Results for ankle stiffness



Results for ankle stiffness

17 abstracts found

Abbasian, A., Zaidi, R., Guha, A., Goldberg, A., Cullen, N. and Singh, D. Anonymous Comparison of three different fixation methods of calcaneal osteotomies. Foot & Ankle International 2013 34(3):420-425.

BACKGROUND: There are various methods available to fix a calcaneal osteotomy, ranging from screws to plates and staples. It is not clear if one method is superior to the other. In this series we compare the complications and union rates of 3 different methods of fixation. METHODS: A retrospective review of the records of a consecutive series of patients who had a calcaneal osteotomy was undertaken. All patients had their osteotomy by the same technique, however the subsequent fixation was performed using 3 different methods: a lateral locking plate, a headless, or a headed screw. The screws were placed through a separate stab incision inserted from the infero-posterior heel. Records were kept of subsequent symptoms from the hardware and need for hardware removal as well as any complications. When screws were inserted, the entry point in relation to the weight-bearing surface of the calcaneus was also recorded. Sixty-seven osteotomies were investigated, of which 17 were fixed using a headed screw, 18 using a headless screw, and the remaining 32 were fixed using a lateral plate. RESULTS: There was an overall 97% union rate. The only 2 cases of delayed union were both fixed using a lateral plate. Overall, 47% of the headed screws, 11% of the headless screws, and 6% of the lateral plates were removed to address symptoms that were suspected to arise from the hardware. There was a 10% rate of wound complication in the lateral plate cohort. There were no cases of sural nerve injury or neuroma. No correlation was found between entry position of screw and subsequent hardware symptoms. CONCLUSIONS: Calcaneal osteotomies have high union rates regardless of fixation method. Fixation using a headed screw is associated with a high rate of secondary screw removal. This was unrelated to the position of the screw in relation to the weight-bearing surface of the calcaneus in our series. Hardware problems were less frequent in the headless screw or the lateral plate groups; however, the incidence of local wound complications and radiological delayed union was higher in the group fixed with a lateral plate. This may be related to the greater soft tissue dissection and lesser compression achieved at the osteotomy site. LEVEL OF EVIDENCE: Level III, retrospective case control study.

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Alfahd, U., Roth, S. E., Stephen, D. and Whyne, C. M. Anonymous Biomechanical comparison of intramedullary nail and blade plate fixation for tibiotalocalcaneal arthrodesis. Journal of orthopaedic trauma 2005 19(10):703-708.

OBJECTIVE: Tibiotalocalcaneal arthrodesis is used to manage severe bone loss, arthritis, and/or instability. The goal is to relieve pain through a stable, well-aligned hindfoot and ankle. The purpose of this study was 2-fold: to biomechanically compare 1) initial stability, and 2) the effect of bone density on the stability of intramedullary nail and blade plate fixation in tibiotalocalcaneal arthrodesis. DESIGN: Biomechanical study using anatomic specimens. METHODS: Ankle and subtalar joint capsules were exposed for 7 pairs of fresh-frozen anatomic specimens. One ankle from each pair was instrumented with an interlocked intramedullary nail inserted retrograde across the subtalar and ankle joint while the contralateral hind foot was stabilized with a lateral cannulated blade plate. Specimen stability was tested in plantar/dorsiflexion and inversion/eversion to a maximum bending moment of 12 Nm and in internal/external rotation to a maximum torque of 7 Nm. Physical measurements of bone density were made to determine its effect on stability. MAIN OUTCOME MEASURES: Maximum angular displacement of the constructs in plantarflexion, dorsiflexion, inversion, eversion, internal rotation, and external rotation. RESULTS: No significant differences were observed between the plated and nailed constructs in the 3 loading configurations (Power = 0.77). Only 6 pairs were included in the results because of fixation failures. A small but significant reduction in internal rotation alone of 1.8 degrees was found with the plated compared with the nailed construct (P = 0.045). Reduced stability was associated with lower bone density in torsion and inversion/eversion in the plated constructs (r = 0.67- 0.87) with a similar trend seen in torsion in the nailed constructs (r = 0.5). CONCLUSION: Initial construct stabilities and the effect of reduced bone density were found to be similar between the blade plate and the intramedullary nail in tibiotalocalcaneal arthrodesis, thus implant choice may be based on other clinical factors, such as surgeon preference or soft-tissue status.

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Anderson, T., Linder, L., Rydholm, U., Montgomery, F., Besjakov, J. and Carlsson, A. Anonymous Tibio-talocalcaneal arthrodesis as a primary procedure using a retrograde intramedullary nail: a retrospective study of 26 patients with rheumatoid arthritis. Acta Orthopaedica 2005 76(4):580-587.

