Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “ANKLE”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 109 records · Page 6Linked to original sources
PubMed1997

Effect of ankle-foot orthosis on active ankle moment in patients with hemiparesis.

The paper investigates the effect of dorsi/plantar rigidity and the initial angle of ankle-foot orthoses (AFOs) on the moment generated by ankle musculature (referred to as active ankle moment) during gait in patients with hemiparesis. In the early stance phase, the active ankle moment in the direction of dorsiflexion is negligible, and AFOs play an important role in supplementing weak dorsiflexion. In mid to late stance, the moment generated by AFOs is very small compared with the active ankle moment in the direction of plantarflexion. AFOs therefore play only a limited role in assisting plantar flexors during this period. The active ankle moment in the direction of plantarflexion varies significantly with changes in the rigidity and initial angle of AFOs in 11 out of 20 subjects. The implication of this finding is discussed in relation to the need for dynamic matching of AFOs in individual patients with hemiparesis.

Adult↗
PubMed2006

[Ankle arthrodesis versus ankle replacement: a comparison].

Ankle arthrodesis is performed for the treatment of unstable, arthritic, painful, and deformed ankle joints. A wide variety of surgical options and approaches exist to treat the difficult problem of an ankle arthrodesis. In patients with only minor ankle deformity and minor bone loss arthroscopically assisted fusion is the treatment of choice. The risk for the development of a pseudarthrosis depends on clinical factors like corticoid medication, nicotine, incorrect alignment and improper mobilization. With adequate shoes the patients can remain asymptomatic for long time. Adjacent joints may show radiological degenerative changes in the long-term follow-up; however, they do not need to be clinically symptomatic. Nowadays total ankle replacement is a valid alternative. The surgical technique is demanding. Implants of the 1st and 2nd generation did not show satisfying results. The newer 3rd generation total ankle arthroplasties show promising medium-term and long-term results.

Ankle Joint↗
PubMedDate not supplied

Occult ankle fracture detected by an ankle effusion on plain radiography: a case report.

Subtle ankle fractures may escape detection on plain radiography. These occult fractures can cause prolonged disability and pain. We present a case of blunt ankle trauma where plain radiography failed to reveal any bony abnormalities. The recognition of an ankle effusion on plain radiographs prompted us to perform a computed tomography (CT) scan of the ankle. The CT scan demonstrated an anterior plafond fracture of the distal tibia, which required surgical fixation. Had the fracture not been identified, our patient would have been treated inappropriately for a ligament sprain. An occult fracture should be suspected if an ankle is grossly swollen after blunt trauma, and plain radiography demonstrates an effusion. In this circumstance, performance of further imaging studies, such as conventional or CT, are advised to rule out an occult ankle fracture.

Adult↗
PubMed2005

Automatic ankle pressure measurements using PPG in ankle-brachial pressure index determination.

OBJECTIVE: To evaluate a new technique using a photoplethysmographic (PPG) probe for automatic ankle pressure measurements. DESIGN: Comparative study on two techniques for ankle pressure measurement. SETTING: University hospital. MATERIAL: Thirty-five patients with leg arterial disease and eight healthy volunteers. Ankle-brachial indices (ABPI) were measured using conventional CW Doppler technique and PPG-based prototype equipment for the ankle pressure recordings. CHIEF OUTCOME MEASURES: ABPIs calculated from CW Doppler and PPG ankle pressure measurements. The PPG signals were analysed both by visual judgement and by a software based, automatic algorithm. MAIN RESULTS: The mean difference between ABPIs calculated from CW Doppler recordings and PPG (visual analysis) was -0.01 (limits of agreement (+/-two standard deviations) +0.16 to -0.19). The correlation coefficient was 0.93. When the algorithm was used, the mean difference (CW Doppler-PPG) was 0.05 (limits of agreement 0.28 to -0.18, r=0.89). CONCLUSIONS: The PPG method is a promising technique with an inherent potential for automatisation of the ankle pressure measurements, thereby reducing the observer-dependency in ABPI recordings.

