UNUSUAL ANKLE FRACTURE: A LITERATURE REVIEW

2021 ◽  
pp. 70-71
Author(s):  
Aditya Kumar Jha ◽  
Rahul Kumar ◽  
A. K. Baranwal
Keyword(s):  
Blood Supply ◽  
Ankle Fracture ◽  
Sagittal Plane ◽  
Bone Fractures ◽  
Weight Bearing ◽  
The Body ◽  
Medial Malleolus ◽  
Vertical Fracture ◽  
Body Fracture ◽  
Anatomic Reduction

Background:- Fractures of the talus are unusual, and talar body fractures in the sagittal plane are still rarer. Its treatment aims a crucial anatomic reduction to reimpose congruency of the ankle and decrease the risk of avascular necrosis by conserving any remaining blood supply. We present the case of a body talar fracture in the sagittal plane related to fracture of the medial malleolus in an adult. The mechanism of the fracture was, internal rotation, plantar hyperexion, and axial compression. We performed an open reduction and stabilization with two screws for the talus and screwed the medial malleolus. Material & Methods:- We included 30 patients in this study among which a 25 years old man presented in Department Of Orthopaedics, Mgmmch, Jamsehedpur, Jharkhand with a grossly expand and deformed right ankle. Radiographs revealed a displaced vertical fracture of the neck of the talus traversing through the body with vertical fracture of the medial malleolus and medial talar shift. Results:- Fractures of the talus have a relatively little incidence accounting for 0.3% of all bone fractures and 3% to 6% of all foot fractures.[1,2] Union of the fracture in such a case is extremely slow as it depends on a new blood supply growing into the avascular bone.[3] Hence, the fracture needs preservation for a long time, and non-weight bearing is recommended for three months or until the union has occurred. Malunion can produce substantial alteration in load across the ankle and subtalar joints and result in arthrosis. The reported case should have the best prognosis as it was closed and underwent immediate operative reduction with early signs of revascularization. After 13 months following the injury, the patient had the best range of movement with some pain. Conclusion:- Talar body fracture associated with ankle fracture is very rare. Still, the malleolar fracture that allows adequate visualisation, anatomical reduction, and appropriate fracture xation can give us hope to reduce complications.

scholarly journals TREATMENT OF TALAR BODY FRACTURES WITH CLOSED REDUCTION AND PERCUTANEOUS FIXATION AT ORTHOPAEDICS DEPARTMENT OF DMCH, LAHERIASARAI, BIHAR

2020 ◽  
pp. 1-3
Author(s):  
Ramashish Yadav ◽  
Ramsagar Pandit ◽  
Nand Kumar ◽  
Debarshi Jana
Keyword(s):  
Closed Reduction ◽  
Weight Bearing ◽  
Distal Tibia ◽  
Functional Results ◽  
The Body ◽  
Radiographic Evaluation ◽  
Full Weight Bearing ◽  
Medial Malleolus ◽  
Percutaneous Fixation ◽  
Medial Malleolus Fracture

Background: Fractures of the talus have a relatively low incidence accounting for 0.3% of all bone fracturesand 3–6% of all foot fractures. These injuries affect the neck of the talus, more than the head or the body. Talar body fractures of the talus are uncommon accounting for 7–38% of all talus fractures. Patients and Methods: Fifteen patients with fracture of the talus were operated on using closed reductionand percutaneous screws fixation. The patients (Table 1) were followed up for an average of 20 months (range 12-30 months). In 12 patients the talar fracture was an isolated fracture of the talus in the foot and ankle region. Patient no. 2 had ipsilateral fractures of the distal tibia, fibula, and calcaneus. Patient no. 7 suffered from ipsilateral fracture of the fifth metatarsal. Patient 4 had ipsilateral medial malleolus fracture. Results: Radiographic evaluation postoperative showed exact reduction in all cases but three which had astep of 2mm and 1.5 mm displacement. There were no re-displacements of the fractures, and all patients achieved union radiologically and clinically and could walk without external aid with full weight bearing by third to sixth month postoperative. Functional results according to Hawkins were excellent in five patients, good in seven, fair in three, and no poor results. Conclusion: Closed reduction and percutaneous fixation of talar body fractures is a good technique withaccepted clinical and radiological results, and less complications

scholarly journals To fix or not to fix: a novel approach to the safe management of unstable open medial malleolar fractures

