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At least 19 recordsLinked to original sources
PubMed1989

[The value of ultrasound in the diagnosis of capsule ligament injuries of the upper ankle joint].

Ankle ligament injuries are usually diagnosed by clinical and radiological examination. In this study we tried to determine the accuracy of dynamic sonography in the diagnosis of ankle ligament injuries. From 1 April 1987 to 1 July 1988, 72 patients with ligamentous injuries of the ankle were examined sonographically. The dynamic stability of the anterior talofibular ligament was determined by measuring the length of the ligaments under normal and stressed conditions. The anatomical course of the ligaments was used as the plane of section. Clinical and radiological examinations were used to determine whether an operation was indicated, and the results of these examinations were compared after the operation with the sonographic and intraoperative findings. Dynamic examination of the stability of the anterior talofibular ligament yielded findings compatible with the intraoperative findings in 64 of the 72 cases (88.8%). The mean difference in length between normal and stressed conditions was 7.4 mm, with a range of 6-12 mm in the case of rupture of the ligament. A high level of agreement between sonographic and intraoperative findings was also found for the calcaneofibular ligament. In 62 of the 72 cases (86.1%) a correct diagnosis was possible. The mean difference in length in this plane of section was 10.6 mm, with a range of 7-17 mm. The sensitivity and specificity of ultrasound in the diagnosis of rupture of the ligaments were between 80% and 90%, respectively, and the positive predictive value was about 95%. Sonography with a high-resolution scanner allows a correct diagnosis of ligamentous lesions at the ankle joint in 80-90% of cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1997

Arthroscopy of the ankle joint.

Ankle arthroscopy has become a standard procedure for a variety of indications. Joint distraction is applied by many authors. A recent retrospective multicentre study provoked the following questions. Is there an indication for diagnostic arthroscopy? Can arthroscopic surgery of the ankle joint be routinely performed without joint distraction? Does the range of motion increase after arthroscopic treatment of an anterior impingement syndrome? A series of 122 consecutive patients were prospectively studied in a protocol that included preoperative history taking, physical examination, and standardized follow-up at 4 months and 2 years postoperative. Excellent and good results of arthroscopic treatment were obtained in 84% of impingement lesions, in 88% of osteochondral defects, and in 88% of loose body removal. In patients in whom no definite preoperative diagnosis was made and for whom diagnostic arthroscopy was performed, only 26% benefitted from the procedure. Treatment of anterior impingement lesions resulted in a subjective feeling of increase in range of motion in 66% of the patients. In 20% of patients, however, the dorsiflexion at 2-year follow-up increased > or = 5 degrees. The arthroscopic procedures could be performed without the use of joint distraction in 98% of the cases. Arthroscopic surgery of the ankle joint is a successful procedure in treatment of impingement lesions, osteochondral defects, and removal of loose bodies. It is beneficial to perform the procedure without joint distraction. There is only limited indication for diagnostic arthroscopy.

Adult↗
PubMedDate not supplied

An artificial ankle joint.

Ankle fusion has been the time-honored treatment for painful debilitating conditions of the ankle due to osteoarthritis and rheumatoid arthritis. It is not a uniformly successful operation and has a high complication rate. If there is pre-existing disease in the knee or midtarsal joints, the pain is frequently made worse by ankle fusion. If there is no pre-existing disease, then painful degenerative changes frequently occur in the midtarsal joints subsequently. An artificial ankle joint has been used successfully since 1973 in patients who otherwise would require ankle fusion. The design of the prosthesis allows unrestricted motion in all planes. It also allows imperfect placement of the device without compromising results. The dome of the talus is not resected during insertion of the prosthesis. Only 1 cm of distal tibia is resected, thus allowing fusion without difficulty should it later become necessary. The superior position of the polyethylene device decreases wear from particulate matter which might settle by gravity. Study of 50 total ankle arthroplasty cases shows that predictably good results can be obtained in ankles with good stability, reasonably normal anatomy, and rheumatoids who are not on long-term steroid therapy.

Ankle Joint↗
PubMed1977

[Injuries of the capsular ligament of the ankle joint, so-called "ankle joint distorsion"].

The capsular and ligamentous lesion of the ankle is the most frequent injury and very common in sports. Still these injuries are frequently minimized and not treated properly. Late results are instability, subluxation and finally posttraumatic osteoarthritis. Anterio-lateral instability indicates lateral capsular-ligamentous lesions. Antero-lateral instability can be proved chinically by the anterior drawer-test and radiologically by a standardized stress x-ray in lateral position. The fresh lesion has to be treated by primary ligamentous suture or by plaster cast for 6 weeks. The treatment of chronic instability is secondary reconstruction. Severe osteoarthritis can be treated by an ankle replacement (endoprosthesis) or by arthrodesis.

Ankle Injuries↗
PubMedDate not supplied

The use of an ankle joint distractor in ankle arthroscopy.

