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Postoperative Imaging of the Ankle: a Review
Postoperative Imaging of the Ankle: A Review Society of Skeletal Radiology Annual Meeting, 2020 Okezika Kanu MD1, Sameh A. Labib MD2, Adam Singer MD1, Monica Umpierrez MD1, Felix Gonzalez MD1, Philip Wong MD1 1Emory University School of Medicine Department of Radiology and Imaging Sciences Division of Musculoskeletal Imaging 2Emory University School of Medicine Department of Orthopaedics Correspondence: [email protected] Objectives • To review common procedures performed in the ankle • Be come familiar with the expected postoperative appearance of the various procedures • Recognize complications associated with these procedures Posterior Ankle PROCEDURES ❑ Primary end-to-end Achilles tendon repair ❑ Achilles tendon lengthening ❑ Flexor hallucis longus (FHL) transfer ❑ Haglund excision and Achilles tendon reattachment Achilles Tendon Repair A B C 53 year old female with right posterior ankle pain after hearing a pop. (A): Sagittal PD FS of the ankle demonstrating full thickness midsubstance tear of the Achilles tendon with tendon gap of approximately 4.0 cm (bracket). (B and C): Sagittal T1 and PD FS postoperative images 3 years after primary end-to-end repair. There is expected thickening of the repaired tendon, which is intact. Linear intermediate intrasubstance signal (arrows) within the mid substance may represent minimal degeneration or postoperative changes. Additionally, there is loss of the calcaneus declination angle, indicative of possible lengthening of the Achilles. Achilles Lengthening A B C Achilles tendon lengthening procedures are typically done for patients with congenital or acquired equinus contracture. Z-lengthening Technique: (A): Illustration demonstrating the Z-lengthening technique. This is an open procedure with longitudinal incision made 2-6 cm proximal to the insertion. -
Hemi-Castaing Ligamentoplasty for the Treatment of Chronic Lateral Ankle Instability: a Retrospective Assessment of Outcome
International Orthopaedics (SICOT) DOI 10.1007/s00264-011-1284-9 ORIGINAL PAPER Hemi-Castaing ligamentoplasty for the treatment of chronic lateral ankle instability: a retrospective assessment of outcome Tim Schepers & Lucas M. M. Vogels & Esther M. M. Van Lieshout Received: 30 April 2011 /Accepted: 17 May 2011 # The Author(s) 2011. This article is published with open access at Springerlink.com Abstract augmentation (i.e. the Broström-Gould technique) and the Purpose In the treatment of chronic ankle instability, most non-anatomical repair should be reserved for unsuccessful non-anatomical reconstructions use the peroneus brevis cases after anatomical repair or in cases where no adequate tendon. This, however, sacrifices the natural ankle stabilising ligament remnants are available for reconstruction. properties of the peroneus brevis muscle. The aim of this study was to evaluate the functional outcome of patients treated with a hemi-Castaing procedure, which uses only half Introduction the peroneus brevis tendon. Methods We performed a retrospective cohort study of It has been estimated that more than 80 techniques exist for patients who underwent hemi-Castaing ligamentoplasty for the treatment of lateral ankle instability [16, 18]. One of the chronic lateral ankle instability between 1993 and 2010, earliest ideas was to prevent chronic instability from with a minimum of one year follow-up. Patients were sent a happening by early suturing of the acutely ruptured postal questionnaire comprising five validated outcome ligaments; currently, this management strategy is no longer measures: Olerud-Molander Ankle Score (OMAS), Karlsson in use [26]. Nowadays, most agree to perform surgery in Ankle Functional Score (KAFS), Tegner Activity Level Score the 15–40% of patients with recurrent instability who are (pre-injury, prior to surgery, at follow-up), visual analog scale hampered in daily or sporting activities [4, 7, 37]. -
