scholarly journals RARE CASE OF DELTOID LIGAMENT AVULSION WITH MEDIAL MALLEOLUS FRACTURE OF ANKLE JOINT: CASE REPORT

2013 ◽  
Vol 2 (37) ◽  
pp. 7047-7051
Author(s):  
Maruthi C.V ◽  
Roshan Pais
Keyword(s):  
Case Report ◽  
Ankle Joint ◽  
Rare Case ◽  
Deltoid Ligament ◽  
Medial Malleolus ◽  
Medial Malleolus Fracture

scholarly journals Association of Bosworth, Pilon, and Open Talus Fractures: A Very Unusual Ankle Trauma

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Kevin Moerenhout ◽  
Georgios Gkagkalis ◽  
Rayan Baalbaki ◽  
Xavier Crevoisier
Keyword(s):  
Case Report ◽  
Fracture Dislocation ◽  
Tibial Tubercle ◽  
Medial Malleolus ◽  
Distal Fibula ◽  
Rare Lesion ◽  
Ankle Trauma ◽  
One Year ◽  
Medial Malleolus Fracture ◽  
Hindfoot Arthrodesis

Introduction. A Bosworth fracture-dislocation is a rare lesion resulting in a fixed dislocation of the distal fibula behind the posterior tibial tubercle. Only few cases have been reported showing an associated consequent fracture, namely, a pilon or a medial malleolus fracture. Case Report. We present a case report of a patient with an unusual combination of a Bosworth injury with a pilon fracture and an open multifragmentary talus fracture and our approach for open reduction and internal fixation. At one year postoperative, the patient developed an invalidating tibiotalar and subtalar arthrosis that eventually required an ankle-hindfoot arthrodesis. A Bosworth injury is an infrequent entity and is even rarer when associated with other fractures. Careful preoperative planning is necessary, as the combination of these fractures is a surgical challenge. Special care must be taken to preserve the neurovascular bundle. Discussion. The present case highlights a Bosworth injury involving a severity that has never been described before and suggests adding an eighth stage to the classification presented by Perry et al.

Reconstruction of Medial Malleolus and Deltoid Ligament using Bone - Patella Tendon Graft in a Child: Case Report

1995 ◽  
Vol 30 (5) ◽  
pp. 1463
Author(s):  
Yong Hoon Kim ◽  
Jong Deuk Rha ◽  
Myung Ho Lee ◽  
Hyun Soo Park ◽  
Woo Cheon Lee ◽  
...  
Keyword(s):  
Case Report ◽  
Tendon Graft ◽  
Deltoid Ligament ◽  
Medial Malleolus ◽  
Patella Tendon

scholarly journals Weightbearing Radiographs and stability in SER II - IV Ankle Fractures

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0001
Author(s):  
Henrik Baecker ◽  
Timo Schmid ◽  
Fabian Krause ◽  
Harald Marcel Bonel ◽  
Marc Attinger
Keyword(s):  
Ankle Joint ◽  
Structural Integrity ◽  
Deltoid Ligament ◽  
Medial Malleolus ◽  
Malleolar Fractures ◽  
Ligament Rupture ◽  
Clear Space ◽  
Complete Rupture ◽  
Physiological Load ◽  
The Stability

Category: Ankle, Sports, Trauma, Radiography, Weber B Fracture Introduction/Purpose: SER lateral malleolar fractures are common. The assessment of the stability of the ankle fracture is crucial for decision making of treatment which is associated with the integrity of the deltoid ligament (SERII-III). Slight talar shift can lead to extensive decrease of tibio-talar contact area (Ramsey 1999). Several clinical tests have been proposed of which static weightbearing radiography is used to measure the lateral talar shift with the medial clear space to detect medial instability (SERIV). However, the correlation of a stable ankle joint under weightbearing load with the structural integrity of the deltoid ligament has not been shown yet which we want to investigate. Methods: 17 patients with lateral malleolar fractures were investigated who underwent an MRI and weightbearing radiography examination. In the MRI, the deep deltoid ligament was assessed as intact, partial und complete rupture. The medial clear space was measured - distance between the lateral border of the medial malleolus and the medial border of the talus at the level of the talar dome (millimeter). Results: 7 patients suffered from deep deltoid ligament rupture (4 partial; 3 complete).The medial clear space in patients with intact deep deltoid ligament was 2.96+0.41 mm in mean, in partial rupture 2.8+0.38 mm, in complete rupture 3.43+0.23 mm. When counting the complete and partial ruptures together the mean was 3.07+0.45 mm and in partial ruptures plus the intact ones 2.91+0.40 mm. Conclusion: Our results show no significant correlation between the medial clear space and the integrity of the deep deltoid ligament (figure1). A negative weightbearing radiograph does not exclude deep deltoid ligament rupture. This fact might indicate the importance of the intrinsic stability provided by the osseous contour of the highly congruent ankle joint. In our opinion, malleolar fracture with deep deltoid ligament rupture (SERIV) can therefore be treated conservatively as long as ankle stability is provided under physiological load.

