Syndesmotic stabilization in pronation external rotation ankle fractures.

Unlabelled: Boden et al. suggested syndesmosis fixation was not necessary in distal pronation external rotation (PER) ankle fractures if rigid bimalleolar fracture fixation is achieved and was not necessary with deltoid ligament injury if the fibular fracture is no higher than 4.5 cm of the tibiotalar joint.

Biomechanical and clinical evaluation of posterior malleolar fractures. A systematic review of the literature.

Introduction: Ankle fractures often have involvement of the posterior malleolus. Treatment guidelines exist based on limited biomechanical evidence and still is considered controversial. The objective of this article is to review the biomechanical literature concerning changes in tibiotalar contract area, changes in contact pressures, changes in ankle stability and incongruency of the joint after a posterior malleolar ankle fracture, and to review the clinical literature concerning the outcome of operative and nonoperative treatment of these fractures.

The anatomy in relation to injury of the lateral collateral ligaments of the ankle: a current concepts review.

Injuries to the lateral ligament complex of the ankle are common problems in acute care practice. We believe that a well-developed knowledge of the anatomy provides a foundation for understanding the basic mechanism of injury, diagnosis, and treatment, especially surgical treatment, of lateral collateral ankle ligament injury. To address this issue we performed this review with regard to the anatomy of the lateral collateral ankle ligaments.

Operative aspects of the syndesmotic screw: review of current concepts.

The distal tibiofibular syndesmosis is important for stability of the ankle mortise and thus for weight transmission and walking. Syndesmotic injuries are most commonly associated with fibular fractures, but they can also occur in isolation or with damage to the lateral ankle ligament after traumatic supination. The need for trans-syndesmotic fixation of the distal tibiofibular joint has been controversial.

Early complications after high tibial osteotomy: a comparison of two techniques.

This prospective cohort study compared opening wedge high tibial osteotomy with use of the Puddu plate and the Vitoss synthetic cancellous bone versus closing wedge high tibial osteotomy with use of the AO/ASIF L-plate, focusing on complications (nonunions, infections, loss of correction, reoperations) and patient satisfaction (visual linear analog scale). During a 10-month period, we performed high tibial osteotomy for 40 patients experiencing medial knee osteoarthritis and a varus deformity. The average follow-up was 11 months.

Arthroscopic debridement for grade III and IV chondromalacia of the knee in patients older than 60 years.

Arthroscopic debridement has been used to treat patients with degenerative knee osteoarthritis, although there is sometimes conflicting evidence documenting its efficacy. This study evaluates the success of arthroscopic debridement in elderly patients with grade III and IV chondromalacia of the knee as measured by patient satisfaction and the need for additional surgery. From December 1998 to August 2001, a total of 102 consecutive cases of knee arthroscopy in 99 patients > 60 years were performed.

Which ankle fractures require syndesmotic stabilization?

Syndesmotic ruptures associated with ankle fractures are most commonly caused by external rotation of the foot, eversion of the talus within the ankle mortise, and excessive dorsiflexion. The distal tibiofibular syndesmosis consists of the anterior inferior tibiofibular ligament, posterior inferior tibiofibular ligament, and interosseous ligament, and it is essential for stability of the ankle mortise. Despite the numerous biomechanical and clinical studies pertaining to ankle fractures, there are no uniform recommendations regarding the use of the syndesmotic screw for specific injury patterns and fracture types.

What is the evidence for viscosupplementation in the treatment of patients with hip osteoarthritis? Systematic review of the literature.

Introduction: Osteoarthritis (OA) is a disease of the synovial joints and is the most common cause of chronic pain in the elderly. One of the treatment modalities for OA of the hip is viscosupplementation (VS). Today there are several different formulations of viscosupplements produced by different manufactures of different molecular weights.

The distal fascicle of the anterior inferior tibiofibular ligament as a cause of tibiotalar impingement syndrome: a current concepts review.

Impingement syndromes of the ankle involve either osseous or soft tissue impingement and can be anterior, anterolateral, or posterior. Ankle impingement syndromes are painful conditions caused by the friction of joint tissues, which are both the cause and the effect of altered joint biomechanics. The distal fascicle of the anterior inferior tibiofibular ligament (AITFL) is possible cause of anterior impingement.

Viscosupplementation in symptomatic severe hip osteoarthritis: a review of the literature and report on 60 patients.

Osteoarthritis of the hip is a frequent joint disorder in adults aged 50 years and older. The management focuses on pain reduction, by means of non-steroidal anti-inflammatory drugs and analgesics, physical therapy and weight reduction. When these treatments fail, total hip replacement can be considered.

Outcome of open versus endoscopic approach for the surgical treatment of carpal tunnel syndrome.

The authors retrospectively evaluated two comparable groups of patients who underwent either open (103 patients) or endoscopic decompression (86 patients) of the carpal tunnel with the two portal technique. There were 95 patients available for follow-up in the open group and 79 in the endoscopic group. The average follow-up period was 38 months (range: 12 to 60).

Surgical stabilisation of the proximal tibiofibular joint using temporary fixation: a technical note.

Proximal tibiofibular instability is a symptomatic hypermobility of this joint possibly associated with subluxation. It is a rare condition both in clinical practice and in literature. The treatment of choice for proximal tibiofibular instability remains conservative, using a brace 1 cm underneath the head of the fibula.