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At least 487 records · Page 27Linked to original sources
PubMed2002

Arch-shaped versus flat arthrodesis of the ankle joint: strength measurements using synthetic cancellous bone.

The aim of this study was to see if preservation of the arch shape of the ankle at arthrodesis contributes to stability. The ankle joint was simulated by paired blocks of a synthetic material corresponding to rheumatoid cancellous bone with low stiffness and strength. Flat end constructs with and without subchondral bone were compared with arch-shape constructs with and without subchondral bone. The pairs were fixed with two screws simulating an arthrodesis. These constructs were then tested to failure in four-point bending and torque. In four-point bending the subchondral bone increased the strength, regardless of shape. Stiffness was higher in the arch-shaped specimens but was not influenced by the subchondral bone. In torque, both arch-shape and subchondral bone increase the strength. Stiffness was increased by arch-shape but not subchondral bone. The results imply that the arch-shape and subchondral bone should be preserved when performing an ankle arthrodesis, especially in weak rheumatoid bone.

Ankle Joint↗
PubMed2000

[Arthroscopy of the upper ankle joint. A retrospective analysis of complications].

The purpose of this retrospective study was to analyse the complications of our arthroscopic procedures at the ankle joint. In all patients we evaluated the treatment protocols and in 111 patients (79.3%) we also evaluated the clinical and radiologic results. All in all we have found complications in 14 patients. In 4 cases we have seen a delayed wound healing, in 2 cases a superficial infection, in 3 cases a deep infection, in 3 cases a neural damage and in 2 cases a phlebothrombosis. Our study show, that the complication rate could be minimized by detailed knowledge of the anatomy, exact preoperative diagnostic and planing of the operation and careful preparation of the portals. The use of a laser also shows a tendency to a lower complication rate.

Adult↗
PubMedDate not supplied

[Talocrural angle and ankle joint mobility in Germans and Japanese].

1980 Krämer and Gudat introduced the talo crural angle, which provides exact measurement of the mobility of the ankle joint. In field studies in Germany we found a greater range of mobility in female compared with male persons. With advancing age range of mobility decreased in both sex. Same examinations in Japan were performed to determine influence of genetic and way of life pattern.

Adult↗
PubMed1999

[MRI of the ankle joint. Comparison of the 1.0-T and the 0.2-T units].

PURPOSE: Comparison of ankle joint injuries with different MR systems and at different field strengths. METHOD: Ten patients with acute ankle injuries were examined using mid-field (1.0 T) and dedicated low-field (0.2 T) MR units. Findings of ligamentous injury, sinus tarsi involvement, bone injury, and tendon injury were correlated. RESULTS: There was no significant difference between mid- and low-field MR imaging for ligamentous injuries (chi 2 = 0.0395), sinus tarsi changes bone injuries (chi 2 = 0.0507; critical value = 5,991). CONCLUSION: This study showed good agreement in pathological findings in ankle injury on mid-field and low-field MR imaging.

Acute Disease↗
PubMed1988

Human ankle joint stiffness over the full range of muscle activation levels.

System identification techniques have been used to track changes in dynamic stiffness of the human ankle joint over a wide range of muscle contraction levels. Subjects lay supine on an experimental table with their left foot encased in a rigid, low-inertia cast which was fixed to an electro-hydraulic actuator operating as a position servo. Subjects generated tonic plantarflexor or dorsiflexor torques of different magnitudes ranging from rest to maximum voluntary contractions (MVC) during repeated presentations of a stochastic ankle angular position perturbation. Compliance impulse response functions (IRF) were determined from every 2.5 s perturbation sequence. The gain (G), natural frequency (omega n), and damping (zeta) parameters of the second-order model providing the best fit to each IRF were determined and used to compute the corresponding inertial (I), viscous (B) and elastic (K) stiffness parameters. The behaviour of these parameters with mean torque was found to follow two simple rules. First, the elastic parameter (K) increased in proportion to mean ankle torque as it was varied from rest to MVC; these changes were considerable involving increases of more than an order of magnitude. Second, the damping parameter (zeta) remained almost invariant over the entire range of contractions despite the dramatic changes in K.