scholarly journals Ligament Balancing During TAR in Varus Deformity by Open Wedge Osteotomy of the Medial Malleolus

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0000
Author(s):  
Joe Wagener ◽  
Christine Schweizer ◽  
Lukas Zwicky ◽  
Beat Hintermann
Keyword(s):  
Ankle Joint ◽  
Wedge Osteotomy ◽  
Deltoid Ligament ◽  
Medial Malleolus ◽  
Open Wedge ◽  
Open Wedge Osteotomy ◽  
Ankle Arthritis ◽  
Ligament Balancing ◽  
Ankle Replacement

Category: Ankle Arthritis Introduction/Purpose: After reducing the tilted talus during total ankle replacement (TAR) in severe varus deformities, the surgeon is faced to a contract medial joint and an abducted medial malleolus leaving a wide gutter. A sliding osteotomy will release the deltoid ligament but the “horizontal” position of the medial malleolus remains and bony containment of the ankle joint is not restored. We propose an open wedge osteotomy, which will both lengthen and adduct the medial malleolus and restore ligament balancing. Fixation is done by either screw or plate fixation. We present our primary results with this new technique. Methods: From 2008-2015 Total Ankle Replacement combined with open wedge medial malleolar osteotomy was done in 50 ankles (48 patients). Inclusion criteria: Takakura stages 3 and 4 ankle arthritis. Minimum follow-up was defined as one year. Results: Neutral alignment was achieved in all ankles at last follow-up. AOFAS score increased from 36 preoperative to 82 at last follow-up. In 15 Ankles an additional bony procedure was done during the TAR surgery (Calcaneus Osteotomy: 5, Dorsiflexion Osteotomy of first ray: 6, Fibula Osteotomy: 4, peritalar fusion: 4) Complications included one non-union of the medial malleolus, which resolved after revision. One deep infection that was treated in a staged procedure with reimplantation of a TAR and no recurrence of infection. Two luxations of the polyethylene due to insufficient lateral ligaments and syndesmotic dehiscence, both were stable at final follow-up after revision (ligament reconstruction and tight-rope Fixation). Conclusion: Open wedge osteotomy of the medial malleolus restores the bony containment of the ankle joint and decreases the tension of the deltoid ligament. It is a valuable tool for ligament balancing during TAR.

scholarly journals An incalcitrant symptomatic paediatric closed tibial medial malleolus fracture (case report)

2017 ◽  
Vol 15 (3) ◽  
pp. 262-265
Author(s):  
T. Al-Sadek ◽  
F. Yu-Sing Chan ◽  
A. Al-Sadek3 ◽  
G. Dimitrov ◽  
K. Marinov
Keyword(s):  
Case Report ◽  
Medial Malleolus ◽  
Medial Malleolus Fracture

scholarly journals Physiotherapy Rehabilitation in Operated Case of Patellar Fracture and Medial Malleolus Fracture- A Case Report

2021 ◽  
pp. 266-270
Author(s):  
Sawari Bhagwatkar ◽  
Pratik Phansopkar ◽  
Neha Chitale
Keyword(s):  
Case Report ◽  
Traffic Accidents ◽  
Road Traffic ◽  
External Rotation ◽  
Clinical Findings ◽  
Medial Malleolus ◽  
Patellar Fracture ◽  
Medial Aspect ◽  
Lacerated Wound ◽  
Medial Malleolus Fracture

Introduction: Road traffic accidents (RTA) are responsible for a considerable amount of global death and morbidity, particularly in developing nations. 'Hidden pandemics,' such as mortality from RTA, often go unnoticed over the world.(1) These days traffic road accidents lead to many fractures included patellar fracture. Patellar fractures account for about 1% of all skeletal fractures and are most common in people between the ages of 20 and 50. 1–3 Men have nearly twice as many cases as women. Clinical Findings: On physical examination respiratory system, cardiovascular system and central nervous system are normal and on local examination of left lower limb demonstrate attitude of limb in hip and knee in extension and foot in external rotation and multiple abrasions are present over the knee and there were abrasion of 10*2cm present over medial aspect of great toe and abrasion of 5*2cm present over the postero-medial aspect of distal 3rd leg, lacerated wound on medial malleolus.In this case patient was on 8 week protocol for physiotherapy management. Discussion: In this case report we are discussing a case of 36 year old male with fracture of patella and medial malleolus managed with tension band wiring and nailing respectively. The primary goal of physiotherapy management was to prevent secondary complications and make the patient independent for which rehabilitation protocol was planned which included isometric exercises, dynamic quadriceps bed mobility exercises and ambulation. Conclusion: Physiotherapy plays an important role in rehabilitation of patient with medial malleolus and patella fracture.

