Trimalleolar fractures of the ankle joint

1946 ◽  
Vol 71 (5) ◽  
pp. 625-635
Author(s):  
Leo Faske ◽  
Alfred L. Shapiro
Keyword(s):  
Ankle Joint ◽  
Trimalleolar Fractures

The role of a small posterior malleolar fragment in trimalleolar fractures

2018 ◽  
Vol 100-B (1) ◽  
pp. 95-100 ◽  
Author(s):  
J. Evers ◽  
M. Fischer ◽  
I. Zderic ◽  
D. Wähnert ◽  
R. G. Richards ◽  
...  
Keyword(s):  
Pressure Distribution ◽  
Ankle Joint ◽  
Scientific Evidence ◽  
Study Groups ◽  
Joint Surface ◽  
Joint Stability ◽  
Trimalleolar Fractures ◽  
Group I ◽  
Load To Failure ◽  
Group Ii

Aims The aim of this study was to investigate the effect of a posterior malleolar fragment (PMF), with < 25% ankle joint surface, on pressure distribution and joint-stability. There is still little scientific evidence available to advise on the size of PMF, which is essential to provide treatment. To date, studies show inconsistent results and recommendations for surgical treatment date from 1940. Materials and Methods A total of 12 cadaveric ankles were assigned to two study groups. A trimalleolar fracture was created, followed by open reduction and internal fixation. PMF was fixed in Group I, but not in Group II. Intra-articular pressure was measured and cyclic loading was performed. Results Contact area decreased following each fracture, while anatomical fixation restored it nearly to its intact level. Contact pressure decreased significantly with fixation of the PMF. In plantarflexion, the centre of force shifted significantly posteriorly in Group II and anteriorly in Group I. Load to failure testing showed no difference between the groups. Conclusion Surgical reduction of a small PMF with less than 25% ankle joint surface improves pressure distribution but does not affect ankle joint stability. Cite this article: Bone Joint J 2018;100-B:95–100.

Single Hemicerclage for Lateral Type B Malleolar Fracture - A Novel, Minimal and Reliable Osteosynthesis

Swiss Surgery ◽  
2003 ◽  
Vol 9 (6) ◽  
pp. 283-288
Author(s):  
Maurer ◽  
Stamenic ◽  
Stouthandel ◽  
Ackermann ◽  
Gonzenbach
Keyword(s):  
Ankle Joint ◽  
Weight Bearing ◽  
Fracture Type ◽  
Type B ◽  
Malleolar Fracture ◽  
Metallic Wire ◽  
Long Term Outcome ◽  
X Ray ◽  
Upper Ankle Joint ◽  
Upper Ankle

Aim of study: To investigate the short- and long-term outcome of patients with isolated lateral malleolar fracture type B treated with a single hemicerclage out of metallic wire or PDS cord. Methods: Over an 8-year period 97 patients were treated with a single hemicerclage for lateral malleolar fracture type B and 89 were amenable to a follow-up after mean 39 months, including interview, clinical examination and X-ray controls. Results: The median operation time was 35 minutes (range 15-85 min). X-ray controls within the first two postoperative days revealed an anatomical restoration of the upper ankle joint in all but one patient. The complication rate was 8%: hematoma (2 patients), wound infection (2), Sudeck's dystrophy (2) and deep vein thrombosis (1). Full weight-bearing was tolerated at median 6.0 weeks (range 2-26 weeks). No secondary displacement, delayed union or consecutive arthrosis of the upper ankle joint was observed. All but one patient had restored symmetric joint mobility. Ninety-seven percent of patients were satisfied or very satisfied with the outcome. Following bone healing, hemicerclage removal was necessary in 19% of osteosyntheses with metallic wire and in none with PDS cord. Conclusion: The single hemicerclage is a novel, simple and reliable osteosynthesis technique for isolated lateral type B malleolar fractures and may be considered as an alternative to the osteosynthesis procedures currently in use.

