The Use of the Lateral Tibial Line to Assess Ankle Alignment: A Preliminary Investigation.

Background: Although the medial clear space (MCS) is commonly used to assess talar alignment and ankle stability, its measurement is variable with multiple reported normal values. We have observed that the lateral tibial shaft is a reliable landmark to assess talar alignment. The objective of the current investigation was to determine the normal relationship of the lateral tibia to the superolateral talus using a tangent drawn inferiorly from the lateral tibial shaft, which we refer to as the "lateral tibial line" (LTL).

Case Series: Allograft Tibiotalocalcaneal Arthrodesis Utilizing Fresh Talus.

Background: Talar body osteonecrosis can be a difficult condition to treat. Recent reports highlight a high rate of failure with the use of femoral head allograft. Additionally, higher rates of failure have been reported in diabetics and smokers.

Screw distraction technique for gaining fibular length.

Shortening of fibular length is most commonly secondary to fracture, especially in cases of malreduction, malunion or nonunion. In the presence of deltoid ligament incompetence, a shortened fibula causes lateral talar shift, widening of the mortise, decreased tibiotalar contact area and increased incidence of post-traumatic arthrosis. Restoring fibular length is important for normal anatomic relationships and kinematics of the ankle joint.

Tibiotalocalcaneal Arthrodesis With Bulk Talar Allograft for Treatment of Talar Osteonecrosis.

Unlabelled: Talar body osteonecrosis can be a devastating, painful condition that is difficult to manage surgically when conservative treatments have failed. With early disease, nonoperative treatments can prolong the need for operative correction in the young patient. Later stage disease with extensive involvement may require a tibiotalocalcaneal (TTC) arthrodesis to retain functionality of the limb.

Intraoperative Femur Fracture Risk During Primary Direct Anterior Approach Cementless Total Hip Arthroplasty With and Without a Fracture Table.

Background: There is no study to date comparing intraoperative femur fractures (IFFs) in the direct anterior approach (DAA) with and without a fracture table. We hypothesize that there is no significant difference in the IFF with and without a fracture table when performed by experienced DAA hip surgeons.

Methods: This study is a 1-year retrospective review of patients who underwent DAA total hip arthroplasty by 2 surgeons: one surgeon uses a flat table and manually elevates the femur with a large bone hook, while the other surgeon uses a fracture table and a mechanical femoral elevator.

Sitting sagittal balance is different from standing balance in children with scoliosis.

Background: Several variables can have effect on sagittal balance. The changes that occur between standing and sitting have been inadequately studied, especially in the, pediatric population.

Methods: Preoperative sagittal radiographs were obtained in both standing and sitting positions for 26 patients with idiopathic scoliosis before spinal fusion and instrumentation.

2,2,2-trichloroethanol activates a nonclassical potassium channel in cerebrovascular smooth muscle and dilates the middle cerebral artery.

Trichloroacetaldehyde monohydrate [chloral hydrate (CH)] is a sedative/hypnotic that increases cerebral blood flow (CBF), and its active metabolite 2,2,2-trichloroethanol (TCE) is an agonist for the nonclassical two-pore domain K(+) (K(2P)) channels TREK-1 and TRAAK. We sought to determine whether TCE dilates cerebral arteries in vitro by activating nonclassical K(+) channels. TCE dilated pressurized and perfused rat middle cerebral arteries (MCAs) in a manner consistent with activation of nonclassical K(+) channels.