Foot & ankle international
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External rotation stress is used intraoperatively for diagnosing medial ankle and syndesmotic instability in rotational ankle fractures after reduction and fixation of the fibula. However, external rotation includes hindfoot, midfoot, and ankle motion. The purpose of this study was to determine the effect of hindfoot positioning when using the external rotation stress test. Isolated deep deltoid ligament (DDL) instability and combined DDL and syndesmotic instability were modeled. An intact fibula was used as a surrogate for an anatomically fixed fibula fracture. ⋯ These findings may lead to improved clinical detection of rotational ankle instability from combined DDL and syndesmotic disruption, which may affect decision making for using syndesmotic fixation when using intraoperative stress fluoroscopy images. Occult DDL instability may be underdiagnosed, and this may affect future directions of the treatment of rotational ankle fractures and severe sprains.
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The incidence of Achilles rupture appears to be less in women, although this notion has not been specifically investigated in the literature. ⋯ Level III, retrospective comparative series.
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The aim of this study was to evaluate clinical outcomes after surgery for displaced intra-articular fractures using an external fixator and minimal internal fixation. ⋯ Level IV, retrospective case series.
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Comparative Study
Relationship between glycosylated hemoglobin level and sciatic nerve block performance in diabetic patients.
The objective of the present study was to explore the effects of deficiencies in glucose regulation on the onset, regression, and block performance times in a group of patients with diabetes-related foot problems. ⋯ Level II, prospective comparative study.
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To our knowledge, there are only a few prospective studies on the use of magnetic resonance imaging (MRI) to diagnose injuries associated with ankle sprains in children. We hypothesized that MRI examinations of acute ankle sprains in growing children would show relevant injuries that may have been overlooked by conventional clinical, radiological, and ultrasound examinations. ⋯ The injury patterns diagnosed through MRI examination did not correlate with clinical findings. With adequate progressive rehabilitation, the pathological changes diagnosed with MRI healed without further complications. MRI examinations of acute ankle distortion injuries in children did not result in any additional therapeutic value. Therefore, we believe conventional clinical, radiological, and ultrasound diagnostic methods are sufficient for the primary diagnosis of ankle fractures and ankle ligament injuries in children.