scholarly journals In Different Gender Groups, What Is the Impact of the Fibular Notch on The Severity of High Ankle Sprain: A Retrospective Study of 240 Cases

2021 ◽  
Author(s):  
Xiaoyao Peng ◽  
Fan Su ◽  
Xiangyu Tang ◽  
Yuening Yang ◽  
Junyao Chen ◽  
...  
Keyword(s):  
Ankle Sprain ◽  
Normal Group ◽  
Ligament Injury ◽  
Control Group ◽  
Level Of Evidence ◽  
Tibiofibular Ligament ◽  
Flat Type ◽  
Retrospective Comparative Study ◽  
High Ankle Sprain ◽  
The Impact

Abstract Background: The function of the distal tibiofibular ligament on the ankle in the occurrence of high ankle sprain (HAS) has been widely studied. Then, in different genders, the effect of the anatomical morphology of fibular notch (FN) on HAS is unclear. Therefore, on the basis of excluding the anatomical differences caused by gender, we explore the impact of different types of FN on the severity of HAS.Methods: We selected 120 patients and further classified these 120 patients into four HAS groups according to FN depth with deep concave type FN ≥ four mm and shallow flat type FN < four mm. A further 120 normal individuals were served as a control group. FN morphological indicators, tibiofibular distance (TFD), and ankle mortise indexes were measured and compared between patients and control groups.Results: In males with shallow flat type, the Anterior tibiofibular distance (aTFD), Middle tibiofibular distance (mTFD), Posterior tibiofibular distance (pTFD), Front tibial width (FTiW), Middle tibial width (MTiW), Posterior tibial width (PTiW) and Depth of ankle mortise (DOAM) of HAS group were higher than those in normal group (P < 0.05). In males with deep concave type, the aTFD, mTFD and DOAM of patients were significantly higher (P < 0.05). Among females with shallow flat type, the aTFD, mTFD, pTFD, FTiW and MTiW in HAS group were greater than those in normal group (P < 0.05). Among the females with deep concave type, the mTFD and pTFD of patients were higher (P < 0.05).Conclusions: After analyzing the morphological indicators of FN, it is found that in both males and females, HAS patients have significant differences in TFD and certain ankle mortise indexes compared with normal people. But more importantly, the above abnormalities are often more common in HAS patients with shallow flat FN, indicating that shallow flat FN may be related to more serious distal tibiofibular ligament injury and ankle mortise widening, resulting in a worse prognosis.Level of evidence: Level III, retrospective comparative study.

scholarly journals The Effect of “High-ankle Sprain” Taping on Ankle Syndesmosis Congruity: A Cadaveric Study

2020 ◽  
Vol 13 (1) ◽  
pp. 123-128
Author(s):  
Stéphanie Lamer ◽  
Jonah Hébert-Davies ◽  
Vincent Dubé ◽  
Stéphane Leduc ◽  
Émilie Sandman ◽  
...  
Keyword(s):  
Ankle Sprain ◽  
Weight Bearing ◽  
Axial Loading ◽  
Cadaveric Study ◽  
P Value ◽  
Level Of Evidence ◽  
Parametric Data ◽  
Custom Made ◽  
Significant Difference ◽  
High Ankle Sprain

Background: Different treatment options exist for dynamically unstable purely ligamentous syndesmotic injury, including surgery, walking boot, brace and taping. Objective: The main purpose of this study was to evaluate the effect of high-ankle sprain taping (ring taping) on syndesmotic stability in various ligament conditions when axial loading is applied. Methods: This controlled cadaveric laboratory study included ten cadaveric specimens installed in a custom-made device applying 750N of axial loading in order to simulate weight-bearing. Sectioning of syndesmotic ligaments, AiTFL and IOL, was done sequentially and CT scan images were taken with and without high-ankle sprain taping. A validated measurement system consisting of 3 lengths and 1 angle was used. Results were compared with Wilcoxon tests for paired samples and non-parametric data. Results: In every ligament condition (intact vs. cut), no statistically significant difference was observed between specimens, with or without high-ankle sprain taping and with or without axial loading. When the data from ankles with AiTFL and IOL ruptures were compared, the mean for length “b” without axial loading was 7.19 (±2.17), compared to 7.20 (±1.98) with axial loading (p-value = 0.905). With taping and the leg still in axial loading, the value was 7.17 (±2.09) (p-value = 0.721), which is not statistically significant. Conclusion: It is impossible to conclude regarding high-ankle sprain taping’s capacity to maintain syndesmosis congruity because no significant difference was observed, regardless of condition. The most important finding is that high-ankle sprain taping did not cause malreduction of the injured syndesmosis. Level of Evidence: Level V cadaveric study

scholarly journals Treatment of Severe Ulnar Instability of the MCP Joint Improves Function in LRTI Arthroplasty for Osteoarthritis of the Thumb CMC Joint

