side using standard technique with a plate prevented talar shift but not talar tilt. In adequately stabilised ankle specimens, there was no loss of fixation on axial loading. Conclusion: This biomechanical cadaveric experiment demonstrates that under the standardised test conditions, all SER fracture ankle specimens with an intact posterior deep deltoid ligament behaved as stable injuries. The posterior portion of the deep deltoid ligament is a crucial structure in conferring stability to SER stage 4 injuries. The clinical implication of this is that when the posterior deep deltoid ligament is intact, SER fractures may be managed without surgical intervention in a plantigrade cast. We also conclude that without immobilisation, the talus may tilt in the mortise risking long-term deltoid incompetence.

Prospective Computed Tomographic Analysis of Osteochondral Lesions of the Ankle Joint Associated With Ankle Fractures

2016 ◽  
Vol 37 (8) ◽  
pp. 829-834 ◽  
Author(s):  
Tomasz L. Nosewicz ◽  
M. Suzan H. Beerekamp ◽  
Robert-Jan O. De Muinck Keizer ◽  
Tim Schepers ◽  
Mario Maas ◽  
...  
Keyword(s):  
Ankle Joint ◽  
Ankle Fractures ◽  
Osteochondral Lesions ◽  
Computed Tomographic ◽  
Tomographic Analysis

scholarly journals Surgery versus non-operative treatment for ER-stress unstable Weber-B unimalleolar fractures: a study protocol for a prospective randomized non-inferiority (Super-Fin) trial

2021 ◽  
Vol 3 (1) ◽  
pp. e000098
Author(s):  
Tero Kortekangas ◽  
Ristomatti Lehtola ◽  
Hannu-Ville Leskelä ◽  
Simo Taimela ◽  
Pasi Ohtonen ◽  
...  
Keyword(s):  
Ankle Joint ◽  
Operative Treatment ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Ankle Fractures ◽  
Primary Concern ◽  
Current Standard ◽  
Cast Immobilization ◽  
Fibula Fracture ◽  
Increased Risk

Roughly two-thirds of ankle fractures are unimalleolar injuries, the Weber B-type fibula fracture being by far the most common type. Depending on the trauma and the accompanying soft-tissue injury, these fractures are either stable or unstable. Current clinical practice guidelines recommend surgical treatment for unstable Weber B-type fibula fractures. An ongoing randomized, parallel group, non-inferiority trial comparing surgery and non-operative treatment for unstable Weber B-type ankle fractures with allocation ratio 1:1. The rationale for non-inferiority design is as follows: By being able to prove non-inferiority of non-operative treatment, we would be able to avoid complications related to surgery. However, the primary concern related to non-operative treatment is increased risks of ankle mortise incongruency, leading to secondary surgery, early post-traumatic osteoarthritis and poor function. After providing informed consent, 126 patients aged 16 years or older with an unimalleolar Weber B-type unstable fibula fracture were randomly assigned to surgery (open reduction and internal fixation) or non-operative treatment (6-week cast immobilization). We have completed the patient enrolment and are currently in the final stages of the 2-year follow-up. The primary, non-inferiority outcome is the Olerud-Molander Ankle Score (OMAS) at 2 years (primary time point). The predefined non-inferiority margin is set at 8 OMAS points. Secondary outcomes include the Foot and Ankle Score, a 100 mm Visual Analogue Scale for function and pain, the RAND-36-Item Health Survey for health-related quality-of-life, the range-of-motion of the injured ankle, malunion (ankle joint incongruity) and fracture union. Treatment-related complications and harms; symptomatic non-unions, loss of congruity of the ankle joint, reoperations and wound infections will also be recorded. We hypothesize that non-operative treatment yields non-inferior functional outcome to surgery, the current standard treatment, with no increased risk of harms.

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