RESUMO
Ankle fractures are important injuries involving a weight-bearing joint critical to mobility. This article will discuss the necessity of and justification for surgical correction of virtually all ankle fractures. Various ankle fracture types will be explored, mechanisms illuminated and proper treatment outlined for these complex injuries.
Assuntos
Traumatismos do Tornozelo/terapia , Traumatismos do Tornozelo/diagnóstico por imagem , Traumatismos do Tornozelo/fisiopatologia , Traumatismos do Tornozelo/cirurgia , Fenômenos Biomecânicos , Parafusos Ósseos , Fíbula/lesões , Fixação Interna de Fraturas , Fraturas Ósseas/classificação , Fraturas Ósseas/diagnóstico por imagem , Fraturas Ósseas/fisiopatologia , Fraturas Ósseas/cirurgia , Humanos , Osteoartrite/epidemiologia , Radiografia , Tálus/lesões , Resultado do Tratamento , Suporte de Carga , CicatrizaçãoRESUMO
The nature of the pilon fracture has caused evolution of treatment methods and its historically high rate of complication and poor outcome continue to direct choice of treatment. Attention to the delicate soft tissue envelope surrounding the ankle and recognition of the severity of the initial injury is crucial to ensure a satisfactory outcome and to minimize complications. Understanding the importance of staging surgical interventions will help to improve outcomes, but even optimal treatment may result in less than satisfactory results.
Assuntos
Fraturas Cominutivas/cirurgia , Fraturas da Tíbia/cirurgia , Fenômenos Biomecânicos , Transplante Ósseo , Fixadores Externos , Fíbula/lesões , Fraturas Ósseas/classificação , Fraturas Cominutivas/diagnóstico por imagem , Humanos , Radiografia , Lesões dos Tecidos Moles/cirurgia , Fraturas da Tíbia/diagnóstico por imagem , Fraturas da Tíbia/fisiopatologiaRESUMO
Congenital transverse deficiency is a rare structural anomaly, primarily occurring in utero. Even though it is rare, congenital transverse deficiency is seen in the private practice setting, and many physicians may be unprepared to make the diagnosis or offer treatment. Furthermore, congenital transverse deficiencies, particularly of the lower extremity, are given little attention in literature. This article briefly highlights congenital transverse deficiencies and discusses the differences and similarities between true Ainhum and congenital transverse deficiency. It provides a case presentation in the hope of helping readers understand, identify, and treat patients who have such afflictions.
Assuntos
Síndrome de Bandas Amnióticas/patologia , Pé/patologia , Adulto , Idade de Início , Constrição Patológica , Deformidades Adquiridas do Pé/diagnóstico , Humanos , Recém-NascidoRESUMO
Fractures of the forefoot are common injuries of various causes. Although not crippling, forefoot fractures can be debilitating if they go undiagnosed or are mistreated. Whenever patients complain of foot pain with ambulation or difficulty ambulating, radiographs should be taken as part of a standard routine to assess for bony pathology. This article discusses the classification and treatment of metatarsal fractures, digital and sesamoid fractures, and open fractures about the forefoot.
Assuntos
Antepé Humano/lesões , Ossos do Metatarso/lesões , Síndromes Compartimentais/etiologia , Síndromes Compartimentais/cirurgia , Fraturas Ósseas/complicações , Fraturas Ósseas/cirurgia , Fraturas Expostas/complicações , Fraturas Expostas/cirurgia , Humanos , Ossos do Metatarso/cirurgiaRESUMO
Although ankle injuries are common, it is imperative for the treating physician to be able to identify the mechanism of injury and accurately restore the normal anatomy of the ankle joint. Attention must be given to restoring the normal alignment and length of the fibula because of its dominant role in controlling talar stability. The medial ankle must not be overlooked, with the role of the deltoid taken into consideration. With a thorough understanding of the anatomy, biomechanics, mechanism of injury, and fixation techniques, repair of the damaged ankle joint can lead to rewarding outcomes for the patient and physician.
Assuntos
Traumatismos do Tornozelo/cirurgia , Fraturas Ósseas/cirurgia , Traumatismos do Tornozelo/classificação , Traumatismos do Tornozelo/diagnóstico , Fraturas Ósseas/classificação , Fraturas Ósseas/diagnóstico , HumanosRESUMO
The management of delayed union and nonunion is complex and is contingent on appropriate diagnosis and classification. Detection techniques and treatment options, including cast immobilization, electrical stimulation, surgical repair, or a combination of regimens, are discussed in this article.
Assuntos
Artrodese/métodos , Mau Alinhamento Ósseo/cirurgia , Artrodese/efeitos adversos , Mau Alinhamento Ósseo/fisiopatologia , Mau Alinhamento Ósseo/terapia , Terapia por Estimulação Elétrica , Humanos , Reoperação , Cicatrização/fisiologiaRESUMO
Pantalar arthrodesis is a demanding procedure that serves a useful purpose for stabilization of the ankle, rearfoot, and midfoot. These fusions should be recognized as salvage procedures in the treatment of unstable and debilitating conditions as a result of severe degenerative joint disease, rheumatoid arthritis, neuropathic joint destruction, and paralytic or flail extremity dysfunction. As with all salvage-type procedures, patient and physician expectations must be the same to afford an acceptable and functional postoperative result.