International Journal of Innovative Technology and Exploring Engineering
International Journal of Innovative Technology and Exploring Engineering ISSN : 2278 - 3075 Website: www.ijitee.org Volume-9 Issue-8, JUNE 2020 Published by: Blue Eyes Intelligence Engineering and Sciences Publication xploring En E gi d ne an e r y in g g lo o n h c e T IjItEe e I n v i t t e E a X r v P N n o L O a O I n T t R A i o I V n N O I G N n IN f a o l l J a o r n u www.ijitee.org Exploring Innovation Editor-In-Chief Dr. Shiv Kumar Ph.D. (CSE), M.Tech. (IT, Honors), B.Tech. (IT), Senior Member of IEEE, Member of the Elsevier Advisory Panel CEO, Blue Eyes Intelligence Engineering and Sciences Publication (BEIESP), Bhopal (MP), India Associate Editor-In-Chief Dr. Takialddin Al Smadi Professor, Department of Communication and Electronics, Jerash Universtiy, Jerash, Jordan Dr. Vo Quang Minh Senior Lecturer and Head, Department of Land Resources, College of Environment and Natural Resources (CENRes), Can Tho City, Vietnam. Dr. Stamatis Papadakis Lecturer, Department of Preschool Education, University of Crete, Greece. Dr. Ali OTHMAN Al Janaby Lecturer, Department of Communications Engineering, College of Electronics Engineering University of Ninevah, Iraq. Dr. Rabiul Ahasan Professor, Department of Industrial Engineering, King Saud University, Saudi Arabia. Dr. Hakimjon Zaynidinov Professor and Head, Department of Computer Science, Tashkent University of Information Technologies, Uzbekistan. Prof. MPS Chawla Ex-Chairman, IEEE MP Sub-Section, India, Professor-Incharge (head)-Library, Associate Professor in Electrical Engineering, G.S. -
Probabilidades E Estat´Istica
Probabilidades e Estat´ıstica Segundo exame/segundo teste - 08/07/2006 Sala QA Capacidade: 55 34078 FRANCISCO JORGE CAMPANTE AMARO 35935 LU´IS MIGUEL DA MOTA DORES PONCE DE LEAO˜ 39428 PEDRO MIGUEL DE ALMEIDA LIMA 40587 NUNO PEDRO CARDOSO BARRADAS BOTELHO LOUREN ¸CO 41723 NUNO PEDRO RIBEIRO 42708 NUNO ALEXANDRE OLIVEIRA FELIX´ 42844 SANDRA MARIA PEDRO MARQUES CASTELO 43285 FERNANDO JOSE´ PEREIRA MARQUES 44032 PEDRO MARIA VASCONCELOS DE ALBERGARIA PINHEIRO MOREIRA 44181 MARIA DE FATIMA´ BICHARDO BRAVO 45341 HUGO DANIEL RAMOS FONSECA 45507 LU´IS PEDRO RIBEIRO SANTANA RODRIGUES 45551 PEDRO MIGUEL GOMES MOTA CARVALHO 45570 RICARDO MIGUEL CUSTODIO´ MAUR´ICIO 45599 TIAGO MANUEL FERREIRA VIEIRA 46016 D´ILIA MARIA TAVARES LACERDA DE FIGUEIREDO 46212 SONIA´ ALEXANDRA HELENO FERREIRA 46241 JOAO˜ FILIPE RODRIGUES DRUMOND 46450 FILIPE MIGUEL BORGAS DUARTE 46698 SAMUEL CALVARIO´ PAIS MARTINS 46806 ANDRE´ FILIPE MENAIA CORREIA DELGADO 46836 DIOGO MIGUEL DIAS DUARTE 46841 FILIPE ALEXANDRE LEITAO˜ DOS SANTOS 46849 GON ¸CALOFILIPE RODRIGUES FORTES 46884 JOAO˜ RICARDO TEODOSIO´ GLORIA´ FRAGOSO 46886 JONAS GALHORDAS DUARTE ALVES 46899 LUC´ILIO SABINO GUIMARAES˜ COELHO DE OLIVEIRA 46929 NELSON MANUEL EDUARDO VER´ISSIMO 46940 NUNO MIGUEL VAZ AFONSO 46950 PEDRO MANUEL NATAL 46980 RUI GON ¸CALOMATIAS SAMPAIO 47152 PEDRO JOSE´ LUCAS NEVES PEREIRA 47165 PEDRO NUNO RODRIGUES BENTO 47609 TIAGO MANUEL DOS SANTOS RODRIGUES 47685 HUGO MIGUEL COSTA BRAS´ 48223 ANDRE´ MARTINS MAUR´ICIO 48224 ANTONIO´ PEDRO MARQUES FERREIRO 48249 FERNANDO MIGUEL CORREIA LEANDRO FERREIRA -