Adult↗
PubMed2001

Geometry and mechanics of the human ankle complex and ankle prosthesis design.

The main objective of the study was to develop a model of the intact human ankle complex. It was also aimed at designing total ankle replacement which would better reproduce the physiological function of the joint. Passive flexion was analysed in seven lower-leg preparations with a stereophotogrammetric system. The articular surfaces and fibres within the calcaneofibular and tibiocalcaneal ligaments prescribed the changing positions of the axis of rotation. Joint motion included rolling as well as sliding. A computer-based model elucidated the observed kinematics at the intact joint. The experimental evidence and the geometrical model gave the basis for the design of models of replaced ankle in the sagittal plane. A three-component, convex-tibia prosthesis was eventually selected with articular surface shapes compatible with the geometry of the ligaments. It was demonstrated that in intact ankle joint, the geometry of the articular surfaces is strictly related to that of the ligaments and that current prosthesis designs do not restore physiological pattern of ligament tensioning. Careful reconstruction of the ligaments is recommended in any ankle surgery for maintenance of the normal kinematics and mechanics. A proposed novel design based on ligament/shape compatibility may improve total ankle replacement results.

Ankle Joint↗
PubMed2001

Quantitative EMG analysis to investigate synergistic coactivation of ankle and knee muscles during isokinetic ankle movement. Part 1: time amplitude analysis.

Synergy generally refers to the coordinated action of several motor elements to produce a specific motor task, either intentionally or automatically. One example is motor irradiation, a sudden spread of synergistic muscular coactivation resulting from a forceful single joint movement. To investigate this type of synergy pattern, a quantitative EMG approach was employed to characterize explicit neuromuscular synergy in the ankle-knee complex during maximal ankle isokinetic contraction. In the present study, isokinetic ankle contractions, both dorsiflexion and plantarflexion, at four different speeds (30, 60, 120, and 240 degrees/s) were studied in a normal adult population (N=11) to assess synergistic coactivation of the prime movers (tibialis anterior and gastrocnemius) and irradiated muscles (ipsilateral and contralateral rectus femoris and biceps femoris) of the ankle-knee complex. Electromyographic signals were collected with surface EMG electrodes and processed with traditional time-amplitude analysis to examine specific neural control strategies. The data generally supported several empirical assumptions common to neurological facilitation techniques. (1) Motor irradiation to the knee muscles due to ankle muscle isokinetic contraction was strongly directionally dependent. (2) Motor irradiation to the ipsilateral knee muscles due to ankle isokinetic contraction was speed dependent. (3) The prime movers demonstrated a similar control strategy, irrespective of different contraction speeds.

Adult↗
PubMedDate not supplied

Ankle arthroscopy: follow-up study of 33 ankles--effect of physical therapy and obesity.

A retrospective analysis was conducted of 32 patients (33 ankles) who had undergone surgical ankle arthroscopy for chronic ankle pain that was recalcitrant to conservative treatment. All patients were examined clinically and completed a written questionnaire. Intraoperative ankle arthroscopy showed hypertrophic synovitis, adhesive bands, chondral bands with synovitis, osteophytes, and abnormalities in the talar dome. Results of treatment after an average follow-up time of 1.4 years (range: 0.33 to 12.5 years) showed ankle scores of 15 excellent, 11 good, 5 fair, and 2 poor. Obesity was significantly related to the outcomes of arthroscopy procedures. Obese patients were more likely to be rated as fair or poor, while nonobese patients were significantly more likely to be rated excellent or good. Those patients who received physical therapy postoperatively for one or more months had significantly better ankle ratings than those who did not elect to have physical therapy.

Adolescent↗
PubMed1999

Validation of the Ottawa Ankle Rules in children with ankle injuries.

