THE MINIARTHROTOMY TECHNIQUE OF ANKLE ARTHRODESIS: A CADAVER STUDY OF OPERATIVE VASCULAR COMPROMISE AND EARLY CLINICAL RESULTS

Background: The aim of this prospective study was to evaluate and analyse the first clinical results of a recently developed low-profile anatomic plate in combination with two headless compression screws for tibiotalar arthrodesis. Methods: The case series involved 20 consecutive patients who underwent ankle arthrodesis using a hybrid technique. Radiographs were obtained at 6 and 12 weeks and 1 year postoperatively. The outcome was evaluated by using AOFAS and SF 12-questionnaire. Any complications related to the arthrodesis were recorded. Results: The follow-up rate was 100%. Patients mean age at the time of surgery was 60.1 years (range, 40-79). Arthrodesis with full weight-bearing occurred in every patient within 12 weeks postoperatively. There were no patients with delayed union, non-union, infection or implant failure. AOFAS Score and SF-12 scores increased considerably compared to preoperatively. Conclusion: The hybrid technique for ankle arthrodesis is a tibiotalar compression with screws in combination with rigid anterior plate fixation. Our clinical results demonstrated no implant failure, no infection and fusion in any of the 20 patients. Further studies are necessary to support our first results.

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Posterolateral plate fixation with Talarlock® is more stable than screw fixation in ankle arthrodesis in a biomechanical cadaver study

Foot and Ankle Surgery ◽

10.1016/j.fas.2017.02.005 ◽

2018 ◽

Vol 24 (3) ◽

pp. 208-212 ◽

Cited By ~ 1

Author(s):

N. Gutteck ◽

H. Martin ◽

T. Hanke ◽

J.B. Matthies ◽

A. Heilmann ◽

...

Keyword(s):

Screw Fixation ◽

Plate Fixation ◽

Ankle Arthrodesis ◽

Cadaver Study

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Assessing Fibular Length Using Bimalleolar Angular Measurements

Foot & Ankle ◽

10.1177/107110078901000210 ◽

1989 ◽

Vol 10 (2) ◽

pp. 104-109 ◽

Cited By ~ 24

Author(s):

Bruce Rolfe ◽

William Nordt ◽

Julian G. Sallis ◽

Michael Distefano

Keyword(s):

External Rotation ◽

Clinical Results ◽

Cadaver Study ◽

X Rays ◽

Confidence Limits ◽

Average Difference ◽

Angular Difference ◽

Angular Measurements ◽

Biomechanical Changes ◽

Mortise View

Shortening of the fibula after fracture is common and often difficult to appreciate. Loss of lateral malleolar anatomy causes significant biomechanical changes in the ankle and correlates with poor clinical results. We studied angular measurements of distal fibular length to serve as a guide for assessing fibular reduction after ankle fracture. Mortise view X-rays of 50 normal ankles from 25 healthy volunteers were obtained. The average talocrural angle measured 78.5°. However, individual variation was high with values ranging from 75 to 86°. Comparing contralateral ankles demonstrated an average difference of 1.3° (range 0 to 4°). A new, simpler bimalleolar angle was devised which compares the long axis of the fibula with a line drawn between the tips of the malleoli. The average bimalleolar angle measured 77.8° (range 72 to 86°). The contralateral difference averaged 1.2° (range 0 to 3°). This angle was simpler to use and more reproducible. Angular measurements were tolerant of usual radiographic techniques. Internal or external rotation of the ankle up to 5° caused an insignificant change in the angular measurements. One degree change in the talocrural or bimalleolar angle was found to correspond with a 1 mm change in fibular length for the average ankle, calculated radiographically and confirmed in a cadaver study. Abnormal fibular shortening is detected with an angular difference between injured and contralateral sides of 3.0° using the talocrural angle or 2.5° using the bimalleolar angle (95% confidence limits). Thus, a 2.5 to 3.0° contralateral difference should serve as a minimum value required to direct a change in therapy. We conclude that comparing angular measurements of the injured with the contralateral ankle provides the most accurate guide for assessing fibular length.

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Reconstruction of Fingertip Defects with the Neurovascular Tranquilli-Leali Flap

Journal of Hand Surgery (European Volume) ◽

10.1016/j.jhsb.2005.11.007 ◽

2006 ◽

Vol 31 (3) ◽

pp. 280-284 ◽

Cited By ~ 14

Author(s):

P. LORÉA ◽

N. CHAHIDI ◽

S. MARCHESI ◽

R. EZZEDINE ◽

F. MARIN BRAUN ◽

...