Adult↗
PubMed2004

Ankle joint evertor-invertor muscle torque ratio decrease due to recurrent lateral ligament sprains.

OBJECTIVE: To determine an ankle inversion-eversion movement range part where evertor/invertor muscles torque ratio is altered after recurrent ankle lateral ligament sprains. DESIGN: The ankle evertor/invertor muscles torque ratios were determined in the different range parts of angular positions by the muscle isokinetic movements. BACKGROUND: It is important to determine the movement range part where the evertor muscle weakness after the ankle lateral ligament sprains is more expressed and a repeated trauma of the lateral ligaments is more probable. METHODS: Twenty-eight male handball players participated in the tests using an ankle isokinetic inversion-eversion movement investigation dynamometer system. Thirty-three ankle joints were uninjured, but 23 underwent recurrent lateral ligament sprains. RESULTS: The ankle evertor/invertor muscles torque ratio for the sprained ankles was significantly lower in comparison with the uninjured joints in inversion positions at 50 degrees and 60 degrees of the range of movements in all applied velocities, except the slowest movement (30 degrees /s). CONCLUSIONS: The recurrent ankle lateral ligament sprains reduced the evertor/invertor muscles torque ratio in the inversion positions of the range of movements and therefore the evertor muscle weakness was more expressed in the beginning of the eversion movement.

Adolescent↗
PubMed2002

Three-dimensional kinematics at the ankle joint complex in rheumatoid arthritis patients with painful valgus deformity of the rearfoot.

OBJECTIVE: To evaluate the three-dimensional (3D) kinematics of the ankle joint complex (AJC) in rheumatoid arthritis (RA) patients with painful valgus deformity of the rearfoot. METHODS: Fifty patients with RA underwent gait analysis using electromagnetic tracking techniques to measure 3D kinematics at the AJC under barefoot and shod walking conditions. Three axial rotations (dorsiflexion/plantarflexion, inversion/eversion and internal/external rotation) were measured during the gait cycle, and the angular positions at key gait events, range of motion and the motion: time integral were measured. Descriptive and analytical comparisons were made with normative data derived from a sex- and age-matched population (n=45). RESULTS: AJC dysfunction in RA was characterized by excessive eversion motion (within an eversion range) and no inversion motion through the neutral joint position for the subtalar component of the joint complex, in both barefoot and shod walking conditions. Motion was coupled such that internal rotation of the leg relative to the rearfoot was greater than normal. AJC motion was different for all rotations between barefoot and shod conditions, but in both situations there were statistically significant between-group differences in the motion:time integral for inversion/eversion (barefoot, P<0.0001; shod, P<0.0001) and external/internal rotation (barefoot, P<0.0001; shod, P<0.0001). There were no statistically significant differences between RA and normative data for dorsiflexion/plantarflexion motion under barefoot (P=0.16) and shod (P=0.50) walking conditions. CONCLUSION: Painful valgus deformity of the rearfoot is associated with changes in the 3D kinematics affecting eversion at the AJC and internal rotation of the leg, both when walking barefoot and in shoes.

Adult↗
PubMed1989

[Fixation or screws in arthrodeses of the upper ankle joint. A retrospective comparison of 76 patients].

In a retrospective study, the results of 76 patients treated by different methods for arthrodesis of the ankle joint were compared. With external-compression clamps, solid fusion was achieved in 48 patients after an average of 4.5 months, with lag-screw fixation in 25 patients after 3 months. The nonunion rate was only 4% in the group with external clamps, the followup time was 2 years (maximum 6 years, minimum 6 months). Eighty percent of the patients reported pain relief, 58% in the lag-screw reported being free of symptoms, 23% as did of the external-clamps group. Most of the complications after external fixation were related to pin-site infections (48%). Infection, instability and inability to undergo physiotherapy were the main problems after clamps. Arthrodesis with lag screws provides optimal biomechanical fixation, with early functional treatment and a fusion within 3 months. Compared to external clamps arthrodesis, the lag-screw group had fewer problems with skin and bone healing and could be discharged earlier.

