Foot & ankle international
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A special type of trimalleolar fracture with the involvement of the entire posterior tibial plafond has been reported recently. Because of the low incidence, the characteristics of the fracture in different studies have not been consistent. We describe our clinical experience with this fracture type. ⋯ This fracture pattern may be classified into two types with different injury mechanisms, which has not been described previously. After anatomic reduction and stable fixation through a combined operative approach, the short-term outcome was good.
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The purpose of this study was to compare the axial and torsional stiffness between anterolateral and medial distal tibial locking plates in a pilon fracture model. ⋯ We believe this study indicates the primary concern when treating a pilon fracture may be soft-tissue considerations. Further clinical studies are required before definitive changes can be recommended regarding pilon fracture fixation.
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Randomized Controlled Trial
Ankle tourniquet pain control in forefoot surgery: a randomized study.
Forefoot surgery is often performed under regional anesthesia in awake patients, using tourniquet or Esmarch bandage to obtain a bloodless field. The purpose of this study was to examine the value and need for local tourniquet pain control using local subcutaneous analgesic mixture in patients undergoing forefoot surgery under ankle block anesthesia. ⋯ An ankle tourniquet was well-tolerated by patients without need for local anesthetic beneath the cuff.
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When treating ankle fractures with associated syndesmosis injury, failure to anatomically reduce the syndesmosis may lead to poor outcome. While shortening and posterior subluxation of the distal fibula are readily detected by intraoperative fluoroscopy, it is unclear how well malrotation can be assessed. The ability of fluoroscopy to detect rotational malreduction of the fibula was the subject of this study. ⋯ In the setting of ankle fractures with syndesmosis disruption, fixing the fibula in as much as 30 degrees of external rotation may go undetected using intraoperative fluoroscopy alone.