Ankle Archives : Wheeless' Textbook of Orthopaedics

Sub-Talar Joint

– See: – Sub Talar Dislocation – Subtalar Fusion – Transverse tarsal joint – Triple Arthrodesis – Discussion: – anatomy: – axis of rotation: – axis of subtalar joint is approx 42 deg upward from the horizontal in saggital plane & 16 to 23 deg medial to midline of foot in transverse plane; – upward … Read more

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

Optimal Position of Ankle Arthrodesis

– Recommended Position of Ankle Fusion: – it is essential to position forefoot perpendicular to long axis of tibia; – if minimal resection of the joint surfaces is carried out (to minimize shortening), then it will often be necessary to lengthen the heel cord in order to obtain the optimal position; … 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