Adolescent↗
PubMed1993

[Malleolar fractures with ankle joint instability--experience with the positioning screw].

UNLABELLED: Malleolar fractures with an unstable ankle joint require additional stabilization. Different implants exist: We present the results of 135/155 patients treated with the so-called positioning screw. In 123 patients the positioning screw showed a spontaneous loosening with functional treatment and was therefore removed with the rest of the implants after eight to twelve months. In twelve cases the screw was broken. In 3/21 patients with the old 3.5 mm cortical screw with a core diameter of 1.9 mm in a correct position and in 9/113 patients with the new 3.5 mm cortical screw with inner core of 2.4 mm in an incorrect position. CONCLUSION: Positioning screws require early removal only if they fail to loosen or if a persistent limitation of dorsiflexion is still present after three months.

Adult↗
PubMed1980

[Results of surgically treated luxation fractures of the upper ankle joint (author's transl)].

113 patients were followed up after an average period of 27.2 months postoperatively following surgical treatment of luxation fractures of the ankle joint, from a closed series of 200 operations carried out in accordance with AO principles. Unsatisfactory late results were found in Type C in 38.6% of the cases, in the total group in 29.2% of the cases. The rate of infection was about 2%. One-third of the poor results were due to pre-arthrotic deformities or damages due to accidents; over and above this, surgico-technical complications led to unsatisfactory treatment results.

Adult↗
PubMed1988

[Disorders of vascularization following fracture of the ankle joint in children].

In the Department of Paediatric Surgery of the University of the Heidelberg, 64 children were admitted during five years to the hospital after an ankle fracture. 12 children showed a typical fracture of the growth plate (v. Laer). All 12 were not older than 12 years. The problem of this typical form of fracture is that even careful accurate treatment may be followed by growth problems of the tibial malleolus. A microangiographic postmortem study using plastinated shetts (v. Hagens) showed a normal distribution of vascularity of the ankle joint. The vascular damage after fracture and the damage of the local vascularity in the area at the growth plate after surgical treatment are comparable.

Ankle Injuries↗
PubMed1989

[Biomechanics of the ankle joint].

According to Fick, the tree-dimensional patterns of foot motion are best characterized as jawlike movement. Anatomically and biomechanically, this process represents conjoined, synchronous motion within the three mobile segments of the hindfoot: the ankle joint, the posterior subtalar joint, and the anterior subtalar joint. Foot kinematics can be described more completely if the anterior subtalar joint is defined not only as the talocalcaneal navicular joint, but as including the calcaneocuboid joint, thus representing the transverse joint of the tarsus, i.e., the Chopart joint. The axes of these three joints can be defined precisely. In some parts they represent a screwlike motion, clockwise or counter-clockwise, around the central ligamentous structures (fibulotibial ligament, talocalcaneal interosseous ligament, bifurcate ligament). The individual anatomy and structure of these ligaments provide variations in the degree and direction of foot motion. A precise knowledge of foot kinematics is important in surgical ligament and joint reconstruction and in selective foot arthrodeses.

Ankle Joint↗
PubMedDate not supplied

[Minimally invasive distraction arthrodesis of the ankle joint using threaded titanium cages].

