Ankle fractures are relatively common orthopaedic injuries; however, irreducible ankle fractures with or without dislocations are a rare, unstable type of injury that require surgical treatment. The structures impeding the accurate reduction of ankle fractures may be soft tissues, such as the deltoid ligament, extensor retinaculum, tendons, or bony fragments between the fracture sites. A 47-year-old male patient with irreducible medial malleolus and distal fibula fracture was referred for treatment. Intraoperatively, it was discovered that failed reduction was due to the interposition of the posterior tibial tendon in the syndesmosis. The posterior tibial tendon was pushed posteriorly through the tibiofibular interosseous interval and relocated to its anatomical position. Reduction and fixation were only achieved after relocation of the tendon. In conclusion, when anatomical reduction is not easily achieved, interposition of the posterior tibial tendon in the syndesmosis should be considered.
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http://dx.doi.org/10.5152/j.aott.2022.22098 | DOI Listing |
Arthrosc Tech
December 2024
Department of Orthopaedic Surgery, Okayama Rosai Hospital, Minamiku, Okayama, Japan.
This Technical Note describes a surgical approach that combines circumferential fiber augmentation with transtibial pullout repair for the treatment of medial meniscal posterior root tears. To address the challenge of meniscal extrusion and subsequent joint space narrowing that predisposes to osteoarthritis, this technique uses an artificial ligament to add circumferential collagen fiber reinforcement to improve meniscal extrusion. This integrated approach is designed to address the limitations of conventional tibial pullout repairs by potentially providing better results in preventing meniscal extrusion.
View Article and Find Full Text PDFJ Orthop Surg Res
January 2025
Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100083, China.
Background: Meniscus tears can change the biomechanical environment of the knee joint and might accelerate the development of osteoarthritis. The aim of this study was to investigate the dynamic biomechanical effects of different medial meniscus tear positions and tear gaps on the knee during walking.
Methods: Seven finite element models of the knee joint were constructed, including the intact medial meniscus (IMM), radial stable tears in the anterior, middle, and posterior one-third regions of the medial meniscus (RSTA, RSTM, RSTP), and the corresponding unstable tears (RUTA, RUTM, RUTP).
Eur J Trauma Emerg Surg
January 2025
Department of Orthopaedics, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
Purpose: (1) To evaluate the incidence and combination types of concomitant malleolar and fibular fractures in patients with distal spiral tibial shaft fractures. (2) To evaluate the risk factors for concomitant malleolar fractures in patients with distal spiral tibial shaft fractures.
Methods: A retrospective review was performed on 64 cases of surgically treated distal spiral tibial shaft fractures with complete radiographs and computed tomography (CT) scans.
JBJS Essent Surg Tech
January 2025
The Ohio State University College of Medicine, Columbus, Ohio.
Background: An all-inside endoscopic flexor hallucis longus (FHL) tendon transfer is indicated for the treatment of chronic, full-thickness Achilles tendon defects. The aim of this procedure is to restore function of the gastrocnemius-soleus complex while avoiding the wound complications associated with open procedures.
Description: This procedure can be performed through 2 endoscopic portals, a posteromedial portal (the working portal) and a posterolateral portal (the visualization portal).
Arch Orthop Trauma Surg
January 2025
Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan.
Introduction: Stair ascent and descent are physically demanding tasks requiring higher functional ability of the lower extremity muscles and joint range of motion than level walking, and are associated with patient satisfaction after total knee arthroplasty (TKA). This study aimed to investigate stair ascent and descent ability after cruciate-retaining (CR)-TKA using the patient-reported outcomes, and to examine the role of knee sagittal stability and handgrip strength in postoperative stair ascent and descent ability.
Materials And Methods: This study included 84 female patients who underwent primary unilateral CR-TKA for knee osteoarthritis at our institute between April 2015 and February 2019.
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