• Title/Summary/Keyword: Ankle fracture

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Treatment of Lateral Malleolar Fractures with Cannulated Screws in Danis-Weber type B Ankle Fractures (Danis-Weber B형 족근 관절 골절에 있어 유경 나사를 이용한 비골 외 과 골절의 치료)

  • Park, Yong-Wook;Chung, Yung-Khee;Yoo, Jung-Han;Park, Hong-Jun;Yu, Sun-O;Kang, Ki-Man
    • Journal of Korean Foot and Ankle Society
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    • v.5 no.2
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    • pp.129-135
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    • 2001
  • Purpose: To evaluate the radiographic results of the treatment for Danis-Weber type B lateral malleolar fracture with 2 cannulated screws. Materials and Methods: Thirty-four cases of Danis-Weber type B lateral malleolar fracture were available. Follow-up averaged 8 months (6-25 months). The medial clear space for lateral displacement of talus, talo-crural angle for lateral malleolar shortening, and malunion evidence of lateral malleolar fracture were observed. Results: Medial clear space was from 2mm to 4mm in 34 cases. Talo-crural angle was from $73^{\circ}$ to $82.5^{\circ}$ in 33 cases. One case was complicated with malunion of lateral malleolus. But, we found the same condition in the immediate post- operative radiographic film. Conclusion: We believe that the 2 cannulated screws fixation for Danis-Weber type B lateral malleolar simple fractures is an excellent treatment method.

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Sural Nerve Entrapment by Fragments of Calcaneal Fracture (A Case Report) (종골 골절 시 골절편에 의해 발생한 비복 신경의 포착(1예 보고))

  • Lee, Yun-Tae;Lee, Tae-Jin;Kim, Sung-Hwan;Yoon, Han-Kook
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.1
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    • pp.44-46
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    • 2011
  • Sural nerve is a sensory nerve that innervates the lateral side of ankle and foot, and the injury of this nerve can be usually caused by surgical approch of calaneal fracture or achilles tendon injury. Entrapment neuropahty of sural nerve caused by bony fragment after calcaneal fracture is not reported, yet. Authors experienced one case that sural nerve injury due to bony fragment after calcaneal fracture and we regard that it is a rare case, so we report this case after reviewing literatures.

Impact of Weight Bearing Surface on Fractures of the Talus (거골 골절에서 체중 부하 관절면의 중요성)

  • Chung, Hyun-Wook;Yoo, Si-Hoon;Suh, Jin-Soo
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.2
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    • pp.156-161
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    • 2009
  • Purpose: The fracture of talus has critical complications and results in various clinical outcomes. The purpose of this study is to evaluate clinical outcome and influence on involvement of ankle and subtalar joint. Materials and Methods: From December 1999 to December 2008, a total of 66 fractures and dislocations of talus was treated with minimal 9 months follow up period. Ankle-hindfoot scale of the American Orthopedic Foot & Ankle Society (AOFAS) was used to evaluate the clinical outcome. The complications and sequential radiologic findings were also analyzed. Results: There were 28 neck fractures, 11 lateral process fractures, 10 body fractures, 7 osteochondral fractures, 4 posteromedial tubercle fractures and 4 medial process fractures. In 38 cases, there were concomitant injuries. Ipsilateral ankle fracture, which found in 19 cases, was most common. The surgical treatment was performed in 36 cases. Mean AOFAS score was 85.5 (range, 72 to 96). In 13 of 47 cases, one or more fracture lines involving weight bearing surface were confirmed. The involvement of ankle or subtalar joint had resulted in unsatisfied outcome. Complications were developed as follows, post-traumatic arthritis in 8 cases, avascular necrosis in 3 cases, and deep infection in 2 cases. Conclusion: The involvement of ankle or subtalar joint in fractures of talus seemed to be common and to impact the clinical outcome. Meticulous consideration about that will be positively necessary.

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The Effect of Fibular Fixation on Ankle Function in Intramedullary Nailing for Distal Tibiofibular Fractures (원위 경비골 골절에 대한 골수강내 금속정술에서 비골 고정이 족근 관절 기능에 미치는 영향)