scholarly journals Simultaneous traumatic dislocation of the hip knee and ankle joints in an ipsilateral limb, does it happen? A case report

2018 ◽  
Vol 5 (7) ◽  
pp. 2660
Author(s):  
Lokesh Kumar S. N. ◽  
Deepak Kumar ◽  
Sameer Aggarwal
Keyword(s):  
Ankle Joint ◽  
Hip Joint ◽  
Weight Bearing ◽  
Posterior Dislocation ◽  
Fracture Dislocation ◽  
Radiographic Examination ◽  
Medial Malleolus ◽  
Pilon Fracture ◽  
Medial Malleolus Fracture ◽  
Dislocation Of The Hip

Simultaneous dislocation of three joints the hip knee and ankle joint in an ipsilateral limb is a very rare pattern of injury and only a single case has been reported in the literature, but it is associated with acetabulum fracture. A 34-year-old male had met with a road traffic accident involving left lower limb. Radiographic examination revealed (i) Posterior dislocation of the hip joint without any fracture (ii) Posterior dislocation of the knee joint(iii)Open fracture dislocation of the ankle joint with medial malleolus fracture tibial pilon fracture. The patient underwent an immediate closed reduction of the hip joint by Allis method. Simultaneous reduction of the knee and ankle joint was done and appropriate splintage gave. Open wounds were well debrided and trans-articular fixator was placed over knee and ankle joint. At a second stage, the medial malleolus fracture and tibia pilon fracture were fixed. MRI scan was done which revealed an anterior cruciate ligament injury of the knee. At 6-month follow-up, the patient was ambulating with full weight-bearing on both lower extremities without any assistive devices. There always lies a high risk of hemodynamic instability and other serious and life-threatening injuries due to the high velocity of trauma involved in such cases. The outcome of ipsilateral hip knee and ankle dislocation can vary widely depending on the circumstances and other associated injuries.

scholarly journals Radiography in in SER II - IV Ankle Fractures

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0001
Author(s):  
Henrik Baecker
Keyword(s):  
Ankle Joint ◽  
Structural Integrity ◽  
Deltoid Ligament ◽  
Medial Malleolus ◽  
Malleolar Fractures ◽  
Ligament Rupture ◽  
Clear Space ◽  
Complete Rupture ◽  
Physiological Load ◽  
The Stability

Category: Ankle, Sports, Trauma Introduction/Purpose: SER lateral malleolar fractures are common. The assessment of the stability of the ankle fracture is crucial for decision making of treatment which is associated with the integrity of the deltoid ligament (SERII-III). Slight talar shift can lead to extensive decrease of tibio-talar contact area (Ramsey 1999). Several clinical tests have been proposed of which static weightbearing radiography is used to measure the lateral talar shift with the medial clear space to detect medial instability (SERIV). However, the correlation of a stable ankle joint under weightbearing load with the structural integrity of the deltoid ligament has not been shown yet which we want to investigate. Methods: 17 patients with lateral malleolar fractures were investigated who underwent an MRI and weightbearing radiography examination. In the MRI, the deep deltoid ligament was assessed as intact, partial und complete rupture. The medial clear space was measured - distance between the lateral border of the medial malleolus and the medial border of the talus at the level of the talar dome (millimeter). Results: 7 patients suffered from deep deltoid ligament rupture (4 partial; 3 complete).The medial clear space in patients with intact deep deltoid ligament was 2.96+0.41 mm in mean, in partial rupture 2.8+0.38 mm, in complete rupture 3.43+0.23 mm. When counting the complete and partial ruptures together the mean was 3.07+0.45 mm and in partial ruptures plus the intact ones 2.91+0.40 mm. Conclusion: Our results show no significant correlation between the medial clear space and the integrity of the deep deltoid ligament (figure1). A negative weightbearing radiograph does not exclude deep deltoid ligament rupture. This fact might indicate the importance of the intrinsic stability provided by the osseous contour of the highly congruent ankle joint. In our opinion, malleolar fracture with deep deltoid ligament rupture (SERIV) can therefore be treated conservatively as long as ankle stability is provided under physiological load.

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