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1.
Article in Spanish | LILACS, BINACIS | ID: biblio-1358106

ABSTRACT

El condroblastoma es un tumor óseo benigno infrecuente que representa el 1-2% de todos los tumores óseos primarios. Como aproximadamente solo el 4% se localiza en el astrágalo, la bibliografía es escasa. Se presenta a un varón de 18 años con un condroblastoma localizado en el astrágalo derecho. El paciente tuvo una buena evolución, sin complicaciones a los 15 meses de la cirugía. Revisamos los casos ya publicados para analizar la forma de presentación y la evolución luego del tratamiento quirúrgico. Nivel de Evidencia: IV


Chondroblastoma (CB) is a rare benign bone tumor that represents between 1% to 2% of all primary bone tumors. Because only abouy 4% of them are located in the talus, the literature is scarce. We present a case of an 18-year-old male patient who presents with a chondroblastoma located in the right talus. He had an uneventful recovery; with no complications at his last follow-up at 15 months. We also reviewed the published literature to discuss the diagnosis and treatment of chondroblastoma in the talus. Level of evidence: IV


Subject(s)
Adolescent , Talus , Chondroblastoma
2.
Article in Spanish | LILACS, BINACIS | ID: biblio-1358100

ABSTRACT

Introducción: Las fracturas del cuello del astrágalo son infrecuentes, pero la tasa de complicaciones y reintervenciones es alta. El objetivo de este estudio fue analizar y describir las complicaciones a mediano y largo plazo en 20 pacientes con fractura del cuello del astrágalo. Nuestra hipótesis fue que, en las lesiones graves, la reducción abierta y fijación interna genera una tasa alta de complicaciones que requerirán de nuevas intervenciones quirúrgicas. Materiales y métodos: Se evaluó a 20 pacientes con fractura del cuello del astrágalo: 6 Hawkins II (29%), 11 Hawkins III (52%) y 3 Hawkins IV (19%). El seguimiento promedio fue de 11 años. Se analizaron el tipo de fractura (simple o conminuta), las lesiones asociadas, las complicaciones y la necesidad o no de un nuevo procedimiento quirúrgico. Resultados: Once pacientes (55%) tenían lesiones asociadas y 14 (70%), conminución en el trazo de fractura. Quince (75%) sufrieron complicaciones. Nueve (45%) requirieron una segunda intervención para tratar la complicación. Conclusiones: Los factores más relacionados con el desarrollo de complicaciones y la necesidad de una nueva intervención son: conminución en el trazo de fractura, lesiones asociadas en el miembro inferior homolateral, fracturas tipos III y IV de Hawkins, y fracturas expuestas. Creemos que, en las lesiones graves del cuello del astrágalo (tipos III y IV de Hawkins) con uno o más de estos factores, la artrodesis primaria podría disminuir el riesgo de complicaciones y de nuevas cirugías, y acortar el tiempo de recuperación de los pacientes. Nivel de Evidencia: IV


Introduction: Talar neck fractures are rare but present a high rate of complications and reoperations. The objective of this work was to analyze and describe the complications in the medium and long term in 20 patients with talar neck fracture. Our hypothesis was that, in severe injuries, ORIF presents a high rate of complications that will require new surgical interventions. Materials and methods: We evaluated 20 patients with talar neck fracture: 6 Hawkins II (29%), 11 Hawkins III (52%), and 3 Hawkins IV (19%). The mean follow-up was 11 years. We analyzed the fracture pattern (simple or comminuted), the presence of associated injuries, complications, and the need to perform a new surgical procedure. Results: 11 (55%) had associated injuries and 14 (70%) had comminution in the fracture line. We presented complications in 15 patients (75%). 9 (45%) pa-tients required a second intervention to treat the complication. Conclusions: The factors most related to the development of complications and the need for a new intervention are: comminution in the fracture line, associated injuries in the ipsilateral lower limb, Hawkins type III and IV fractures, and exposed fractures. We believe that in severe talar neck injuries (Hawkins type III and IV) with one or more of these factors, primary arthrodesis reduces the risk of complications and new surgeries and shortens recovery time. Level of Evidence: IV


Subject(s)
Adult , Postoperative Complications , Talus/surgery , Talus/injuries , Treatment Outcome , Foot Injuries , Fractures, Bone
3.
Article in Spanish | LILACS, BINACIS | ID: biblio-1353891

ABSTRACT

Las luxaciones subastragalinas (periastragalinas) sin fractura asociada son un cuadro poco frecuente. Representan solo el 1% de las luxaciones en el ser humano. Presentamos tres casos de luxaciones mediales puras en pacientes que sufrieron un traumatismo de alta energía. En todos los casos, el tratamiento consistió en la reducción cerrada bajo anestesia y posterior inmovilización; la evolución fue satisfactoria. Las luxaciones subastragalinas requieren de un diagnóstico temprano y una rápida resolución. Con estos casos se quiere demostrar la importancia de la sospecha diagnóstica y el beneficio de un tratamiento precoz y acertado. Nivel de evidencia: IV


