SURGICAL TREATMENT OF FRACTURE-DISLOCATIONS OF THE ANKLE JOINT WITH BIODEGRADABLE IMPLANTS

The distal tibiofibular syndesmosmotic ligament complex is important for dynamic stability and congruency of the ankle joint. Syndesmotic lesions in the ankle fracture-dislocations are well recognized and classified systematically. Chronic insufficiency of the syndesmosis leads to a lateral shift of the talus and under eversion stress permits a pathological rotation of the talus. There is also retroversion of the distal fibula representing a painful deformity. Little experience exists with surgical reconstruction of the syndesmosis. This article describes a new ligamentoplasty with a split peroneus longus tendon graft that mimics the normal anatomic conditions of the syndesmotic complex in 16 patients with symptomatic chronic syndesmotic insufficiency after pronation-external rotation and pronation abduction injuries to the ankle joint. Postoperatively, no infections or hematomas were seen. One patient had asymptomatic breakage of the syndesmosis screw; one patient had a 10° decrease of dorsiflexion at the ankle because of a partial anterior tibiofibular synostosis. Fifteen of 16 patients had pain relief at a mean follow-up period of 16.4 months (range, 13–29 months); all patients had relief of the chronic swelling of the ankle and the giving way. The mean Karlsson score at follow-up was 88 (range, 70–100) points. It may be concluded that peroneus longus ligamentoplasty in a preliminary series resulted in reliable ankle stability and considerable pain relief in patients with chronic syndesmotic instability.

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Surgical treatment of chronic lateral instability of the ankle joint

The American Journal of Sports Medicine ◽

10.1177/036354658901700220 ◽

1989 ◽

Vol 17 (2) ◽

pp. 268-274 ◽

Cited By ~ 110

Author(s):

Jón Karlsson ◽

Tommy Bergsten ◽

Olle Lansinger ◽

Lars Peterson

Keyword(s):

Surgical Treatment ◽

Ankle Joint ◽

Lateral Instability

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Surgical Treatment of Humerus Fracture-Dislocations: Medium-Term Results

Traumatology and Orthopedics of Russia ◽

10.21823/2311-2905-2020-26-4-68-79 ◽

2020 ◽

Vol 26 (4) ◽

pp. 68-79

Author(s):

K. A. Egiazaryan ◽

A. P. Ratyev ◽

D. S. Ershov ◽

E. A. Kuruch ◽

V. N. Kuznetsov ◽

...

Keyword(s):

Surgical Treatment ◽

Humerus Fracture ◽

Medium Term ◽

Fracture Dislocations

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Management of Fracture of Posterior Malleolus, Trimalleolar Fracture, Fracture Dislocations, and Syndesmosis Injury of Ankle Joint

Journal of Foot and Ankle Surgery Asia Pacific ◽

10.5005/jp-journals-10040-1077 ◽

2017 ◽

Vol 4 (2) ◽

pp. 90-96

Author(s):

Satish R Gawali ◽

Raman O Toshniwal ◽

Shashikant B Kukale, ◽

Pramod V Nirvane,

Keyword(s):

Soft Tissue ◽

Ankle Joint ◽

Open Reduction ◽

Tissue Injury ◽

Soft Tissue Injury ◽

Malleolar Fractures ◽

Posterior Malleolus ◽

Syndesmosis Injury ◽

Fracture Dislocations ◽

Trimalleolar Fracture

ABSTRACT Background Malleolar fractures of ankle are usually complex injuries, as they are associated with significant ligament and soft tissue injury—injury to syndesmosis and injury to medial and lateral collateral ligaments. The open reduction and internal fixation is not feasible until recovery of significant soft tissue injury and subsidence of edema. Malleolar fractures are articular fractures and have associated subluxation and dislocation of talus. The aims of treatment are to restore normal anatomy and provide sufficient stability for early movements. Malleolar fractures more often require open reduction. Our study aimed to know efficacy and outcome of operative management of them. Materials and methods From January 2013 to March 2015, 35 patients with syndesmotic ankle injury and trimalleolar ankle fractures admitted to the Government Medical College, Latur, India, were operated and followed up prospectively. Results Mean age of patients is 35 years (25–60 years). Fracture union was seen radiologically in 3 to 4 months depending on fracture geometry. We achieved good to excellent results of 90%. Conclusion We conclude that malleolar fractures encountered in clinical practice need thorough assessment and meticulous surgical intervention, as they are associated with injury to ligament complex, i.e., ligament is a key structure in the stability of ankle mortise. Abduction and external rotation types of injuries are the most common types to be seen. We achieved stable fixation and performed early mobilization of the ankle joint, which limits the complications of mainly ankle stiffness. Each malleolus has got its inherent associated complications and calls for special attention for identifying associated conditions, such as syndesmotic injury, talus dislocation in posterior malleolar fractures, irreducible ankle dislocation with trimalleolar fracture, and entrapped fibula behind tibia with irreducible dislocation. How to cite this article Gawali SR, Kukale SB, Nirvane PV, Toshniwal RO. Management of Fracture of Posterior Malleolus, Trimalleolar Fracture, Fracture Dislocations, and Syndesmosis Injury of Ankle Joint. J Foot Ankle Surg (Asia-Pacific) 2017;4(2):90-96.

