[Lateral ankle ligament injuries].

Lateral ankle ligament injuries occur in connection with inversion traumas and are one of the most common injuries, both in the general population and among athletes. A lateral ankle ligament injury weakens the stabilising structures in the ankle and disposes the ankle joint to prolonged instability. Acute lateral ankle ligament injuries with no suspicion of fracture can be treated and followed up conservatively in the primary health service.

Outcome after nonoperative treatment of stable Lisfranc injuries. A prospective cohort study.

Background: The aim of this study was to evaluate the outcome after nondisplaced and stable Lisfranc injuries.

Methods: 26 patients with injuries to the Lisfranc joint complex detected on CT scans, but without displacement were tested to be stable using a fluoroscopic stress test. The patients were immobilized in a non-weightbearing short leg cast for 6 weeks.

Unilateral, Volume-expanding Os Subcalcis: Patient History and Treatment: A Case Report.

Accessory bones of the foot are common, but the presence of accessory bones located at the plantar aspect of the calcaneus is rare. We present the case of a 72-year-old female that suffered with a volume expanding os subcalcis. Due to marked disability, the large os subcalcis was excised with a favorable outcome.

Temporary Bridge Plating vs Primary Arthrodesis of the First Tarsometatarsal Joint in Lisfranc Injuries: Randomized Controlled Trial.

Background: Unstable Lisfranc injuries are best treated with anatomic reduction and stable fixation. There are controversies regarding which type of stabilization is best. In the present study, we compared primary arthrodesis of the first tarsometatarsal (TMT) joint to temporary bridge plating in unstable Lisfranc injuries.

Two Cases of Periprosthetic Fracture After Surgery for Acute Midfoot Charcot.

Charcot neuroarthropathy is a rare condition that often results in deformity of the foot and ankle, with a high incidence of ulceration and a high risk of amputation. Traditionally, treatment of the acute stages of Charcot foot has been nonoperative until consolidation. Still, a large number of patients develop deformities, and early operative treatment of unstable Charcot feet has been suggested.

Open Reduction and Internal Fixation of Acute Lisfranc Fracture-Dislocation with Use of Dorsal Bridging Plates.

Lisfranc injuries consist of a wide spectrum of injuries, ranging from subtle injuries to severe fracture-dislocations. Injuries with instability of the tarsometatarsal, intercuneiform, or naviculocuneiform joints should be treated with anatomic reduction and stable fixation. The best method of fixation is debated.

Lisfranc injuries: Incidence, mechanisms of injury and predictors of instability.

Background: In Lisfranc injuries the stability of the tarsometatarsal joints guides the treatment of the injury. Determining the stability, especially in the subtle Lisfranc injuries, can be challenging. The purpose of this study was to identify incidence, mechanisms of injury and predictors for instability in Lisfranc injuries.

Tibial Nerve Palsy After Lateralizing Calcaneal Osteotomy.

Lateralizing calcaneal osteotomy (LCO) is a common procedure used to correct hindfoot varus. Several complications have been described in the literature, but only a few articles describe tibial nerve palsy after this procedure. Our hypothesis was that tibial nerve palsy is a common complication after LCO.

Flexor hallucis longus tendon transfer for chronic Achilles tendon rupture. A retrospective study.

Background: The transfer of Flexor Hallucis Longus Tendon (FHL) is an established method for the treatment of chronic Achilles tendon ruptures. An extensive examination of power, strength, endurance and complications related to this procedure is presented.

Methods: 21 patients treated with open FHL transfer for chronic Achilles tendon rupture were studied retrospectively.

Proximal Medial Gastrocnemius Recession and Stretching Versus Stretching as Treatment of Chronic Plantar Heel Pain.

Background:: Plantar heel pain is a common disorder that can lead to substantial pain and disability. Gastrocnemius recession has been described as an operative treatment option, but there is a lack of prospective clinical and biomechanical outcome data. The aim of this study was to evaluate the clinical and biomechanical outcomes of gastrocnemius recession and stretching compared with a stretching exercise protocol for patients with plantar heel pain lasting more than 12 months.

Validation of a New Device for Measuring Isolated Gastrocnemius Contracture and Evaluation of the Reliability of the Silfverskiöld Test.

Background: Important aspects on the diagnostics of isolated gastrocnemius contractures (IGCs) have been poorly described. This study was designed to validate a new ankle range of motion (ROM) measuring device for diagnosing an IGC. In addition, we wanted to investigate the reliability of the clinical Silfverskiöld test.

Endoscopic Transfer of Flexor Hallucis Longus Tendon for Chronic Achilles Tendon Rupture: Technical Aspects and Short-Time Experiences.

Background: Chronic Achilles tendon ruptures can lead to reduced power of plantar flexion in the ankle with impaired gait ability. The open 1- or 2-incision technique for flexor hallucis longus transfer has proven good functional outcome but has the disadvantage of relatively extensive surgery performed at a vulnerable location. To reduce the risk of soft tissue problems, the flexor hallucis longus transfer can be performed endoscopically.

High Incidence of Recurrent Ulceration and Major Amputations Associated With Charcot Foot.