2019 ◽  
Vol 09 (02) ◽  
pp. 105-115
Author(s):  
Johanna Wirth ◽  
Eva-Maria Baur
Keyword(s):  
Patient Satisfaction ◽  
Strength Function ◽  
Ulnar Collateral Ligament ◽  
Metacarpophalangeal Joint ◽  
Metacarpal Bone ◽  
Control Group ◽  
Level Of Evidence ◽  
Pinch Grip ◽  
Significant Difference ◽  
Retrospective Comparative Study

Abstract Background Comorbidity in the metacarpophalangeal joint (MCPj) of the thumb, i.e., hyperextension or ulnar collateral instability, could affect the outcome of arthroplasty in the thumb carpometacarpal joint (CMCj). Objective In a retrospective study, we evaluated the effect of arthrodesis of the MCPj for thumbs with unstable MCPj and simultaneous ligament reconstruction tendon interposition (LRTI) arthroplasty for the CMCj in terms of strength, function, and patient satisfaction. Patients and Methods A total of 69 thumbs treated with a LRTI arthroplasty of the CMCj were included. In 14 of those cases, an arthrodesis of the MCPj was performed as well. In 12 thumbs, both procedures were done simultaneously; in one case MCPj arthrodesis followed LRTI arthroplasty, whereas one patient already had MCPj arthrodesis at time of LRTI arthroplasty. Those 14 thumbs were compared with the control group of 55 thumbs who had only undergone LRTI. At a mean follow-up of 4 to 5 years (mean 54 [10–124] months) postoperative assessments included range of motion (ROM) of the CMC, MCP, and interphalangeal (IP) joint of the thumb, as well as any instability of the MCPj. Pinch and grip strength were examined, also the visual analogue scale (VAS), patient satisfaction, QuickDASH, PRWE-Thumb, and the Kapandji's Opposition Score. Radiologically, proximalization of the first metacarpal bone was measured. Student's t-test was used to determine significance, p < 0.05 was considered significant. Results Additional arthrodesis of the MCPj provided no significant difference of function in thumbs that only had a hyperextension-instability. However, in thumbs with marked ulnar instability, stronger pinch-grip was obtained with arthrodesis, compared with only LRTI. Conclusion In patients with advanced painful thumb CMCj osteoarthritis, we recommend (simultaneous) arthrodesis of the MCPj, to allow a stable thumb grip if there is additional marked ulnar collateral ligament instability. Level of Evidence This is a Level III, retrospective comparative study.

Correlating Arthroscopic and Radiographic Findings of Deep Deltoid Ligament Injuries in Rotational Ankle Fractures

2020 ◽  
pp. 107110072096279
Author(s):  
D’Ann Arthur ◽  
Casey Pyle ◽  
Stephen J. Shymon ◽  
David Lee ◽  
Thomas Harris
Keyword(s):  
External Rotation ◽  
Open Reduction Internal Fixation ◽  
Ankle Fractures ◽  
Ligament Injury ◽  
Deltoid Ligament ◽  
Posterior Tibial Tendon ◽  
Level Of Evidence ◽  
Radiographic Findings ◽  
Type Iv ◽  
Retrospective Comparative Study

Background: The deep deltoid ligament (DDL) is a key stabilizer to the medial ankle and ankle mortise and can be disrupted in ligamentous supination external rotation type IV (LSER4) ankle fractures. The purpose of this study was to define the medial clear space (MCS) measurement on injury mortise radiographs that corresponds with complete DDL injury. Methods: A retrospective record review at a level 1 hospital was performed identifying patients with LSER4 ankle fractures who underwent arthroscopy and open reduction internal fixation. Chart reviews provided arthroscopic images and operative reports. Complete DDL injury was defined as arthroscopic visualization of the posterior tibial tendon (PTT). Inability to completely visualize the PTT was defined as a partial DDL injury. MCS was measured on injury mortise radiographs. Eighteen subjects met inclusion criteria. Results: Twelve subjects had complete and 6 subjects had partial DDL injury based on arthroscopic findings. Patients with complete DDL injury and those with partial DDL injury had injury radiograph MCS ranging from 5.5 to 29.9 mm and 4.0 to 5.0 mm, respectively. All patients with MCS ≥5.5 mm on injury radiographs had complete DDL injury and all patients with MCS ≤5.0 mm on injury radiographs had partial DDL injury. Conclusion: Complete DDL injury was found on injury ankle mortise radiographs as MCS widening of ≥5.5 mm, which correlated with arthroscopic visualization of the PTT. Using this cutoff, surgeons can surmise the presence of a complete deltoid ligament injury, allowing for improved preoperative planning. Level of Evidence: Level III, retrospective comparative study.