Final Scientific Programme Revised
SICOT/SIROT 2008 XXIV Triennial World Congress Scientific Programme 24-28 August 2008 Hong Kong Convention and Exhibition Centre Hong Kong, China 1 Programme Colour Key SICOT - Spine SICOT - Joint SICOT - Sports Medicine SICOT - Paediatrics SICOT - Foot & Ankle SICOT - Trauma SICOT - Tumours SICOT - Hand & Wrist SICOT - Shoulder & Elbow SICOT - Basic Science SICOT - General Orthopaedics SIROT Participating Associations and Societies 2 Sunday, 24 August 2008 Theatre 1 Theatre 2 Grand Hall 08:00 Free Papers Free Papers -09:00 SIROT: Biomechanics SIROT: Osteoporosis 09:00 Free Papers Free Papers -10:30 SIROT: Infections SIROT: Joint Replacement Break 11:00 Free Papers Free Papers -12:00 SIROT: Fracture Healing SIROT: Tissue Engineering 12:00 Free Papers Free Papers -13:00 SIROT: Infections / SIROT: Tumours Tissue Engineering Lunch 14:00 SICOT/SIROT -16:45 Research Commission: Stem Cells and Orthopaedics 17:30 SICOT Opening Ceremony -19:00 Sunday, 24 August 2008 Theatre 1 08:00-09:00 Free Papers – SIROT: Biomechanics Moderator : Ping-Chung LEUNG (Hong Kong) 18395 RADIOSTEREOMETRIC ANALYSIS (RSA) OF THREE-DIMENSIONAL MICROMOTION IN A FRACTURE MODEL OF FEMUR Saravana Vail KARUPPIAH, Martin DOWNING, George P. ASHCROFT, Alan J. JOHNSTONE, Blair ASHCROFT (United Kingdom) 18359 SUTURE ANCHORS FOR BANKART REPAIR REVISITED Ilias BISBINAS, Petros MIKALEF, Evangelos MAGNISSALIS, Theodoros BESLIKAS, Ioannis CHRISTOFORIDIS (Greece) 18270 INFLUENCE OF A SINGLE SHAFT ANGLE-STABLE SCREW IN OSTEOPOROTIC DISTAL RADIUS FRACTURES TREATED WITH VOLAR FIXED-ANGLE -
Facts Around the Saddle Joint (CMC1 Joint) Instructional Course SGH 17.09.2020
Facts around the saddle joint (CMC1 joint) Instructional Course SGH 17.09.2020 Esther Vögelin, MD, Prof Hand Surgery and Surgery of Peripheral Nerves Anatomy • Thumb • STT and midcarpal joints • CMC joint • MCP joint • IP joint Anatomy • How many trapezial articulations? • Two more important joints: 2 - Scaphotrapezoidal joint (5) 3 - MCP joint 1 5 4 • Skeletal Radiol 2015;44:165-77 Anatomy • Two opposing saddles à wide range of motion • Skeletal Radiol 2015;44:165-77 Anatomy • Stability à 3 main ligament complexes • Palmar (anterior)[2]: • AOL („beak“), ulnar collateral • Dorsal (posterior)[3]: • POL, DRL • Intermetacarpal [2] • Skeletal Radiol 2015;44:165-77 Radiology • Robert‘s view (pa), oblique, lateral Staging Stages Radiological disease change 1 Slight widening of joint space, < 1/3 subluxation of joint 2 <2mm osteophytes present, 1/3 subluxation of joint 3 >2mm osteophytes present, > 1/3 subluxation of joint, joint space narrowing 4 Erosion of scaphotrapezial joint, significant joint space narrowing, major subluxation of joint Early stage treatment • Stabilization of CMC joint • Synovectomy • CMC joint alignement • CMC joint arthroscopy à debridement, synovectomy, electrothermal shrinkage of ligaments - Normal radiographs, - Restricted painful mobility • J AM Acad Orthop Surg 2008;16(3):140-51 Early stage treatment • Ligament reconstruction for stabilization of the CMC joint - Littler Eaton procedure: ½ FCR à AOL, intermetacarpal, dorsoradial ligaments J Bone Joint Surg Am 1973;55(8):1655-66 J Hand Surg Am 2000;25(2):297-304 - Brunelli procedure: APL Tendon à 1st and 2nd MC J Hand Surg Br Vol 1989;14B:209-212 - Pechlaner technique: ECRL strip through 1st MC and trapezium Pechlaner S. -
Three-Ligament Tenodesis” Procedure Restore Carpal Architecture in Static Chronic Scapholunate Dissociation ?
