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At least 19 recordsLinked to original sources

A study of ankle instability utilizing ankle arthrography.

A preclinical and clinical study of ankle arthrography for chronic ankle instability was performed. In the first study, ankle arthrograms were done on 50 cadaver ankles to demonstrate the limits of the normal ankle joint, and it was demonstrated that contrast in tendon sheaths is not a sign of a torn ankle ligament. The second study consisted of investigating ten cases of chronic ankle instability utilizing ankle arthrography. It was concluded that ankle arthrography is helpful in diagnosing torn ankle ligaments if all remaining investigative procedures are negative. A positive ankle arthrogram is proof that a torn capsule and ligament has occurred. However, in this small series a negative a negative arthrogram and a normal talar tilt was still associated with a torn ligament of the ankle.

Adolescent

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

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

Total ankle replacement versus nonoperative management for end-stage ankle osteoarthritis: A comparative analysis.

BACKGROUND: The optimal management of end-stage ankle osteoarthritis remains debated. This study compared short-term outcomes between non-operative treatment, total ankle replacement (TAR), and cases in which indicated surgery was delayed. METHODS: In this secondary analysis of prospectively collected data, treatment survival, Foot and Ankle Outcome Score (FAOS), and patient satisfaction were assessed at baseline and at 1- and 2-year follow-up. RESULTS: In a total of 316 patients one-year treatment survival was highest for TAR (99.3%), followed by NOM (94.4%) and delayed surgery (80.9%). TAR demonstrated significantly superior FAOS pain and quality-of-life scores compared with NOM and delayed surgery. Delayed surgery was associated with significantly worse pain and quality-of-life outcomes. Patient satisfaction was highest in the TAR group and lowest in the delayed surgery group. CONCLUSIONS: TAR provides superior pain relief, quality of life, and satisfaction compared with non-operative management in end-stage ankle OA. While NOM remains a valid option for selected patients, delaying indicated surgery results in inferior outcomes, underscoring the importance of timely, shared decision-making.

Humans

Controlled trial of an ankle support (Malleotrain) in acute ankle injuries.

A randomized, controlled parallel-group trial has assessed 14 days' use of a new ankle support (Malleotrain, Bauerfeind, Aldershot, UK) in 220 patients (118 Malleotrain, 102 control group) with acute ankle injuries. Self-assessed pain levels were significantly lower in the group using Malleotrain at the end of the trial (P less than 0.05), as were median times taken for reduction of symptom scores to 10% (P less than 0.05) and total analgesic consumption during the trial (P less than 0.05). Overall clinical assessment scores were significantly superior in the Malleotrain group (P less than 0.02). Of those patients who received Malleotrain, 112 of 116 patients who commented (95% of all Malleotrain-treated patients) did so positively and only one patient stopped wearing the support during the trial. Malleotrain is acceptable to patients with acute ankle injuries and its use increases the rate of alleviation of symptoms. Its use should therefore be considered in the management of all such patients.

Acute Disease

Ankle arthrography and ankle distortion.

A ligament rupture is found in some 60% of patients with ankle distortion. The rupture usually involves the anterior talofibular ligament, and there may be associated ruptures of other ankle ligaments. Clinical findings and conventional radiological examination (including stress exposures) are insufficiently reliable for demonstration or exclusion of a ligament lesion. Ankle arthography is a relatively simple method of investigation; interpretation of the images obtained is generally no problem. Surgical exploration has nearly always confirmed the arthrographic diagnosis 'ligament lesion'.

Ankle Injuries

Treatment of ankle sprains with joint aspiration, xylocaine infiltration, and early mobilization. Ankle sprains treated with xylocaine infiltration and early mobilization.

Ninety-nine ankle sprains were arbitrarily divided into a control (54 patients) and a study (45 patients) group. Both groups were treated with elevation, ice compression wraps crutches, and early mobilization. In addition, the study group underwent ankle joint aspiration and local injection of the involved ligaments with 4-10 cc of 1% xylocaine. The difference between recovery times in the control group (mean, 10.7 days) and in the study group (mean, 4.4 days) reached statistical significance at p less than 0.001 by Wilcoxon two-sample test. Because there are inherent risks in this treatment, it is not recommended for all patients. However, for those requiring early remission of symptoms to allow early return to pre-injury activities, this treatment is suggested by the author.

