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At least 235 records · Page 13Linked to original sources
PubMed2003

Soft tissue problems in ankle fractures treated surgically. A prospective study of 154 consecutive closed ankle fractures.

We performed a prospective registration of primary soft tissue injuries and perioperative soft tissue complications the first 3 months after surgery in ankle fractures treated by open reduction and internal fixation. Open fractures and polytraumatized patients were excluded. The 154 consecutive patients (90 women) with an average age of 54.5 (S.D. 18.3) years were registered. Primary soft tissue injuries according to Tscherne's classification were noted in 22 patients (14.2%). Major perioperative soft tissue complications requiring revision occurred in five patients (3.2%). Minor perioperative soft tissue complications treated non-operatively occurred in 29 patients (18.8%). A significantly higher incidence of perioperative soft tissue complications occurred in alcohol abusers (P=0.043), after high-energy trauma (P=0.043), and after primary soft tissue injuries (P=0.004). Other possible risk factors such as age, gender, fracture type, diabetes, arteriosclerosis, coronary heart disease, and hypothyroidism had no statistically significant influence on the incidence of perioperative soft tissue complications.

Adolescent↗
PubMed1999

A comparison of the Sport Stirrup, Malleoloc, and Swede-O ankle orthoses for the foot-ankle kinematics of a rapid lateral movement.

Little information exists about the efficacy of various brace designs to restrict inversion during lateral movements. The purpose of the study was to determine whether semi-rigid stirrup (AirCast Sport Stirrup), semi-rigid modified stirrup (Malleoloc), or a soft, sleeve design (Swede-O) brace varied in their abilities to restrict inversion without hindering plantar/dorsiflexion when a lateral cutting movement is performed compared to a no-brace condition (No-Br). Nineteen volunteers who had previously sprained their right ankles performed 10 sideward cutting trials/brace condition. Based on kinematic data, captured using high-speed cameras, none of the braces restricted inversion compared to the No-Br condition. Plantar flexion was inhibited for all braces, and less dorsiflexion was exhibited for the Swede-O. For three participants, greater toe-in landings were observed for the Swede-O. Based on chi-square analyses, the participants rank of braces for stability and overall performance in decreasing order: Malleoloc, AirCast, Swede-O. It was concluded that the participants may have exhibited injury avoidance behavior during conditions perceived to be less stable, thereby reducing inversion when wearing no brace or the Swede-O brace. It also is tenable that the motion of the shoe was influenced by the presence of the braces, hence, no inversion restriction was observed.

Adult↗
PubMed2000

The effects of ankle compliance and flexibility on ankle sprains.

PURPOSE: The goal of this study was to examine the influence of changes in subtalar joint flexibility and compliance on ankle sprain occurrence. METHODS: Muscle model driven simulations of 10 subjects performing the landing phase of a side-shuffle movement were performed. The passive flexibility or compliance of the subtalar joint was varied, and each subject-specific simulation was exposed to a set of perturbed floor conditions. RESULTS: Increases in flexibility and compliance both led to an increase in the occurrence of excessive supination, while changes in flexibility had a greater influence. Changes in flexibility or compliance caused only small changes in the occurrence of excessive supination torques. CONCLUSION: These results suggest that increased mechanical laxity does not directly cause an increase in sprain occurrence during side-shuffle movements.

Ankle Injuries↗
PubMed1988

[Models of the geometry of the human ankle bone pulley: two series of geometric models for demonstrating the biomechanics of the ankle joint].

2 series of models demonstrate the geometrical shape of the human trochlea tali. We have changed step by step the shape of the 2 flanking articular facets of the trochlea, the course of the edges of the trochlea, and the length of their radii, and so we have found a model responding to the biomechanic conditions of the trochlea tali. The convex surface of this model (corresponding to the superior articular surface, i.e. the facies superior trochleae tali) is a torse, the medial flanking facet (corresponding to the medial articular facet of the trochlea, i.e. the facies malleolaris medialis) is a flat cone, the lateral flanking facet (corresponding to the lateral articular facet of the trochlea, i.e. the facies malleolaris lateralis) is a screwed (helicoidal) face. The resulting model shows the 2 completely different phases of motion in the ankle joint: During dorsiflexion (motion setting out from the neutral position towards the final position of dorsiflexion), the internal malleolus leads the talus, whereas the external malleolus is pushed outwards by the screwed lateral articular facet of the trocheal. The trochlea is moved like a hinge. In the final position of dorsiflexion, the malleoli tightly embrace the 2 flanking facets of the trochlea, whilst an obvious cleft appears dorsally and medially between the superior articular surface of the trochlea and the tibial roof (i.e. the facies articularis inferior tibiae). During plantarflexion (motion setting out from the neutral position towards the final position of plantarflexion), the external malleolus leads the talus, whereas the medial articular facet of the trochlea withdraws from the internal malleolus. The trochlea is moved like a screw. In the final position of plantarflexion, the superior articular surface of the trochlea closely contacts the tibial roof, whilst an obvious cleft appears between the medial articular facet of the trochlea and the internal malleolus.