Isolated subtalar dislocations without associated fracture are a rare entity. They represent only 1% of dislocations in humans. We present a series of 3 cases of pure medial dislocations in patients who suffered high-energy trauma. In all cases, the treatment was closed reduction under anesthesia and subsequent immobilization; all with good results. Subtalar dislocations require early diagnosis and rapid resolution. The aim of this presentation is to demonstrate the importance of diagnostic suspicion and the benefit of early treatment for successful outcome. Level of evidence: IV


Subject(s)
Adult , Middle Aged , Talus/injuries , Joint Dislocations
4.
Rev. Asoc. Argent. Ortop. Traumatol ; 85(4): 303-304, dic. 2020.
Article in Spanish | LILACS, BINACIS | ID: biblio-1351405

Subject(s)
Osteochondritis , Talus
5.
Rev. Asoc. Argent. Ortop. Traumatol ; 85(4): 387-392, dic. 2020.
Article in Spanish | LILACS, BINACIS | ID: biblio-1351414

ABSTRACT

La fractura del cuerpo del astrágalo es un cuadro extremadamente raro en la población infantil, y se asocia con mecanismos de alta energía. Se trata de una lesión muy grave y tiene un manejo complejo para el cirujano ortopedista, no exento de complicaciones, como la necrosis avascular, la artrosis postraumática o la seudoartrosis. Presentamos a un niño de 10 años con una fractura-luxación del cuerpo del astrágalo, su manejo de urgencia, el tratamiento definitivo y la evaluación clínico-radiológica al año de la lesión. Nivel de Evidencia: IV


Talar body fractures are an extremely rare presentation in children that are associated with high-energy trauma. They constitute devastating injuries and a management challenge for orthopedic surgeons, which could be further complicated by avascular necrosis, post-traumatic arthritis, and non-union. We report a case of a fracture-dislocation of the talar body in a 10-year-old boy, including emergency management, definitive treatment, and 1-year follow-up clinical and radiologic findings. Level of Evidence: IV


Subject(s)
Child , Talus , Treatment Outcome , Fractures, Bone
6.
Rev. Asoc. Argent. Ortop. Traumatol ; 85(4): 447-450, dic. 2020.
Article in Spanish | LILACS, BINACIS | ID: biblio-1351420

Subject(s)
Osteochondritis , Talus
7.
Rev. chil. ortop. traumatol ; 61(2): 69-74, oct. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1342414

ABSTRACT

Las lesiones osteocondrales de la articulación subtalar es una patología infrecuente y de incidencia variable, dado su reporte principalmente como hallazgo en el estudio de dolor crónico de tobillo y ya con cambios degenerativos articulares. La sospecha clínica y el estudio imagenológico dirigido, permiten investigar esas lesiones en estadios iniciales, evitando así el uso de técnicas que no preservan la articulación para su manejo. La artroscopía subtalar es una excelente herramienta tanto diagnóstica como terapéutica para la resolución de dichas lesiones. Dadas las características anatómicas y biomecánicas de la articulación, en estadios iniciales, el manejo mediante sinovectomía y microfracturas es una alternativa con excelentes resultados funcionales. Este trabajo incluye dos casos de lesiones osteocondrales de la faceta posterior de la articulación subtalar manejadas vía artroscópica mediante sinovectomía y microfracturas y su posterior evolución.


Osteochondral lesions in the subtalar joint are an uncommon pathology with a variable incidence, being mainly reported as a finding in chronic ankle pain studies and with already visible degenerative joint changes at time of diagnosis. Clinical suspicion and directed imaging study, allows to investigate these lesions during early stages, thus avoiding the use of invasive techniques with scarce joint preservation. Subtalar arthroscopy is an excellent diagnostic and therapeutic tool for the resolution of these lesions. Given the anatomical and biomechanical characteristics of the joint, in the early stages the management by synovectomy and microfractures is an alternative with excellent functional results. This study includes two cases of osteochondral lesions of the posterior facet of the subtalar joint managed through arthroscopically synovectomy and microfractures and their subsequent evolution.


Subject(s)
Humans , Male , Adult , Middle Aged , Arthroscopy/methods , Subtalar Joint/surgery , Talus/surgery , Talus/injuries , Subtalar Joint/diagnostic imaging , Talus/diagnostic imaging , Fractures, Stress , Treatment Outcome , Synovectomy
8.
Int. j. morphol ; 38(4): 894-898, Aug. 2020. tab, graf
Article in English | LILACS | ID: biblio-1124872

ABSTRACT

SUMMARY: The Stieda process (SP) and os trigonum (OT) are primary risk factors for posterior ankle impingement syndrome. The aim of this study was to elucidate the prevalence of the elongated lateral tubercle of the posterior talar process (SP) and OT in Turkish subjects using lateral ankle radiographs. In this study, 1088 ankle radiographs in the lateral view were evaluated retrospectively using a picture archiving and communication system at two large medical centers. Subjects with a history of mild-to-moderate trauma were selected from the emergency departments of both hospitals from January to June 2019. Data on the presence of SP and OT, the side of the foot that was evaluated, sex, and age were recorded. The prevalence of SP and OT was 16.7 % and 9.3 %, respectively, in the Turkish population. The prevalence of SP was significantly higher in men (20.3 %) than in women (12.7 %) (p = 0.001). The prevalence of OT was also significantly higher in men (13.7 %) than in women (4.3 %) (p = 0.000). The SP and OT were found in 17 % and 9.9 % of the right feet, respectively, and 16.4 % and 8.6 % of the left feet, respectively, with no statistical difference. Approximately one-fourth of the Turkish population had SP or OT, which made them susceptible to posterior ankle impingement syndrome. The prevalence of SP was higher than that of OT, and both were more common in men than in women.