OBJECTIVES: The Ottawa Ankle Rules (OAR) have been found to be 100% sensitive in adult patients with ankle injuries, and application of the OAR has resulted in a 28% reduction in the number of x-rays ordered. The objectives of this study were to determine the sensitivity and specificity of the OAR in children and to determine the potential change in x-ray utilization. METHODS: Children, aged 2-16 years, presenting to the EDs of two children's hospitals, with an ankle injury in the previous 48 hours, were enrolled. All patients were assessed by either staff physicians or fellows. X-rays were ordered according to standard clinical practice. Prior to reviewing x-rays, the physical examination was recorded on a standardized form. Positive outcomes (clinically significant) were defined as fractures with fragments > or =3 mm. Patients not x-rayed and asymptomatic at five to seven days postinjury were considered to have no significant fracture. RESULTS: Six hundred seventy patients were enrolled. The OAR were 100% sensitive (95% CI = 95% to 100%) for significant ankle fractures, with a specificity of 24% (95% CI = 20% to 28%). The OAR were 100% sensitive (95% CI = 82% to 100%) for the midfoot, with a specificity of 36% (95% CI = 29% to 43%). If the OAR had been followed, there would have been a reduction of ankle x-rays by 16% and foot x-rays by 29% without missing any clinically significant fracture. However, analysis of the two hospitals showed that if the rules had been applied, one would have a reduction in x-rays, while the other center would have an increase. CONCLUSIONS: This study demonstrates the OAR to be sensitive for detecting clinically significant (> or =3 mm) ankle and midfoot fractures in children. The application of these rules may reduce the number of x-rays ordered. A further study is required to determine the effect of using the OAR in clinical practice.

Adolescent↗
PubMed2003

Accuracy of Ottawa ankle rules to exclude fractures of the ankle and mid-foot: systematic review.

OBJECTIVE: To summarise the evidence on accuracy of the Ottawa ankle rules, a decision aid for excluding fractures of the ankle and mid-foot. DESIGN: Systematic review. DATA SOURCES: Electronic databases, reference lists of included studies, and experts. REVIEW METHODS: Data were extracted on the study population, the type of Ottawa ankle rules used, and methods. Sensitivities, but not specificities, were pooled using the bootstrap after inspection of the receiver operating characteristics plot. Negative likelihood ratios were pooled for several subgroups, correcting for four main methodological threats to validity. RESULTS: 32 studies met the inclusion criteria and 27 studies reporting on 15 581 patients were used for meta-analysis. The pooled negative likelihood ratios for the ankle and mid-foot were 0.08 (95% confidence interval 0.03 to 0.18) and 0.08 (0.03 to 0.20), respectively. The pooled negative likelihood ratio for both regions in children was 0.07 (0.03 to 0.18). Applying these ratios to a 15% prevalence of fracture gave a less than 1.4% probability of actual fracture in these subgroups. CONCLUSIONS: Evidence supports the Ottawa ankle rules as an accurate instrument for excluding fractures of the ankle and mid-foot. The instrument has a sensitivity of almost 100% and a modest specificity, and its use should reduce the number of unnecessary radiographs by 30-40%.

Ankle Injuries↗
PubMedDate not supplied

Ankle sensorimotor control and eversion strength after acute ankle inversion injuries.

We performed this study to monitor changes in ankle eversion strength and sensorimotor control functions after acute ankle inversion injury. Forty-four patients with clinical grade II to III first-time ankle inversion sprains were tested for 1) pathologic talar tilt and anterior talar translation at 1 and 12 weeks after injury; 2) isometric eccentric ankle eversion strength and 3) peroneal reaction time to sudden ankle inversion at 3, 6, and 12 weeks after injury; and 4) accuracy of inversion position assessment 1, 3, 6, and 12 weeks after injury. Not all patients could perform all tests at the early follow-up visits. There was mechanical instability in 19 of 40 tested patients at 1 week and in 4 patients at 12 weeks after injury. Eversion strength was 88% of the contralateral side 3 weeks after injury, rising to 96% after 12 weeks. The magnitude of error of inversion position sense was 190% of the contralateral side 1 week after injury; this was still affected after 12 weeks, but fell to 133%. Patients with pathologic talar tilt or anterior talar translation, or both, at 1 week after injury did not show significantly greater error in position assessment or reduction in eversion strength when compared with patients with ankles that remained stable after injury.

