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At least 667 records · Page 37Linked to original sources
PubMed1993

Comminuted fracture of the calcaneus associated with subluxation of the talus.

Two cases of complex fracture dislocation of the calcaneus having an unusual pattern of injury are described. The cases exhibit the following special characteristics: (1) fracture dislocation of the calcaneus where the primary fracture line separates the calcaneus into an anteromedial fragment that maintains its normal relationship to the talus and a posterolateral fragment that is dislocated from the subtalar joint. This posterolateral fragment moves laterally and lies adjacent to the fibula; (2) a secondary fracture line separating the lateral portion of the posterior facet from the tuberosity of the calcaneus. Both fragments are dislocated from their normal anatomical position; (3) talar tilt as shown on AP view of the ankle caused by inversion of the talus due to rupture of the lateral collateral ligament. Also, the posterolateral fragments impinging on the fibula pushes the heel downward and contributes to the talar tilt; (4) involvement of the calcaneocuboid joint; (5) dislocation of the peroneal tendons. This fracture pattern is unusual and has not been described before. Recognition of this unusual injury with subsequent and proper management may prevent major disability to the patient. Conservative treatment by casting or early range of motion is contraindicated. Closed reduction should be attempted immediately, and if not successful, a lateral approach with open reduction and internal fixation is the treatment of choice for this complex injury.

Adult↗
PubMed1995

Operative treatment of acute displaced intra-articular calcaneus fractures.

A retrospective study of 18 operatively treated calcaneal fractures was conducted. The fractures were all type II and type III fractures according to the classification system of Crosby et al. The average follow-up was 32 months and consisted of subjective and objective criteria. The findings were compared with the results of nonoperative treatment reported by Crosby et al. The findings suggests that type II fractures have a similar outcome when either operative or nonoperative treatment is used. Type III fractures, however, fared considerably better with operative intervention when compared with those treated with nonoperative techniques.

Accidental Falls↗
PubMed1997

Traumatic dislocations of the lesser toes.

Traumatic dislocations of lesser metatarsophalangeal joints (DLMTPJ) and lesser interphalangeal joints (DLIPJ) are very uncommon. A retrospective analysis of 31 cases and of the 16 reported cases was conducted to clarify our understanding of the pathomechanics, the role of associated injuries, recommended treatment, and outcome. Hyperextension with axial loading produces the injuries. Ipsilateral foot fractures or dislocations often occur and thus may compromise the outcome. Thirty percent of DLMTPJ and virtually all DLIPJ require open reduction; most often, the plantar plate prevents closed treatment of either DLMTPJ or DLIPJ. At follow-up, treated isolated DLMTPJ have few or no complaints; disability persists in patients who suffered concomitant displaced ipsilateral midfoot or forefoot fractures or dislocations. Neglected DLMTPJ remain symptomatic. All reduced DLIPJ are pain free.

Adolescent↗
PubMed1999

Inferomedial (subsustentacular) dislocation of the navicular: a case report.

A unique case of subsustentacular dislocation of the navicular is presented. The authors propose that such a severe displacement cannot occur until there is complete instability across the whole midfoot. The mechanism of injury and the treatment options are discussed. In the present case, there was late collapse of the foot into abduction because the lateral column was not primarily stabilized. Avascular necrosis is a common complication which leads to navicular collapse. A midfoot arthrodesis gave a good result in our patient.

Arthrodesis↗
PubMed1981

Pediatric Lisfranc injury: "bunk bed" fracture.

A common pediatric fracture is often overlooked due to the subtle deformity of the proximal first metatarsal. The injury is produced during a fall from a height, resulting in a flexion force that wedges the oblique first cuneiform-first metatarsal epiphysis into the first metatarsal-second metatarsal interspace. The injury is more severe than indicated by the bone injury, in that ligaments are involved in subluxation. Anatomic features of the first metatarsal-first cuneiform area present a suitable site for the described injury to occur. The pathogenesis of adult Lisfranc tarsometatarsal dislocation is the model for the pediatric equivalent. The clinical, physical, and radiologic findings of 16 patients are reviewed.

Child↗
PubMed1984

Tarsometatarsal fracture-dislocation.

Closed and open treatment were compared in 12 cases of tarsometatarsal dislocation. When the dislocation involved the lateral component only, good results were observed in one of three cases treated closed and six of seven cases treated open. It is essential to reduce and stabilize the dislocation which is often overlooked unless carefully analyzed clinically and radiographically.

Adult↗
PubMed1984

Planal dominance.

Explore the source record for details and available documents.

Ankle Joint↗
PubMed2001

Articular cartilage transplantation. Current and future limitations and solutions.

