ABSTRACT
Early designs of Total Ankle Replacement (TAR) had a high failure rate. More recent experience with the 3-piece, meniscal bearing, total ankle replacement has been more promising. We report a review of the early results of our first 22 prostheses in 20 patients undergoing Scandinavian Total Ankle Replacement (STAR) in Northern Ireland. There was a mean follow-up time of 26 months. Seventeen patients are pain-free at the ankle joint during normal daily activities. Two of the early cases have required revision surgery due to technical errors. Other complications have included malleolar fractures, poor wound healing and postoperative stiffness. These early results show high levels of patient satisfaction, and we are encouraged to continue with total ankle arthroplasty. There is a steep initial learning curve and use of TAR should be restricted to foot and ankle surgeons.
Subject(s)
Ankle Joint/surgery , Arthroplasty, Replacement/instrumentation , Prostheses and Implants , Adult , Aged , Female , Humans , Male , Middle Aged , Prosthesis Design , Treatment OutcomeABSTRACT
We describe a case series involving a very unusual injury in children, i.e. a Milch 1 fracture of the lateral condyle with an associated dislocation of the elbow. This fracture configuration is normally stable as the intact capitellotrochlear groove serves as a lateral buttress for the coronoid-olecranon ridge of the ulna. In this series, however, each patient had an associated dislocation. These injuries usually present as a clinical dislocation and if the elbow is manipulated before radiographic imaging, the fracture line can be difficult to see on the post-reduction films. We recommend that all patients with a dislocated elbow should have elbow stability assessed under general anaesthesia, because a missed lateral condylar injury can lead to abnormalities in carrying angle, epiphyseolysis or an unstable elbow.