OBJECTIVE: We present the theoretical principles and the results of a new kind of minimal invasive distraction arthrodesis of the ankle joint using threaded titanium cages. METHOD: Experimental operation was done on eight cadavers using a anterio-medial and lateral approach. Threaded titanium cages (12 mm diameter), known from spine surgery, were implanted under distraction. Four operations were done without and four with radiologic control. RESULTS: The samples demonstrated a high primary stability. After dissection of the ligaments a good position of the implants, with one exception, which was implanted without radiological control, was found. Cages, which were implanted under radiological control, were nearly parallel in sagittal direction, divergence ranged from 1 degree to 3 degrees (mean 2 degrees). Operation time was always shorter than 20 minutes. CONCLUSION: As indication for using this experimental operation in patients a primary osteoarthritis with intact ligaments and without severe malposition can be regarded. From the theoretical view advantages of this technique can be seen in the minimal invasive approach, the short duration of the operation and the high primary stability.

Ankle Joint↗
PubMed2000

Dynamic contrast-enhanced MR angiography from the distal aorta to the ankle joint with a step-by-step technique.

OBJECTIVE: The aim of this study was to visualize the arteries from the distal aorta to the ankle joint and to determine the accuracy of MR angiography for detecting stenoses and occlusions. SUBJECTS AND METHODS: Twenty-four patients with peripheral arterial occlusive disease underwent digital subtraction angiography and were examined on a 1.5-T MR scanner. The transit time for contrast material was determined with a test bolus injection. A T1-weighted three-dimensional gradient-echo sequence with short TR and TE was used for a dynamic measurement at the level of the iliac arteries, the upper leg, and the lower leg arteries. For each level a single dose of gadolinium was injected into an antecubital vein with an MR power injector. Maximal-intensity-projection reconstructions were calculated after subtraction of the first measurement at each level. Two experienced MR radiologists who were unaware of the digital subtraction angiography results interactively evaluated both the MIP reconstructions and the single slices on a workstation, first independently and then in a consensus interpretation. RESULTS: With digital subtraction angiography, 80 hemodynamically significant stenoses and 39 occlusions were detected. For the stenoses and occlusions, a sensitivity of 100% was found for MR angiography. The specificity for the assessment of stenoses and occlusions was 98% and 94%, respectively, for the iliac arteries; 98% and 94%, respectively, for the upper leg arteries; and 94% and 95%, respectively, for the lower leg arteries. Most false-positive findings of occlusion were due to metal stents present in the iliac (n = 3) and upper leg (n = 4) arteries. CONCLUSION: The MR imaging technique that we used revealed the arteries from the distal aorta to the ankle and proved to be reliable at showing arterial stenoses and occlusions.

Aged↗
PubMed1983

Mechanical resonance of the human body during voluntary oscillations about the ankle joint.

Viscoelastic models of the musculoskeletal system suggest resonant frequencies of oscillatory movement at which maximal output is realized with minimal energy expenditure. To investigate this, resonance at the human ankle joint was explored by comparing predicted and experimental gain/frequency and phase frequency functions. These functions were predicted from viscous (B) and elastic (K) coefficients of ankle extensors which were determined from the damped sinusoidal force produced after landing with muscles in sustained contraction (B = 3986 kg/s, K = 31,898 kg/s2). Experimental input/output functions were determined from Fourier analysis of force (output) and rectified, filtered EMG (input) obtained during voluntary sinusoidal oscillations of ground reaction force of a specified magnitude and frequency. Correlations between predicted and experimental functions were significant (p less than 0.02) in four of five subjects. The average resonant frequency was 3.33 +/- 0.15 Hz. The mechanical properties of muscle are considered to be as important as the nervous system in determining the choice of both the movement pattern and the strategy which is adopted in response to changing conditions.

Ankle Joint↗
PubMedDate not supplied

Sagittal plane range of motion of the pediatric ankle joint: a reliability study.

Measurement of ankle dorsiflexion is a routine part of the podiatric examination of children, yet the reliability of this measure is largely unknown in healthy individuals. This study assessed the intrarater and interrater reliability of the first and second resistance levels of sagittal ankle range of motion in 4- to 6-year-old children. The results show that measures of ankle dorsiflexion in children are highly variable among examiners, and, in general, gastrocnemius range of motion is more reliable than soleal range of motion.

Ankle Joint↗