The Ankle-joint

BMJ ◽  
1951 ◽  
Vol 1 (4721) ◽  
pp. 1494-1494
Author(s):  
J. S. Batchelor
Keyword(s):  
Ankle Joint

INFLUENCE OF FOOT INSOLE ON THE GAIT PERFORMANCE IN SUBJECTS WITH FLAT FOOT DISORDER

2019 ◽  
Vol 19 (06) ◽  
pp. 1950050
Author(s):  
M. T. KARIMI ◽  
R. B. TAHMASEBI ◽  
B. SATVATI ◽  
F. FATOYE
Keyword(s):  
Range Of Motion ◽  
Ankle Joint ◽  
Lower Limb ◽  
Walking Speed ◽  
Force Plate ◽  
Flat Foot ◽  
Gait Performance ◽  
Positive Effects ◽  
Significant Difference ◽  
Foot Disorder

Flat foot is the most common foot disorder that influences the alignment of the lower limb structure. It is controversial whether the use of foot insole influences kinetic and kinematic of the leg or not. Therefore, this study investigated the influence of foot insole on the gait performance in subjects with flat foot disorder. A group of flat foot subject was recruited into this study (the number of subjects was 15). The motion of the leg joints was determined using the Qualysis motion analysis system. Moreover, the force applied on the lower limb was recorded by a Kistler force plate. The range of motion of the lower limb joints, the moments applied on the lower limb joints and force transmitted through the leg were the parameters used in this study. The difference between these parameters during walking with and without insole was evaluated using the paired [Formula: see text]-test. Significant value was set at [Formula: see text]. There was no significant difference between the range of motion of ankle joint while walking with and without insole. However, the medial directed force applied on the leg decreased significantly [Formula: see text]. The use of foot insole did not influence the moments transmitted through the hip and knee joints. The walking speed of the subjects improved while walking with foot insole. Use of foot insole influenced the magnitude of the force applied on the leg and the adductor moment of ankle joint due to its influence on foot alignment. As the walking speed of the improved subjects follows the use of insole, it can be concluded that it may have a positive effects on the performance of flat foot subjects.

Ankle joint mechanical contribution in running is reduced after mountain ultramarathon races of different distances

2021 ◽  
Vol 13 (sup1) ◽  
pp. S89-S91
Author(s):  
Sébastien Pavailler ◽  
Nicolas Masson ◽  
Nicolas Horvais
Keyword(s):  
Ankle Joint

scholarly journals Effect of Distal Tibial Varus and Valgus Deformity on Tibiotalar Joint Contact

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0025
Author(s):  
Zhao Hong-Mou
Keyword(s):  
Contact Pressure ◽  
Ankle Joint ◽  
Contact Area ◽  
Peak Pressure ◽  
Tibiotalar Joint ◽  
Force Center ◽  
Fibular Osteotomy ◽  
Group I ◽  
Joint Contact ◽  
Group A

Category: Ankle; Basic Sciences/Biologics Introduction/Purpose: To study the effect of different degrees of distal tibial varus and valgus deformities on the tibiotalar joint contact, and to understand the role of fibular osteotomy. Methods: Eight cadaveric lower legs were used for biomechanical study. Nine conditions were included: normal ankle joint (group A), 10° varus (group B), 5° varus (group C), 5° valgus (group D), 10° valgus (group E) with fibular preserved, and 10° varus (group F), 5° varus (group G), 5° valgus (group H), and 10° valgus (group I) after fibular osteotomy. The joint contact area, contact pressure, and peak pressure were tested; and the translation of contact force center was observed. Results: The joint contact area, contact pressure, and peak pressure had no significant difference between group A and groups B to E (P>0.05). After fibular osteotomy, the contact area decreased significantly in groups F and I when compared with group A (P<0.05); the contact pressure increased significantly in groups F, H, and I when compared with group A (P<0.05); the peak pressure increased significantly in groups F and I when compared with group A (P<0.05). There were two main anterior-lateral and anterior-medial contact centers in normal tibiotalar joint, respectively; and the force center was in anterior-lateral part, just near the center of tibiotalar joint. While the fibula was preserved, the force center transferred laterally with increased varus angles; and the force center transferred medially with increased valgus angles. However, the force center transferred oppositely to the medial part with increased varus angles, and laterally with increased valgus angles after fibular osteotomy. Conclusion: Fibular osteotomy facilitates the tibiotalar contact pressure translation, and is helpful for ankle joint realignment in suitable cases.

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