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Surgical treatment of patients with osteoarthritis of the ankle joint

Kazan medical journal ◽

10.17816/kmj2142 ◽

2012 ◽

Vol 93 (1) ◽

pp. 38-43

Author(s):

Yu A Plakseychuk ◽

R Z Salikhov ◽

V V Soloviev

Keyword(s):

Surgical Treatment ◽

Ankle Joint ◽

Bone Grafting ◽

Comparison Group ◽

Functional Results ◽

Main Group ◽

Radiographic Evaluation ◽

Results Of Treatment ◽

Ilizarov Apparatus

Aim. To evaluate the results of treatment using the authors’ proposed method of arthrodesis of the ankle and subtalar joints, based on the combination of bone grafting with compression in the Ilizarov apparatus. Methods. Conducted was a clinical and radiographic evaluation of the results of arthrodesis in the Ilizarov apparatus in 286 patients with osteoarthritis of the ankle and subtalar joints (during the last 15 years). 36 (12.6%) patients (the main group) were operated on using the authors’ proposed technique. Results. Bone adhesion as a result of arthrodesis was achieved in all patients of the main group. Excellent functional results were achieved in 11 out of 36 patients (30.5%), good results - in 22 (61.1%) patients, satisfactory results - in 3 (8.4%) patients. Bone adhesion as a result of arthrodesis in 250 patients of the comparison group was achieved in 243 patients (97.2%). In this group excellent functional results were achieved in 76 out of 250 patients (30.4%), good results - in 145 (58%) patients, satisfactory results - in 21 (8.4%) patients, poor results - in 8 (3.2%) patients. Conclusion. The proposed method of biarticular arthrodesis makes it possible to improve the trophism of the arthrodesis zone, to conduct the correction of posttraumatic deformities in the region of the ankle and subtalar joints, provides a durable and solid bone ankylosis of the ankle and subtalar joints, and makes it possible to achieve adhesion even in severe forms of osteoarthritis of the ankle and subtalar joints.

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METHOD OF SURGICAL TREATMENT OF PATIENTS WITH RECURRENT ACHILLES TENDON RUPTURES

Traumatology and Orthopedics of Russia ◽

10.21823/2311-2905-2010-0-3-126-130 ◽

2010 ◽

Vol 16 (3) ◽

pp. 126-130

Author(s):

L. A. Rodomanova ◽

A. Yu. Kochish ◽

D. V. Romanov ◽

S. V. Valetova

Keyword(s):

Surgical Treatment ◽

Achilles Tendon ◽

Ankle Joint ◽

Clinical Experience ◽

New Method ◽

Clinical Use ◽

Anatomic Study ◽

Anatomical Studies ◽

Results Of Treatment ◽

Tendon Ruptures

In order to justify a new method of surgical treatment of patients with recurrent and chronic Achilles tendon ruptures conducted applied topographic-anatomic study of 12 fixed and 8 fixed preparations of the lower extremities was performed. In the developed technique were carried out operations in 18 patients aged from 30 to 72 years with repeated ruptures Achilles tendon. The results of treatment were followed-up in all 18 patients in the period from 6 months to 3 years. Repeated tears of Achilles tendon were not observed. The range of motions in ankle joint reconstructed almost in its entirety. Performed topographic and anatomical studies and accumulated clinical experience allow us to recommend the proposed method for a wider clinical use.

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Lisfranc fracture-dislocations: current management

EFORT Open Reviews ◽

10.1302/2058-5241.4.180076 ◽

2019 ◽

Vol 4 (7) ◽

pp. 430-444 ◽

Cited By ~ 10

Author(s):

Inmaculada Moracia-Ochagavía ◽

E. Carlos Rodríguez-Merchán

Keyword(s):

Surgical Treatment ◽

Weight Bearing ◽

Correct Diagnosis ◽

Foot Deformities ◽

Current Management ◽

Lisfranc Joint ◽

Fracture Dislocations ◽

Post Traumatic ◽

The Stability ◽

Lisfranc Injuries

It is essential to know and understand the anatomy of the tarsometatarsal (TMT) joint (Lisfranc joint) to achieve a correct diagnosis and proper treatment of the injuries that occur at that level. Up to 20% of Lisfranc fracture-dislocations go unnoticed or are diagnosed late, especially low-energy injuries or purely ligamentous injuries. Severe sequelae such as post-traumatic osteoarthritis and foot deformities can create serious disability. We must be attentive to the clinical and radiological signs of an injury to the Lisfranc joint and expand the study with weight-bearing radiographs or computed tomography (CT) scans. Only in stable lesions and in those without displacement is conservative treatment indicated, along with immobilisation and initial avoidance of weight-bearing. Through surgical treatment we seek to achieve two objectives: optimal anatomical reduction, a factor that directly influences the results; and the stability of the first, second and third cuneiform-metatarsal joints. There are three main controversies regarding the surgical treatment of Lisfranc injuries: osteosynthesis versus primary arthrodesis; transarticular screws versus dorsal plates; and the most appropriate surgical approach. The surgical treatment we prefer is open reduction and internal fixation (ORIF) with transarticular screws or with dorsal plates in cases of comminution of metatarsals or cuneiform bones. Cite this article: EFORT Open Rev 2019;4:430-444. DOI: 10.1302/2058-5241.4.180076

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