Ortho Oracle - orthopaedic operative atlas

Osteochondral Lesions of the Talus – Allograft Repair

Co-Authors:  Milford H. Marchant Jr., M.D.; Mark E. Easley, M.D.; James A. Nunley II., M.D. Osteochondral Lesions of the Talus Review Etiology – Primary Causes – Trauma – Ischemic Necrosis – Embolic phenomenon – Ossification Defects – Predisposing Factors – Endocrine Disorders – Peripheral vascular disease – Genetic Predisposition? – 10-25% Bilateral Lesions Evaluation – … Read more

Reduction of Ankle Syndesmosis

– Discussion:      – note that the main displacement of the fibula is posterior (not lateral);      – reduction is achieved w/ IR of ankle & manual translation of fibula in an anterior direction until it reaches anterior tubercle of tibia;      – fibular fracture is reduced & provisionally transfixed to the tibia w/ horizontal 1.6 mm … Read more

Posterior Ankle Pain

– Diff Dx:     – Achilles Tendonitis     – Achilles Tendinosis     – Os Trigonum / Posterior Impingement     – Posterior Talar Process Fracture     – FHL Tendonitis     – Peroneal Tendonitis     – Tibialis Posterior Tendonitis     – Deltoid Ligament Sprain     – Osteochondral Lesions of … Read more

Lateral Radiograph of the Ankle

– Radiographic Findings:     – ankle frx:           – fibula overlaps posterior aspect of tibia, but posterior tubercle of tibia can still be seen;           – posterior subluxation of talus in mortise may be assoc w/ posterior lip frx or posterior talofibular ligament tear;     … Read more

Case Examples of SER / Weber B frx

– Examples: ——————————– ——————————– ——————————————————- —————————————————— – a case of postoperative synostosis; – Case Examples: comparison mortise views in neutral dorsiflexion; postop films.    

Blood Supply to Talus

Discussion body of talus is furnished w/ blood vessels from inferior talar surface in sinus tarsi and from talar neck; non displaced fractures of talar neck disrupt intraosseous branches of tarsal sinus and tarsal canal, but major vascular sling remains intact; w/ displaced fractures of talar neck, branches from dorsalis pedis artery to talar neck, artery … Read more

Biodegradable Fixation of Ankle Fractures

– See: Bioabsorble Implant Discussion Fixation with Bioabsorbable Screws for the Treatment of Fractures of the Ankle. Surgical treatment of fracture-dislocations of the ankle joint with biodegradable implants: a prospective randomized study. Biodegradable fixation of ankle fractures. Complications in a prospective study of 25 cases. Intense granulomatous inflammatory lesions associated with absorbable internal fixation devices … Read more

Complications of Ankle Arthrodeses

div class=”mh-row clearfix”> h1>/h1> div class=”bodycopy”>hr size=”3″/> strong>- Pseudarthrosis:/strong>br/>        – a major complication;br/>        – consider managing patient nonoperatively w/ orthosis;br/>        – w/ operative treatment consider if old incisions can be used;br/>        – acquired pes valgus, metatarsalgia, or other complication may occur;br/>        – ref: a href=”http://www.ncbi.nlm.nih.gov/pubmed/24043351″>Establishing the relationship between clinical outcome … Read more