Few studies have evaluated the long-term clinical outcomes of Charcot foot. The present study evaluated the long-term effects of Charcot foot in a population treated with early weightbearing in a removable Charcot restraint orthotic walker. A retrospective study of 62 consecutive patients (74 feet) treated for Charcot foot from January 2003 to March 2014 was conducted.

Clinical and Functional Outcomes of Gastrocnemius Recession for Chronic Achilles Tendinopathy.

Background: Although gastrocnemius recession has been proposed and used in the treatment of chronic noninsertional Achilles tendinopathy, only weak evidence exists to support this operative indication. The purpose of our study was to assess the clinical and functional outcomes of patients treated with gastrocnemius recession at 2 institutions for this problem.

Methods: Thirty-four patients were identified through our medical records and asked to participate in this study.

Surgically treated talar fractures. A retrospective study of 50 patients.

Background: Talar fractures are associated with a high incidence of avascular necrosis (AVN), osteoarthritis (OA) and malunion. The aim of this study was to evaluate the complications, the functional outcome, and the need for secondary surgery following surgically treated talar fractures.

Methods: Fifty patients with 52 talar fractures were included in the study.

A pilot study testing the feasibility of skin temperature monitoring to reduce recurrent foot ulcers in patients with diabetes--a randomized controlled trial.

Background: Although monitoring foot skin temperatures has been associated with diabetic foot ulcer recurrence, no studies have been carried out to test the feasibility among European Caucasians. Moreover, the educational and/or motivational models that promote cognitive or psychosocial processes in these studies are lacking. Thus, we conducted a pilot randomized controlled trial to test the feasibility of monitoring foot skin temperatures in combination with theory-based counselling to standard foot care to reduce diabetic foot ulcer recurrence.

Results after gastrocnemius recession in 73 patients.

Background: Very few studies describe the clinical results and complications following the surgical procedure of gastrocnemius recession.

Purpose: To survey the patient reported outcomes in patients operated with gastrocnemius recession as single procedure for various foot conditions.

Material And Methods: 93 patients operated with gastrocnemius recession as single procedure between 2006 and 2011 were detected in the database.

Posterior tibial tendon transfer improves function for foot drop after knee dislocation.

Background: Knee dislocation may be associated with an injury to the common peroneal nerve with a subsequent foot drop. Previous studies have demonstrated good functional results after posterior tibial tendon transfer in patients with foot drop. No studies, to our knowledge, have focused exclusively on knee dislocation as the cause of common peroneal nerve injury leading to foot drop.

[Miniinvasive plate osteosynthesis of distal tibial fractures].

The end result after open reduction and internal fixation in distal leg fractures is jeopardized by soft tissue complications. Functional conservative treatment of the same type of fractures often results in delayed and non-union, malunion or non-optimal functional result concerning ankle mobility. Mini-invasive plateosteosynthesis was performed in ten patients with sustained juxta or intra-articular fractures of the distal tibia.

Carvedilol reduces ischaemic skeletal muscle necrosis.

Carvedilol is an alpha1 and nonselective beta-adrenergic receptor antagonist with antioxidative properties known to protect against reperfusion injury in the heart, brain, and kidneys. The aim of this study was to test the hypothesis that carvedilol improves postischaemic reperfusion and tissue survival in skeletal muscle. Sixteen Wistar rats underwent tourniquet ischaemia of the left hindlimb for 3 hours and 15 minutes at 27 degrees C.

Protective effect of the endothelin antagonist Bosentan against ischemic skeletal muscle necrosis.

We tested the hypothesis that blocking of the endothelin system by Bosentan, a combined endothelin-A and -B receptor antagonist (Hoffmann La Roche, Basel, Switzerland), improves postischemic skeletal muscle reperfusion and reduces tissue damage. 16 Wistar rats were subjected to 3 h and 15 min hindlimb tourniquet ischemia at 27 degrees C. Perfusion was continuously measured with Laser Doppler Flowmetry (LDF) in the anterior tibial muscle during ischemia and the first 2 h of reperfusion.

Compartment pressure in nailed tibial fractures. A threshold of 30 mmHg for decompression gives 29% fasciotomies.

During the past few years we have monitored tissue pressure in patients treated with intramedullary nailing of tibial shaft fractures. A value of 30 mmHg has been used as the threshold for fasciotomy. The purpose of this study was to evaluate this practice.

Severe hypothermic injury to the foot and ankle caused by continuous cryocompression therapy.

Iatrogenic hypothermic injury in the treatment of traumatic disorders is a rare complication. Cryocompression therapy is widely used in the treatment of pre- and postoperative pain and swelling, but hypothermic damage to the soft tissues has not yet been reported. We present a case in which a patient sustained a hypothermic injury after continuous preoperative cryocompression therapy of an ankle fracture.

Endothelin-1 is upregulated during skeletal muscle ischemia and reperfusion.

The aim of the present study was to test the hypothesis that the vasoconstrictive peptide endothelin-1 is upregulated in ischemia and reperfusion in skeletal muscle. Sixty-eight Wistar rats were included in the series: 12 served as controls that did not undergo the procedure, 16 underwent sham operations, and 40 were subjected to a modified tourniquet ischemia for 3 hours and 20 minutes. Of the 40 rats, 16 were killed at the end of the ischemic period, 16 underwent reperfusion for 2 hours, and eight underwent reperfusion for 72 hours.