Ankle Reconstruction for Malunion by Fibular Osteotomy and Lengthening with Direct Control of the Distal Fragment: A Report of Three Cases and Review of the Literature

Foot & Ankle ◽  
1992 ◽  
Vol 13 (1) ◽  
pp. 7-13 ◽  
Author(s):  
Craig Roberts ◽  
Orrin Sherman ◽  
David Bauer ◽  
Ralph Lusskin
Keyword(s):  
Clinical Result ◽  
Ankle Fractures ◽  
Distal Fragment ◽  
Review Of The Literature ◽  
Direct Control ◽  
Talocrural Joint ◽  
Fibular Osteotomy ◽  
Good Clinical Result ◽  
Osteochondral Injury

Malunion of ankle fractures will lead to severe osteoarthritis when the architecture and mechanics of the talocrural joint are deranged. When fibular shortening is present, ankle reconstruction can be achieved by fibular lengthening and can provide an alternative to early arthrodesis for deformity and pain. Acceptable clinical and radiographic results can be achieved, provided that accurate reconstruction is achieved and intra-articular osteochondral injury is minimal. Restoration of fibular length, necessary for a good clinical result, can be estimated radiographically by the bimalleolar angle. We report three cases of ankle reconstruction by fibular lengthening with an average follow-up of 33 months.

Anterior cervical discectomy without interbody bone graft

1972 ◽  
Vol 37 (1) ◽  
pp. 71-74 ◽  
Author(s):  
Michael G. Murphy ◽  
Mokhtar Gado
Keyword(s):  
Bone Graft ◽  
Clinical Result ◽  
Anterior Cervical Discectomy ◽  
Incomplete Fusion ◽  
Cervical Disc ◽  
Content Type ◽  
Cervical Discectomy ◽  
Good Clinical Result ◽  
Fine Print

✓ Twenty-six patients had anterior cervical discectomy without interbody bone graft for lateral cervical disc syndrome. Twenty-four (92%) had a good clinical result. Radiological follow-up was obtained in 20 cases. The incidence of fusion was 72% for discectomy at a single level. Patients undergoing discectomy at two adjacent levels were too few to permit a statement regarding the incidence of fusion. In those cases of incomplete fusion, dynamic films demonstrated stability at the operated site. Half of the cases who had posterior osteophytes preoperatively showed some degree of resorption after 12 months. Neither incomplete fusion nor failure of osteophyte resolution was incompatible with a good clinical result.

Frontoethmoidal Encephalocele Correction Surgery in Benin: A Case Report

2021 ◽  
Vol 56 (2) ◽  
pp. 197-202
Author(s):  
Marc Prod’homme ◽  
Duccio Boscherini ◽  
Oumama El Ezzi ◽  
Mirko Dolci ◽  
Raymond Bossou ◽  
...  
Keyword(s):  
Case Report ◽  
Reconstructive Surgery ◽  
Multidisciplinary Team ◽  
Clinical Result ◽  
Surgical Procedure ◽  
Case Presentation ◽  
Technical Description ◽  
Good Clinical Result ◽  
Correction Surgery

<b><i>Introduction:</i></b> Primary encephalocele is a rare deformity that is challenging for the neurosurgeon. It requires a multidisciplinary team for adequate reconstructive surgery. <b><i>Case Presentation:</i></b> We report the case of a 6-month-old African boy who presented with a frontoethmoidal encephalocele; we present a technical description of the surgical procedure, using no implant. <b><i>Discussion/Conclusion:</i></b> The postoperative evolution of the boy was uneventful, with a good clinical result at the follow-up.

scholarly journals A lean bioabsorbable magnesium-zinc-calcium alloy ZX00 used for operative treatment of medial malleolus fractures

2020 ◽  
Vol 9 (8) ◽  
pp. 477-483
Author(s):  
Patrick Holweg ◽  
Valentin Herber ◽  
Martin Ornig ◽  
Gloria Hohenberger ◽  
Nicolas Donohue ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Clinical Investigation ◽  
Blood Analysis ◽  
Ankle Fractures ◽  
Fracture Reduction ◽  
Medial Malleolus ◽  
Aofas Score ◽  
Talocrural Joint ◽  
The Mean

