ABSTRACT
BACKGROUND: Tibiotalar joint fusion ways are various, and it is a difficulty in necrotic tibiotalar joint fusion. There are few comparative studies on the repair outcomes of each implant. OBJECTIVE: To compare the effectiveness and safety of modified sliding chute bone graft plus hollow screw fixation with simple screw internal fixation and plate internal fixation for tibiotalar joint fusion. METHODS: Fifty-six patients who underwent tibiotalar joint fusion were Included, Including 16 cases of screw fixation, 22 cases of plate fixation and 18 cases of modified sliding chute bone graft plus hollow screw fixation. Ankle function was compared after simple screw internal fixation, plate internal fixation and modified sliding chute bone graft plus hollow screw fixation. The ankle foot scoring system of American Orthopedic Foot and Anlde Society was used for evaluation. At the same time, the operation time, brace fixation time and fusion time of the three surgical methods ware compared. The gait at the last follow-up was compared. The average follow-up time was 2.4 years. The experiment met the ethical requirements of the First Affiliated Hospital of Harbin Medical University. All patients provided written informed consent for study participation. RESULTS AND CONCLUSION: (1) All the patients obtained exactly bony fusion. Compared with the plate fixation group, the slide bone grafting group had significant advantages in the fusion time and the last gait (P < 0.05), and the screw fixation group had significant advantages in the operation time (P < 0.05). (2) Using the ankle foot scoring system of American Orthopedic Foot and Ankle society, there was no significant difference between the sliding chute bone graft group and the plate fixation group, but both groups were significantly better than the screw fixation group (P < 0.05). (3) Adverse events had not been found in each group. (4) These results suggest that modified sliding chute bone graft plus hollow screw fixation for anlde joint lusion can effectively improve ankle joint fusion rate compared with single screw fixation, which is effective and safe.
ABSTRACT
La luxación cerrada sin fractura asociada de tobillo es una entidad extremadamente rara. Se presenta el caso de un hombre de 35 años que se lesionó mientras jugaba fútbol. El tratamiento consistió en reducción cerrada seguido de inmovilización con una botina de yeso durante 6 semanas y descarga de la extremidad las primeras 10 semanas. A los 12 meses de seguimiento, el paciente había retomado la práctica deportiva con un rango de movimiento completo. Se revisó la bibliografía existente y se propone una nueva clasificación(AU)
Closed dislocation of ankle with no associated fracture is an extremely rare entity. A case of 35 year-old man who was injured while playing soccer is presented. The treatment consists of closed reduction followed by immobilization with a walking cast for 6 weeks and unloading of the injured extremity the first 10 weeks. At 12 months follow-up, the patient had reinitiated sport at full range of motion. The literature was reviewed and a new classification is proposed(AU)
La luxation fermée de cheville sans fracture associée est une affection très rare. Le cas d’un homme (35 ans) lésé en jouant au football est présenté. Le traitement a consisté en réduction fermée, suivie d’immobilisation par botte plâtrée pendant 6 semaines, et mise en décharge du membre inférieur les dix premières semaines. Douze mois après, le patient a repris la pratique sportive en un rang de mouvement complet. On a fait une revue de la littérature, et on propose une nouvelle classification(AU)
Subject(s)
Humans , Male , Adult , Athletic Injuries/etiology , Ankle Injuries , Joint Dislocations/classification , SoccerABSTRACT
PURPOSE: Ankle fusion that is operated on severe ankle arthritis has its weakness in that normal walking is impossible, even though the result is pretty good. As a alternative choice, total ankle replacement pursues the longer survivorship with material improvement. However, it is not yet known how much range of motion is possible after the replacement, or how it has changed overtime. Therefore, we need an analyzation for that. MATERIALS AND METHODS: A retrospective review of sixty-seven patients undergoing STAR total ankle replacement at our institution between 1998 and 2002 was conducted. Of those, twenty-six (39%) had complete sets of full dorsiflexion and plantar flexion lateral radiographs both between "immediate" postop and at a minimum of 2-years follow-up and no revision procedure during that time. The mean age of these patients was 63.2 years when the surgery was done; the etiology of arthrosis was 21(81%) post-traumatic/degenerative, 4 rheumatoid and 1 psoriatic. RESULTS: Average "immediate" ankle range of motion was 15.9 degrees, and total foot (non-ankle) motion was 20.6 degrees. At one, two, and three years the average ankle and total foot ranges of motion were 17.4 degrees, 17.6 degrees, 15.6 degrees and 21.0 degrees, 22.0 degrees, 21.2 degrees respectively. Statistically there was no significant difference between "immediate" postop motion and one to three years postop (all p>0.05). CONCLUSION: The range of motion after the STAR total ankle replacement is maintained from the "immediate" postoperative range of motion, but not increased, in the 1-3 year post replacement period.
Subject(s)
Humans , Ankle , Arthritis , Arthroplasty , Arthroplasty, Replacement, Ankle , Follow-Up Studies , Foot , Range of Motion, Articular , Retrospective Studies , Survival Rate , WalkingABSTRACT
[Objective]To evaluate the effect of fibula shortening on biomechanical characters of tibiotalar joint and prescribe the most acceptable extent of fibula shortening.[Method]Six fresh cadaveric specimens were disarticulated though the knee,and the soft tissues were removed from the knee to the level of the ankle joint.The position of the ankle joint during testing simulated the single leg stance phase of gait.Every group of specimen carried out a biomechanical test in the turn of intact,fibula 2mm shortening,4mm shortening,6mm shortening.The biomechanical change of the tibiotalar joint after fibular shortening was found.[Result]The total contact area of the tibiotalar joint tended to decrease in the fibular shortening model.The contact area and contact pressure in anteromedial and posteromedial quadrant tended to decrease,while,the contact area and contact pressure in anterolateral and posterolateral quadrant tended to increase.[Conclusion]The 2 mm fibular shortening(including 2 mm) significantly alter the biomechanical characters in tibiotalar joint.