  • Suh, Byung-Ho;Lee, Soo-Won;Kong, Gyu-Min;Kim, Dong-Jun;Oh, Hyun-Keun
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.2
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    • pp.169-174
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    • 2009
  • Purpose: To evaluate the clinical results between interlocking intramedullary nail with fibular fixation and nail only for treating distal tibiofibular diaphyseal fractures. Materials and Methods: From March 2003 to September 2006, 19 distal tibiofibular fractures were antegrade nailed after anatomical reduction and fixation of fibular fractures, and another 37 fractures fixed with nails only. Average age of patients was 48.6 years. These two groups were compared by VAS (visual analogue scale) & ankle ROM according to degree of comminution and fracture configuration. The statistical analysis was evaluated by t-test. Results: There was no statistical difference between fibular fixation group and non-fixation group in VAS score according to fracture comminution and configuration (p>0.05). However, compared according to fracture configuration, mean ankle eversion of fibular fixation group in oblique fractures was 18.3 degrees, and that of non-fixation group was 12.5 degrees (p<0.05). In addition, mean ankle plantar flexion, dorsiflexion, inversion and total ankle ROM of fibular fixation group in spiral fractures was 40.0, 20.0, 30.0 and 108.3 degrees of each and that of non-fixation group was 38.3, 18.5, 27.0 and 101.7 degrees (p<0.05). Conclusions: In oblique and spiral fractures of distal tibiofibular diaphysis, interlocking intramedullary nail with fibular fixation had the advantage in postoperative ankle ROM. So, it can be a worthy method for the treatment of distal tibiofibular diaphyseal fractures.

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Surgical Treatment of Ankle Fractures in the Elderly (고령 환자 족관절 골절의 수술적 치료)

  • Choi, Jae-Yeol;Jeong, Hwa-Jae;Shin, Hun-Kyu;Kim, Eugene;Park, Se-Jin;Seo, Dong-Seok
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.1
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    • pp.23-27
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    • 2013
  • Purpose: The optimal management for ankle fracture in elderly patients remains controversial. This study was undertaken to review the results of surgical treatment of ankle fracture in the elderly and to compare with other studies. Materials and Methods: The participants in this study were 33 patients over the age of 65(average 71.5 years) who underwent surgical treatment of ankle fracture from January 2004 to December 2011. The study was a retrospective review of outcomes after open reduction and internal fixation (ORIF) of ankle fractures. To measure the clinical outcomes, we assessed postoperative complications, the pre- and post-operative mobility status, fracture union status, the time of fracture union and the AOFAS (American Orthopaedic Foot and Ankle Society) Ankle-Hindfoot scale. The level of patient satisfaction was also identified. Results: Delayed wound healing occurred in three patients(9.1%) but their wounds healed with repeated dressings without additional surgical treatment. Malunion occurred in one patient(3%). One patient(3%) had postoperative infection but healed with antibiotic treatment. 24 patients(96%) returned to preoperative mobility status. VAS score was lower than 2 in all patients. Bone union occurred with the 3.8 months (average months) after the surgery in all patients. Average AOFAS score was 87.4 and these were similar results as other studies of young patients. All patients were satisfied with surgical outcomes according to interviews. Conclusion: Surgical treatment of ankle fractures in the elderly can carry a significant risk of delayed wound healing and infection but incidence is relatively low. Internal fixation of ankle fractures in the elderly can be undertaken safely and the majority of patients can expect good outcome.

Heterotopic Ossification of Distal Tibiofibular Syndesmosis after Ankle Fractures (족관절 골절 후 발생한 원위 경비 인대의 이소성 골형성)

  • Chung, Hyung-Jin;Choi, Yun-Seok;Choi, Jung-Yun
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.1
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    • pp.88-91
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    • 2006
  • Purpose: To evaluate the effect on clinical course of heterotopic ossification of distal tibiofibular syndesmosis after ankle fractures. Materials and Methods: From June 2001 to May 2004, we found nine cases of heterotopic ossification of distal tibiofibular syndesmosis after ankle fractures. There were 8 male patients and 1 female patient; their mean age was 42 years old. There were 6 Weber type B and 2 Weber type C fractures, and there is 1 case with posterior malleolus fracture only. Among them, 8 ankle fractures were operated. Follow up period was averaged for 14 months. We were able to review radiographs at initial injury and to review clinical menifestation and radiographs at last follow up. We used an ankle-hindfoot scoring system of AOFAS which combined symptom, function and alignment with maximum score of 100 point. Results: In all cases ankle dorsiflexion and plantarflexion were not significantly different from that of the contralateral side. The patients who had developed heterotopic ossification in distal tibiofibular syndesmosis had a similar functional score. The mean ankle-hind foot score was 94 points. Conclusion: We concluded that the heterotopic ossification of distal tibiafibular syndesmosis after ankle fractures had little effect on clinical course and range of motion of ankle joint.

