Radiographic Evaluation of Ankle Joint Stability After Calcaneofibular Ligament Elevation During Open Reduction and Internal Fixation of Calcaneus Fracture

2016 ◽  
Vol 37 (9) ◽  
pp. 944-949 ◽  
Author(s):  
Chien-Shun Wang ◽  
Yun-Hsuan Tzeng ◽  
Chun-Cheng Lin ◽  
Ching-Kuei Huang ◽  
Ming-Chau Chang ◽  
...  
2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0006
Author(s):  
Rajiv Shah

Category: Trauma Introduction/Purpose: Primary subtalar fusion for Sander IV calcaneus fractures was considered to be the standard of care till recent past. Presently debate is on whether to manage Sander IV calcaneus fracture cases with primary subtalar fusion or with open reduction and internal fixation. Bilateral Sander IV calcaneus fractures are seen in cases with fall from height. No study has ever been conducted till date to compare the results of primary fusion of a Sander IV calcaneus fracture on one side and open reduction and internal fixation on another side in cases with bilateral Sander IV calcaneus fractures. We present a study comparing the results of primary fusion versus open reduction and internal fixation for bilateral sander IV calcaneus fracture cases. Methods: Twelve cases with bilateral closed Sander IV calcaneus fractures where included in the present study. Cases were operated between four to six weeks by a single surgeon after the appearance of wrinkles. All right sided fractures underwent open reduction and internal fixation with proximal tibia grafting. While all left-sided fractures underwent subtalar fusion with the use of ipsilateral anterior iliac crest grafts. Cases were followed up for 24 months. Results: Though operative time was more in the fusion group wound problems were equal in both the groups. Four months of average time to union was the same in both the groups and so was time to return to work. At two years, the AOFAS score was slightly better in the fusion group but it was not statistically significant. Conclusion: Primary subtalar fusion is with almost similar results as those with open reduction and internal fixation in bilateral Sander IV at 24 months. Long term follow up with more number of cases is required to prove the benefit of one over other.


Author(s):  
Satoshi Yamakawa ◽  
Takuma Kobayashi ◽  
Kei Kimura ◽  
Daisuke Suzuki ◽  
Kota Watanabe ◽  
...  

Ankle sprains are common injuries in daily and athletic activities. An epidemiological report indicated that the incidence rate of ankle sprains treated in emergency departments in the USA is more than 2 per 1000 persons a year, and the rate is estimated to be more than double as for ankle sprains in athletic activity [1]. Better understanding of ankle biomechanics is, therefore, important for the improvement of clinical outcome. Many investigators have performed in vitro and in vivo experiments to determine the mechanical roles of ankle structures such as range of motion, contribution of ankle ligaments to joint stability, joint instability due to ligament transection, and so on. In spite of these efforts, tensile forces in ankle ligaments in response to specific loading conditions still remains unclear because of a lack of experimental methodology. Meanwhile, the use of robotic technology for knee joint biomechanics study has been established by Fujie et al [2]. Using the technique, tensile forces in knee cruciate ligaments have been determined by Woo et al [3], Li et al [4], Fujie et al [5], and other groups, while ligament reconstruction technique has been evaluated by many investigators [for example 6–8]. Therefore, the objectives of the present study were to determine the ankle joint instability due to ligament transection and to determine the tensile forces in the anterior tarofibular ligament (ATFL) and calcaneofibular ligament (CFL) in response to anterior-posterior (AP) drawer force to the human cadaveric ankle joints.


2016 ◽  
Vol 40 ◽  
pp. 8-13 ◽  
Author(s):  
Takuma Kobayashi ◽  
Satoshi Yamakawa ◽  
Kota Watanabe ◽  
Kei Kimura ◽  
Daisuke Suzuki ◽  
...  

1982 ◽  
Vol 11 (2) ◽  
pp. 77-81 ◽  
Author(s):  
O Rasmussen ◽  
K Andersen

For analysing the ligaments of the ankle joint, their function, and the traumatic mechanisms which cause them to rupture, an apparatus was developed which enables graphic registration of rotatory movements in the ankle joint in two planes simultaneously, when a given torque is applied to the talus. In a modified form, this apparatus is applicable also for other joints. A lever with strain gauges and potentiometers is fixed in the talus of an osteoligamentous preparation. The lever is moved manually, and signals from the strain gauges and potentiometers are collected by a microcomputer for later transfer to a computer service centre where the mobility at the chosen torque is calculated and plotted as mobility patterns. The appearance of these patterns depends upon which ligaments are intact. The patterns plotted in any situation are reproducible, provided that the state of the ligaments is unchanged. In cutting experiments it was possible to demonstrate that rupture of the anterior talofibular ligament may occur simultaneously with partial rupture of the posterior talofibular ligament, although the calcaneofibular ligament remains intact. This occurs if the distortion trauma causing the rupture consists of an internal rotation of the talus, not if it consists mainly of a tilting of the talus in the ankle mortise.


2017 ◽  
Vol 11 (1) ◽  
pp. 1073-1080 ◽  
Author(s):  
Juan Marcelo Giugale ◽  
Juntian Wang ◽  
Robert A. Kaufmann ◽  
John R. Fowler

Background: Proximal interphalangeal (PIP) fracture dislocations remain a complex injury pattern to treat. There are several treatment methods available aimed to restore stability, preserve range of motion, and reconstitute the articular surface. This study looked at the mid-term clinical and radiographic results of open reduction internal fixation through a shotgun approach of comminuted PIP fracture dislocations. Methods: A retrospective review was conducted of all PIP fracture dislocations treated through a volar, shotgun approach at a single institution over a 15-year period. Patients identified were contacted and asked to return to the office for clinical and radiographic evaluation. Patient reported outcomes were assessed with the Michigan hand questionnaire (MHQ) and visual analog scale (VAS) for pain. Results: 5 patients returned to the office for further evaluation with average follow-up of 69 months (range, 33-133 months). 3 patients were found to have post traumatic arthritis on radiographs. 1 case had recurrent instability and one case had a deep infection, both necessitating further surgical intervention. Average PIP arc of motion was found to be 79°. Average VAS score of 0 and MHQ result of 95 (out of a possible score of 100) indicating no residual pain and excellent functionality of the affected hand. Conclusion: Open reduction internal fixation of comminuted PIP fracture dislocations utilizing the volar, shotgun approach provides excellent mid-term functional results despite the high incidence of post traumatic arthritis.


1991 ◽  
Vol 1 (3) ◽  
pp. 166-175 ◽  
Author(s):  
Jon Karlsson ◽  
Tommy Bergsten ◽  
Lars Peterson ◽  
Bengt E. Zachrisson

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