RESUMEN: El proceso de Stieda (Stieda process) (SP) y el Os trigonum (OT) son factores de riesgo primarios para el síndrome de pinzamiento del tobillo posterior. El objetivo de este estudio fue determinar la prevalencia del tubérculo lateral alargado del proceso talar posterior (SP) y OT en sujetos turcos mediante radiografías laterales de tobillo. Se evaluaron retrospectivamente 1088 radiografías de tobillo con vista lateral, utilizando un sistema de archivo y comunicación de imágenes en dos centros médicos importantes. Los sujetos con antecedentes de trauma leve a moderado fueron seleccionados en las unidades de urgencia de ambos hospitales de enero a junio de 2019. Se registraron datos sobre la presencia de SP y OT, el lado del pie que se evaluó, el sexo y la edad. La prevalencia de SP y OT fue de 16,7 % y 9,3 %, respectivamente, en la población turca. La prevalencia de SP fue significativamente mayor en hombres (20,3 %) que en mujeres (12,7 %) (p = 0,001). La prevalencia de OT también fue significativamente mayor en hombres (13,7 %) que en mujeres (4,3 %) (p = 0,000). El SP y OT se encontraron en 17 % y 9,9 % de los pies derechos, respectivamente, y 16,4 % y 8,6 % de los pies izquierdos, respectivamente, sin diferencia estadística. Aproximadamente un cuarto de la población turca tenía SP u OT, lo que los hizo susceptibles al síndrome de pinzamiento del tobillo posterior. La prevalencia de SP fue mayor que la de OT, y ambos fueron más comun en hombres que en mujeres.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Ankle/abnormalities , Ankle/diagnostic imaging , Turkey , Radiography , Talus , Prevalence , Retrospective Studies
9.
Int. j. morphol ; 38(2): 472-476, abr. 2020. graf
Article in Spanish | LILACS | ID: biblio-1056464

ABSTRACT

El ligamento tibiofibular anterior suele presentar un fascículo distal independiente de la banda principal, denominado fascículo distal del ligamento tibiofibular anterior (FD-LTFA). Este discurre oblicuamente, cubriendo sus fibras más inferiores la zona anterolateral de la articulación talocrural. Su presencia se asocia a pellizcamiento del tobillo en esta zona, el cual puede producir un desgaste cartilaginoso de la cara anterolateral de la tróclea talar. El propósito de este estudio fue determinar la presencia y biometría del FD-LTFA, y su relación con la troclea talar en tobillos de un grupo de individuos Chilenos. En este estudio se utilizaron 30 miembros inferiores de cadáveres de individuos adultos. Se evaluó en el fascículo distal: Ancho en la inserción tibial, ancho en la inserción fibular, longitud del margen superior, longitud del margen inferior y el espesor. Se determinó si había contacto talar por parte del FD-LTFA y se observó desgaste articular en la superficie del domo talar, a nivel de la región de contacto del mencionado ligamento. El FD-LTFA fue encontrado en un 76,7 % de los casos, su anchura a nivel del sitio de fijación tibial fue de 5,30 mm (± 1,4) y a nivel fibular 4,43 mm (± 0,85). En cuanto a su longitud en el margen superior fue de 14,26 mm (± 3,66) y a nivel del margen inferior fue de 16,74 mm (± 2,91). Su espesor fue de 2,1 mm (± 0,36). En las 23 muestras de tobillo con presencia del FD-LTFA, hubo contacto talar en el 100 % de los casos y desgaste articular en esta zona en 3 de ellas (13,04 %). Los datos biométricos aportados por este estudio complementarán el conocimiento anatómico del FD-LTFA en la población Chilena.


The anterior tibiofibular ligament usually presents an independent distal fascicle of the main band, denominated distal fascicle of the anterior tibiofibular ligament (DF-ATiFL). Which obliquely passes, covering its most inferior fiber to the anterolateral corner of the talocrural articulation. Its presence is associated with the anterolateral impingement of the ankle in this area, which can produce cartilage wear of the anterolateral surface of the talar trochlea. The purpose of this study was to determine the presence and biometry of DF-ATiFL and its relation with the talar trochlea on the ankles of a group of Chilean individuals. Thirty inferior members were used in this study, all from adult individuals. It was evaluated: Width of the tibial insertion, width of the fibular insertion, length of the top margin, length of the bottom margin, and the thickness. It was determined whether there was talar contact by the distal fascicle of the anterior tibiofibular ligament. Also, it was observed the articular wear on the surface of the talar dome, at the level of the contact region of the distal fascicle of the anterior tibiofibular ligament. The DFATiFL was found in 76.7 % of the cases, its width at the level of the place of tibial fixation was 5.30 mm (± 1.40), and at the fibular level 4.43 mm (± 0.85). Regarding its length on the top margin was 14.26 mm (± 3.66), and at the bottom, the margin level was 16.74 mm (± 2.91). Its thickness was 2.1 mm (± 0.36). In the 23 ankles samples with the presence of DF-ATiFL, there was talar contact in 100 % of the cases and articular wear in this area in 3 of them (13.04 %). The biometric data contributed by this study will supplement the anatomical knowledge of the distal fascicle of the anterior tibiofibular ligament on the Chilean population.