Acute Disease↗
PubMed2005

Ankle arthrodesis with a retrograde femoral nail for Charcot ankle arthropathy.

BACKGROUND: Tibiocalcaneal arthrodesis with retrograde intramedullary nailing has gained acceptance as a salvage procedure for a multitude of ankle and hindfoot disorders and is frequently used in Charcot arthropathy of the ankle. Because of the severe osteopenia often associated with Charcot arthropathy of the ankle, an area of stress concentration leading to stress fracture at the proximal aspect of the nail has been identified. METHODS: To determine if this potential complication can be avoided, nine consecutive diabetic individuals with Charcot arthropathy of the ankle had ankle arthrodesis with a longer retrograde femoral nail. The average age of the patients was 52.3 years. Their average weight was 102.6 kg. RESULTS: Fusion was evident on radiographs in all nine patients at an average of 10.5 weeks. None of the patients developed a stress fracture or evidence of stress concentration at the proximal metaphyseal tip of the nails. One wound infection resolved after debridement and antibiotic therapy, and one postoperative hematoma resolved without surgery. At an average 32-month followup, all patients were ambulatory, using commercially available therapeutic footwear. None had developed a new foot ulcer, infection, or new episode of Charcot arthropathy. CONCLUSIONS: The use of a retrograde femoral nail for ankle arthrodesis in patients with Charcot arthropathy appears to decrease the risk of stress fracture compared with shorter nails without increasing the risk of other complications.

Ankle Joint↗
PubMedDate not supplied

The pneumatic ankle tourniquet with ankle block anesthesia for foot surgery.

The use of a pneumatic ankle tourniquet applied to the supramalleolar ankle region is a useful method of obtaining a bloodless field in surgery of the foot. The pneumatic ankle tourniquet allows for more accurate and reproducible control of circumferential compression than the standard Esmarch bandage, when used in conjunction with the regional ankle block. Between March 1987 and October 1990, 84 foot surgeries were performed using the pneumatic tourniquet and ankle block technique on 76 patients by one surgeon. Tourniquet ischemia lasted from 30 to 105 min. Tourniquet pressure was set to 100 to 150 mm of mercury above systolic blood pressure without exceeding 325 mm of mercury. Two patients reported mild pain directly beneath the tourniquet after 45 and 70 min, respectively. Neither patient required deflation of the tourniquet to complete the procedure. The clinical and electrophysiologic evidence showed that no neurologic or vascular damage occurs. The use of the pneumatic tourniquet in conjunction with regional ankle block anesthesia provides a reasonable alternative to the standard thigh tourniquet for surgery of the foot.

Ankle↗
PubMed1995

Effectiveness of prophylactic ankle stabilisers for prevention of ankle injuries.

Ankle injuries are common at many levels of athletic participation. A relatively recent approach in injury intervention is the use of prophylactic ankle stabilisers (PAS). PAS are used with the intention of reducing the frequency and severity of ankle injuries in a cost-effective manner. To date, 4 studies have been completed to determine the clinical efficacy of PAS. Although all of the studies have methodological limitations, a general consensus of agreement exists among the findings: PAS are effective in reducing the incidence of acute ankle sprains. However, the effect of PAS on ankle sprain severity remains unclear, as varying results have been reported. PAS do not increase the risk of knee injuries. The use of PAS for ankle injury reduction appears to be justified although further research is required.