Aims This study is a prospective, non-randomized trial for the treatment of fractures of the medial malleolus using lean, bioabsorbable, rare-earth element (REE)-free, magnesium (Mg)-based biodegradable screws in the adult skeleton. Methods A total of 20 patients with isolated, bimalleolar, or trimalleolar ankle fractures were recruited between July 2018 and October 2019. Fracture reduction was achieved through bioabsorbable Mg-based screws composed of pure Mg alloyed with zinc (Zn) and calcium (Ca) ( Mg-Zn0.45-Ca0.45, in wt.%; ZX00). Visual analogue scale (VAS) and the presence of complications (adverse events) during follow-up (12 weeks) were used to evaluate the clinical outcomes. The functional outcomes were analyzed through the range of motion (ROM) of the ankle joint and the American Orthopaedic Foot and Ankle Society (AOFAS) score. Fracture reduction and gas formation were assessed using several plane radiographs. Results The follow-up was performed after at least 12 weeks. The mean difference in ROM of the talocrural joint between the treated and the non-treated sites decreased from 39° (SD 12°) after two weeks to 8° (SD 11°) after 12 weeks (p ≤ 0.05). After 12 weeks, the mean AOFAS score was 92.5 points (SD 4.1). Blood analysis revealed that Mg and Ca were within a physiologically normal range. All ankle fractures were reduced and stabilized sufficiently by two Mg screws. A complete consolidation of all fractures was achieved. No loosening or breakage of screws was observed. Conclusion This first prospective clinical investigation of fracture reduction and fixation using lean, bioabsorbable, REE-free ZX00 screws showed excellent clinical and functional outcomes. Cite this article: Bone Joint Res 2020;9(8):477–483.

Pneumomediastinum: A Rare Presentation of Inflicted Injuries in Infants

2020 ◽  
Author(s):  
Adam Lee ◽  
Adam Bajinting ◽  
Abby Lunneen ◽  
Colleen M. Fitzpatrick ◽  
Gustavo A. Villalona
Keyword(s):  
Literature Review ◽  
Retrospective Review ◽  
Review Of The Literature ◽  
Rare Presentation ◽  
Spontaneous Pneumomediastinum ◽  
Nonaccidental Trauma ◽  
Comprehensive Literature Review ◽  
Healthy Infants ◽  
History Of

AbstractReports of incidental pneumomediastinum in infants secondary to inflicted trauma are limited. A retrospective review of infants with pneumomediastinum and history of inflicted trauma was performed. A comprehensive literature review was performed. Three infants presented with pneumomediastinum associated with inflicted trauma. Mean age was 4.6 weeks. All patients underwent diagnostic studies, as well as a standardized evaluation for nonaccidental trauma. All patients with pneumomediastinum were resolved at follow-up. Review of the literature identified other cases with similar presentations with related oropharyngeal injuries. Spontaneous pneumomediastinum in previously healthy infants may be associated with inflicted injuries. Clinicians should be aware of the possibility of an oropharyngeal perforation related to this presentation.

Intramedullary Teratoma: Case Report and Review of the Literature

1996 ◽  
Vol 82 (6) ◽  
pp. 616-620 ◽  
Author(s):  
Riccardo Caruso ◽  
Mariano Antonelli ◽  
Luigi Cervoni ◽  
Maurizio Salvati
Keyword(s):  
Case Report ◽  
Surgical Removal ◽  
International Literature ◽  
Review Of The Literature ◽  
Personal Case

Aims and Background Intramedullary teratoma is an extremely exceptional tumor (5 cases), although a careful review of international literature has shown it to be more frequent (32 cases) than believed. Methods The authors present a personal case with some unusual aspects. Results Our case is unusual not only because it was diagnosed by MRI (only one case has been reported in the literature) but also because surgical removal of the tumor was apparently total (only 4 other cases have been described), with a long follow-up period (4.5 years) and excellent results, in clinical and neuroradiologic terms.

Plafond Malreduction and Talar Dome Impaction Accelerates Arthrosis After Supination-Adduction Ankle Fracture

2021 ◽  
pp. 107110072110060
Author(s):  
Michael F. Githens ◽  
Malcolm R. DeBaun ◽  
Kimberly A Jacobsen ◽  
Hunter Ross ◽  
Reza Firoozabadi ◽  
...  
Keyword(s):  
Case Series ◽  
High Energy ◽  
Ankle Fractures ◽  
Posttraumatic Arthritis ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Radiographic Findings ◽  
Posttraumatic Arthrosis ◽  
Patient Reported

Background: Supination-adduction (SAD) type II ankle fractures can have medial tibial plafond and talar body impaction. Factors associated with the development of posttraumatic arthritis can be intrinsic to the injury pattern or mitigated by the surgeon. We hypothesize that plafond malreducton and talar body impaction is associated with early posttraumatic arthrosis. Methods: A retrospective cohort of skeletally mature patients with SAD ankle fractures at 2 level 1 academic trauma centers who underwent operative fixation were identified. Patients with a minimum of 1-year follow-up were included. The presence of articular impaction identified on CT scan was recorded and the quality of reduction on final intraoperative radiographs was assessed. The primary outcome was radiographic ankle arthrosis (Kellgren-Lawrence 3 or 4), and postoperative complications were documented. Results: A total of 175 SAD ankle fractures were identified during a 10-year period; 79 patients with 1-year follow-up met inclusion criteria. The majority of injuries resulted from a high-energy mechanism. Articular impaction was present in 73% of injuries, and 23% of all patients had radiographic arthrosis (Kellgren-Lawrence 3 or 4) at final follow-up. Articular malreduction, defined by either a gap or step >2 mm, was significantly associated with development of arthrosis. Early treatment failure, infection, and nonunion was rare in this series. Conclusion: Malreduction of articular impaction in SAD ankle fractures is associated with early posttraumatic arthrosis. Recognition and anatomic restoration with stable fixation of articular impaction appears to mitigate risk of posttraumatic arthrosis. Investigations correlating postoperative and long-term radiographic findings to patient-reported outcomes after operative treatment of SAD ankle fractures are warranted. Level of Evidence: Level IV, retrospective case series.

