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At least 739 records · Page 41Linked to original sources
PubMed1995

Tarsometatarsal (Lisfranc's) injuries--results of open reduction and internal fixation.

Injuries of the tarsometatarsal (Lisfranc's) joint are uncommon and are potentially associated with chronic disability. The aim of our study was to review retrospectively the results of open reduction with Kirschner wire internal fixation of tarsometatarsal injuries. In this study, 12 patients with Lisfranc's injuries treated between January 1986 and March 1993 were reviewed at an average of 36 months after the injuries. Majority of the patients suffered from type B injuries (Hardcastle's classification, 1982). There were 9 closed and 3 open injuries. All were high energy injuries sustained in motor vehicle accidents, fall from a height or crush force. All were treated with open reduction and internal fixation with Kirschner wires. Anatomical reduction was achieved and maintained. There was no postoperative redisplacement. During follow-up, most patients developed radiological evidence of post-traumatic osteoarthritic changes. However, majority of the patients were pain-free or had very little foot pain, and were able to return to their previous occupation. Our study showed that open reduction with Kirschner wire internal fixation offered satisfactory anatomical and functional results.

Accidental Falls↗
PubMed1998

Arthroscopic removal of palmar/plantar osteochondral fragments (POF) in the metacarpo- and metatarso-phalangeal joints of standardbred trotters--outcome and possible genetic background to POF.

A clinical material of 133 Standardbred horses with palmar/plantar osteochondral fragments (POF) in the metacarpo- and metatarsophalangeal joints were studied. All horses had their fragments removed with arthroscopic surgery. 102 of the horses were 3 years old or younger when surgery was performed. Anatomical localisations of the fragments were in agreement with earlier reports. There was no statistical significant difference in month of birth in the POF--group compared to the total population. Eighty % of the horses that had raced before surgery came back to racing. The racing performance relative to their contemporaries remained the same after the POF operation. 65% of the horses that had not raced before surgery raced after the operation. The breeding index BLUP (Best Linear Unbiased Prediction) was used to evaluate if the POF-horses differed genetically in racing ability from the total population. The average BLUP value of the POF group was 103.4 (+/- 0.65), while the mean BLUP value of the total population was 98.9. This difference was highly significant and indicated that these POF horses belonged to a selected group. A homogeneity test of allele frequencies in blood type systems was performed to evaluate if any genetic difference was persistent between POF horses compared to the total population. The statistical analysis of gene frequencies for alleles in blood type systems indicated a genetic discrimination in blood type systems D and Tf.

Age Factors↗
PubMed1984

Lisfranc dislocations: fractures and/or dislocations through the tarso-metatarsal joints.

Because of the anatomical configuration of the tarso-metatarsal joints with their strong ligamentous connections, pure dislocations in this region are rare. We describe our experience of 24 cases of Lisfranc dislocation. Classification is according to Wilson. In the long term, functional and radiological results appear to depend on the accuracy of reduction. For good anatomical results, immediate closed or, if necessary, open reduction and stabilization by percutaneous Kirschner wires is required. Because of the severity of soft tissue damage, decompression with dorsal skin incisions should also be considered.

Adolescent↗
PubMed2001

Distal tibial osteotomies for the treatment of foot and ankle disorders.

Distal tibial osteotomy is an effective treatment for a variety of pediatric and adult foot and ankle disorders. Exposure osteotomies provide access to the tibiotalar joint for such problems as talar body fractures and osteochondral lesions of the talus. The channel osteotomy provides improved access to posterior talar dome lesions, especially for the use of osteochondral autograft. Although technically demanding, the supramalleolar osteotomy can benefit many patients, including patients with residual clubfoot deformity, primary and secondary osteoarthritis, malunion, and physeal arrest.

Ankle Joint↗
PubMedDate not supplied

Arthroscopic treatment of osteochondral lesions of the talar dome: a retrospective study of 48 cases.

We treated 48 symptomatic osteochondral lesions of the talar dome arthroscopically. Of these, 18 patients had an osteochondral fracture with a loose fragment located in every case on the anteriolateral side of the talus. Treatment consisted of removal (16 cases) or fixation (2 cases) of the bone fragment. Thirty patients had chronic lesions (27 subchondral necrosis with a sequestrum and 3 extensive cysts). The lesion was posteromedial in 27 cases and the treatment consisted of removal of the sequestrum with curettage of the subchondral bone necrosis (27 cases) or transchondral drilling if the cartilage surface was intact (3 cases). All the patients were clinically and radiogically reviewed with a mean follow-up of 5 years (7 months to 11 years). Patients treated for an osteochondral fracture obtained significant better results (16 excellent or good results out of 18 cases) than those treated for chronic lesions (20 excellent or good results out of 30 cases). On radiographic examination, we noticed that, even at the longest follow-up, the bone healing was usually incomplete and the bone defect persisted indefinitely in case of extensive subchondral bone necrosis. The articular surface could be seen in 11 cases (8 computed arthrotomographies, 1 magnetic resonance imaging, and 2 second-look arthroscopies). The fibrous cartilaginous surface was apparently regular in 6 cases without any clear correlation with our clinical results. This study suggests that we must make a distinction between osteochondral fractures (recent or not healed) located in the anterolateral part of the talar dome, which carry a good prognosis, and necrotic lesions located medially, which are less likely to have a favorable outcome.

