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 The Surgical Outcomes of Unstable Ankle Fractures in Patients Aged >65 Years

2021 ◽  
Vol 12 ◽  
pp. 215145932199776
Author(s):  
Adem Sahin ◽  
Anıl Agar ◽  
Deniz Gulabi ◽  
Cemil Erturk
Keyword(s):  
Surgical Outcomes ◽  
External Rotation ◽  
High Energy ◽  
Ankle Fractures ◽  
Medial Malleolus ◽  
Aofas Score ◽  
Non Union ◽  
The Mean ◽  
Medial Malleolus Fracture ◽  
Mechanism Of Trauma

Aim: To evaluate the surgical outcomes and complications of patients over 65 years of age, with unstable ankle fractures. Material and Method: The study included 111 patients (73F/38 M) operated on between January 2015 and February 2019 and followed up for a mean of 21.2 months (range, 6-62 months).Demographic characteristics, comorbidities, fracture type, and mechanisms of injury were evaluated. Relationships between postoperative complications and comorbidities were examined. In the postoperative functional evaluations, the AOFAS score was used and pre and postoperative mobilization (eg, use of assistive devices) was assessed. Results: The mean age of the patients was 70.5 ± 6.1 years (range, 65-90 years). The mechanism of trauma was low-energy trauma in 90.1% of the fractures and high-energy trauma in 9.9%. The fractures were formed with a SER injury (supination external rotation) in 83.7% of cases and bimalleolar fractures were seen most frequently (85/111, 76%).Complications developed in 16 (14.4%) patients and a second operation was performed in 11 (9.9%) patients with complications. Plate was removed and debridement was performed in 5 of 6 patients due to wound problems. Nonunion was developed in the medial malleolus in 4 patients. Revision surgery was performed because of implant irritation in 2 patients and early fixation loss in the medial malleolus fracture in one patient. Calcaneotibial arthrodesis was performed in 3 patients because of implant failure and ankle luxation associated with non-union. A correlation was determined between ASA score and DM and complications, but not with osteoporosis. The mean follow-up AOFAS score was 86.7 ± 12.5 (range, 36-100).A total of 94 (84.7%) patients could walk without assistance postoperatively and 92 (82.9%) were able to regain the preoperative level of mobilization. Conclusion: Although surgery can be considered an appropriate treatment option for ankle fractures in patients aged >65 years, care must be taken to prevent potential complications and the necessary precautions must be taken against correctable comorbidities.

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.

scholarly journals OUTCOME OF SURGICAL MANAGEMENT OF BIMALLEOLAR FRACTURES IN ADULTS

2017 ◽  
Vol 10 (11) ◽  
pp. 252
Author(s):  
Krishna Bhargavevem ◽  
Anvesh Kumar Kondlapudi ◽  
Sai Pavan Kumar Murari ◽  
Srinivasa Murthy
Keyword(s):  
Road Traffic ◽  
External Rotation ◽  
Weight Bearing ◽  
Damage Mechanism ◽  
Fracture Site ◽  
Medial Malleolus ◽  
Joint Stability ◽  
Clear Space ◽  
Functional Scores ◽  
K Wires

  Objectives: Appropriate management of malleolar injuries is crucial as the ankle is an important weight-bearing joint, and locomotion is determined by and dependent on joint stability. We studied the functional outcome of surgically managed bimalleolar fractures of the ankle.Methods: Fractures were classified anatomically and as per Lauge–Hansen, arbeitsgemeinschaft für osteosynthesefragen (AO)/orthopedic trauma association classification. The stability of the structures at the fracture site, the extent of damage, mechanism of injury was assessed. Radiologically, tibiofibular clear space of >6 mm and widening of the medial clear space of >4 mm were indicators of syndesmotic instability.All underwent open reduction and internal fixation under spinal and/epidural anesthesia. We used tension band wiring, malleolar screw, Kirschner wires (K-wires), cancellous screws for fixing medial malleolus; one-third tubular plate and K-wires for lateral malleolus. Patients were followed up at 6 weeks for 6 months, evaluated using Biard and Jackson’s ankle scoring system.Results: Of 30 patients, 25 (83.3%) were men. The right ankle was involved in 56.6%. Road traffic accident was the cause in 83.3%. 14 (46.6%) had supination external rotation injuries. The AO Type B was the most common (66.6%). All had a complete union, with a mean time for union 10.6 weeks (8-14 weeks). Functional scores were categorized into excellent (60%), good (26.6%), fair and poor (n=02 each). Superficial and deep infection (n=02 each), delayed union (n=01) were the complications.Conclusion: ORIF restores the articular congruity of the ankle joint. Cancellous or malleolar screws are better for fixation of the medial malleolus and lateral plating for fibular fractures.

