A Two-Portal Posterior Endoscopic Approach in the Treatment of a Complex Talus Fracture

2009 ◽  
Vol 99 (5) ◽  
pp. 443-446 ◽  
Author(s):  
Tahir Ogut ◽  
Aksel Seyahi ◽  
Onder Aydingoz ◽  
Nafiz Bilsel
Keyword(s):  
Subtalar Joint ◽  
Posterior Approach ◽  
Posterior Part ◽  
Endoscopic Approach ◽  
New Technique ◽  
Treatment Alternative ◽  
Talus Fracture ◽  
Hindfoot Endoscopy

The two-portal hindfoot endoscopy is a relatively new technique that is becoming increasingly popular. It gives excellent access to the posterior ankle compartment, the subtalar joint, and extra-articular structures. We report a 24-year-old man with a complex talus fracture involving the posterior part of the talar body and posterolateral process. He was treated endoscopically, with a two-portal posterior approach to the hindfoot. This approach allowed a better visualization and treatment of accompanying pathologies. Combined excision of the posterolateral process and fixation of the fracture was performed with the two-portal hindfoot endoscopy, which has not been previously described to our knowledge. The two-portal posterior endoscopic approach can be an attractive treatment alternative for the posterior part fractures of the talus, which can in turn, be a new indication for this technique. (J Am Podiatr Med Assoc 99(5): 443–446, 2009)

Snowboarder's Talus Fracture

2005 ◽  
Vol 33 (6) ◽  
pp. 871-880 ◽  
Author(s):  
Victor Valderrabano ◽  
Thomas Perren ◽  
Christian Ryf ◽  
Paavo Rillmann ◽  
Beat Hintermann
Keyword(s):  
Surgical Treatment ◽  
Subtalar Joint ◽  
External Rotation ◽  
Sport Activity ◽  
Treatment Algorithm ◽  
Activity Level ◽  
Talus Fracture ◽  
Level Of Evidence ◽  
Lateral Process

Background Fracture of the lateral process of the talus is a typical snowboarding injury. Basic data are limited, particularly with respect to treatment and outcome. Hypothesis As the axial-loaded dorsiflexed foot becomes externally rotated and/or everted, fracture of the lateral process of the talus occurs. Primary surgical treatment may improve the outcome of this injury, reducing the risk of secondary subtalar joint osteoarthritis. Study Design Cohort study; Level of evidence, 2. Methods We recorded details of the treatment and evaluation of 20 patients (8 female and 12 male; age at trauma, 29 years [range, 17-48 years]) who sustained a lateral process of the talus fracture while snowboarding. The injury pathomechanism was documented. The patients were treated either nonsurgically or surgically based on a fracture-type treatment algorithm. The evaluation at most recent follow-up (mean, 42 months [range, 26-53 months]) included clinical and functional examination, follow-up of sport activity, and radiological assessment (radiograph, computed tomography scan). Results The injury mechanism included axial impact (100%), dorsiflexion (95%), external rotation (80%), and eversion (45%). Using the American Orthopaedic Foot and Ankle Society hindfoot score, the patients obtained a mean of 93 points; the surgically treated group (n = 14) scored higher (97 points) than did the nonoperative group (n = 6; 85 points) (P <. 05). Degenerative disease of the subtalar joint was found in 3 patients (15%; operative, 1 patient; nonoperative, 2 patients). All but 4 (20%, all after nonsurgical treatment) patients reached the same sport activity level as before injury. Conclusion The snowboarding-related lateral process of the talus fracture represents a complex hindfoot injury. In type II fractures, primary surgical treatment has led to achieving better outcomes, reducing sequelae, and allowing patients to regain the same sports activity level as before injury.

A Case Report of Simultaneous Ipsilateral Floating Knee and Hip

2020 ◽  
Author(s):  
Babak Siavashi ◽  
Seyyed Hossein Shafiei ◽  
Farhad Mahdavi ◽  
Salar Baghbani ◽  
Mohammad Reza Golbakhsh
Keyword(s):  
Case Report ◽  
Surgical Technique ◽  
Posterior Approach ◽  
Pelvic Ring ◽  
Posterior Part ◽  
Femoral Shaft ◽  
Rare Injury ◽  
Standard Guideline

Background: Simultaneous ipsilateral floating knee and hip is a very rare injury and so far, no standard guideline has been determined for its treatment. Case Report:In the current study, we report a surgical technique for the treatment of a 17-year-old patient with this condition on his left side. Conclusion: We recommend to start the fixation from proximal and stabilize the pelvic ring at first, then fix the posterior part of the acetabulum and femoral shaft with the same posterior approach.

scholarly journals Symphysiotomy Using Posterior Approach

2021 ◽  
Vol 12 (1) ◽  
pp. 374-377
Author(s):  
Ali S Al-Qahtani ◽  
Osamah A Al-Qahtani
Keyword(s):  
Stainless Steel ◽  
Posterior Approach ◽  
Posterior Part ◽  
Symphysis Pubis ◽  
Front Part ◽  
Posterior Aspect ◽  
Life Saving ◽  
Skin Scar ◽  
And Cartilage

The invention relates to an apparatus used in the separation of the Symphysis pubis joint from its posterior aspect. This process medically named as Symphysiotomy. The apparatus consists of 3 parts: (1). Size 14G cannula which is 14cm in length, made of stainless steel and has a sharp bevel and thickened posterior part to enable the user to have a good grip on it during usage. (2). A stylet 14cm long made of stainless steel to fit in the inside of the cannula to prevent coring of the tissues during the introduction of the cannula. It has a vertical end to stop the advancement inside the cannula. (3). A cutter which is 14cm long and made of stainless steel and fits inside the cannula when the stylet is removed. Its front part is sharp on one side to cut through the ligament and cartilage of the symphysis pubis from its posterior aspect. Its back has a half-circle end to prevent the cutter from advancing beyond the bevel of the cannula inside the tissues. This is a life-saving operation and used to widen the diameter of the pelvis during certain situations of obstructed delivery of the baby. The design of the apparatus and instructions of its use enable doctors and midwives to perform the symphysiotomy procedure once they are trained on its use. The use of the invention avoids bleeding, injury to urethra and bladder, and avoids the formation of skin scar. The symphysiotomy scalpel obtained patent status from the King Abdulaziz City for Science & Technology (5910 dated 20 May 2018).