Subject(s)
Humans , Tibia/anatomy & histology , Fibula/anatomy & histology , Ligaments/anatomy & histology , Ankle/anatomy & histology , Talus/anatomy & histology
10.
Rev. chil. ortop. traumatol ; 61(3): 94-100, 2020. ilus, tab
Article in Spanish | LILACS | ID: biblio-1177770

ABSTRACT

OBJETIVO Mostrar una fractura infrecuente del tubérculo posteromedial del astrágalo diagnosticado y tratado de manera aguda mediante osteosíntesis con tornillo Acutrak® (2014 Acumed® LLC). MATERIAL Y MÉTODOS Varón de 28 años, que acude a Urgencias tras torcedura de tobillo con dolor al mover tobillo y hallux y tumefacción en cara interna. En Urgencias pasó desapercibida. En consulta a la semana refería sensación de que se le engancha el primer dedo con la flexoextensión. Se observa fractura del tubérculo medial de la apófisis posterior del astrágalo con desplazamiento >3mm y clínica de posible interposición del flexor hallucis longus. Se decidió tratamiento quirúrgico con tornillo Acutrak®. Se inmovilizó con férula 3 semanas y descarga 6 semanas. RESULTADOS A los 8 meses balance articular completo, sin dolor ni limitación para las ABVD y sin clínica de atrapamiento del flexor del hallux. Como complicación aguda, se verificó infección de herida quirúrgica que se trató con antibióticos. DISCUSIÓN Ese tipo de fracturas son infrecuentes. El mecanismo lesional suele ser dorsiflexión-pronación. Es importante un diagnóstico temprano y para ello es necesario una alta sospecha diagnóstica. Para su diagnóstico, son necesarias radiografías anteroposterior y lateral y si no se visualiza la lesión, proyección oblicua con 30°- 40° de rotación externa. En casos agudos resulta de utilidad la TAC y en casos crónicos la RM. CONCLUSIÓN Aunque generalmente el tratamiento es conservador, en ocasiones puede ser necesario la cirugía mediante osteosíntesis o exéresis del fragmento cuando la fractura provoca impingement.


OBJECTIVE Show an infrequent fracture of the posteromedial tubercle of the talus diagnosed and treated acutely by Acutrak® screw (2014 Acumed® LLC) osteosynthesis. MATERIAL AND METHODS A 28-year-old man attended the Emergency Department after spraining his ankle with pain when moving his ankle and hallux and swelling on the internal face. In the ER it went unnoticed. A week later in the clinic, he refered to the sensation that the first finger is hooked with the flexion extension. A fracture of the medial tubercle of the posterior process of the talus is observed with a displacement of > 3 mm and clinical signs of possible interposition of the hallucis longus . Surgical treatment with Acutrak® screw was made. He was immobilized with a splint for 3 weeks and discharge for 6 weeks. RESULTS At 8 months complete joint balance, without pain or limitations for BADL and without hallux flexor entrapment symptoms. As an acute complication, surgical wound infection that was treated with antibiotics. DISCUSSION These types of fractures are rare. The injury mechanism is usually dorsiflexion-pronation. Early diagnosis is important and a high diagnostic suspicion is required. Anteroposterior and lateral radiographs are necessary for its diagnosis and if the lesion is not visualized, oblique projection with 30°- 40° external rotation. CT is useful in acute cases and MRI in chronic cases. CONCLUSION Although the treatment is conservative, surgery may sometimes be necessary by means of osteosynthesis or excision of the fragment when the fracture causes impingement.


Subject(s)
Humans , Male , Adult , Talus/surgery , Fractures, Bone/surgery , Fractures, Bone/diagnosis , Fracture Fixation, Internal/methods , Bone Screws , Talus/injuries , Talus/diagnostic imaging , Early Diagnosis
11.
Einstein (Säo Paulo) ; 18: e0AO5052, 2020. graf
Article in English | LILACS | ID: biblio-1090065

ABSTRACT

ABSTRACT Objective To compare screw fixation strength for subtalar arthrodesis. Methods Eight matched pairs of cadaver feet underwent subtalar joint arthrodesis with two 7.3mm cannulated screws. Randomization was used to assign screw orientation, such that one foot in each pair was assigned dorsal to plantar screw orientation (DP Group), and the other foot, plantar to dorsal orientation (PD Group). Standard surgical technique with fluoroscopy was used for each approach. Following fixation, each specimen was loaded to failure with a Bionix ® 858 MTS device, applying a downward axial force at a distance to create torque. Torque to failure was compared between DP and PD Groups using Student's t test, with p=0.05 used to determine statistical significance. Results Statistical analysis demonstrated that the mean torque to failure slightly favored the DP Group (37.3Nm) to the PD Group (32.2Nm). However, the difference between the two groups was not statistically significant (p=0.55). Conclusion In subtalar arthrodesis, there is no significant difference in construct strength between dorsal-to-plantar and plantar-to-dorsal screw orientation. The approach chosen by the surgeon should be based on factors other than the biomechanical strength of the screw orientation.