The ultimate goal of replacing cartilage with a bioengineered graft, autologous graft, or allograft is to replace the damaged articulating surface with tissue containing the anatomical, biomechanical, and functional properties of native articular cartilage, which will have resultant satisfactory clinical outcome. For transplanted articular cartilage to obtain the original histologic arrangement of hyaline cartilage with secure incorporation into host tissue, progressive integrated multidisciplinary research must continue. Although autologous chondrocyte transplantation of the talus is not yet FDA approved, this technique may provide the surgeons with a cutting-edge method to treat patients with nondegenerative osteochondral lesions of the talus and possibly other articulating joints of the foot.

Ankle Joint↗
PubMedDate not supplied

Our results in the treatment of fractures dislocations of Lisfranc's joint.

The authors report their experience in the treatment of traumatic injuries of Lisfranc's joint based on 30 cases treated by surgery between 1984 and 1999. All of the patients were re-evaluated clinically and radiographically. What emerges from the study is the need for surgical stabilization with percutaneous Kirschner wires or by open procedure in cases where there are doubts or where reduction is impossible. The prognosis is worse in injuries of the medial column and in exposed fractures or when mortification of the soft tissues is present.

Accidents, Traffic↗
PubMed1977

Stages and roentgenological picture of diabetic osteoarthropathy.

The course and roentgenographic signs of diabetic osteoarthropathy are discribed on the basis of literary data and of 23 cases of the author. Three stages are distinguished: in stage I dislocation, circumscribed porosis and cortical defect are observed. The characteristic sign of stage II is osteolysis, accompained by fragmentation, fracture, periosteal reaction. In stage III the healing takes place according to five radiologically distinguishable patterns. The good healing tendency is typical. Regarding the differential diagnosis of the disease, the possibility of inflammatory and tumourous changes and neurothropic osteoarthropathies of other origin must be considered.

Aged↗
PubMed2006

Lisfranc joint injuries: diagnosis and treatment.

Injuries to the tarsometatarsal or Lisfranc joint, though rare, are often undiagnosed or inadequately treated, resulting in poor long-term outcomes. Clinical and radiographic data are needed to recognize and treat these injuries for optimal outcomes. In this article, we review the anatomy, biomechanics, injury mechanisms, clinical presentation, radiographic evaluation, injury classification, treatment, outcome, and complications of Lisfranc joint injuries.

Biomechanical Phenomena↗
PubMed1989

[Clinical significance and treatment concept of Lisfranc dislocation and dislocation fracture].

Dislocations and fracture dislocations of the tarsometotarsal joint are uncommon (only 30 cases have been treated in our hospital in a 20-year period). The late results of tarsometotarsal injuries in 20 patients have been reviewed. The average follow-up was 3.8 years (range 8 months to 20 years). Methods of treatment were either open (n = 15) or closed (n = 5) reduction with (n = 18) or without (n = 2) internal fixation and cast immobilization (n = 10). Late results clearly correlate with the quality of reduction. An open procedure is usually necessary to achieve anatomical reduction. Diagnostic and operative problems are discussed.

Adolescent↗
PubMed1986

Occult midtarsal subluxation.

Of 14 patients with navicular tuberosity avulsion, seven had damage to the anterior process of the calcaneum at the calcaneocuboid joint--possibly the result of an occult subluxation of the midtarsal joint. These patients were all middle-aged women who had slipped or fallen a short distance. They were unable to bear full weight because of pain on the medial and lateral aspects of the foot. The associated midtarsal injury was initially missed in five of seven patients because of failure to interpret the radiographic appearance. All seven patients had prolonged symptoms, and three had persistent but not disabling pain at least three years after injury. Degenerative arthritis had developed in the calcaneocuboid joint in four of the five patients at follow-up examinations. Patients with occult subluxation of the midtarsal joint should be managed initially by a period of non-weight-bearing followed by application of a walking cast. The need for early surgical treatment is open to question.

Adolescent↗
PubMed1987

Torsion-transmitting properties of the hind foot.

The torsion-transmitting capacity of the hind foot was studied experimentally in ten cadaver specimens. An average of 0.44 degrees of outward rotation of the tibia occurred for every degree of supination of the foot. The relationship was linear. There was less transmission of torsion during dorsal extension than during plantar flexion of the ankle. The joint complex of the hind foot somewhat resembles a universal joint except that the distal fork of the universal joint changes its configuration through its range of motion. This distal fork, consisting of the calcaneus, the cuboid, and the navicular, together with the central piece, the talus, constitutes a three-arm link system, which explains the configurational change. The process of balance when standing on one leg and when walking on uneven surfaces, when the torsion-transmitting effect plays a central role, can be controlled as rotations in the hip joint. This torsion-transmitting model helps to elucidate the trauma mechanisms of various ankle fractures. It also may explain why anterior knee pain due to malalignment can be relieved with supinating foot supports.

Ankle Joint↗