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At least 361 records · Page 20Linked to original sources
PubMed1997

Replacement of the lateral malleolus of the ankle joint with a reversed proximal fibular bone graft.

Infrequently, prior reports have described the use of the ipsilateral proximal fibula to replace an absent distal fibula caused by either trauma, infection, or resection for tumor. This is a 27-year follow-up of a 12-year-old patient who lost the distal 7.5 cm of her fibula secondary to trauma. The soft tissue defect was replaced early by an abdominal flap and the bone defect was eventually replaced with 7.5 cm of proximal fibula. The lateral ankle ligaments were reconstructed with the peroneus brevis, and the ankle joint has remained stable. Although traumatic arthrosis has progressed slowly, the patient at age 39 has a relatively painless, mobile ankle joint.

Adult↗
PubMed1979

Recurrent instability of the ankle joint. Surgical repair by the Watson-Jones method.

Twenty-one ankle joints with recurrent lateral instability, treated with surgical repair by the Watson-Jones method, were included in a follow-up study 1--5 years after operation. Good results were achieved in 80 per cent. However, the results were not better than those after free dissection and direct suture of the ligamentous ruptures. It is therefore recommended that the more extensive Watson-Jones procedure be reserved for selected cases.

Adolescent↗
PubMed1983

Mathematical model of the human ankle joint.

It has been suspected that the mechanical environment in which a particular joint functions has an effect on the initiation or progression of degenerative joint disease. The objective of this study is to define the mechanical environment of the ankle joint, specifically, the contact areas and pressure distributions, through the development and analysis of a simplified mathematical model. Since the state of pressure across articular surfaces during function is influenced by joint incongruity, cartilage thickness profile and the geometry of the opposing surfaces, these factors have been incorporated into the model formulation. Mathematical analysis of the model has resulted in pressure distributions in both the anterior-posterior and medial-lateral directions and contact area growth plots which correlate well with observed ankle contact patterns obtained from in vitro investigations. The significance of joint incongruity to these pressure distributions and to the relative immunity of the ankle joint to primary osteoarthritis is discussed.

Ankle Joint↗
PubMed1986

[Surgical therapy of chronic instability of the upper ankle joint using periostal bridle-plasty].

We have used the technique of the autoplastic periostal bridle graft for operative treatment of chronic lateral instabilities of the ankle joint in 78 cases since 1978. Clinical and radiological follow-ups of 55 patients were made at two different intervals of time. In more than 90% of these there was no more evidence of instability and good or very good subjective results were obtained. The substitute ligament can be either fastened via drill holes or fixed to the bone with a screw. The autoplastic periostal bridle graft is a simple, anatomically appropriate and reliable procedure to restore the stability of the lateral ankle joint. Several renowned authors have also reported good results in the meantime.

Adult↗
PubMed1993

[Comments on measuring the mobility of the upper ankle joint by the neutral-0-method].

The pivot and axes of the ankle joint not easily determined. Instruction and some experience are required to determine the values by the Neutral 0 Method as accurately and reproducibly as at all possible. The following recommendations are based on theoretical considerations and clinical experience: 1. The experienced physician can measure the correct angle by taking the patient's foot in his hand and asking the patient to raise and lower the foot. From the overall posture and reaction of the foot it is possible to correctly "feel" the neutral 0 position as initial value, and therefrom the raising and lowering. 2. A highly recommended procedure is to examine the patient in recumbent position on the couch with the heal upright as it touches the couch. The foot is then lowered until the sole touches the couch while the knee is bent, a small supporting board serving to determine the axis as the foot is raised. This is a safe method for both the beginners and the experienced. The angles can be determined even better than by the "free" method. 3. In patients who do not cooperate well, lowering and raising of the foot can be checked additionally with the patient standing and bending his knee as well as by standing on tiptoe. In this case the passive forces must be taken into consideration, especially during forward bending of the lower leg. Hence, with this method, it is necessary to distinguish clearly between active and passive function.

Ankle Joint↗
PubMedDate not supplied

Arthrodesis of the ankle joint with rheumatoid arthritis: experience with the transfibular approach.

There are man methods of ankle joint arthrodesis, but nearly all are used for treatment of posttraumatic talocrural joint arthritis. Relatively few case reports of ankle arthrodesis are found in the literature on rheumatoid arthritis. The transfibular approach is remarkably effective for the fusion of talocrural joints destroyed and deformed by rheumatoid arthritis. In nine cases, the overall results were excellent in six and good in three. A sliding inlay graft in one case also produced a good result. Because patients with rheumatoid arthritis have osteoporosis caused by steroid therapy or its disuse, and some vascular disease, compression arthrodesis is unsafe. Moreover, the lateral transfibular approach provides better surgical exposure as well as protecting fragile rheumatoid tendons, vessels and nerves.