RESUMO Objetivo Comparar a força de fixação dos parafusos para artrodese subtalar. Métodos Oito pares de pés de cadáveres frescos foram submetidos à artrodese da articulação subtalar com dois parafusos canulados de 7,3mm. A randomização foi usada para atribuir a orientação do parafuso, de modo que um pé em cada par foi designado com orientação de dorsal para plantar (Grupo DP), e o outro pé com orientação de plantar para dorsal (Grupo PD). Técnica cirúrgica padrão com radioscopia foi usada para os procedimentos. Após a fixação, cada amostra foi testada até a falha com um dispositivo Bionix®858 MTS, aplicando força axial descendente a uma distância para criar torque. O torque de falha foi comparado entre os Grupos DP e PD, usando o teste t de Student, com p=0,05 usado para determinar significância estatística. Resultados A análise estatística demonstrou que a média do torque até a falha favoreceu ligeiramente o Grupo DP (37,3Nm) em relação ao PD (32,2Nm). No entanto, a diferença entre os dois grupos não foi estatisticamente significativa (p=0,55). Conclusão Na artrodese subtalar, não há diferença significativa na força de compressão entre as orientações dos parafusos dorsal-plantar e plantar-dorsal. A abordagem escolhida pelo cirurgião deve ser baseada em outros fatores, sem preocupação com a força biomecânica da orientação dos parafusos.


Subject(s)
Humans , Arthrodesis/methods , Bone Screws , Subtalar Joint/surgery , Arthrodesis/instrumentation , Biomechanical Phenomena , Cadaver , Calcaneus/surgery , Talus/surgery , Reproducibility of Results , Treatment Failure , Torque
12.
Article in Chinese | WPRIM | ID: wpr-776143

ABSTRACT

OBJECTIVE@#To evaluate clinical effect of autogenous iliac bone graft in treating osteochondral lesion of the talus with subchondral cyst.@*METHODS@#Twenty-two osteochondral lesion of talus patients with subchondral cyst were collected from January 2011 to December 2014, including 18 males and 4 females aged from 34 to 58 years old with an average of (46.4± 6.9) years old. All patients manifested pain and swelling of ankle joint, 7 patients manifested partially limited activity of ankle joint, 2 patients manifested unstable of ankle joint, and 2 patients manifested poor force line of foot. All lesions located on the medial side of talus dome. The area of cartilage injury ranged from 64 to 132(101.6±27.1) mm2, and diameter of subchondral cyst ranged from 9 to 15(10.5±1.8) mm. VAS score and AOFAS score were used to evaluate pain releases and recovery of ankle joint function before operation, 12 and 24 months after operation. Healing condition of autograft was assessed under arthroscopy after removal of internal fixation at 1 year after operation.@*RESULTS@#All patients were followed up from 24 to 60 months with an average of(42.5±9.9) months. Postoperative MRI at 12 months showed autograft healed well but little cyst still seen. Bone grafting and talus healed well, and formation of fibrocartilage well under arthroscopy. Postoperative MRI at 24 months showed combination of bone grafting and surrounding bone well, and small cyst could seen but less than before. VAS score at 12 months after operation 2.8±0.8 was less than that of before operation 6.2±1.5, but had no differences compared with 24 months after operation 2.6 ±0.8 (>0.05). AOFAS score at 12 months after operation 83.0±5.6 was less than that of before operation 55.3±13.7, but had no differences compared with 24 months after operation 83.7±6.6(>0.05).@*CONCLUSIONS@#Autogenous iliac bone graft in treating osteochondral lesion of the talus with subchondral cyst could have a good synosteosis and fibrous cartilage on surface, and relieve clinical symptoms.


Subject(s)
Adult , Ankle Joint , Arthroscopy , Bone Cysts , General Surgery , Bone Transplantation , Cartilage, Articular , Female , Humans , Male , Middle Aged , Talus , Treatment Outcome
13.
Yonsei Medical Journal ; : 882-886, 2019.
Article in English | WPRIM | ID: wpr-762117

ABSTRACT

Ameloblastoma in the tibia is rare. Limb reconstruction after tumor resection is challenging in terms of selection of the operative method. Here, we report a case of radical resection of an ameloblastoma in the mid-distal tibia combined with limb salvage using a three-dimensional (3D)-printed prosthesis replacement, with 1-year follow-up results. After receiving local institutional review board approval, a titanium alloy prosthesis was designed using a computer and manufactured with 3D-printing technology. During the operation, the stem of the prosthesis was inserted closely into the proximal tibial medullary cavity. Then, the metal ankle mortise and the talus were compacted closely. Radiographic results at 1-year follow up showed that the prosthesis was well placed, and no loosening was observed. The Musculoskeletal Tumor Society (MSTS) 93 functional score was 26 points, and the functional recovery percentage was 86.7%. Computer-assisted 3D-printing technology allowed for more volume and structural compatibility of the prosthesis, thereby ensuring a smooth operation and initial prosthetic stabilization. During the follow up, the presence of bone ingrowths on the porous surface of some segments of the prosthesis suggested good outcomes for long-term biological integration between the prosthesis and host bone.


