PubMed · 10402840
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W S Ferguson. 1999. From twisted ankles.. https://pubmed.ncbi.nlm.nih.gov/10402840/
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OBJECTIVES: To determine if semi-rigid synthetic casts provide any measurable advantages compared to rigid synthetic casts. BACKGROUND: Glass fibre bandages are now commonly applied immediately post-injury to provide rigid immobilisation of the limb, for both weight bearing and non-weight bearing casts. However, composite casts that have inherent flexibility are also available and it is claimed they provide some functionality. METHODS: Five members of the orthopaedic department each applied a rigid and a semi-rigid below elbow (Colles) and a below knee walking cast to a single volunteer subject. Joint immobilisation and functional movement was assessed using electrogoniometry and limb support using pressure transducers. RESULTS: Semi-rigid Colles casts provided slightly greater immobilisation at the wrist while allowing full finger function and greater support to the forearm during hand movements. Similarly, semi-rigid below knee walking casts produced greater immobilisation at the ankle while allowing more forefoot movement and were less of an impediment to walking. CONCLUSIONS: Semi-rigid casting techniques have measurable advantages compared to rigid synthetic casts and represent a further development in the conservative management of fractures and soft tissue injuries. RELEVANCE: Semi-rigid casting is a relatively new technique that can reduce some of the problems of rigid cast immobilisation and could potentially shorten the rehabilitation phase following injury. Information about the performance of these casts to assess their value in specific applications is very limited.
Tibialis anterior tenosynovitis is a rare orthopaedic condition that usually resolves with conservative treatment. Surgery may be required for chronic cases and endoscopy seems to be a valid therapeutic alternative. During debridement of the hypertrophic synovium, care must be taken to avoid damaging the extensor retinaculum to prevent potential postoperative bowstring phenomenon of the tendon.
The Cotton test assists the orthopaedic surgeon in the intra-operative evaluation of potential incompetence of the ankle syndesmosis. A variation of this test is proposed that simplifies this test, while providing a direct distraction force to the syndesmotic ligamentous complex.