The posterior fibulotalocalcaneal ligament complex: a forgotten ligament.

Purpose: The purpose of the present anatomical study was to define the exact morphology of the posterior fibulotalocalcaneal ligament complex (PFTCLC), both for a better orientation and understanding of the anatomy, especially during hindfoot endoscopy.

Methods: Twenty-three fresh frozen specimens were dissected in order to clarify the morphology of the PFTCLC.

Results: In all specimens, the ligament originated from the posteromedial border of the lateral malleolus between the posterior tibiofibular ligament (superior border) and the calcaneofibular ligament (CFL), (inferior border).

Surgical treatment for posteromedial talar process fractures.

Purpose: The first descriptions on medial talar tubercle fractures are attributed to Cedell. He described avulsion fractures of the insertion of the posterior talotibial ligament. However the true etiology has not been established.

A rare cause of lateral ankle pain: A symptomatic talus secundarius.

The talus secundarius is one of the rarest accessory tarsal bones, being present in 0.01% of all ankles. It is located at the lateral side of the talus, distally to the tip of the fibula.

Talus bipartitus: a systematic review and report of two cases with arthroscopic treatment.

Purpose: The aim of this study was to provide a literature review on talus bipartitus and to introduce an arthroscopic treatment option.

Methods: A systematic review of published case reports and small case series was performed. Medline, Embase, CINAHL, Google Scholar and Web of Science databases were searched for relevant publications.

Anatomy of the ankle ligaments: a pictorial essay.

Understanding the anatomy of the ankle ligaments is important for correct diagnosis and treatment. Ankle ligament injury is the most frequent cause of acute ankle pain. Chronic ankle pain often finds its cause in laxity of one of the ankle ligaments.

Identification of the superficial peroneal nerve: Anatomical study with surgical implications.

Purpose: To prevent iatrogenic damage to the superficial peroneal nerve during ankle arthroscopy, it needs to be identified. The purpose of the present study was to determine which clinical test identified the superficial peroneal nerve most frequently and which determinants negatively affected the identification.

Methods: A total of 198 ankles (99 volunteers) were examined for identification of the superficial peroneal nerve.

Midterm results of posterior arthroscopic ankle fusion.

Purpose: The presented study was performed to evaluate the midterm clinical and radiological results and complication rates of the first 40 patients with an ankle fusion through a posterior arthroscopic approach.

Methods: Forty consecutive patients with end-stage post-traumatic ankle osteoarthritis were treated with posterior arthroscopic ankle fusion. All patients were assessed clinically as well as radiologically with a minimum follow-up of 2 years.

Posterior Ankle Impingement in Two Athletic Twin Brothers, Could Genetics Play a Role?

Pain posteriorly in the ankle can be caused by bony impingement of the posterolateral process of the talus. This process impinges between the tibia and calcaneus during deep forced plantar flexion. If this occurs it is called posterior ankle impingement syndrome.

Safety and efficiency of posterior arthroscopic ankle arthrodesis.

Purpose: To study the safety and efficiency of posterior arthroscopic ankle arthrodesis.

Methods: Ten fresh-frozen human lower leg specimens without evidence of previous surgery to the foot and ankle were selected. Arthroscopic debridement of the tibiotalar joint was performed in all specimens using a standardized protocol.

Anatomy of the ankle ligaments: a pictorial essay.

Understanding the anatomy of the ankle ligaments is important for correct diagnosis and treatment. Ankle ligament injury is the most frequent cause of acute ankle pain. Chronic ankle pain often finds its cause in laxity of one of the ankle ligaments.

The course of the superficial peroneal nerve in relation to the ankle position: anatomical study with ankle arthroscopic implications.

Despite the fact that the superficial peroneal nerve is the only nerve in the human body that can be made visible; iatrogenic damage to this nerve is the most frequently reported complication in anterior ankle arthroscopy. One of the methods to visualize the nerve is combined ankle plantar flexion and inversion. In the majority of cases, the superficial peroneal nerve can be made visible.

Anterior ankle arthroscopy, distraction or dorsiflexion?

Anterior ankle arthroscopy can basically be performed by two different methods; the dorsiflexion- or distraction method. The objective of this study was to determine the size of the anterior working area for both the dorsiflexion and distraction method. The anterior working area is anteriorly limited by the overlying anatomy which includes the neurovascular bundle.

Arthroscopy and endoscopy of the ankle and hindfoot.

Ankle arthroscopy provides the surgeon with a minimally invasive treatment option for a wide variety of indications such as impingement, osteochondral defects, loose bodies, ossicles, synovitis, adhesions, and instability. Posterior ankle pathology can be treated using endoscopic hindfoot portals. These posteromedial and lateral hindfoot portals provide excellent access to the posterior aspect of the ankle and subtalar joint.

Delayed operative treatment of syndesmotic instability. Current concepts review.

Objective: To review the literature concerning articles evaluating the delayed operative treatment of isolated syndesmotic instability.

Material And Methods: The main databases Pubmed/Medline, Cochrane Database of Systematic Reviews, Cochrane Clinical Trial Register, Current Controlled Trials and Embase were searched from 1988 to September 2008 to identify studies relating to the late reconstruction of the distal tibiofibular syndesmosis after isolated syndesmotic injury. The level of evidence of the included articles was scored.

A soccer player with idiopathic osteonecrosis of the complete lateral talar dome: a case report.

We report a 13-year-old soccer player with osteonecrosis of the talus and a large carticular fragment. The defect was revitalized with curettage and drilling and filled with autologous bone graft followed by the fixation of the carticular fragment with two conventional lag screws. Screw placement was such that they could be removed arthroscopically.

A 3-portal approach for arthroscopic subtalar arthrodesis.

We present a 3-portal approach for arthroscopic subtalar arthrodesis with the patient in the prone position. The prone position allows the use of the two standard posterior portals and it allows for accurate control of hindfoot alignment during surgery. Furthermore, the introduction of talocalcaneal lag screws is easy with the patient in this position.

Potential pitfall in the microfracturing technique during the arthroscopic treatment of an osteochondral lesion.

Debridement and bone marrow stimulation of the subchondral bone is currently considered to be the primary surgical treatment of most osteochondral lesions of the talus. Different methods of bone marrow stimulation are used, including drilling, abrasion, and microfracturing. The latter has gained recent popularity.

Imaging from an orthopaedic point of view. What the orthopaedic surgeon expects from the radiologist?

The paradigm of coping with sometimes gross pathology, while having some small and at first sight insignificant lesions demands for accurate radiological detection and orthopaedic treatment makes it interesting and challenging to be involved in the treatment of professional athletes. In the diagnostic process we differentiate between acute, posttraumatic and overuse injuries. We must realize the importance of reproducible routine X-rays as a first step in the diagnostic process.