scholarly journals Failed Latarjet procedure: a systematic review of surgery revision options

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Matteo Buda ◽  
Riccardo D’Ambrosi ◽  
Enrico Bellato ◽  
Davide Blonna ◽  
Alessandro Cappellari ◽  
...  
Keyword(s):  
Systematic Review ◽  
Case Series ◽  
Review Of The Literature ◽  
Inclusion Criteria ◽  
Latarjet Procedure ◽  
Shoulder Stabilization ◽  
Recurrent Instability ◽  
Level Of Evidence ◽  
Radiographic Outcomes

Abstract Background Revision surgery after the Latarjet procedure is a rare and challenging surgical problem, and various bony or capsular procedures have been proposed. This systematic review examines clinical and radiographic outcomes of different procedures for treating persistent pain or recurrent instability after a Latarjet procedure. Methods A systematic review of the literature was performed using the Medline, Cochrane, EMBASE, Google Scholar and Ovid databases with the combined keywords “failed”, “failure”, “revision”, “Latarjet”, “shoulder stabilization” and “shoulder instability” to identify articles published in English that deal with failed Latarjet procedures. Results A total of 11 studies (five retrospective and six case series investigations), all published between 2008 and 2020, fulfilled our inclusion criteria. For the study, 253 patients (254 shoulders, 79.8% male) with a mean age of 29.6 years (range: 16–54 years) were reviewed at an average follow-up of 51.5 months (range: 24–208 months). Conclusions Eden–Hybinette and arthroscopic capsuloplasty are the most popular and safe procedures to treat recurrent instability after a failed Latarjet procedure, and yield reasonable clinical outcomes. A bone graft procedure and capsuloplasty were proposed but there was no clear consensus on their efficacy and indication. Level of evidence Level IV Trial registration PROSPERO 2020 CRD42020185090—www.crd.york.ac.uk/prospero/

scholarly journals Profile vs Tubular Plate in Unimalleolar or Bimalleolar Fractures: is There a Real Difference in Wound complications?

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0015
Author(s):  
Paolo Ceccarini ◽  
Rosario Petruccelli ◽  
Michele Bisaccia ◽  
Giuseppe Rinonapoli ◽  
Auro Caraffa
Keyword(s):  
Wound Dehiscence ◽  
Deep Infection ◽  
Ankle Fractures ◽  
Bone Union ◽  
Wound Complications ◽  
Fisher Exact Test ◽  
Superficial Infection ◽  
Operative Care ◽  
Group B

Category: Ankle; Trauma Introduction/Purpose: The aim of our study is to compare two types of plates, one third tubular plate and LCP distal fibula plate, evaluating the clinical outcome and the skin complications associated with their use. Methods: We collected the data of 122 consecutive unimalleolar or bimalleolar fractures treated by internal fixation for a closed, displaced distal closed fibular fracture. Exclusion criteria were: 1) open ankle fractures,2) trimalleolar fractures, 3) previous ankle fractures 4) severe venous insufficiency, 5) ankleosteoarthritis previous to surgery, 6) associated ankle dislocation. After this selection, 93 patients were included in our study and assigned in two groups, based on using of different implant: in group A48 patients were treated with one-third tubular and in group B 45 patients were treated with LCP distalfibula plate. There were no significant differences in the baseline characteristics. Patients received the same surgical procedure and the same post-operative care, then they were radiologically evaluated at1-3-12 months and clinical examination was made at 24 (range 15-36) months using AOFAS clinical rating system. All data were evaluated using chi-square test. Results: At the final 24-month follow-up a comparison between the two groups showed no statistical significant differences in reduction accuracy and bone union ratio at radiological examination. The wound complications rate of the overall study group was 7.6%. There were no statistical differences in the rate of wound complications between the two groups. There were no differences between both group in percentage of hardware removal at follow-up (overall 5.4%). In the group A occurred 1 deep infection, 2 superficial infection, no wound dehiscence; in group B occured 1 deep infection, 1 superficial infection and 2 wound dehiscence. There were no statistical differences in the rate of wound complications between the two groups (p=0.70; Fisher exact test). Conclusion: Our study has shown no difference in radiographic bone union rate, no significant differences in terms of clinical outcomes, in time of bone reduction and wound complication rate between the LCP distalfibula plate and conventional one-third tubular plate. RCT or metanalasys are in this case useful to improve scientific evidence and give more information for the correct surgical treatment of ankle fractures.

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