Acta Orthop. Belg., 2013, 79, 271-274 ORIGINAL STUDY Does the “three-ligament tenodesis” procedure restore carpal architecture in static chronic scapholunate dissociation ? Luc DE SMET, Sofie GOEMINNE, Ilse DEGREEF From the University Hospitals Leuven, Pellenberg, Belgium The effect of the three-ligament tenodesis on the angle on the lateral view (normally between 45 and scapholunate angle and scapholunate gap was stud- 60°). Both parameters assess the SL malalignment ied. A comparison was made between these angles in patients before surgery. Procedures such as sca- preoperatively and postoperatively in 12 patients. photrapeziotrapezoid (STT) arthrodesis (15) and the There was a significant decrease in the scapholunate original Brunelli procedure (3) concentrate on re- angle from 77 to 68°, and the scapholunate gap was ducing the SL angle without addressing the SL gap. reduced from 4.25 mm to 3.29 mm. We also studied the correlation between scapholunate angle and When rotatory disassociation is seen, some at- scapholunate gap postoperatively in a cohort of 25 pa- tenuation of extrinsic ligaments must have occurred. tients and found a significant correlation. This was the rationale for the flexor carpi radialis This suggests that the principle of the procedure is (FCR) tenodesis described by Brunelli and correct, but the aims are not fully achieved, and that Brunelli (3). A distally based strip of the FCR is the procedure has a similar effect on SL gap and SL passed through a drill hole through the scaphoid and angle. fixed on the dorsal rim of the distal radius. Later Keywords : wrist ; scapholunate ; carpus ; instability ; Van den Abbeele et al (14) and Garcia-Elias et ligamentoplasty ; Brunelli ; DISI. -
Radio-Luno-Triquetral Bone-Ligament Transfer As an Additional Stabilizer
Archives of Orthopaedic and Trauma Surgery https://doi.org/10.1007/s00402-020-03690-2 HANDSURGERY Radio‑luno‑triquetral bone‑ligament transfer as an additional stabilizer in scapholunate‑instability Luzian C. P. Haug1 · Tom Adler1 · Dietmar Bignion1 · Esther Voegelin1 Received: 23 April 2020 / Accepted: 11 November 2020 © The Author(s) 2020 Abstract Introduction Reconstruction of the scapho-lunate (SL) ligament is still challenging. Many diferent techniques, such as capsulodesis, tendon graft and bone-ligament-bone graft have been described to stabilize reducible SL dissociation. If primary ligament repair alone is not possible, an additional stabilizer is needed to achieve scapho-lunate stability. A new local bone-ligament transfer using half of the radio-luno-triquetral ligament is performed. The direction of traction of the transposed ligament is very similar to the original ligament. Ideal tension can be attained by fxation of the bone block at the dorsal ridge of the scaphoid. The biomechanical stability of this bone-ligament transfer shall be examined biomechanically. Material and methods Computed tomography imaging was performed using eight cadaveric forearms with a defned posi- tion of the wrist. Axial load was accomplished with tension springs attached to the extensor and fexor tendons. Three series ([a] native, [b] divided SL ligament and [c]) after reconstruction with bone-ligament transfer] were reconstructed three- dimensionally to determine the angles between radius, scaphoid and lunate. The radial distal part including a bone fragment of the radio-luno-triquetral ligament was transferred from its insertion at the distal edge of the radius to be attached to the dorsal ridge of the scaphoid. -
Combined Tenodesis–Capsulodesis for Scapholunate Instability: Minimum 2-Year Follow-Up
