Foot & ankle international
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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.
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Controlled Clinical Trial
Influence of age, body mass index and leg dominance on functional ankle stability.
The aim of this study was to examine the influence of age, body mass index (BMI) and leg dominance on the PRT, balance control and foot position sense. ⋯ The PRT and the postural stability correlate with age and BMI, whereas the position sense test of the ankle does not. Furthermore, the PRT in right legs is always faster. This should be noted when functional ankle stability is evaluated in patients.
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Internal fixation of the os calcis is often complicated by prolonged soft tissue management and posterior facet disruption. An ideal calcaneal construct would include minimal hardware prominence, sturdy posterior facet fixation and nominal soft tissue disruption. The purpose of this study was to develop such a construct and provide a biomechanical analysis comparing our technique to a standard internal fixation technique. ⋯ This fixation technique provides a biomechanically stable construct with the potential for a minimally invasive approach and improved post-operative soft tissue healing.
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Comparative Study
Biomechanical comparison of blade plate and intramedullary nail fixation for tibiocalcaneal arthrodesis.
Tibiocalcaneal arthrodesis is an uncommon salvage procedure used for complex problems of the ankle and hindfoot. A biomechanical evaluation of the fixation constructs of this procedure has not been studied previously. The purpose of this study was to compare intramedullary nail to blade plate fixation in a deformity model in fatigue endurance testing and load to failure. ⋯ The ankle arthrodesis intramedullary nail provides greater stiffness for fixation in tibiocalcaneal arthrodesis, which may improve healing.