Joint distraction, whether manual or mechanical, is a common practice in orthopedic surgery for knee and shoulder arthroscopy and can be extrapolated to include ankle joint arthroscopy. Manual joint distraction involves manipulation of the ankle joint by gravity or manual traction applied by an assistant. Mechanical distraction can be achieved by joint infiltration with solution or a joint distractor. Although the use of a joint distractor in arthroscopy of the ankle is not a new technique, podiatric literature has rarely reported on its use to allow for easier access and implementation of arthroscopic instruments. The ankle joint distractor allows the surgeon to take advantage of pathologic ligamentous laxity, thus increasing the joint space from an average 3.4 to 7.8 mm.

Adolescent↗
PubMed1995

[Physical prevention of thrombosis with the ankle joint with the motorized ankle joint movement device. Initial results of a clinical study].

Between 1993 and 1994 the value of the "Artroflow" device in deep venous thrombosis was tested in 95 trauma surgical high risk patients. Parallel to the application of Heparin and physical methods, the "Artroflow" device was employed. The test and compare group showed an equal amount of risk parameters and comparable injuries. In all patients until full mobilization a weekly clinical examination, a compression sonography of the deep leg veins and a venous Doppler examination was performed. In the test group 1 deep venous thrombosis (2.3%) and no clinically manifest lung embolism occurred. In the control group, the deep venous thrombosis rate was 21.6%. This showed a highly significant drop of the deep venous thrombosis rate in trauma surgical patients (p < 0.0041 Fisher test) and allows us to suggest the use of the "Artroflow" device in high risk patients parallel to heparin prophylaxis.

Adolescent↗
PubMed2005

Ankle joint distraction.

Ankle joint distraction is a viable alternative to ankle arthrodesis or ankle replacement. A congruent, painful, mobile, and arthritic ankle joint that is treated with this technique can achieve good to excellent results. Attention to the principles (anterior osteophyte resection, equinus contracture release, and ankle joint realignment procedures) is as important for a successful outcome as the accurate application of the hinged ankle joint distraction technique itself.

Animals↗
PubMed1995

The influence of orthoses on the proprioception of the ankle joint.

The ankle joints of 14 healthy volunteers and 16 patients with unstable ankle joints were tested regarding their functional and proprioceptive capabilities. All of them were active athletes. Three tests were used of the study: single-leg stance test, single-leg jumping course test, angle-reproduction test. The influence of three stabilization devices (lace-on-brace/"Mikros", stirrup-brace/"Aircast", taping) on the proprioceptivity of stable and unstable ankle joints was evaluated. The scores of the single-leg jumping course without any stabilizing device (category "standard") ranged between 8.06 and 13.68 (10.65 +/- 1.29). In the categories "Mikros" (9.85 +/- 0.99), and "Aircast" (9.99 +/- 1.14) as well as with the tape bandage (10.27 +/- 0.81) better scores were achieved. The differences "standard vs. Mikros" and "standard vs. Aircast" revealed a significant reduction of the scores with orthoses (P < 0.01). The error rate in the single-leg stance test was within the range of 0-16 (5.12 +/- 2.85) for the category "standard". It was lower for the categories "Mikros" (3.65 +/- 2.65) and "Aircast" (4.17 +/- 2.59). The error rate was highest in the group with a tape bandage (5.79 +/- 3.53). The differences "standard vs Mikros" as well as "standard vs. Aircast" were significant (P < 0.01). There was also a significant difference between these categories regarding injured and not injured ankle joints (P < 0.01). The angle-reproduction-test showed higher values for the category "standard" (2.36 degrees +/- 0.97) in comparison to the categories "Mikros" (1.46 degrees +/- 0.72), "Aircast" (1.62 degrees +/- 0.91) and "taping" (1.84 degrees +/- 0.41).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[10 years follow-up of athrodeses of the hindfoot joints and upper ankle joint].

PURPOSE: What is the clinical and radiographic outcome of arthrodeses at the hindfoot and at the ankle more than 10 years postoperatively? METHODS: Between 1968 and 1988, 155 arthrodeses (ankle joint, triple arthrodeses, subtalar, pantalar and talonavicular arthrodeses) were performed on 147 patients. Indications for arthrodesis were posttraumatic arthritis, congenital deformity, idiopathic degenerative arthritis and rheumatoid arthritis. A variety of internal fixation devices or no internal fixation were used. 79 patients with 82 arthrodeses were reexamined clinically and radiographically, after 11.1 years on average. Static and dynamic foot print measurements were recorded with a capacitive sensor system. Another 26 patients with 27 arthrodeses replied to a questionnaire. RESULTS: Subjectively, the average pain score improved significantly. The overall function score improved only slightly. Results were inferior in the talonavicular arthrodesis. Radiographic evaluation revealed bony union in only 59 percent of the arthrodeses, one third at the talonavicular joint. Secondary degenerative arthritis of the foot and ankle occurred in 107 joints of the 82 feet. Evaluation of dynamic foot pressure measurements revealed an overall prolonged weightbearing on the midfoot region. CONCLUSION: An unacceptably low rate of bony union in some locations, a high incidence of secondary degenerative changes at neighboring joints, and a persistent abnormality of the plantar weightbearing pattern in the operated feet demonstrate unsatisfactory results with the techniques used more than 10 years ago. We now recommend stable internal fixation with optimum adaptation of the bone surfaces of the arthrodesis.