Scientific Article 11 Combined Tenodesis–Capsulodesis for Scapholunate Instability: Minimum 2-Year Follow-Up Pablo De Carli, MD1 Agustin G. Donndorff, MD1 Miguel Tovar Torres, MD1 Jorge G. Boretto, MD1 Gerardo L. Gallucci, MD1 1 Hospital Italiano de Buenos Aires, “Carlos E. Ottolenghi” Institute, Address for correspondence Pablo De Carli, MD, Hospital Italiano de Hand Surgery and Upper Extremity Center, Buenos Aires, Argentina Buenos Aires, “Carlos E. Ottolenghi” Institute, Hand Surgery and Upper Extremity Center, Gascón 450, CABA, C1199ACK Buenos Aires, J Wrist Surg 2017;6:11–21. Argentina (e-mail: [email protected]). Abstract Background The aim of this study is to evaluate the clinical and radiological midterm results of a combined dorsal tenodesis–capsulodesis for static and reducible scapho- lunate dissociation (SLD). Patients and Methods We evaluated 20 of 22 consecutive patients with static SLD minimum with follow-up of 2 years operated between 2003 and 2012. The mean age was 40 years (range: 23–65 years). Seventeen were men. Final evaluation included comparative wrist range of motion (ROM) and grip strength, pre- and postoperative pain and function by visual analog scale, and QuickDASH and Wrightington scores. Radio- graphs included preoperative, early postoperative, and final X-rays. Scapholunate space (SLS) and scapholunate and radioscaphoid angles (SLA and RSA) were measured. Statistical significance was evaluated with Student t-test, considered significant when p < 0.05. Results Mean follow-up was 67 months (range: 24–126 months). Mean final ROM was: flexion 55 degrees (73%), extension 62 degrees (90%), radial deviation 19 degrees (82%), and ulnar deviation 44 degrees (90%). -
Hemi-Castaing Ligamentoplasty for the Treatment of Chronic Lateral Ankle Instability: a Retrospective Assessment of Outcome
International Orthopaedics (SICOT) (2011) 35:1805–1812 DOI 10.1007/s00264-011-1284-9 ORIGINAL PAPER Hemi-Castaing ligamentoplasty for the treatment of chronic lateral ankle instability: a retrospective assessment of outcome Tim Schepers & Lucas M. M. Vogels & Esther M. M. Van Lieshout Received: 30 April 2011 /Accepted: 17 May 2011 /Published online: 3 June 2011 # The Author(s) 2011. This article is published with open access at Springerlink.com Abstract augmentation (i.e. the Broström-Gould technique) and the Purpose In the treatment of chronic ankle instability, most non-anatomical repair should be reserved for unsuccessful non-anatomical reconstructions use the peroneus brevis cases after anatomical repair or in cases where no adequate tendon. This, however, sacrifices the natural ankle stabilising ligament remnants are available for reconstruction. properties of the peroneus brevis muscle. The aim of this study was to evaluate the functional outcome of patients treated with a hemi-Castaing procedure, which uses only half Introduction the peroneus brevis tendon. Methods We performed a retrospective cohort study of It has been estimated that more than 80 techniques exist for patients who underwent hemi-Castaing ligamentoplasty for the treatment of lateral ankle instability [16, 18]. One of the chronic lateral ankle instability between 1993 and 2010, earliest ideas was to prevent chronic instability from with a minimum of one year follow-up. Patients were sent a happening by early suturing of the acutely ruptured postal questionnaire comprising five validated outcome ligaments; currently, this management strategy is no longer measures: Olerud-Molander Ankle Score (OMAS), Karlsson in use [26]. Nowadays, most agree to perform surgery in Ankle Functional Score (KAFS), Tegner Activity Level Score the 15–40% of patients with recurrent instability who are (pre-injury, prior to surgery, at follow-up), visual analog scale hampered in daily or sporting activities [4, 7, 37]. -