2019 ◽  
Vol 12 (4) ◽  
pp. e228965
Author(s):  
Tom H Carter ◽  
Calum HC Arthur ◽  
Andrew D Duckworth ◽  
Timothy O White
Keyword(s):  
Ankle Fracture ◽  
Weight Bearing ◽  
Fracture Dislocation ◽  
Medial Malleolus ◽  
Wound Debridement ◽  
Soft Tissue Envelope ◽  
Malleolar Fractures ◽  
Novel Approach ◽  
Safe Management ◽  
Fibular Fixation

Displaced medial malleolar fractures, either in isolation or as part of an unstable ankle fracture dislocation, are conventionally treated with internal fixation. We outline the case of a 76-year-old man with diabetes presenting with a grossly deformed open ankle fracture and extruded tibia through a large medial wound. Following irrigation, wound debridement and minimally invasive fibular fixation, the medial fracture reduced anatomically. Contrary to traditional teaching, the medial malleolus was left without fixation. The patient mobilised partially weight-bearing, progressing to both clinical and radiographic union by 3 months. Nine months following an injury, he walks unaided, can squat and drive and has no medial pain or instability with an Olerud–Molander Ankle Score of 80/100, indicating a good outcome. This is the first reported case of such unique management in the literature and highlights the potential to treat open medial malleolar fractures safely without fixation, particularly when concerned about the soft tissue envelope.

Body balance in a free-standing position in road and off-road cyclists

2014 ◽  
Vol 6 (4) ◽  
Author(s):  
Paulina Hebisz ◽  
Rafal Hebisz ◽  
Marek Zaton
Keyword(s):  
Sagittal Plane ◽  
Standing Position ◽  
The Body ◽  
Free Standing ◽  
Body Balance ◽  
Eyes Closed ◽  
Road Cycling ◽  
Progressive Exercise ◽  
Before And After ◽  
Road Cyclists

AbstractBackground: The purpose of this study was to compare body balance in road and off-road cyclists, immediately before and after the racing season.Material/Methods: Twenty individuals participated in the study and they were divided into two groups: specialists in road-cycling (n = 10) and in off-road cycling (n = 10). Immediately before and after the five-month racing season stabilographic trials were carried out (at rest and after progressive exercise). In assessing body balance the distance and velocity of the centre shifts (in the anterior-posterior and left-right direction) were analysed. The tests were performed with the cyclists’ eyes open, eyes closed, and in feedback.Results: After the racing season, in the off-road cyclists’ group, distance and velocity of the centre of pressure shifts increased after a progressive exercise.Conclusions: In the off-road cyclists’ group the balance of the body in the sagittal plane deteriorated after the racing season. Moreover, after the racing season off-road cyclists were characterized by a worse balance of the body, compared to road cyclists

Correction of Posture Deviations in the Sagittal Plane Using the Pilates Method

2019 ◽  
pp. 3-13
Author(s):  
Alexandru Cîtea ◽  
George-Sebastian Iacob
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Postural Control ◽  
Human Body ◽  
Sagittal Plane ◽  
The Body ◽  
Lower Limbs ◽  
Low Back ◽  
Pilates Method ◽  
The Relationship

Posture is commonly perceived as the relationship between the segments of the human body upright. Certain parts of the body such as the cephalic extremity, neck, torso, upper and lower limbs are involved in the final posture of the body. Musculoskeletal instabilities and reduced postural control lead to the installation of nonstructural posture deviations in all 3 anatomical planes. When we talk about the sagittal plane, it was concluded that there are 4 main types of posture deviation: hyperlordotic posture, kyphotic posture, rectitude and "sway-back" posture.Pilates method has become in the last decade a much more popular formof exercise used in rehabilitation. The Pilates method is frequently prescribed to people with low back pain due to their orientation on the stabilizing muscles of the pelvis. Pilates exercise is thus theorized to help reactivate the muscles and, by doingso, increases lumbar support, reduces pain, and improves body alignment.