Use of an aiming device in posterior atlantoaxial transarticular screw fixation

2002 ◽  
Vol 97 (1) ◽  
pp. 123-127 ◽  
Author(s):  
Masashi Neo ◽  
Mutsumi Matsushita ◽  
Tadashi Yasuda ◽  
Takeshi Sakamoto ◽  
Takashi Nakamura
Keyword(s):  
Posterior Approach ◽  
Screw Fixation ◽  
Guide Wire ◽  
Posterior Part ◽  
Cannulated Screw ◽  
Atlantoaxial Joint ◽  
Transarticular Screw ◽  
Content Type ◽  
Transarticular Screw Fixation ◽  
Fine Print

✓ Posterior atlantoaxial transarticular screw fixation is an excellent procedure associated with high fusion rates. There is, however, the potential risk of vertebral artery (VA) injury. The authors designed a special aiming device that allows a cannulated screw to be inserted accurately in the most posterior part of the C1–2 joint via the most posterior and medial part of the isthmus of C-2; this screw pathway most safely avoids VA injury. The instruments include an aiming device and a flexible screw-inserting system. The tip of the aiming device is placed on the ridge of the C-2 isthmus just posterior to the atlantoaxial joint. The guide wire should then pass 1 mm below the device tip. The system consists of flexible guide wires, a drill, a tap, and a screwdriver, and the screw is inserted easily via a posterior approach in which the patient's back is not obstructive. Ten patients with atlantoaxial subluxation or osteoarthritis underwent surgery in which the device was used. In all cases, the screws were inserted safely without causing VA injury, although preoperative computerized tomography (CT) reconstructions revealed a high-risk high-riding unilateral VA in three patients. Postoperative CT reconstructions demonstrated that all screws but one were inserted as planned, and successfully cleared the vertebral groove. In conclusion, this newly designed device is practical and useful for the accurate insertion of screws, thus avoiding VA injury during atlantoaxial transarticular screw fixation.

Fracture of the Entire Posterior Process of Talus Associated with Subtalar Dislocation: A Case Report

1996 ◽  
Vol 17 (4) ◽  
pp. 226-229 ◽  
Author(s):  
Yeung-Jen Chen ◽  
Robert Wen-Wei Hsu ◽  
Hsin-Nung Shih ◽  
Tsung-Jen Huang
Keyword(s):  
Case Report ◽  
Closed Reduction ◽  
Subtalar Joint ◽  
Traffic Accident ◽  
Talus Fracture ◽  
Posterior Portion ◽  
Subtalar Dislocation ◽  
Posterior Process ◽  
And Inversion

This is a case report of a 52-year-old woman who sustained a medial subtalar dislocation with fracture of the posterior process of the talus in a traffic accident. After closed reduction of the subtalar dislocation, tomography demonstrated that the talus fracture involved the entire posterior process and the posterior portion of the talar body. The fracture of the talus was treated with an open reduction and miniscrew fixation. At follow-up examination 32 months later, the functional and radiographic results were graded as good. The proposed mechanism of this case was a forced plantarflexion and inversion acting simultaneously on the subtalar joint. This was different from an isolated medial subtalar dislocation, which was caused by an inversion.

Anatomic Considerations for a Posterior Endoscopic Approach to the Cricoarytenoid Joint

2019 ◽  
Vol 128 (5) ◽  
pp. 420-425
Author(s):  
Michael Z. Lerner ◽  
Sherry A. Downie ◽  
Melin Tan-Geller
Keyword(s):  
Horizontal Plane ◽  
Vocal Fold ◽  
Posterior Approach ◽  
Average Distance ◽  
Endoscopic Approach ◽  
Anatomic Study ◽  
Anatomic Landmarks ◽  
Cricoarytenoid Joint ◽  
Vocal Fold Motion ◽  
Adult Cadaver

Objective: This anatomic study considers the feasibility of a posterior endoscopic approach to the cricoarytenoid joint (CAJ) by describing relationships between readily identifiable anatomic landmarks and the posterior CAJ space in cadaver larynges. Study Design: Anatomic study. Methods: Six adult cadaver larynges (2 male, 4 female) were studied. Digital calipers were used for measurements, and Image J software was used for angle calculations. All cricoarytenoid joints were injected with colored gel via a posterior approach using a 27-gauge needle. Results: The average age of the larynges studied was 78.7 ± 10 years. The average posterior CAJ space (pCAJs) length measured 4.95 ± 0.9 mm. The average distance from the superior aspect of the midline cricoid lamina (MCL) to the center of pCAJs and the corniculate cartilage (CC) to the center of the pCAJs were 8.35 ± 1.5 mm and 14.54 ± 1.9 mm, respectively. The average pCAJs angle of declination (AD) from the horizontal plane was 54° ± 6.2°. All 12 cricoarytenoid joints were successfully injected with colored gel via a posterior approach. Conclusions: The posterior CAJ space can be located surgically using readily identifiable anatomic landmarks. An understanding of this posterior CAJ anatomy may allow for more consistent intra-articular injection and support the development of other CAJ procedures for a range of disorders of vocal fold motion or malposition.

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