Subject(s)
Alloys , Ameloblastoma , Ankle , Ethics Committees, Research , Extremities , Follow-Up Studies , Limb Salvage , Methods , Prostheses and Implants , Talus , Tibia , Titanium
14.
Article in Korean | WPRIM | ID: wpr-738418

ABSTRACT

Chondroblastoma is a rare benign tumor that produces giant cells and cartilage matrix. The tumor occurs in people between 10 and 25 years with slightly higher incidence in males. The condition occurs in the proximal epiphysis of the tibia and humerus, distal epiphysis of the femur, but its occurrence in the talus is relatively rare, accounting for 4% of the total number of chondroblastoma cases. Chondroblastoma is often misdiagnosed as a primary aneurysmal bone cyst, giant cell tumor, chondromyxoid, and lesion of a secondary aneurysmal bone cyst by fibrous dysplasia. The most commonly used surgical method for chondroblastoma is broad curettage with bone grafting. In general, an aneurysmal bone cyst is associated with a second degree chondroblastoma, which is approximately 20%. Chondroblastoma of the talus and secondary aneurysmal bone cysts can be misdiagnosed as primary aneurysmal bone cysts. This paper reports a case of a young male patient with chondroblastoma of the talus, which was initially misdiagnosed as an aneurysmal bone cyst with involvement of the talo-navicular joint.


Subject(s)
Aneurysm , Bone Cysts , Bone Cysts, Aneurysmal , Bone Transplantation , Cartilage , Chondroblastoma , Curettage , Epiphyses , Femur , Giant Cell Tumors , Giant Cells , Humans , Humerus , Incidence , Joints , Male , Methods , Talus , Tibia
15.
Article in Korean | WPRIM | ID: wpr-764828

ABSTRACT

Despite the increasing number of osteochondral lesions of the talus, there are a lack of definite evidence-based treatment protocols. Several types of treatments are available, each having their advantages and disadvantages. First-line therapy consists of well-conducted conservative treatment. Surgical treatment is the second choice. Treatments are chosen based on the size of the lesion, location, chronicity, and the condition of the neighboring cartilage. This article reviews the current updates in the treatment of osteochondral lesions of the talus to help clinicians use the available treatment strategies more efficiently.


Subject(s)
Cartilage , Chondrocytes , Clinical Protocols , Joints , Talus
16.
Artrosc. (B. Aires) ; 26(2): 67-73, 2019.
Article in Spanish | LILACS, BINACIS | ID: biblio-1016586

ABSTRACT

Introducción: El osteoma osteoide (OO) es el tumor osteoblástico benigno más frecuente. La ubicación en el astrágalo es del 2 al 10%. La resección es la única opción curativa. Presentamos una serie de 2 casos de osteoma osteoide en cuello del astrágalo con resección artroscópica y radiofrecuencia como tratamiento. Material y Métodos: Presentamos dos pacientes de 23 y 24 años, con dolor crónico en tobillo e imágenes por tomografía y resonancia compatibles con osteoma osteoide. Resultados: Los pacientes evolucionaron favorablemente, con una mejoría notable del score AOFAS, recuperación completa del cuadro y sin recidivas a los 18 meses de seguimiento. Discusión: El diagnóstico suele ser tardío, siendo el primer síntoma el dolor de predominio nocturno y que alivia con el uso de salicilatos. La extirpación artroscópica del OO del tobillo puede ser un procedimiento exitoso con mínimas complicaciones, siendo el tumor fácil de localizar y visualizar. Conclusión: Obtuvimos resultados satisfactorios para el paciente, con tiempos de recuperación breves y menor riesgo de infección. El procedimiento muy recomendable. Tipo de estudio: Serie de casos. Nivel de Evidencia: V


Introduction: Osteoid osteoma (OO) is the most frequent benign osteoblastic tumor. The location in the talus is 2 to 10%. Resection is the only curative option. We present arthroscopic resection and use of radiofrequency as treatment. Material and methods: We present two patients aged 23 and 24 years, with chronic ankle pain, computed tomography and magnetic resonance images compatible with osteoid osteoma. Results: Patients showed complete recovery after procedures, with an notable improvement of AOFAS and no recurrence after a follow-up of 18 months. Discussion: Late diagnosis is usually due to the first symptom being a pain, with nocturnal predominance and relieved by the use of salicylates. Arthroscopic removal of the OO of the ankle can be a successful procedure with minimal complications, being easy to locate and completely visualize the tumor. Conclusion: We obtained satisfactory postoperative results, with short recovery times and decreased risks of infection. We highly recommend the procedure. Type of study: Case series. Level of Evidence: V


Subject(s)
Adult , Osteoma, Osteoid , Arthroscopy/methods , Bone Neoplasms/surgery , Talus/pathology , Radiofrequency Therapy
17.
Int. j. morphol ; 36(4): 1368-1371, Dec. 2018. tab, graf
Article in Spanish | LILACS | ID: biblio-975710