Adult

[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

Acute rupture of the lateral ligaments of the ankle joint, diagnosis and surgical treatment.

A useful method for the diagnosis of acute rupture of the lateral ligament of the ankle joint is presented. Twenty-three patients with ruptures of the lateral ligament of the ankle joint were treated surgically with suture of the lateral ligaments of the ankle. Accurate preoperative diagnosis with stress films and arthrography under local anesthesia of the ankle joint is imperative. No instances of infection or other complications were observed. All patients achieved a normal range of ankle function within three to six months. Radiograhs of the injured ankle in the forced inversion position following operation showed full stability of the ankle joint. In our opinion, all ankle injuries should be examined roentgenographically with forced inversion of the foot. Tilting of the talus of at least 10 degrees must be followed by arthrography of the ankle joint under local anesthesia. If there is leakage of contrast material along the peroneal tendon sheaths and around the joint cavity, the lateral ligament of the ankle must be sutured immediately in order to regain stability of the ankle joint.

Ankle Injuries

[Diagnostic arthroscopy and arthroscopic surgery of the upper ankle joint].

Arthroscopy of the ankle joint was limited to the anterior compartments for a long time. The key to the entire diagnostic and therapeutic arthroscopy procedure on the ankle joint was the distension of the joint space through modern distraction techniques. The distraction devices available make arthroscopic surgery of the ankle joint as effective as in other joints like the knee and shoulder. Distension of the joint space allows visualization of all compartments, including the posterior ankle. In the case of hidden cartilage pathology of the posterior talus, an osteotomy linked with hardware removal through a second operation can be avoided today. The indications for arthroscopy of the ankle are pain, swelling, instability, hemarthrosis and joint locking. Generally, arthroscopy of the ankle joint is performed utilizing three general portals: anterolateral, anteromedial and posterolateral. Arthroscopic standard equipment, including the small joint set, is sufficient to treat the major part of ankle pathology through the standard portals. Arthroscopic ankle joint debridement in degenerative arthritis, removal of osteophytes, elimination of loose bodies and the management of soft tissue and bony impingement are possible. A complete synovectomy can be performed, including the posterior compartments. The treatment of osteochondritis dissecans is facilitated through the transmalleolar approach in combination with the distraction device. Arthroscopic ankle arthrodesis is possible and induces less trauma because an arthrotomy can be avoided. In our opinion diagnostic arthroscopy and arthroscopic surgery of the ankle joint is a procedure of great benefit for the patients if the indications are strictly adherred to.

Ankle Injuries

Arthrodesis for failed ankle arthroplasty.

Thirty-eight ankles in 36 patients who underwent fusion for failed total ankle arthroplasty were reviewed. Twenty-two patients were women and 14 were men, and their mean age was 56.8 years. The fusion methods performed in the 38 ankles were malleolar resection in 13, intercalated bone graft in 20, and posterior tibiotalocalcaneal fusion in 5. Fixation was external in 36 ankles and internal in 2. Bone graft was used in 32 ankles. Union was achieved in 33 ankles (89%). The average duration of the follow-up period in 29 patients (31 ankles) was 8.3 years (range, 2-14.4 years). Patients had no or mild pain in 24 ankles (80%). Complications occurred in five ankles (13%). Failed total ankle arthroplasty may be successfully salvaged by arthrodesis.

Adult

Force and motion analysis of the normal, diseased, and prosthetic ankle joint.

A 2-dimensional motion and force study of the ankle joint during gait has been carried out on normal subjects and patients with ankle joint disease, before and 1 year following total ankle replacemetn. The methods employed involved the use of high-speed motion picture film, force plate and foot-switch data. The Achilles and anterior tibial tendon forces, the compressive and tangential (shear) forces across the ankle during stance phase of gait were determined, based on a quasi-static analysis. During stance phase of gait normal subjects used a mean of 24.4 degree of sagittal plane ankle motion. Patients with ankle joint disease showed reduced motion which returned to near normal values 1 year following total ankle replacement. Compressive force across the ankle joint rose to about 5 times body weight during the latter part of stance phase. Backward, or aft, shear forces or nearly full body weight were demonstrated during all but the last 20% of stance phase. Patients with ankle joint disease apparently altered their gait to markedly reduce these forces. Following total ankle replacement, shear forces returned toward more normal values, but compressive forces were not significantly changed.

Adult