Adult↗
PubMed1992

[Benefits and risks of surgical therapy of acute lateral fibular ligament rupture of the upper ankle joint. Results of a retrospective study].

In 60 patients with an intra-operatively confirmed first-time tear of the lateral ligaments of the ankle joint an examination carried out after a period ranging from 11.6 and 35 months post-op. showed that ligament suturing coupled with immobilisation for 6 weeks was not associated with any major or persistent impairment. The important advantage of the procedure was the possibility of accurately determining the extent of the injury, together with the chance of providing suitable and immediate correction. In 91% of the patient group, a comparison of sides revealed equal or greater stability of the surgically treated ankle joint. Even when occasional temporary, varyingly pronounced, sensory disorders are taken into account, in comparison with the possibilities of conservative therapy, we consider that these results confirm a tear of the lateral ligaments of the ankle to be a justifiable indication for surgery.

Adolescent↗
PubMed1998

Measurement of surface contact area of the ankle joint.

OBJECTIVE: To determine the distribution of contact area of the ankle joint with axial loading and in positions of maximal dorsiflexion, plantar flexion, supination, and pronation. We also tested the effects of extrinsic tendon loading and arch instability. DESIGN: Nine cadaveric feet were studied in the intact condition and following transection of ligaments to create arch instability. BACKGROUND: Assessment of ankle contact in various joint positions and degrees of instability is difficult to accomplish with conventional methods. METHODS: Displacement of the talus relative to the tibia was measured with a magnetic tracking device and tibiotalar joint contact from proximity calculations of digitized joint surfaces. RESULTS: Contact area did not change significantly from unloaded condition to 667 N load condition in the medial, central, and lateral zones. Central zone contact area decreased in plantar flexion by an average of 324 mm(2) (SD, 165 mm(2)) (P = 0.0004). Medial zone contact area decreased in plantar flexion by a mean of 55 mm(2) (SD, 28 mm(2)) (P = 0.0004), decreased in pronation by an average of 42 mm(2) (SD, 36 mm(2)) (P = 0.0086), and increased in supination by an average of 20 mm(2) (SD, 26 mm(2)) (P = 0.0430). Lateral zone contact decreased in plantar flexion by a mean of 124 mm(2) (SD, 57 mm(2)) (P = 0.0002). CONCLUSIONS: In plantar flexion, there was a decrease in contact area. Loading extrinsic tendons to the foot did not significantly increase ankle contact area, but arch instability caused a decrease in central and lateral zone contact area. RELEVANCE: This technique was used to assess joint contact characteristics in various loading conditions and will be useful for evaluating the extent to which treatment for ankle or hindfoot problems such as bracing or reconstruction operations restores normal joint contact.

Journal Article↗
PubMed2004

Microneurographically recorded Ia discharge from the tibial nerve mainly transmits the angular velocity of the ankle joint in humans.

Investigations of the Ia afferent discharge in clarifying problems in disused and malused skeletal muscles have been carried out mainly in muscles of the upper extremities. However, such problems actually occur more frequently in the antigravity muscles of the lower extremities, such as the triceps surae muscle. An analysis of microneurographically recorded Ia discharges from the tibial nerve innervating the triceps surae muscle during dynamic movement of the ankle joint indicated that they mainly transmitted information on the angular velocity of the joint. However, the information on the position sense of the joint was not as well transmitted through Ia discharges. There was no correlation between the joint angle and the static response. However, the dynamic response of a Ia afferent was well correlated to the angular velocity. It is concluded that the human proprioception of the triceps surae muscle was not dependent on the position of the ankle joint, but largely on its movement by the stretching of the muscle.

Adult↗
PubMed2003

Supramalleolar osteotomy for the treatment of distal tibial angular deformities and arthritis of the ankle joint.

In a 5-year period (1996-2001), the authors performed supramalleolar osteotomies for the correction of distal tibial mechanical malalignment of at least 10 degrees with concomitant pain and with or without radiographic evidence of arthritic changes. The method was also applied as an alternative to other common procedures for the treatment of a small group of patients with degenerative changes of the ankle joint without previous traumatic event and with minimal or moderately altered alignment. There were 12 patients (13 feet) with an average follow-up of 33.6 months. All osteotomies healed at an average time of 14 weeks. The average AOFAS score improved from 53.8 to 87 points, the average ankle score in the scale described by Takakura et al. improved from 56.7 to 82, and the average pain score improved from 14.6 to 32.3. In the presence of deformity, the average tibial-ankle surface angles in both the coronal and the sagittal planes were significantly improved. The radiographic degenerative changes in the ankle joint showed no evidence of progression. The choice of technique did not influence the clinical or radiographic outcome or the healing time of the osteotomy.