BACKGROUND: Arthrodesis of the ankle joint using screws or external fixation is often a demanding procedure, notably in patients with rheumatoid arthritis. We investigated whether tibio-talocalcaneal arthrodesis with the use of an intramedullary nail is a safe and simple procedure. PATIENTS AND METHODS: We retrospectively reviewed 25 ankles (25 patients) at median 3 (1-7) years after tibio-talocalcaneal arthrodesis because of rheumatoid arthritis. All had been operated on by retrograde insertion of a retrograde nail. 5 types of nail had been used. Complications, functional outcome scores, and patient satisfaction were determined and the radiographs evaluated for healing. RESULTS: All but 1 ankle had a radiographically healed arthrodesis. We recorded 3 deep infections, all healed--in 2 cases after extraction of the nail--and the arthrodesis healed in all 3 patients. The average functional scores at follow-up were high, considering that the patients suffered from rheumatoid arthritis. 23 patients were satisfied with the outcome. We found a correlation between the functional scores and the general activity of the disease expressed as a Health Assessment Questionnaire score. INTERPRETATION: In patients with rheumatoid arthritis, tibio-talocalcaneal arthrodesis with a retrograde intra-medullary nail results in a high rate of healing, a high rate of patient satisfaction, and relatively few complications.

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Bai, Z., Zhang, E., He, Y., Yan, X., Sun, H. and Zhang, M. Anonymous Arthroscopic ankle arthrodesis in hemophilic arthropathy. Foot and Ankle International 2013 34(8):1147-1151.

Background: Ankle arthrodesis is an accepted treatment for patients with advanced disabling tibiotalar arthritis, mostly in osteoarthritis, rheumatoid, and posttraumatic arthritis. No detailed reports have been published regarding the use of arthroscopy for the treatment of the end-stage hemophilic ankle. The purpose of this article is to report the results of arthroscopic ankle arthrodesis in hemophilic arthropathy of the ankle. Methods: Ten patients (10 ankle joints) who underwent arthroscopically assisted ankle arthrodesis for the treatment of end-stage hemophilic A arthritis were enrolled in this study. The rate of ankle fusion, incidence of complications, and clinical rating by the Morgan system were analyzed. Results: In this series, the fusion rate was 100%, and patients achieved bone fusion as shown by radiographs. The average time to fusion was 10.5 weeks. Superficial wound infection occurred in 1 patient. According to the Morgan system, there were 8 (80%) good to excellent results and 2 (20%) fair results. All patients were satisfied with the outcome of the operation. Conclusions: Arthroscopic ankle arthrodesis was an effective alternative to open technique with established advantages in hemophilic arthropathy. Level of Clinical Evidence: Level IV, retrospective case series. 2013 The Author(s).

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Bonanno, D. R., Landorf, K. B. and Menz, H. B. Anonymous Pressure-relieving properties of various shoe inserts in older people with plantar heel pain. Gait & posture 2011 33(3):385-389.

Plantar heel pain is one of the most common musculoskeletal conditions affecting the foot and it is commonly experienced by older adults. Contoured foot orthoses and some heel inserts have been found to be effective for plantar heel pain, however the mechanism by which they achieve their effects is largely unknown. The aim of this study was to investigate the effects of foot orthoses and heel inserts on plantar pressures in older adults with plantar heel pain. Thirty-six adults aged over 65 years with plantar heel pain participated in the study. Using the in-shoe Pedar() system, plantar pressure data were recorded while participants walked along an 8 m walkway wearing a standardised shoe and 4 different shoe inserts. The shoe inserts consisted of a silicon heel cup, a soft foam heel pad, a heel lift and a prefabricated foot orthosis. Data were collected for the heel, midfoot and forefoot. Statistically significant attenuation of heel peak plantar pressure was provided by 3 of the 4 shoe inserts. The greatest reduction was achieved by the prefabricated foot orthosis, which provided a fivefold reduction compared to the next most effective insert. The contoured nature of the prefabricated foot orthosis allowed for an increase in midfoot contact area, resulting in a greater redistribution of force. The prefabricated foot orthosis was also the only shoe insert that did not increase forefoot pressure. The findings from this study indicate that of the shoe inserts tested, the contoured prefabricated foot orthosis is the most effective at reducing pressure under the heel in older people with heel pain. Copyright 2010 Elsevier B.V. All rights reserved.

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Cameron-Fiddes, V. and Santos, D. Anonymous The use of 'off-the-shelf' foot orthoses in the reduction of foot symptoms in patients with early rheumatoid arthritis. Foot 2013 23(4):123-129.

Background: Foot pain in patients diagnosed with early rheumatoid arthritis is common. Objectives: To investigate effects of off-the-shelf foot orthoses on outcomes of swollen and tender joints, and pain, in patients with early rheumatoid arthritis. Methods: Thirty-five patients with painful and swollen foot joints were recruited. None had previously used foot orthoses or had contraindications to their use. Any patients with concomitant musculoskeletal disease, endocrine disorders, and neurological disease, were excluded. At baseline, participants were prescribed a customised off-the-shelf foot orthosis with chair-side modifications. Data was collected at baseline, three and six months. Foot pain (using Visual Analogue Scale) and the number of tender and swollen foot joints was measured. Results: There was a trend towards a reduction in the number of swollen and tender joints by 3 months with a further improvement by 6 months. Statistically (. p ................
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