Closed total (pan-talar) dislocation of the talus with delayed presentation: a rare case report and review of the literature. (1/6)

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Research and application of absorbable screw in orthopedics: a clinical review comparing PDLLA screw with metal screw in patients with simple medial malleolus fracture. (2/6)

OBJECTIVE: To observe the therapeutic effect of absorbable screw in medial malleolus fracture and discuss its clinical application in orthopedics. METHODS: A total of 129 patients with simple medial malleolus fracture were studied. Among them, 64 patients were treated with poly-D, L-lactic acid (PDLLA) absorbable screws, while the others were treated with metal screws. All the patients were followed up for 12-20 months (averaged 18.4 months) and the therapeutic effect was evaluated according to the American Orthopaedic Foot and Ankle Society clinical rating systems. RESULTS: In absorbable screw group, we obtained excellent and good results in 62 cases (96.88%); in steel screw group, 61 cases (93.85%) achieved excellent and good results. There was no significant difference between the two groups. CONCLUSION: In the treatment of malleolus fracture, absorbable screw can achieve the same result compared with metal screw fixation. Absorbable screw is preferred due to its advantages of safety, cleanliness and avoiding the removal procedure associated with metallic implants.  (+info)

Orthopaedic surgeon's nightmare: iatrogenic fractures of talus and medial malleolus following tibial nailing. (3/6)

Intramedullary interlocking nailing is the gold standard for treatment of tibial shaft fractures. The growing use of intramedullary nailing has resulted in an increased number of tibial nailing in daily clinical practice. Despite adequate surgeon experience, tibial nailing is not without complications if proper techniques are not followed. A case of iatrogenic talar neck and medial malleolus fractures during intramedullary nailing of tibia in a 24-year-old male is reported. It is believed to be caused by forceful hammering of insertion zig with foot dorsiflexed. To the best of our knowledge, no such case has been reported in the literature. It is possible to reduce the risk of this complication by adoption of preventive measures.  (+info)

Bosworth fracture-dislocation of the ankle: a case report. (4/6)

Bosworth fracture-dislocation of the ankle is a rare injury in which the proximal fibular fragment is entrapped behind the tibia. Closed reduction is extremely difficult to achieve. Early open reduction and internal fixation enables a better outcome by minimising soft-tissue damage. We report on a 36-year-old man who underwent open reduction and internal fixation for a Bosworth fracture-dislocation of the ankle complicated by severe soft-tissue swelling and an impending risk of skin necrosis after failed closed reduction.  (+info)

3D model analysis of existing CT syndesmosis measurements. (5/6)

INTRODUCTION: Use of Computed Tomography (CT) to evaluate syndesmotic reduction following injury has significantly increased in recent years. The aim of this study was to compare existing clinical measurements of syndesmotic reduction to gold standard measurements of fibular motion obtained from a full 3D model. METHODS: Three common clinical measures for assessing syndesmotic congruity on axial CT slices were identified in the literature. Each measure was manually performed on 170 cadaveric ankle CT scans obtained with variable degrees of simulated syndesmotic displacement. Clinical measures were assessed for intraobserver and interobserver reliability and compared to objective measures of true medial/lateral and anterior/posterior translation and fibular rotation that were obtained from a 3D model. Pearson correlation coefficients (PCC) were computed to determine which clinical measurements were most accurate for describing syndesmotic motion obtained from the 3D model. RESULTS: All three clinical measurement techniques demonstrated good to excellent interobserver and intraobserver reliability. Medial/lateral displacement of the fibula was best correlated with the difference between the anterior and posterior tibiofibular joint space measurements described by Elgafy et al (PCC = 0.29 small correlation). Anterior/posterior displacement of the fibula was well correlated with the anterior/posterior measurement described by Phisitkul et al (PCC = 0.69 large correlation). Fibular rotation was best correlated with the average of the Elgafy anterior and posterior tibiofibular joint space measurements (PCC = 0.33, moderate correlation). Proximal/ distal displacement of the lateral malleolus was best correlated with the Elgafy posterior tibiofibular joint space measurement (PCC = 0.49, moderate correlation). DISCUSSION: While the clinical measurements were adequately reproducible, they showed only moderate to small correlations with the 3D measurements of movement of the fibula in the longitudinal, medial/lateral or rotational directions. The only fibular translation measured by the 3D model that was well described by the three clinical measures was fibular movement in the anterior/ posterior direction. This work demonstrates a need for improved clinical measurements of syndesmotic congruity on axial CT scans to serve as surrogates for the true movement of the fibula.  (+info)

Combined ankle and talus fractures--a case report. (6/6)

A 50-year-old male patient sustained a supination-adduction type ankle fracture with an associated sagittal split fracture of the talus. The patient was treated initially in a short leg splint, and upon presentation to an orthopaedic surgeon, an external fixator was applied. After the soft tissue swelling improved enough to permit open reduction and internal fixation, the patient was brought back to the operating room for definitive treatment with removal of the external fixator and open reduction and placement of internal fixation. The patient's postoperative course was uncomplicated. At the 6-week follow-up visit, he was noted to have a radiographic Hawkin's sign in the dome of the talus. At 3 months postoperatively, he was weightbearing as tolerated with radiographic evidence of fracture healing, and his ankle range of motion was from 30 degrees of plantar flexion to 15 degrees of dorsiflexion. At 6 months postoperatively, the patient had no complaints and was ambulating in a regular shoe. His plantar flexion was 35 degrees and his dorsiflexion was 15 degrees . His subtalar motion was from 5 degrees of eversion to 10 degrees of inversion. He returned for his one-year follow-up doing well without complaints, and he had returned to his previous activities.  (+info)