Adolescent↗
PubMed2001

Mosaicplasty for the treatment of osteochondral defects of the ankle joint.

Autogenous osteochondral transplantation is a relatively new procedure for the treatment of osteochondral lesions of the ankle joint. The procedure is reserved for larger stage III and stage IV lesions. The corresponding author has had good preliminary results with a high level of patient satisfaction. The procedure is relatively straightforward and reliable. The need for a second surgical site has not proved to be a great disadvantage of the procedure; no complications have occurred to date at the knee donor site. This procedure, which was first described for use in the knee joint, shows excellent promise for use in the ankle and warrants larger investigational studies to assess outcomes.

Ankle Joint↗
PubMed1998

Estimation of age from epiphyseal union at the wrist and ankle joints in the capital city of India.

Various studies conducted in and outside India for estimation of age from long bone joints revealed that unlike other vital parameters no uniform pattern exists for epiphyseal union of long bones in different countries of the world and also in different parts of the same country. A radiological study was conducted in 180 boys and girls of the capital city of India, Delhi, between the age group of 14-20 years to find out the age at which epiphyseal union at wrist and ankle joint takes place. The result of the study showed that the wrist joint epiphyseal union is completed in all cases in the age group of 19-20 years in males and 18-19 years in females. In the ankle joint, 17-18 years was the age group in males and 16-17 years the age group in females which showed complete epiphyseal union in all cases.

Adolescent↗
PubMed2002

Ball-and-socket ankle joint with hypoplastic sustentaculum tali.

A case of unilateral ball-and-socket ankle joint associated with short limb and hypoplastic sustentaculum tali is reported. We think that hypoplastic sustentaculum tali was the cardinal feature in the anatomical and kinematic alterations of the foot in this patient. We review the embryonic development of hindfoot to ascertain the possible origin of this unusual finding.

Adolescent↗
PubMed1988

Effect of ankle disk training on postural control in patients with functional instability of the ankle joint.

The postural control of ten male soccer players with functional instability (FI) of the ankle joint, i.e., recurrent sprains and/or a feeling of giving way, was studied before and after ankle disk training. Postural control was studied by means of stabilometry and an optoelectronic movement recording system. In the present study, we found increased postural sway in men with functional instability, which is in line with previous studies. We found improved postural control after ankle disk training as shown by stabilometry. Postural correction patterns were restored, and segmental displacement amplitudes reached even supranormal values. A subgroup of players with unilateral FI also decreased postural sway when standing on the non-symptomatic, untrained foot after ankle disk training. This bilateral improvement and the restored postural correction pattern do not tally with Freemans proprioceptive theory for postural control, but stresses the importance of central motor programs.

Adult↗
PubMed1986

Para osteo arthropathy--ectopic ossification of healing tendon about the rodent ankle joint: histologic and type V collagen changes.

Ectopic bone formation, or para osteo arthropathy (POA), is commonly seen in humans following lesions to the central nervous system. The condition also occurs after severe trauma, burns, or tetanus, and, rarely, after poliomyelitis or cauda equina lesions. The lack of a suitable laboratory animal model has hampered study of its etiology and treatment. The lesion occurs just above the rodent ankle joint 7 weeks after repair of the severed achilles tendon. Tendon repair using a single silk suture resulted in ectopic calcification in 22 of 23 animals. Ectopic ossification, with extensive mineralization, occurred in 11 animals, 5 of which showed bone marrow. Ectopic mineralization was moderate in 8 others, minimal in 4, and absent in one. Collagen typing thrice during healing indicated that type V collagen increased by one-third at 10 days, doubled at 20 days, and returned to near normal amounts at 50 days. Since type V collagen is a major component of the nonfibrous collagen of blood vessels, increased amounts of type V collagen are consistent with the presence of many new blood vessels in the granulation tissue at 10 and 20 days. Vascularity is less dense at 50 days when ectopic mineralization and new bone formation are observed. These findings suggest that POA and the degree of maturation of healing tendon may be linked to reduced amounts of type V collagen. It is concluded that the sutured tendon of the rodent ankle joint offers an animal model by which to study ectopic bone formation, or para osteo arthropathy.

Achilles Tendon↗