scholarly journals The Effects of Ankle Sprain on Balance Tests in Adolescent Volleyball Players with Previous History of Ankle Sprain

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0018
Author(s):  
Ceyda Sarıal ◽  
Abdulhamıt Tayfur ◽  
Beyza Kap ◽  
Dılara Donder ◽  
Ozum Melıs Ertuzun ◽  
...  
Keyword(s):  
Ankle Sprain ◽  
Previous History ◽  
Control Group ◽  
Balance Test ◽  
Balance Tests ◽  
Volleyball Players ◽  
History Of ◽  
One Year ◽  
The Right ◽  
The Impact

Objectives: To investigate the impact of having previous history of inversion ankle sprain on balance tests in adolescent volleyball players. Methods: Fourty-five adolescent volleyball players with mean age of 15.26±1.03 participated in our study. Twenty-nine were uninjured (control group) and sixteen had previously experienced inversion injuries on right ankle. 9 players had the injury more than than one year ago and 7 players had it before six to twelf months. Balancing abilities were evaluated by Star Excursion Balance Test (SEBT) and Single Limb Hurdle Test (SLHT). The fact that players with history of injury had the ankle sprain at right foot led us to perform the measurements in the control group also for the right foot. We compared the results of injured and uninjured players on both tests. Results: Uninjured players' reaching distance on right foot was found out to be significantly more than in players with ankle sprain at medial and posteromedial directions of SEBT(p<.05), whereas there were no differences detected for the other directions (p>.05). For comparing athletes' performances with SLHT, finishing time was found significantly better in uninjured players (p<.05). Conclusion: Adolescent volleyball players with history of injury show lower performance on balance tests compared to uninjured players. This demonstrates that they should be given a training including balance and stabilization programs.

Arthroscopic Assessment for Intra-articular Disorders in Residual Ankle Disability after Sprain

2005 ◽  
Vol 33 (5) ◽  
pp. 686-692 ◽  
Author(s):  
Masato Takao ◽  
Yuji Uchio ◽  
Kohei Naito ◽  
Ikuo Fukazawa ◽  
Mitsuo Ochi
Keyword(s):  
Ankle Sprain ◽  
Ankle Arthroscopy ◽  
Diagnostic Tools ◽  
Osteochondral Lesions ◽  
Anterior Talofibular Ligament ◽  
Ligament Injuries ◽  
Level Of Evidence ◽  
Double Blind ◽  
Talocrural Joint ◽  
Tibiofibular Ligament

Background After ankle sprain, there can be many causes of disability, the origins of which cannot be determined using standard diagnostic tools. Hypothesis Ankle arthroscopy is a useful tool in identifying intra-articular disorders of the talocrural joint in cases of residual ankle disability after sprain. Study Design Cohort study (diagnosis); Level of evidence, 2. Methods The authors gathered the independent diagnostic results of physical examination, standard mortise and lateral radiography, stress radiography of the talocrural joint, and magnetic resonance imaging for 72 patients with residual ankle disability lasting more than 2 months after injury (mean, 7 months after injury). They performed arthroscopic procedures and compared the double-blind results. Results In all cases, the arthroscopic results matched those of other means of diagnosis. In 14 cases, the arthroscopic approach exceeded the capabilities of the other methods. Including duplications, 39 patients (54.2%) had anterior talofibular ligament injuries, 17 patients (23.6%) had distal tibiofibular ligament injuries, 29 patients (40.3%) had osteochondral lesions, 13 patients (18%) had symptomatic os subfibulare, 3 patients (4.2%) had anterior impingement exostosis, and 3 patients (4.2%) had impingement due to abnormally fibrous bands. There were only 2 cases in which the cause of symptoms could not be detected by ankle arthroscopy, compared with 16 cases in which the cause of disability could not be detected using standard methods. In 3 cases (17.6%) of distal tibiofibular ligament injuries, 8 cases (27.6%) of osteochondral lesions, and all 3 cases (100%) of impingement of an abnormal fibrous band, ankle arthroscopy was the only method capable of diagnosing the cause of residual ankle pain after a sprain. Conclusion The present results suggest that arthroscopy can be used to diagnose the cause of residual pain after an ankle sprain in most cases that are otherwise undiagnosable by clinical examination and imaging study.