Revista De La Asociación Argentina De Ortopedia Y Traumatología Órgano De La Asociación Argentina De Ortopedia Y Traumatología
ISSN 1515-1786 REVISTA DE LA ASOCIACIÓN ARGENTINA DE ORTOPEDIA Y TRAUMATOLOGÍA ÓRGANO DE LA ASOCIACIÓN ARGENTINA DE ORTOPEDIA Y TRAUMATOLOGÍA Año 72 • Número 3 • Septiembre de 2007 Year 72 • Number 3 • September 2007 CONTENIDOS CONTENTS 209 EDITORIAL EDITORIAL E. Bersusky E. Bersusky ESTUDIOS CLÍNICOS CLINICAL STUDIES 215 Inestabilidad lateral del tobillo. Reparación Lateral ankle instability. Repair with modified con técnica de Evans modificada Evans technique G. Paniego, F. Bilbao, M. Carrasco, P. Sotelano, G. Paniego, F. Bilbao, M. Carrasco, P. Sotelano, G. Solari y A. Migues G. Solari and A. Migues El procedimiento de Evans modificado es una The modified Evans procedure is a safe and simple técnica segura y simple. Resuelve eficazmente technique. It effectively resolves the lateral instability la inestabilidad lateral de tobillo en pacientes of the ankle in general population patients. de la población general. 221 Tratamiento quirúrgico de la tendinitis rotuliana Surgery of the patellar tendinitis in en atletas de alto rendimiento high-performance athletes A. R. Salem, A. A. Salem y F. A. Salem A. R. Salem, A. A. Salem and F. A. Salem El tratamiento quirúrgico de la tendinitis rotuliana The surgical treatment of patellar tendinitis grade II en los atletas de alto rendimiento, grado II o III, or III in high-performance athletes provides excellent presenta excelentes y buenos resultados and good results in most of the cases. en la mayoría de los casos. 225 Miniincisión o abordaje posterolateral tradicional Mini incision versus conventional posterolateral en artroplastia total de cadera primaria. approach in primary total hip arthroplasty. Análisis prospectivo con el uso de instrumental Prospective analysis using conventional convencional instrumentation M. -
Athletic Injuries of the Upper Extremity: the Adolescent to the Adult - the Amateur to the Professional Co-Chairs: R
Precourse 12: Athletic Injuries of the Upper Extremity: The Adolescent to the Adult - The Amateur to the Professional Co-Chairs: R. Glenn Gaston, MD, Gary M. Lourie, MD, Thomas A. Wiedrich, MD Program Syllabus Thursday, September 05, 2019 74TH ANNUAL MEETING OF THE ASSH SEPTEMBER 5 – 7, 2019 LAS VEGAS, NV 822 West Washington Blvd Chicago, IL 60607 Phone: (312) 880-1900 Web: www.assh.org Email: [email protected] All property rights in the material presented, including common-law copyright, are expressly reserved to the speaker or the ASSH. No statement or presentation made is to be regarded as dedicated to the public domain. Precourse 12: Athletic Injuries of the Upper Extremity: The Adolescent to the Adult - The Amateur to the Professional The treatment of the injured athlete remains a continued challenge. The skeletally immature, the weekend warrior, the high-level amateur and the professional athlete all pose specific difficulties for the hand surgeon in treating the injury. Ultimately, however, the surgeon is nearly always faced with the goal of early return to play with minimal risk. This goal must be balanced with the chance of re-injury and lasting damage to the patient. The purpose of this pre-course is to offer an up-to-date review of hand, wrist and forearm injuries in the athlete, emphasizing pertinent anatomy, mechanism of injury, conservative and operative treatment and safe return to play. Lectures given by noted faculty will be divided into anatomic modules with attention to bone, ligament, tendon and miscellaneous topics. Case presentations will initiate each talk followed by a concise presentation on the specific topic emphasizing potential differences between the adolescent and the adult and the amateur versus the pro.