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Results after Operative Treatment for Maisonneuve Fracture (Maisonneuve 골절에서 수술적 치료의 결과)

  • Lee, Jun-Young;Ha, Sang-Ho;Sohn, Hong-Moon;Lee, Kwang-Chul
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.1
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    • pp.72-78
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    • 2007
  • Purpose: This study is to analysis the outcome of patient with surgically treated Maisonneuve fracture and find out the factors that might influence the outcome. Material and methods: 20 patients who had surgical treatment due to Maisonneuve fracture between February, 2001 to March, 2005 were studied. The patients were followed for at least 1 year and average follow up period was 25 months. The average age was 41 years, 16 were male and 4 were female. Mechanism of injury according to Rouge-Hansen classification was supination-external rotation. In all cases, percutaneous screw fixation was applied proximal to tibiofibular syndesmosis. The screws were removed after 8 weeks under local anesthesis. Clinical, functional and radiographic results were evaluated. Results: 17 cases (85%) showed satisfying clinical and radiographic results. The mean functional score according to Ankle Scoring System was 91 (83 to 95). Complication occurred in 1 case with underlying systemic disease and 2 cases with initial ankle joint dislocation. Conclusion: Surgical treatment of Maisonneuve fracture showed relatively satisfying result. However, initial injury state and accompanying disease seem to have great effect on the result.

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The Anti-glide Plate in the Treatment of Lateral malleloar fracture (Antiglide 금속판을 이용한 족관절의 외과 골절의 치료)

  • Kim, Do-Young;Shin, Joo-Ho;Cho, Won-Ho;Hwang, Hyun-Chull
    • Journal of Korean Foot and Ankle Society
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    • v.5 no.1
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    • pp.18-22
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    • 2001
  • Most of Danis-Weber type B fracture has an oblique fracture plane proximal posteriorly to distal anteriorly. In these cases, the lateral plate has become widely accepted. However some limitation to the use of the lateral plate exist. The plate must be bent accurately and the screws in the distal fragment must be unicortical to avoid penetration into the joint, predisposing it to poor fixation in the osteoporotic bone. In 1982, Brunner and Weber introduced the antiglide plate for fixation of the shaft oblique fracture of the distal fibula, but it has not widely used. The author reviewed 21 cases treated by antiglide plate fixation from March, 1995 to March, 1999 which could be follow-up more than 1 year. We analysed the result radiographically and clinically using Ankle-Hindfoot scale(100 % total) of the American Orthopedic Foot and Ankle Society. The results obrained were as follows: 1. All fracture were united at average 8 weeks clinically and radiographically. 2. According to the Ankle- Hindfoot scale, 8 cases were above 90 points, 11 cases were beet ween 80 and 89 points and two cases were below 80 points. 3. One case had an injury to intermediate dorsal cutaneous nerve.

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Distal Tibiofibular Synostosis after Open Reduction and Internal Fixation in a Military Soldier (A Case Report) (관혈적 정복술 및 내고정술 후 군인에게 발생한 경비골 원위부 골결합증(1예 보고))

  • Lee, Jun-Young;Nam, Ki-Young;Song, Kyoung-Chul
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.1
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    • pp.105-107
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    • 2010
  • The scanty literature on distal tibiofibular synostosis includes descriptions of relatively few specific complaints. Here we report a case of a 24-year-old young soldier who sustained a left ankle lateral malleolar fracture about 6 months ago and was initially treated by the open reduction and internal fixation with plate & screw. But 6 months later, he suffered from an vague ankle pain, each time the symptoms occurred right after an active ambulation, ankle dorsiflexion, especially when he had exercised aggressively. The radiographs revealed that there was a mature distal tibiofibular synostosis. We treated the patient with surgical excision of synostosis. Post-operative condition was satisfied to all concern and the result was found to be excellent during one-year follow-up.

Usefulness of the Oblique Radiographic View in Ankle Fractures (족근 관절 골절에서 사면상 단순 방사선 사진의 유용성)

  • Cho, Duck-Yun;Song, Sang-Jun;Yoon, Hyung-Ku;Han, Soo-Hong;Chang, Ji-Hoon;Yoon, Byung-Ho
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.1
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    • pp.94-98
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    • 2005
  • Purpose: To compare the radiographic evaluations between two radiographic views (AP and lateral views) and four radiographic views (AP, lateral and both oblique views) in ankle fractures. Materials and Methods: From January 2000 to June 2002, 60 cases of ankle fractures were treated with open reduction and internal fixation and its followed up periods were at least 2 years. All cases were classified into three groups according to the method of preoperative radiographic evaluation. Two radiographic views (AP and lateral views) were taken in group A and four radiographic views (AP, lateral and both oblique views) were taken in group B. 12 Cases were evaluated with three dimensional computed tomography (3D CT). Four radiographic views and 3D CT were taken in group C. All cases were classified according to the Danis-Weber and Lauge-Hansen classification. Displacement of fracture fragment of medial, lateral, posterior malleolus and size of fracture fragment of posterior malleous were measured using picture archiving communication system (PACS). Results: Although kappa value between two or four radiographic views were good or excellent in Danis-Weber classification and Lauge-Hansen classification of ankle fractures, the displacements of medial and lateral malleoli were statistically different. Four radiographic views evalulated the degree of displacement of medial and lateral fragments more accurately compared to two radiographic views. Conclusion: Four radiographic views will be more useful than two radiographic views to decide the method of treatment and operation considering the displacement of fracture fragment.

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