Anteroinferior Tibiofibular Ligament Injury: Not Just Another Ankle Sprain

1989 ◽  
Vol 17 (11) ◽  
pp. 63-69 ◽  
Author(s):  
William W. Briner ◽  
Daniel E. Carr ◽  
Kevin M. Lavery
Keyword(s):  
Ankle Sprain ◽  
Ligament Injury ◽  
Tibiofibular Ligament

520 A Cone-Beam Computed Tomography Study on the Impact of Bruxism in Craniomandibular Morphology of Adults. Preliminary findings

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A205-A205
Author(s):  
Irene Leite ◽  
Sigmar Rode ◽  
Sérgio Lopes ◽  
Miguel Meira e Cruz ◽  
Wagner Oliveira
Keyword(s):  
Structural Changes ◽  
Female Gender ◽  
Cone Beam ◽  
Control Group ◽  
Health And Wellbeing ◽  
Standard Procedures ◽  
Contemporary Medicine ◽  
Retrospective Comparative Study ◽  
The Impact ◽  
Craniomandibular Complex

Abstract Introduction Although bruxism, either during awake and during sleep is still a controversial topic in contemporary Medicine, its prevalence and its putative relationship with several conditions interfering with health and wellbeing make it relevant as a target to be studied in distinct scientific domains. Histological and morphological on the craniomandibular complex (CC) have been documented with different techniques. However, there is a lack of high quality imaging studies showing structural changes among the different anatomical structures therefore leading to a misinterpretation of the real impact of bruxism on such elements.The aim of this clinical retrospective comparative study was to investigate whether there are structural differences on the craniomandibular complex of bruxers in face to non-bruxers evaluated by a cone-beam computed tomohraphy (CBCT). We present the preliminary findings of this still ongoing study. Methods A retrospective analysis of CBCT imaging exams from patients with ages between 18 and 44 years old, were distributed among 1) bruxism group:BG (n=31); 2) Non-bruxism/Control group (n=21). Bruxism diagnosis followed non-instrumental approach suggested by the bruxism consensus 2013. To the craniomorphological evaluation, 3D CBCT SYM Diagnosis protocol was implemented by a calibrated expert at an adequate local with reduced light. Photograpic parameters were analyzed according to standard procedures. Results Female gender prevailed without differences between groups (61,3% in BG and 66,7 in CG; p=0,91). Age of BG was significantly higher than CG (40,1 yo versus 28,4;p=0,002). Mandibular structure as inferred by its shape was significantly higher in BG compared with CG. Conclusion In this preliminary study the CBCT 3D image showed important and significant changes in mandibular structure in bruxers compared with non-bruxers. Support (if any):

scholarly journals The NFL’s Chop-Block Rule Change: Does It Prevent Knee Injuries in Defensive Players?

2018 ◽  
Vol 6 (4) ◽  
pp. 232596711876844 ◽  
Author(s):  
Hayden P. Baker ◽  
Antonios Varelas ◽  
Kevin Shi ◽  
Michael A. Terry ◽  
Vehniah K. Tjong
Keyword(s):  
Relative Risk ◽  
National Football League ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
Ligament Injury ◽  
Level Of Evidence ◽  
Competitive Game ◽  
Rule Change ◽  
Anterior Cruciate ◽  
The Impact

Background: The chop block, a football maneuver in which an offensive player blocks an opponent around the thigh while another offensive player engages the same opponent above the waist, was declared illegal by the National Football League (NFL) before the 2016-2017 season. Chop blocks have been hypothesized to be associated with medial collateral ligament and anterior cruciate ligament injury, especially in offensive/defensive linemen. Purpose: To quantify the impact that the chop-block rule change had on the incidence of knee injuries to defensive players in the NFL over 4 seasons (2014-2018). Study Design: Cohort study; Level of evidence, 3. Methods: NFL injury data for all defensive players from regular-season games played from 2014 through 2018 were collected. For this study, all knee injuries were attributed to competitive game play. Injury rates were reported as the number of injuries per 1000 athletic exposures (with 95% CIs). Results: A total of 256 games were played during the 2014-2015, 2015-2016, 2016-2017, and 2017-2018 NFL regular seasons, and all were included in this study. Among defensive players, the relative risk for a knee injury per 1000 athletic exposures was 0.84 (95% CI, 0.75-0.96) for the 2 seasons after the chop-block rule change (2016-2017 and 2017-2018) versus the 2 seasons before (2014-2015 and 2015-2016) ( P = .009). Thus, the relative risk reduction was 16%. The relative risk for a defensive player to be placed on injured reserve per season was 0.90 (95% CI, 0.72-1.13) for the 2 seasons after the rule change versus the 2 seasons before ( P = .39). Conclusion: The NFL’s recent ruling against in-game chop blocks may have reduced the incidence of knee injuries among defensive players.

scholarly journals Home Run Derby Participation in Major League Baseball Players: Is There Associated Injury Risk and Impact on Second-Half Performance?