Spinal Balance/Alignment—Clinical Relevance and Biomechanics

2019 ◽  
Vol 141 (7) ◽  
Author(s):  
Anoli Shah ◽  
Justin V. C. Lemans ◽  
Joseph Zavatsky ◽  
Aakash Agarwal ◽  
Moyo C. Kruyt ◽  
...  
Keyword(s):  
Social Interaction ◽  
Sagittal Balance ◽  
Sagittal Plane ◽  
The Body ◽  
Optimal Configuration ◽  
Sacral Slope ◽  
Sagittal Imbalance ◽  
Compensatory Mechanisms ◽  
Spinal Balance ◽  
Spinal Imbalance

In the anatomy of a normal spine, due to the curvatures in various regions, the C7 plumb line (C7PL) passes through the sacrum so that the head is centered over the pelvic-ball and socket hip and ankle joints. A failure to recognize malalignment in the sagittal plane can affect the patient's activity as well as social interaction due to deficient forward gaze. The sagittal balance configuration leads to the body undertaking the least muscular activities as possible necessary to maintain spinal balance. Global sagittal imbalance is energy consuming and often results in painful compensatory mechanisms that in turn negatively influence the patient's quality of life, self-image, and social interaction due to inability to maintain a horizontal gaze. Deformity, scoliosis, kyphosis, trauma, and/or surgery are some ways that this optimal configuration can be disturbed, thus requiring higher muscular activity to maintain posture and balance. Several parameters such as the thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence (PI), sacral slope (SS), and hip and leg positions influence the sagittal balance and thus the optimal configuration of spinal alignment. This review examines the clinical and biomechanical aspects of spinal imbalance, and the biomechanics of spinal balance as dictated by deformities—ankylosing spondylitis (AS), scoliosis and kyphosis; surgical corrections—pedicle subtraction osteotomies (PSO), long segment stabilizations, and consequent postural complications like proximal and distal junctional kyphosis. The study of the biomechanics involved in spinal imbalance is relatively new and thus the literature is rather sparse. This review suggests several potential research topics in the area of spinal biomechanics.

scholarly journals Anatomical variants of pulmonary segments and uni-portal thoracoscopic segmentectomy for lung cancer in a patient with Kartagener syndrome: a case report

2021 ◽  
Author(s):  
Di Zhou ◽  
Ye Tian ◽  
Yao Lu ◽  
Xueying Yang
Keyword(s):  
Lung Cancer ◽  
Rare Variants ◽  
Sagittal Plane ◽  
Early Stage ◽  
Situs Inversus Totalis ◽  
Middle Lobe ◽  
The Body ◽  
Kartagener Syndrome ◽  
Early Stage Lung Cancer ◽  
Cancer Lesion

AbstractSitus inversus totalis (SIT) is an extremely uncommon congenital disease where the major organs of the body are transposed through the sagittal plane. Kartagener syndrome is a complication of SIT with immotility of bronchial cilia, bronchiectasis, and chronic sinusitis. There is no report describing patients with Kartagener syndrome who accept uni-portal segmentectomies for lung cancer in past studies. Here we report a 74-year-old female patient with both Kartagener syndrome and a small early-stage lung cancer lesion located in the apical segment of the left upper lobe (LS1). The pulmonary segment anatomy of the left upper lobe in this case, which had very rare variants, was presented and interpreted in detail. This patient underwent an anatomic segmentectomy to the LS1 and a partial excision to the left middle lobe with bronchiectasis through a single 3 cm length incision. We believe that the case can give surgeons some experience and inspiration.

scholarly journals ORTHOPEDIC INJURIES IN ADOLESCENT GYMNASTS: A SYSTEMATIC REVIEW