Ankle Joint↗
PubMed1996

Use of bivalved ankle-foot orthosis in neuropathic foot and ankle lesions.

The neuropathic foot is a common complication of diabetes mellitus and is associated with development of chronic ulcers and Charcot joints. Treatment of these complications presents a complex management task. This report presents long-term follow-up data on 16 patients with neuropathic changes who were treated with a total contact, laminated, bivalved, rocker-bottom-soled ankle-foot orthosis (TCAFO). Of the 16 patients, 6 were treated for Charcot changes only, 10 were treated for ulcers, and 2 of the 10 had ulcers bilaterally. Eight of the 12 ulcers (67%) healed in an average of 10 months (range 1-24 mo), 1 patient required amputation, and 2 patients who had complete healing, 5 have resumed wearing TCAFOs secondary to recurrent ulcers. Three of the 5 patients with Charcot changes no longer use the orthosis and have had negative bone scans after an average of 20.7 months (range 12-28 mo). In this retrospective uncontrolled study, the TCAFO proved to be a safe, functional, and cost-effective therapy for complications of the neuropathic foot.

Adult↗
PubMed1997

Delay in improvement of ankle-arm index and ankle waveforms after lower-extremity revascularization.

Ankle-arm index (AAI) and pulse volume recording (PVR) are commonly used in the early postoperative period to measure the outcome after lower-extremity revascularization. They are also used in addition to duplex scan for long-term follow-up of these patients. We noticed that in some patients the AAI and/or PVR after revascularization procedures did not improve immediately after surgery, but took 24 hours or longer to do so. We retrospectively reviewed the records of 47 patients who underwent various lower-extremity revascularization procedures and found that out of 20 patients who had AAI and/or PVR measured in the recovery room, 8 patients took 24 hours and 1 patient took more than 24 hours for maximal improvement of their AAI and/or PVR. This may be related to vascular spasm, and knowledge of this delayed improvement is important in preventing errors during follow-up.

Aged↗
PubMed2006

Effects of ankle-foot orthoses on ankle and foot kinematics in patients with subtalar osteoarthritis.

OBJECTIVE: To determine whether different foot orthoses have a similar effect on foot kinematics in subjects with subtalar osteoarthritis (OA) when walking on various ground conditions. DESIGN: Within-subject comparison study. SETTING: Biomechanics research laboratory. PARTICIPANTS: Ten subjects with unilateral subtalar OA. INTERVENTIONS: Custom-made ankle foot orthosis (AFO), rigid hindfoot orthosis (HFO-R), and articulated hindfoot orthosis (HFO-A) were used by subjects walking on level, ascending, and descending ramp, and side slope conditions. MAIN OUTCOME MEASURES: The triplanar range of motion of the calcaneus relative to tibia (hindfoot) and metatarsal relative to calcaneus (forefoot) was measured using an 8-camera motion analysis system when subjects with subtalar OA wore different foot orthoses. RESULTS: Braces tended to perform similarly in reducing motion of the forefoot and hindfoot for all ground conditions when compared with unbraced but wearing shoes. The AFO significantly restricted frontal plane hindfoot motion during ramp descent (P<.01) and on a side slope when the arthritic subtalar joint was higher than the unaffected side (P=.02). The HFO-A provided significant frontal plane hindfoot motion restriction during ramp descent (P<.01) and on a side slope when the arthritic subtalar joint was lower than the unaffected side (P=.03). The HFO-R significantly restricted frontal plane hindfoot motion in all ground conditions except ramp ascent (P<.05). CONCLUSIONS: The HFO-R provides significant subtalar joint motion restriction while walking. The HFO-R may be considered an optimal orthosis for patients with subtalar OA pain arising from subtalar motion.

Adult↗