2021 ◽  
Vol 9 (2) ◽  
pp. 232596712098335
Author(s):  
Steven F. DeFroda ◽  
Steven J. Staffa ◽  
Tim Keeley ◽  
Peter K. Kriz
Keyword(s):  
Linear Regression ◽  
Injury Risk ◽  
Major League Baseball ◽  
Linear Regression Analysis ◽  
Control Group ◽  
Level Of Evidence ◽  
Major League ◽  
Maximum Effort ◽  
Multivariable Linear Regression Analysis ◽  
The Impact

Background: The Major League Baseball (MLB) All-Star Game (ASG) Home Run Derby (HRD) remains a highly anticipated event, during which contestants can take hundreds of maximum-effort swings en route to hitting a multitude of home runs. Critics have openly questioned the risk-benefit of HRD participation as it pertains to injury, alterations in swing mechanics, and timing. Purpose: To determine whether participation in the MLB ASG HRD was associated with both increased injury risk and decline in second-half performance in MLB players. Study Design: Cohort study; Level of evidence, 3. Methods: MLB players who participated in the HRD between 2006 and 2019 were identified through publicly available internet databases. A control group of ASG participants who had the highest home run totals in the first half of the corresponding MLB season were selected as a control group. Multivariable linear regression was used to determine independent associations between HRD participation and batting metrics in the second half of the season. Multivariable logistic regression also assessed the impact of HRD participation on injured list placement during the second half of the concurrent MLB season. Results: A total of 114 HRD participants and 114 ASG participant controls competed during the study period. No statistically significant differences were seen in batting metrics in the second half of the MLB season between HRD participants and ASG controls, although HRD participants had a significantly lower wins-above-replacement statistic for the season compared with controls (4.69 ± 2.06 vs 5.33 ± 2.08; P = .021). HRD participation was not significantly associated with injury during the second half. The number of HRD rounds in which a player participated did not result in a statistically significant increased odds of injury during the second half of the MLB season. Conclusion: HRD participants did not have increased odds of being placed on the injured list during the second half of the MLB season compared with controls, nor did they experience second-half performance declines in offensive production versus controls when multivariable linear regression analysis was performed.

scholarly journals Short knee radiographs can be inadequate for estimating TKA alignment in knees with bowing

2020 ◽  
Vol 32 (1) ◽  
Author(s):  
Sung-Mok Oh ◽  
Seong-Il Bin ◽  
Jae-Young Kim ◽  
Bum-Sik Lee ◽  
Jong-Min Kim
Keyword(s):  
Total Knee Arthroplasty ◽  
Logistic Regression ◽  
Full Length ◽  
Control Group ◽  
Coronal Alignment ◽  
Level Of Evidence ◽  
Femorotibial Angle ◽  
Total Knee ◽  
Retrospective Comparative Study ◽  
Femoral Bowing

Abstract Purpose The aim of this study was to compare the discrepancy of alignment categorization in total knee arthroplasty (TKA) between the anatomical femorotibial angle (aFTA) measured on short knee radiographs and the mechanical hip–knee–ankle axis angle (mHKA) measured on full-length radiographs in knees with and without bowing. Methods From January 2014 to June 2017, 107 of 526 osteoarthritic knees at our hospital were found to have femoral or tibial bowing. Bowing was defined as a femoral bowing angle (FBA) > 3° or < − 3° or a tibial bowing angle (TBA) > 2° or < − 2° in full-length preoperative radiographs. Among 419 knees without bowing, we selected 107 knees as a control group using propensity-score matching. Postoperative alignments were categorized by aFTA in short knee radiographs and mHKA in full-length radiographs into neutral (2° ≤ aFTA≤7°, − 3° ≤ mHKA≤3°), varus (aFTA< 2°, mHKA<− 3°), and valgus (aFTA> 7°, mHKA> 3°) alignments. We compared the categorization of alignments between knees with and without bowing using the McNemar test and used logistic regression to find factors for the alignment discordance. Results Coronal alignment was discordant in 26.2% of the knees with bowing and 13.1% of the knees without bowing (p < 0.001). FBAs were a significant factor affecting the discordance of alignment categorization (OR = 1.152, 95%CI 1.038–1.279, p = 0.008). Conclusion Short knee radiographs are insufficient for estimating coronal alignment after TKA, particularly in knees with femoral bowing. Level of evidence: III Retrospective comparative study.

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