Foot & ankle international
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Closed fracture dislocation of the body of the talus is rare. The dislocation of the subtalar and ankle joints (associated with fracture body) has been reported and already described in the current classifications. ⋯ The fracture has healed and there is no evidence of avascular necrosis after 2 years follow up. We recommend early evaluation of this injury by CT scan or by proper radiographic views under sedation and urgent open reduction if one attempt at closed reduction has failed.
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The present study aims to clarify the influence of the interosseous talocalcaneal ligament (ITCL) injury associated with injury to the lateral ankle ligaments on the ankle-subtalar joint complex motion under conditions of physiologic loading. We conducted mechanical tests using five fresh cadaveric lower extremities. Each specimen was mounted in the loading device and an axial cyclic load from 9.8 to 686 N was applied. ⋯ The predominant rotations were plantar flexion and adduction at the ankle joint, with some eversion demonstrated at the subtalar joint. Although ATFL sectioning did not significantly change the motion of the two joints, additional sectioning of the ITCL significantly increased adduction and total rotation of the ankle joint. The present study demonstrated that a combined injury of the ATFL and the ITCL can induce anterolateral rotatory instability of the ankle joint under conditions of axial loading.
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Three purposes of this study were to: 1) describe the sustentaculum tali in relation to surrounding structures, 2) identify its radiographic projection onto the lateral calca neus, and 3) determine optimal angles for screw placement. Twelve cadaver specimens were used. The length a width of the sustentaculum was measured. ⋯ The angles required to pass a pin from point A into the sustentaculum were determined. The sustentaculum projected as a triangular/elliptical structure on the lateral radiograph. It was superimposed on the anterior portion of the posterior facet.
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Eighty six subtalar arthrodeses performed between 1985 and 1996 for complications associated with intra-articular calcaneal fractures were retrospectively evaluated. Patients were divided into three Groups: (I) 59 patients with calcaneal malunions (II) 13 patients with failed open reduction and internal fixation, and (III) eight patients undergoing open reductions and primary fusion for highly comminuted fractures. In each scenario, internal fixation was achieved with cancellous lag screws. ⋯ Scores were similar for all three groups and for the various types of reconstructive procedures used. No correlation was found between postoperative talar declination angle and the AOFAS ankle-hindfoot score. Worker's compensation patients tended to have a poorer clinical outcome.