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0011
Author(s):  
Katie Kim ◽  
Michael Saper
Keyword(s):  
Lower Extremity ◽  
Upper Extremity ◽  
Weight Bearing ◽  
The Body ◽  
Adolescent And Young Adult ◽  
Body Region ◽  
Lower Extremity Injuries ◽  
Common Location ◽  
Orthopedic Injuries ◽  
Extremity Injuries

Background: Gymnastics exposes the body to many different types of stressors ranging from repetitive motion, high impact loading, extreme weight bearing, and hyperextension. These stressors predispose the spine and upper and lower extremities to injury. In fact, among female sports, gymnastics has the highest rate of injury each year. Purpose: The purpose of this study was to systematically review the literature on location and types of orthopedic injuries in adolescent (≤20 years) gymnasts. Methods: The Pubmed, Medline, EMBASE, EBSCO (CINAHL) and Web of Science databases were systematically searched according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines to identify all studies reporting orthopedic injuries in adolescent and young adult gymnasts. All aspects of injuries were extracted and analyzed including location, type and rates of orthopedic injuries. Results: Screening yielded 22 eligible studies with a total of 427,225 patients. Twenty of 22 studies reported upper extremity injuries of which four specifically focused on wrist injuries. Eight studies reported lower extremity injuries. Nine studies reported back/spinal injuries. Seven studies investigated each body location of injury; one study reported the upper extremity as the most common location for injury and six studies reported the lower extremity as the most common location for injury. Of those seven studies, five (23%) reported sprains and strains as the most common injury. One study reported fractures as the most common injury. Conclusion: There is considerable variation in reported injury location. Some studies focused specifically on the spine/back or wrist. The type of gymnastics each patient participated in was also different, contributing to which area of the body was more heavily stressed, or lacking. Current literature lacks data to fully provide evidence regarding which body region is more frequently injured and the type of injury sustained.

scholarly journals Is postoperative non-weight-bearing necessary? INWN Study protocol for a pragmatic randomised multicentre trial of operatively treated ankle fracture

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ramy Khojaly ◽  
Ruairí Mac Niocaill ◽  
Muhammad Shahab ◽  
Matthew Nagle ◽  
Colm Taylor ◽  
...  
Keyword(s):  
Ankle Fracture ◽  
Multicentre Trial ◽  
Short Form ◽  
Plantar Flexion ◽  
Weight Bearing ◽  
Ankle Fractures ◽  
Hospital Length Of Stay ◽  
Complication Rates ◽  
Fracture Patterns ◽  
Randomised Controlled

Abstract Background Postoperative management regimes vary following open reduction and internal fixation (ORIF) of unstable ankle fractures. There is an evolving understanding that extended periods of immobilisation and weight-bearing limitation may lead to poorer clinical outcomes. Traditional non-weight-bearing cast immobilisation may prevent loss of fixation, and this practice continues in many centres. The purpose of this trial is to investigate the safety and efficacy of immediate weight-bearing (IWB) and range of motion (ROM) exercise regimes following ORIF of unstable ankle fractures with a particular focus on functional outcomes and complication rates. Methods A pragmatic randomised controlled multicentre trial, comparing IWB in a walking boot and ROM within 24 h versus non-weight-bearing (NWB) and immobilisation in a cast for 6 weeks, following ORIF of all types of unstable adult ankle fractures (lateral malleolar, bimalleolar, trimalleolar with or without syndesmotic injury) is proposed. All patients presenting to three trauma units will be included. The exclusion criteria will be skeletal immaturity and tibial plafond fractures. The three institutional review boards have granted ethical approval. The primary outcome measure will be the functional Olerud-Molander Ankle Score (OMAS). Secondary outcomes include wound infection (deep and superficial), displacement of osteosynthesis, the full arc of ankle motion (plantar flexion and dorsal flection), RAND-36 Item Short Form Survey (SF-36) scoring, time to return to work and postoperative hospital length of stay. The trial will be reported in accordance with the CONSORT statement for reporting a pragmatic trial, and this protocol will follow the SPIRIT guidance. Discussion Traditional management of operatively treated ankle fractures includes an extended period of non-weight-bearing. There is emerging evidence that earlier weight-bearing may have equivocal outcomes and favourable patient satisfaction but higher wound-related complications. These studies often preclude more complicated fracture patterns or patient-related factors. To our knowledge, immediate weight-bearing (IWB) following ORIF of all types of unstable ankle fractures has not been investigated in a controlled prospective manner in recent decades. This pragmatic randomised-controlled multicentre trial will investigate immediate weight-bearing following ORIF of all ankle fracture patterns in the usual care condition. It is hoped that these results will contribute to the modern management of ankle fractures. Trial registration ISRCTN Registry ISRCTN76410775. Retrospectively registered on 30 June 2019.