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

Acute Rupture of the Tibialis Posterior Tendon without Fracture

2014 ◽  
Vol 104 (3) ◽  
pp. 298-301 ◽  
Author(s):  
Nicolò Martinelli ◽  
Carlo Bonifacini ◽  
Alberto Bianchi ◽  
Laura Moneghini ◽  
Gennaro Scotto ◽  
...  
Keyword(s):  
External Rotation ◽  
Complete Loss ◽  
Tibialis Posterior ◽  
Medial Malleolus ◽  
Emergency Department Setting ◽  
Uncommon Disease ◽  
Acute Rupture ◽  
History Of ◽  
Medial Malleolus Fracture ◽  
Pronation External Rotation

The acute rupture of the tibialis posterior (TP) tendon, compared to an acute rupture of the Achilles tendon, is a quite uncommon disease to be diagnosed in the emergency department setting. In most cases symptoms related to a TP dysfunction, like weakness, pain along the course of the tendon, swelling in the region of the medial malleolus, and the partial or complete loss of the medial arch with a flatfoot deformity precede the complete rupture of the tendon. In this case report, we describe an acute rupture of the TP tendon following a pronation-external rotation injury of the ankle with no association of a medial malleolus fracture and with no history of a prior flatfoot deformity or symptoms.

Epidemiological profile and pattern of injuries in road traffic accidents in Moradabad: A prospective study

2017 ◽  
Vol 3 (02) ◽  
Author(s):  
MohdAmjad Bhat ◽  
Sarvjit Singh Sandhu ◽  
Pardeep Singh
Keyword(s):  
Traffic Accidents ◽  
Motor Vehicle ◽  
Road Traffic ◽  
Pattern Of Injury ◽  
Vehicle Accidents ◽  
Road Users ◽  
Lacerated Wound ◽  
Epidemiological Profile ◽  
Integrated Facility ◽  
A Prospective Study

Background: In many countries, motor vehicle accidents rank first among all fatal accidents. RTAs have got multi-factorial causation. It is a part of the price we pay for our technological progress. Regional differences exist in the pattern of injury sustained by different types of road users that can have significant implications in the development of prevention policies. The objective of the Study: To understand the profile and pattern of injuries sustained and circumstances leading to RTAs in and around Moradabad, U.P. Materials and Methods: After ethical clearance for the study, all RTA victims presenting to the Casualty of TMU Moradabad, U.P. were taken for this study. All relevant details of RTIs were recorded and data collected, entered on a predesigned proforma and then tabulated, analyzed and interpreted statistically. Results: Out of 730 patients included in this study, most common victims were pedestrians (33.01%), most common site of injury was head (86.71%), most common external injury was lacerated wound (46.75%), and intoxication was seen in 24.11%, protective/safety measures used by 10.23%. Conclusion: RTAs continue to be a speedily rising problem, causing heavy loss of manpower and resources. Road users should be properly trained by authorized centers; driving licenses should be issued after strict testing of driving skills. Trauma centers with integrated facility of surgical, orthopedic, neurosurgical, anesthetic experts with modern investigative procedures like USG, CT-Scan and facility of blood-bank is the best solution for RTA victims who are severely injured.

scholarly journals Rare Bosworth Fracture-Dislocation Variant of an Irreducible Distal Fibula Dislocation of the Ankle Without Fibula Fracture

2019 ◽  
Vol 4 (2) ◽  
pp. 247301141882090
Author(s):  
Png Wenxian ◽  
Kinjal Vidyut Mehta
Keyword(s):  
Emergency Department ◽  
Road Traffic ◽  
Ankle Instability ◽  
Fracture Dislocation ◽  
Medial Malleolus ◽  
Distal Fibula ◽  
Level Of Evidence ◽  
Anatomic Reduction ◽  
Medial Malleolus Fracture ◽  
High Index Of Suspicion

Background: Irreducible fracture-dislocations of the ankle are rare orthopedic emergencies that should not be missed. The Bosworth fracture-dislocation is a rare fracture where an incarcerated fibula fragment remains locked behind the posterior lateral tubercle of the tibia. We present a case describing a variation of a Bosworth injury, with a dislocation of an intact distal fibula with an associated medial malleolus fracture. Methods: Our patient is a 55-year old male who presented to the emergency department with a left ankle injury after being involved in a road traffic accident. Radiographs show a posterior dislocation of an intact distal fibula associated with a fracture of the medial malleolus and disruption of the ankle mortise. Results: An attempt to reduce the dislocation at the emergency department under sedation was unsuccessful. The patient was subsequently taken to the operating theatre for manipulation and reduction and application of an external fixator. Definitive fixation was performed successfully a week later. Conclusion: A high index of suspicion is critical for diagnosing a Bosworth fracture-dislocation, as this diagnosis is commonly missed. Early diagnosis and proper surgical anatomic reduction are important to prevent chronic ankle instability and evolution towards ankle arthritis. Level of Evidence: Level IV, case study.

Sign in / Sign up

Export Citation Format

Share Document