ABSTRACT

El tubérculo lateral del proceso posterior del talo se fusiona generalmente con el cuerpo de este hueso, sin embargo, debido al estrés (flexión plantar forzada) aplicado durante los años de la adolescencia o cuando un centro osificado parcialmente e incluso totalmente osificado se fractura, se provoca una falta de unión, dando lugar a un hueso accesorio denominado Os trigonum (OT). En algunos casos puede producirse el síndrome os trigonum o síndrome de pinzamiento posterior, el cual se caracteriza por un dolor agudo o crónico de la región posterior del tobillo. Basado en lo anterior, se realizó un estudio retrospectivo entre el período de Agosto de 2017 a Mayo de 2018, en el cual se analizaron radiografías bilaterales de 205 pacientes concurrentes al Hospital Hernán Henríquez Aravena de Temuco, Chile. De la población estudiada, 154 fueron de sexo femenino y 51 de sexo masculino cuyas edades fluctuaron entre los 15 y 85 años, Las proyecciones radiológicas utilizadas fueron de pie lateral, tobillo lateral o calcáneo lateral, para así para determinar la prevalencia de OT y contribuir acerca de su distribución en pie derecho e izquierdo y aparición según sexo y edad. Del total de la muestra, se encontraron 24 individuos que presentaban OT (11,7 %) de los cuales 18 (75 %) correspondían al sexo femenino y 6 (25 %) al sexo masculino. Además se realizaron mediciones del largo y ancho del OT. Los datos obtenidos son una contribución al conocimiento de los huesos accesorios del pie en la población chilena.


The lateral tubercle of the posterior process of the talus is generally fused with the body of this bone, however, due to stress (forced plantar flexion) applied during the adolescent years. Also, when a partially ossified and even fully ossified center fractures, it causes a lack of union, giving rise to an accessory bone called Os trigonum (OT). In some cases Os trigonum syndrome or posterior impingement syndrome may occur, which is characterized by acute or chronic pain in the posterior region of the ankle. Based on the above, a retrospective study was conducted between August 2017 and May 2018, in which bilateral radiographs of 205 patients attending the Hernán Henríquez Aravena Hospital of Temuco were analyzed. Of the population studied, 154 were female and 51 were male, whose ages fluctuated between 15 and 85 years. The radiological projections used were lateral foot, lateral ankle and calcaneus lateral, to determine the prevalence of OT and provide information about its distribution in right and left foot and appearance according to sex and age. From the total sample, 24 individuals were found who had OT (11.7 %) of which 18 (75 %) corresponded to the female sex and 6 (25 %) to the male sex. In addition, measurements of the length and width of the OT were made. The data obtained is a contribution to the knowledge of the accessory bones of the foot in the Chilean population.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Talus/pathology , Talus/diagnostic imaging , Chile , Prevalence , Retrospective Studies , Age and Sex Distribution
18.
Int. j. morphol ; 36(3): 975-978, Sept. 2018. tab, graf
Article in English | LILACS | ID: biblio-954217

ABSTRACT

Patterns and variant morphometries of calcaneal articular facets on talus are concerned before performing of joint ankle surgery, including used as a sex determination. Types of talar facets have been documented in many populations except in Thai race. Therefore, this study attempted to classify the types of talus facets and to measure the facet lengths on dried tali of Thais. The 372 dried tali (204 males, 168 females) from Khon Kaen University Bone Collection were observed for variant types and measured for their facet lengths. The facets were classified into 6 types: type I, tree facet are separated (1.88 %); type II (A), the anterior and middle facets are partially connected with predominant ridge (34.68 %); type II (B), the anterior and middle facets are partially connected with slight ridge (32.53 %); type III, the anterior and middle facets are fully fused to form a single facet (2.96 %); type IV, the anterior and middle facets are partially separated by a ridge and partly by a groove (27.42 %); type V, all facets are continuous fused to form a single facet (0.54 %). In addition, the morphometric lengths of AP (anterior to posterior process) and ML1&2 (medial to lateral process) in male are significantly greater than those of female. The AP, ML, and ML2 of male are 56.71±0.16, 41.63±0.18, and 37.85±0.36 mm, while of female are 51.21±0.12, 37.74±0.16, and 33.85±0.28 mm, respectively. This incidence can be used as ankle surgery consideration and an anthropological marker for sex determination of unidentified talus.