Ankle Injuries↗
PubMed1982

Mobility of the ankle joint: recording of rotatory movements in the talocrural joint in vitro with and without the lateral collateral ligaments of the ankle.

A method for graphic recording of rotatory movements in osteoligamentous ankle preparations is described. By this method it is possible to record characteristic mobility patterns in two planes at the same time. The ankle is affected by a known torque, so that the individual mobility patterns are reproducible with unchanged condition of the ligaments. Six amputated legs were investigated in the sagittal and horizontal planes and another six in the sagittal and frontal planes. Mobility patterns were recorded with intact ligaments and after successive cutting of the lateral collateral ligaments of the ankle in the anteroposterior direction. In the sagittal plane increased dorsiflexion was observed after total cutting of the lateral ligaments, while plantar flexion remained unchanged. In the horizontal plane the internal rotation of the talus increased in step with increasing injury to the ligament, particularly when the ankle was plantar flexed. When all collateral ligaments had been cut, an increase in external rotation occurred, especially in dorsiflexion. In the frontal plane the talar tilt increased gradually with increasing injury to the ligaments. Talar tilt was at a maximum in the neutral position of the ankle or in plantar flexion. After total severing of the collateral ligaments, however, talar tilt was most marked in dorsiflexion of the ankle.

Ankle Joint↗
PubMed2003

The impact of implementing the Ottawa ankle rules on ankle radiography requests in A&E.

This audit was set up to quantify the effect of implementing the Ottawa ankle rules in a district general hospital that relies on both medical and nursing radiography requests. Data were collected prospectively on 207 patients who presented with an acute ankle injury between August 2001 and February 2002. The department's activity was recorded before and after a period of teaching on the Ottawa ankle rules. Before teaching, 71% of patients with an acute ankle injury were sent for radiography; teaching reduced this figure to 56% (p < 0.05). Auditing the activity of our department enabled us to observe a significant decrease in the number of patients sent for ankle radiography following acute ankle injury. This correlates well with research in other settings. The difficulties of rationalising radiology investigations are discussed.

Adolescent↗
PubMedDate not supplied

The unstable ankle mortise--functional ankle varus.

A new etiology of lateral ankle instability is described. The concept of triplane motion at the ankle joint differs with previous descriptions of ankle joint movement. Triplane movement about the ankle joint creates varus position during plantarflexion, and must be understood when evaluating ankle instability. Functional ankle varus can be assessed and treated appropriately with proper knowledge of its existence.

Ankle Joint↗
PubMed1992

The Effects of the Swede-O, New Cross, and McDavid Ankle Braces and Adhesive Ankle Taping on Speed, Balance, Agility, and Vertical Jump.

Scores from motor performance tests were compared using subjects with taped and untaped ankles. Previous studies have shown that taped ankle support may be detrimental in vertical and standing broad jumping performance. Conflicting data have been published on the effects of commercial ankle braces on various motor tasks. The performances of 18 elite soccer players in selected tests of speed, balance, agility, and vertical jumping were compared under conditions of untaped, nonelastic adhesive taped, Swede-O-braced, New Cross-braced, and McDavid-braced ankles. Vertical jump performance was significantly reduced when subjects wore New Cross braces. There were no significant differences in tests of speed, balance, and agility among any of the support conditions. Until now, nonelastic adhesive tape has been the preferred method of prophylactic ankle support. I conclude that certain commercial ankle braces may be used as a support alternative during selected activities.

Journal Article↗
PubMed1979

Adhesive capsulitis of the ankle (frozen ankle).

Adhesive capsulitis or "frozen ankle" is a syndrome resulting from repeated ankle sprains, or perhaps following immobilization after trauma. Ankle arthrography is a useful and safe diagnostic procedure in this syndrome. Typical arthrographic features are described together with case histories of two patients with frozen ankle. We suggest that early mobilization of the patient following trauma is particularly important in preventing the development of a forzen ankle syndrome.

Adult↗