Activities of Daily Living↗
PubMedDate not supplied

Comparative radiologic study of the influence of ankle joint bandages on ankle stability.

A comparative radiologic study was carried out to test the stabilizing value of ankle strapping and taping on unstable tibiotalar joints. Unstable ankle joints of 51 athletes were examined without bandages, with strapping, and with taping before and after an activity program. The use of taping proved to give the greatest decrease of the talar tilt (TT) angle. This improvement was greater, even after activity, than the stabilization obtained by strapping before any activity.

Adolescent↗
PubMed2001

[Anatomy and biomechanics of the upper ankle joint].

The ankle joint as a component within the construction of the foot must be seen as a compromise between the static and dynamic demands made upon it. In this article the structure and function of the ankle joint are described with special reference to the formation of morphological parameters such as the distribution of subchondral mineralization, cartilage thickness, subarticular cancellous bone and mechanical properties. These parameters could be seen as a biological reflection of the individual mechanical conditions.

Ankle Joint↗
PubMed2003

New concepts in the treatment of ankle joint fractures. The IP-XS (XSL) and IP-XXS (XXSL) nail in the treatment of ankle joint fractures.

INTRODUCTION: The most important factor in the treatment of ankle joint fractures is stable anatomical reconstruction of the syndesmosis and joint surface. In the course of this, attention must be paid to soft-tissue damage with the risk of deep infections. Early functional therapy and exercise tolerance must be called for. The choice of surgical access route, in particular in the case of critical arterial circulation, and the possible irritation of the soft tissue by the osteosynthesis material prompted us to seek alternative osteosynthesis techniques. MATERIAL AND METHODS: Following a preclinical study and very good initial results with the XS nail in the treatment of patella and olecranon fractures, this was now also used for ankle joint fractures at the medial malleolus and lateral malleolus. In the period from 5/2000 to 1/2002, 194 ankle joint fractures were treated using the XS nail. These were predominantly Weber B, C and bimalleolar fractures. In the case of ankle joint fractures, osteosynthesis was carried out following precise open fracture repositioning. In the case of isolated fibula fractures, early loading was allowed within 1 week; in the case of bimalleolar fractures, there was immediate partial loading with 20 kg for 4 weeks, after which they were subjected to full loading. Where there was an additional Volkmann fracture, we allowed only immediate partial loading with 10 kg for 6 weeks. All 194 patients were observed prospectively, and 162 (83.5%) could be followed up after 15 months. The results were classified according to the scale described by Olerud. RESULTS: It has been possible to follow up 162 patients, with an average age of 49.7 years. There were 62 (38.3%) Weber B and 45 (27.8%) Weber C fractures. In 55 (34.0%) cases, bimalleolar fractures were present. According to the Olerud score, 95 (58.6%) of the patients had an excellent outcome, 54 (33.3%) a good one, 9 (5.5%) a fair one and 4 (2.5%) an unsatisfactory outcome. In 3 cases a threaded wire dislocation occurred, without complications. Two mesh graft transplants were necessary; otherwise, there were no soft-tissue problems requiring review. One pseudarthrosis was seen. CONCLUSION: The XS nail which is introduced here fulfils the requirements made of an implant as regards maximum protection of soft tissue, secure fracture fixation and early exercise tolerance, including ankle fractures. No implant dislocation, no deep infection and no re-osteosynthesis were observed. Its advantages over conventional techniques lie precisely in the treatment of complex fractures and for patients with poor bone, vascular and soft-tissue situations.

Adolescent↗
PubMed1989

[Functional anatomy of the upper ankle joint].

The ankle joint is regarded as a hinged joint with a range of motion of about 60 degrees. The shape of the trochlea tali varies, so the axis of rotation and the compensative movements of the fibula do. The ligamentous stabilizers of the medial side are thicker than the lateral ones. At the other hand, the lateral malleolus is more voluminous than the medial one. The lig. fibulotalare ant. is a reinforcement of the joint capsule, the lig. fibulocalcaneare has no connection to the jointcapsule, the lig. fibulotalare post. is partially running through the joint. In neutral- and plantarflexed position, the lig. fibulocalcaneare forms a groove which takes up the tendon sheat of the peroneal tendson. In dorsalextended position the tendons are pushed laterally by the tense ligament. This mechanism supports the peroneal tendon luxation in dorsal extension.

Ankle Joint↗
PubMed1986

[Anatomy of the ligaments of the upper ankle joint].

The ankle joint is stabilized by a specialized system of ligaments. These are the medial and lateral collateral ligaments and the anterior and posterior syndesmoses, the arrangement and orientation of which can only be understood in terms of function. In the vast majority of cases, injury involves the fibular capsuloligamentous apparatus which, according to anatomical and intra-operative findings, exhibits considerable anatomical variability, recognition of which is a prerequisite for the correct diagnosis and therapy of such lesions.

Ankle Joint↗