Keyword(s):

Anatomical Study ◽

Clinical Results ◽

Cadaver Study ◽

Advancement Flap ◽

Proximal Interphalangeal Joint ◽

Dorsal Skin ◽

Fresh Cadaver ◽

Advancement Flaps ◽

The Mean ◽

Flexion Crease

For many years, bipedicled palmar advancement flaps were used rarely in fingers because they sacrificed the dorsal branches of the digital arteries, risking dorsal skin necrosis. In 1995, a short bipedicled neurovascular VY advancement flap raised distally to the PIP flexion crease, which spared the dorsal blood supply, was described by Elliot et al. (1995) . This paper includes an anatomical study on 28 fresh cadaver fingers to evaluate the advancement potential of this flap. It also reviews 22 fingertip reconstructions in 22 patients using this flap. The mean advancement of the flap in the cadaver study was 14 (range 10–16) mm. This procedure gave good clinical results in respect of healing, sensibility, bone cover and appearance. Complications occurred in four fingers (18%), viz. two infections, one neuroma and one stiff proximal interphalangeal joint. Our study suggests that this flap can be used to treat fingertip defects of a size of approximately half of the pulp of the distal phalangeal segment of the finger.

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Combined Transfibular and Anterior Approaches Increase Union Rate and Decrease Non-Weight-Bearing Periods in Ankle Arthrodesis: Combined Approaches in Ankle Arthrodesis

Journal of Clinical Medicine ◽

10.3390/jcm10245915 ◽

2021 ◽

Vol 10 (24) ◽

pp. 5915

Author(s):

Jeong-Jin Park ◽

Whee-Sung Son ◽

In-Ha Woo ◽

Chul-Hyun Park

Keyword(s):

Weight Bearing ◽

Good Method ◽

Clinical Results ◽

Ankle Arthrodesis ◽

Ankle Arthritis ◽

Union Rate ◽

Anterior Plate ◽

Hindfoot Alignment ◽

Additional Surgery ◽

End Stage

The transfibular approach is a widely used method in ankle arthrodesis. However, it is difficult to correct coronal plane deformity. Moreover, it carries a risk of nonunion and requires long periods of non-weight-bearing because of its relatively weak stability. We hypothesized that the transfibular approach combined with the anterior approach in ankle arthrodesis wound yield a higher fusion rate and shorter non-weight-bearing period. This study was performed to evaluate the clinical and radiographic results and postoperative complications in ankle arthrodesis using combined transfibular and anterior approaches in end-stage ankle arthritis. Thirty-five patients (36 ankles) with end-stage ankle arthritis were consecutively treated using ankle arthrodesis by combined transfibular and anterior approaches. The subjects were 15 men and 20 women, with a mean age of 66.5 years (46–87). Clinical results were assessed using the visual analog scale (VAS) for pain, the American Orthopaedic Foot and Ankle Society (AOFAS) scores, and the ankle osteoarthritis scale (AOS) preoperatively and at the last follow-up. Radiographic results were assessed with various radiographic parameters on ankle weight-bearing radiographs and hindfoot alignment radiographs. All clinical scores significantly improved after surgery. Union was obtained in all cases without additional surgery. Talus center migration (p = 0.001), sagittal talar migration (p < 0.001), and hindfoot alignment angle (p = 0.001) significantly improved after surgery. One partial skin necrosis, two screw penetrations of the talonavicular joint, and four anterior impingements because of the bulky anterior plate occurred after surgery. In conclusion, combined transfibular and anterior approaches could be a good method to increase the union rate and decrease the non-weight-bearing periods in ankle arthrodesis.

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Repair of Anterior Palatal Fistula by Local Mucoperiosteal Flap

Bangladesh Critical Care Journal ◽

10.3329/bccj.v5i1.32537 ◽

2017 ◽

Vol 5 (1) ◽

pp. 17-22

Author(s):

Farzana Bilquis Ibrahim ◽

Shafquat Hussain Khundkar ◽

Iftekhar Ibne Mannan ◽

Tanveer Ahmed

Keyword(s):

Surgical Techniques ◽

Clinical Results ◽

Controlled Clinical Trial ◽

High Failure Rate ◽

Palatal Fistula ◽

Vascular Compromise ◽

Mucoperiosteal Flap ◽

Average Size ◽

Type V ◽

Single Technique

Background: The closure of a residual post-palatoplasty anterior palatal fistula can be among the most difficult of all surgical techniques and remains challenging. No single technique is satisfactory and attempts at closure of these fistulae have been associated with high failure rate. The local mucoperiosteal flaps are a useful technique for closing such defect. This flap was selected for its alikeness and its abundant blood supply from the greater palatine vessels. It is also easily accessible, versatile and can be transposed without tension.Objective: To see the outcome of closure of anterior palatal fistula by local mucoperiosteal flap, and also to evaluate the efficacy of closure of this flap without complications such as recurrence.Methods: This is a prospective, non randomized, non controlled clinical trial that was carried out on 15 patients with anterior palatal fistula (Type V), who presented between the time of January 2010 to August 2011 in Medi-Aid hospital, Dhaka.Results: The clinical study comprised of 15 patients (n=15) with anterior palatal fistula with an average of 5.74 years of age. The average size of the fistula in the study group was seen to be 5.93 mm.Donor site morbidity such as haematoma, infection, vascular compromise, flap necrosis, flap dehiscence etc was low and hospital stay was shorter in comparison to a complicated palatal surgery.Conclusion: The clinical results indicated that anterior palatal fistula closure with local mucoperiosteal flap technique is relatively safe, uncomplicated and effective than the other bulky techniques that have been used across the world till date.Bangladesh Crit Care J March 2017; 5(1): 17-22

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