Los patrones y las variantes morfométricas de las facetas articulares calcáneas en el talus deben considerarse antes de la realización de la cirugía del tobillo a nivel articular, incluido su uso para la determinación del sexo. Se han documentado los tipos de facetas en el talus en muchas poblaciones, excepto en la raza tailandesa. Por lo tanto, este estudio clasificó los tipos de facetas del talus y se midieron las longitudes de las facetas del talus, en muestras secas de indiviuos tailandeses. Se analizaron 372 talus secos (204 de hombres, 168 de mujeres) de la colección de huesos de la Universidad Khon Kaen, se observaron distintos tipos de variantes y se midieron las longitudes de las facetas. Las facetas se clasificaron en 6 tipos: tipo I, faceta de árbol separadas (1,88 %); tipo II (A), facetas anterior y media parcialmente conectadas con la cresta predominante (34,68 %); tipo II (B), facetas anterior y media están parcialmente conectadas con una ligera cresta (32,53 %); tipo III, facetas anterior y media están completamente fusionadas para formar una sola faceta (2,96 %); tipo IV, facetas anterior y media están parcialmente separadas por una cresta y en parte por una ranura (27,42 %); tipo V, todas las facetas se fusionan continuamente para formar una sola faceta (0,54 %). Además, las longitudes morfométricas del proceso anterior o posterior (AP) y del proceso medial a lateral (ML1 y ML2) en el varón son significativamente mayores que las de la mujer. El AP, ML1 y ML2 de los hombres son 56,71 ± 0,16, 41,63 ± 0,18 y 37,85 ± 0,36 mm, mientras que las mujeres son 51,21 ± 0,12, 37,74 ± 0,16 y 33,85 ± 0,28 mm, respectivamente. Esta incidencia se puede utilizar como una consideración en la cirugía de tobillo y un marcador antropológico para determinar el sexo del talus no identificado.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Calcaneus/anatomy & histology , Talus/anatomy & histology , Thailand
19.
Rev. Asoc. Argent. Ortop. Traumatol ; 83(2): 118-123, jun. 2018. []
Article in Spanish | LILACS, BINACIS | ID: biblio-956427

ABSTRACT

Una luxación peritalar implica la ruptura simultánea de las articulaciones talocalcánea y talonavicular. Es relativamente poco frecuente y representa aproximadamente del 1% al 1,5% de todas las lesiones traumáticas del pie. La luxación medial es la más frecuente (alrededor del 80% de los casos comunicados). Las luxaciones peritalares laterales son menos frecuentes (17%) y las posteriores (2,5%) y anteriores son raras (1%). Aproximadamente el 55% del subtipo medial y el 72% del subtipo lateral se asocian con fracturas. Se presenta el caso de una mujer de 36 años que sufrió un traumatismo indirecto practicando kitesurf al caerse de la tabla tratando de evitar un accidente. Sufrió una luxación peritalar lateral con fracturas de escafoides tarsiano, calcáneo y peroné asociadas. A los tres días, se intentó una reducción cerrada y a los seis días, se realizó la cirugía. Se recomienda un diagnóstico precoz de las luxaciones peritalares y un rápido reconocimiento de las fracturas asociadas e infrecuentes, con el fin de evitar complicaciones frecuentes. Nivel de Evidencia: IV


A peritalar dislocation involves simultaneous disruption of the talocalcaneal and talonavicular joints. It is relatively uncommon and account for approximately 1% to 1.5% of all traumatic foot injuries. Medial dislocation is the most frequent type accounting for approximately 80% of reported cases. Lateral peritalar dislocations are less common (17%), and posterior (2.5%) and anterior dislocations are rare (1%). Approximately 55% of medial and 72% of lateral subtypes are associated with fractures. We report the case of a 36-year-old woman who suffered an indirect traumatism during kitesurf practice, after falling from the kite-board trying to avoid an accident. She presented a lateral peritalar dislocation with associated navicular, calcaneal and fibular fractures. A closed reduction was attempted three days from trauma. Six days after the lesion, surgery was performed. We recommend an early diagnosis of peritalar dislocations and a correct recognition of infrequent fractures to avoid usual complications. Level of Evidence: IV


Subject(s)
Adult , Talus/injuries , Fracture Dislocation/surgery , Ankle Injuries/surgery
20.
Article in Chinese | WPRIM | ID: wpr-776176

ABSTRACT

OBJECTIVE@#To analyze the operative methods and clinical effects of autologous distal tibial cancellous bone graft with periosteum in treating cartilage injury of talus with Hepple III-IV type.@*METHODS@#From June 2014 to August 2017, 25 patients (25 feet) with Hepple III to IV cartilage injury of talus were treated with autogenous ipsilateral distal tibial cancellous bone graft. Including 14 males and 11 females, aged from 18 to 52 years with an average of (38.4±3.1) years; left foot was in 8 cases and right foot was in 17 cases. According to Hepple classification, type III of 9 cases, type IV of 16 cases. The curative effect was assessed by Amercian orthopedic foot and ankle society (AOFAS) and visual analogue scale (VAS) before operation and 12 months after operation.@*RESULTS@#All 25 patients were followed up for 12 to 28 months with an average of (14.2±2.5) months. AOFAS and VAS scores were improved from preoperative 53.02±10.06, 8.02±1.14 to 88.04±7.45, 1.26±1.74 at 12 months after operation (<0.05). According to AOFAS standard, 16 cases got excellent results, 6 good, 3 poor.@*CONCLUSIONS@#Autologous distal tibial cancellous bone graft with periosteum is an effective method for Hepple III-IV cartilage injury of talus. It can effectively relieve ankle pain and improve ankle joint function.


Subject(s)
Adolescent , Adult , Bone Transplantation , Cancellous Bone , Cartilage , Female , Humans , Male , Middle Aged , Periosteum , Talus , Transplantation, Autologous , Treatment Outcome , Young Adult
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