Adolescent↗
PubMed2001

Free vascularized toe joint transfer to the hand. A technique for simultaneous reconstruction of the soft tissue.

Twelve patients underwent reconstruction of injured finger joints using our technique of a vascularized transfer of the second toe proximal interphalangeal joint. The age of the patients at operation ranged from 7 to 47 years and the postoperative follow-up was 9 to 48 months. All the joint transfers survived and united with resolution of the preoperative joint pain, deformity and instability. The average range of motion of the reconstructed joints was 59 degrees in the proximal interphalangeal and 54 degrees in the metacarpophalangeal joints. No patient complained of pain or functional deficits in the donor foot.

Adolescent↗
PubMed1980

Fractures and fracture-dislocations of the neck of the talus.

Forty fractures and fracture-dislocations of the neck of the talus are reviewed. Undisplaced fractures are associated with a high proportion of good results. Type II fractures, where there has been subluxation of the subtalar joint, require accurate reduction to avoid subtalar joint incongruity, and have a 20% incidence of avascular necrosis. Type III fractures, with dislocation of the body of the talus, have a poor prognosis and have a 100% incidence of avascular necrosis. Hawkins' sign of subcortical radiolucency is helpful in ascertaining the presence or absence of avascular necrosis. Accurate open reduction and rigid internal fixation with early range of motion of the involved joints is recommended where a closed reduction has failed to provide anatomic reduction.

Adolescent↗
PubMed1993

Lisfranc joint injuries: trauma mechanisms and associated injuries.

A retrospective review of the roentgenograms of 750 patients treated in our institution for tarsometatarsal joint injuries or metatarsal fractures over a 10-year-period was performed. Injuries of the Lisfranc joint were found in 66 patients (9%). Twelve patients (19%) had a total dislocation, 47 patients (71%) a partial dislocation, and seven patients (11%) a subtle injury of the Lisfranc joint. Four main groups of trauma mechanisms were identified (low-energy injuries, falls from a height, direct crush injuries, and high-energy vehicular crashes). Lisfranc joint injuries caused by low-energy injuries (21 patients) were as frequent as those caused by high-energy vehicular crashes (22 patients). There was no apparent relationship between the mechanism of injury and the type of Lisfranc joint dislocation. All patients except three had associated metatarsal fractures, most commonly in the second metatarsal. The location of associated metatarsal fractures was different from that in patients with metatarsal fractures alone (p < 0.001). Fractures, dislocations, or fracture-dislocations of midtarsal bones (cuneiforms, cuboid, navicular) occurred in 26 patients (39%). Multiple metatarsal fractures and midtarsal bone injuries were more frequent in high-energy vehicular crashes than in low-energy injuries (p = 0.016 and p = 0.033, respectively). In 23 patients (35%), the treatment had been focused on multiple metatarsal fractures or midtarsal bone injuries without full appreciation of the concomitant Lisfranc joint incongruity. Increasing the knowledge of normal foot anatomy and the appreciation of the risk of Lisfranc joint injury even in seemingly trivial stumbling accidents obviously may improve the diagnosis and treatment of these potentially disabling injuries.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2004

Pantarsal arthrodesis with a customised medial or lateral bone plate in 13 dogs.

Pantarsal arthrodesis was performed in 12 dogs using a customised medial bone plate, and in one using a lateral bone plate. The dogs' ages ranged from 14 months to 144 months (median 30 months) and their bodyweights ranged from 7 to 66 kg (median 32 kg). Before the surgery they had been lame on a pelvic limb for between one and 16 months (median eight months). In eight of the dogs the fixation of the plate was augmented with a calcaneotibial positional screw, and in one of them with a talocrural lag screw. A cranial half cast was applied to 12 of the dogs and an external skeletal fixator to the other for six to eight weeks. Five complications were recorded in four of the dogs. Between 29 and 156 weeks postoperatively the clinical outcome was graded as excellent in six dogs, good in six dogs and fair in the other.

Animals↗
PubMedDate not supplied

Reliability of an isokinetic dorsiflexion and plantar flexion apparatus.

The insufficient amount of research to support high reliability of isokinetic ankle joint adaptations indicates a need for study in this area. Certain brands of isokinetic machinery and specific joint apparatuses have been studied for consistency in adequate numbers of investigations, while there has been little research done on other brands and all other joint adaptations besides the knee. We studied the Biodex B-2000 dorsiflexion and plantar flexion adaptation for reliability between two trials of contractions measuring peak torque. Our results showed generally low reliability coefficients between trials in every condition tested with respect to each ankle motion and two different isokinetic speeds. No connection was seen between ankle motion and isokinetic speed with respect to reliability. Attempts to pinpoint reasons behind inconsistencies concentrate upon such areas as the subject testing position, time between trials, and machine structure. Areas of further study might deal with different brands of isokinetic devices and also the different joint adaptations.

Adolescent↗