Evaluation of Tarsal Navicular Stress Fracture Fixation Using Intraoperative O-arm Computed Tomography

2014 ◽  
Vol 7 (6) ◽  
pp. 515-521 ◽  
Author(s):  
Andrew R. Hsu ◽  
Simon Lee
Keyword(s):  
Computed Tomography ◽  
Stress Fracture ◽  
Guide Wire ◽  
Weight Bearing ◽  
Fracture Site ◽  
Stress Fractures ◽  
Functional Impairments ◽  
Intraoperative Ct ◽  
Intraoperative Computed Tomography ◽  
Anatomic Reduction

Stress fractures of the tarsal navicular are high-risk injuries that can result in displacement, avascular necrosis, malunion, and nonunion. Delayed diagnosis and improper treatment can lead to long-term functional impairments and poor clinical outcomes. Increased shear stress and decreased vascularity in the central third of the navicular can complicate bony healing with often unpredictable return times to activity using conservative management in a non-weight-bearing cast. There recently has been increasing debate regarding the effectiveness of treatment options with a trend toward surgical management to anatomically reduce and stabilize navicular stress fractures in athletes. However, anatomic reduction and fixation of the navicular can be difficult despite direct visualization and intraoperative fluoroscopy. We report a case of a chronic navicular stress fracture in a high-level teenage athlete treated with open reduction internal fixation (ORIF) and calcaneus autograft using intraoperative computed tomography (CT) (O-arm®, Medtronic, Minneapolis, MN) for real-time evaluation of fracture reduction and fixation. Intraoperative CT was fast, reliable, and allowed for confirmation of guide wire orientation, alignment, and length across the fracture site. Anatomic fixation of navicular stress fractures can be challenging, and it is important for surgeons to be aware of the potential advantages of using intraoperative CT when treating these injuries. Levels of Evidence: Therapeutic, Level IV: Case Report

Arthroscopic Reduction and Internal Fixation (ARIF) of a Comminuted Posterior Talar Body Fracture: Surgical Technique and Case Report

2017 ◽  
Vol 10 (5) ◽  
pp. 465-469 ◽  
Author(s):  
Rishin Kadakia ◽  
Jeff Konopka ◽  
Tristan Rodik ◽  
Samra Ahmed ◽  
Sameh A Labib
Keyword(s):  
Case Report ◽  
Surgical Technique ◽  
Internal Fixation ◽  
Case Reports ◽  
Wound Complications ◽  
Open Approach ◽  
Arthroscopic Reduction ◽  
Body Fracture ◽  
Anatomic Reduction ◽  
Talar Body Fracture

The talus is the second most common fractured tarsal bone. While their incidence may be low, talus fractures are severe injuries that can lead to long-term disability and pain. Displaced talar body fractures are typically treated through an open approach with the aim of obtaining anatomic reduction and stable fixation. There are several case reports in the literature demonstrating successful management of talus fractures arthroscopically. An arthroscopic approach minimizes soft tissue trauma, which can help decrease postoperative wound complications and infections. In this article, the authors describe a surgical technique of an arthroscopic reduction and internal fixation of a comminuted posterior talar body fracture. Compared with an open posterior approach with or without osteotomies, an arthroscopic technique improved visualization and allowed precise reduction and fixation. Levels of Evidence: Level V: Case report

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