Foot & ankle international
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Recently, peripheral nerve blocks have increasingly been used in orthopedic surgery. The foot block is an alternative for anesthesia in cases of forefoot and midfoot operations. We propose a modification of the block technique due to potential difficulties concerning the tibial nerve. ⋯ The technique, proposed in the anatomical portion of the study and evaluated in the clinical part, had a similar success rate when compared to techniques published in the literature. Though comparable to currently used techniques, this technique provides easier positioning of a patient and a complete block of the foot can be done with two skin injection sites.
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Comparative Study
Open versus closed treatment of the fibula in Maissoneuve injuries.
Masissoneuve fractures of the proximal half of the fibula are infrequently reported with only a few reports existing recommending closed reduction of the syndesmosis and percutaneous syndesmotic fixation. The purpose of this study was to compare the reduction obtained with open and closed reduction techniques of the fibular fracture with screw fixation of the syndesmosis. ⋯ Proximal fibular fractures with syndesmotic disruption can be difficult to treat, especially with closed reduction and percutaneous fixation of the syndesmosis. In this limited series of patients, we found an unacceptable rate of malreduction with closed reduction and percutaneouso fixation and have now abandoned this technique.
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Deltoid ligament insufficiency has been shown to decrease tibiotalar contact area and increase peak pressures within the lateral ankle mortise. This detrimental effect may create an arthritic ankle joint if left unresolved. Reconstructive efforts thus far have been less than satisfactory. We describe a novel technique that reconstructs both main limbs of the deltoid ligament in anatomic orientation while providing secure graft fixation. ⋯ This utilitarian reconstruction may be incorporated into total ankle arthroplasty, triple arthrodesis, and sports injuries to re-establish lost medial stability.