Data Trace Editor – Discussion: – w/ an “isolated fibular frx,” the paramount indication of an unstable frx is lateral talar shift (which indicates deltoid ligament injury); – this is manifested radiographically as an increase in the medial clear space; – normally the medial clear space (between talus & medial … Read more
– Discussion: – some recommend early motion after operative treatment of ankle fractures; – however, there is little differnece in range of motion between ankles that are treated with early motion and those that are immobilized; – similarly, wt-bearing affects does not appear to affect recovery; – Non Operative … Read more
– See: – Radiographic Studies – AO/Weber Classification & Surgical Treatment: – Type A – Type B (Antiglide Plate: ) – Type C – Antiglide Plate – Fracture Dislocations of the Ankle – Lateral Malleolar Fractures – Lauge Hansen Classification: – Pronation – Abduction Injuries – Pronation-External (Eversion) Rotation Injuries – Supination – Adduction Injuries – … Read more
– Treatment Considerations: – it is essential to reduce the dislocation in the ER, so as to avoid tenting of the skin over the anterior tibia; – w/ a trimalleolar frx-dislocation, consider a posterior approach using an antiglide plate and fixation of the posterior malleolar fragment (which can be accomplished through … Read more
– See: Equinovarus: – Discussion: – most common problem; – in those w/ diplegia, it is bilateral & almost always flexible in child under three years; – diff dx: toe walking – Exam: – it is essential that the ankle and hindfoot be held in varus while … Read more
– Discussion: – select appropriately sized 6.5 mm or 7.0 mm canulated screw (threads must cross the frx site); – consider direction of maximal deformity and displacment; – guide wire insertion (for cannulated screw insertion); – K wire is inserted from deep w/ in sinus … Read more
– See: Sub-Talar Fusion Tibial-Talar-Calcaneal Fusion – Discussion: – for pts w/ well-aligned fusion, walking gait in appropriate shoe is almost normal; – expect 16% decrease in gait velocity and 3 % increase in oxygen consumption; – running … Read more
(see also: Sub-Talar Fusion, Tibial-Talar-Calcaneal Fusion Discussion and Outcomes: optimal position for fusion see gait and role of ankle joint in gait ref: Ankle arthrodesis. Long-term follow-up with gait analysis. Exam: perform an Allen test for the foot vasculature; note function of posterior tibial pulse while the dorsalis pedis pulse is occluded and vice versa; … Read more
Discussion (see also: role of ankle and subtalar joint in gait) normally, during the transition from foot flat to heel off, the foot dorsiflexes as the body moves forward; gait consequences of equinus contracture: patient may adopt a toe to toe gait pattern or a toe to heel gait pattern (premature forefoot loading) reduced propulsion … Read more
Discussion as slip progresses, area of contact between L5 & S1 decreases & body of L5 tilts forward on sacrum; this is referred to as sagittal rotation, angle of slipping, roll, L5/S1 kyphosis, or gibbus; slippage is not present in pts who have mild (grade-I or II) spondylolisthesis, but is more common in pts who … Read more