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Determination of dynamic ankle ligament strains from a computational model driven by motion analysis based kinematic data.

External rotation of the foot has been implicated in high ankle sprains. Recent studies by this laboratory, and others, have suggested that torsional traction characteristics of the shoe-surface interface may play a role in ankle injury. While ankle injuries most often involve damage to ligaments due to excessive strains, the studies conducted by this laboratory and others have largely used surrogate models of the lower extremity to determine shoe-surface interface characteristics based on torque measures alone. The objective of this study was to develop a methodology that would integrate a mo…

Incidence of revision after primary implantation of the Agility™ total ankle replacement system: a systematic review.

Revision of failed total ankle replacement remains a challenge with limited information available to guide treatment options. I undertook a systematic review of electronic databases and other relevant sources to identify material relating to the incidence of revision after primary implantation of the Agility™ Total Ankle Replacement System. In an effort to procure the highest quality studies available, studies were eligible for inclusion only if they involved patients undergoing primary Agility™ Total Ankle Replacement; had evaluated patients at a mean follow-up of 12 months or longer; include…

Brachial-ankle pulse wave velocity is an independent predictor of incident hypertension in Japanese normotensive male subjects.

OBJECTIVES: Cardiovascular morbidity and mortality are closely associated with hypertension, however, predictors of incident hypertension have not been fully established. We have conducted a study aimed at evaluating whether brachial-ankle pulse wave velocity (baPWV) is a predictor of incident hypertension. METHODS: The relation between baPWV, a noninvasive index of aortic stiffness, and incident hypertension was evaluated in a cohort of 2278 Japanese normotensive male subjects with a follow-up of 3 years. RESULTS: Of the 2278 study participants, 151 (6.6%) had incident hypertension during t…

Voluntary ankle flexor activity and adaptive coactivation gain is decreased by spasticity during subacute spinal cord injury.

Although spasticity has been defined as an increase in velocity-dependent stretch reflexes and muscle hypertonia during passive movement, the measurement of flexor muscle paresis may better characterize the negative impact of this syndrome on residual motor function following incomplete spinal cord injury (iSCI). In this longitudinal study Tibialis Anterior (TA) muscle paresis produced by a loss in maximal voluntary contraction during dorsiflexion and ankle flexor muscle coactivation during ramp-and-hold controlled plantarflexion was measured in ten patients during subacute iSCI. Tibialis Ante…

Intraoperative 3-dimensional imaging in foot and ankle trauma-experience with a second-generation device (ARCADIS-3D).

OBJECTIVE: Intraoperative 3-dimensional imaging with the first available device (ISO-C-3D; Siemens, Germany) has shown potential benefit in foot and ankle surgery. The aim of the study was to assess the clinical use of the second-generation device (ARCADIS-3D; Siemens) in comparison with earlier experience with the first-generation device. METHODS: In a matched pair study, the ISO-C-3D/ARCADIS-3D was used for intraoperative visualization after reduction/correction and internal fixation. The ISO-C-3D was used in 62 cases between January 1, 2003, and March 15, 2004, and the ARCADIS-3D was used …

Distally based sural fasciocutaneous flap for soft tissue reconstruction of the distal leg, ankle and foot defects.

BACKGROUND: Soft tissue management around the lower third of the leg and foot presents a considerable challenge to the reconstructive plastic surgeon. The options in this region are limited. A durable flap is the preferred option for coverage of such defects. This descriptive study was conducted at Hayatabad Medical Complex and Said Anwar Medical Centre Peshawar over a period of 4 years to evaluate the efficacy of distally based Sural flap in coverage of the lower third of leg, ankle and foot defects, in 25 patients. METHODS: A descriptive study was conducted at the department of Plastic and …

The association between elevated ankle systolic pressures and peripheral occlusive arterial disease in diabetic and nondiabetic subjects.

OBJECTIVE: The presence of a high ankle-brachial index (ABI) is related to stiff ankle arteries due to medial calcification. Recently, this condition has attracted new interest after reports of a worse cardiovascular prognosis, similar to a low ABI. We sought to compare risk factors contributing to a low (< or =0.90) and high (> or =1.40) ABI. Additionally, we hypothesized that in instances of high ABI, occlusive PAD may coexist. METHOD: This cross-sectional study was conducted at vascular laboratories in a university medical center. The subjects were 510 ambulatory patients (37% had diabetes…

Radiation exposure from fluoroscopy during fixation of hip fracture and fracture of ankle: Effect of surgical experience.

BACKGROUND: Over the years, there has been a tremendous increase in the use of fluoroscopy in orthopaedics. The risk of contracting cancer i … eon during fluoroscopically assisted fixation of fractures of neck of femur (dynamic hip screw) and ankle (Weber B) was performed at a district general hospital in the United Kingdom. MATERIALS AND METHODS: Sixty patients with undisplaced intertrochanteric fracture were included in the hip group, and 60 patients with isolated fracture of lateral malleo …

Two-dimensional digital video ankle motion analysis for assessment of function in the rat sciatic nerve model.

Ankle motion analysis may provide a better method to assess function in the rat sciatic nerve model than the standard method, the sciatic functional index (SFI), but it is not widely used in experiments on nerve regeneration possibly because of complicated analysis. In this study, we investigated the practical use of a two-dimensional (2D) digital video motion analysis system. Reproducibility was investigated in normal rats. Recovery of ankle motion was analyzed after sciatic, tibial, and peroneal nerve crush injury. Results were compared with scores for the SFI. Results were not significantly…

Воздействие углеродно-композиционных оргазмов на ходьбу и походку у бывших пациентов с полиомиелитом.

ЦЕЛЬ: Изучение последствий использования углеродно-контактных композиционных ортелей с коленным орехом (KAFO) для энергозатраты на ходьбу пациентов с бывшим полиомиелитом, которые обычно носят обычную кожаную/металлическую KAFO или пластиковую/металлическую KAFO. DESIGN: Потенциальное неконтролируемое исследование с множественным исходным и последующим дизайном. Последующие измерения продолжались до 26 недель после вмешательства. УЧАСТНИКИ: Двадцать взрослых с остатками полиомиелита (старше 55 лет). ИНТЕРВЕНЦИЯ: Каждый участник получил новый углеродно-композит KAFO, установленный в соответстви

Совпадение в аннотации оригинала
OBJECTIVE: To investigate the effects of total-contact fitted carbon-composite knee-ankle-foot orthoses (KAFOs) on energy cost of walking in patients with former polio who normally wear a conventional leather/metal KAFO or plastic/metal KAFO. DESIGN: A prospective uncontrolled study with a multiple baseline and follow-up design. Follow-up measurements conti…

Free flap reconstruction of foot and ankle defects in pediatric patients: long-term outcome in 91 cases.

BACKGROUND: Free tissue transfer has not been fully adopted as the primary mode of treating foot and ankle defects in potentially indicated patients, partly because of the lack of sizable vessels and the potential in the long term of differential growth in the flap and the recipient site. Also lacking are long-term outcome studies in these growing patients. METHODS: Between 1989 and 2002, 91 children with 93 foot and ankle defects underwent microsurgical reconstructions. The patients underwent reconstruction with flaps with a cutaneous component or with muscle flaps (skin-grafted). RESULTS: …

The COX-2 specific inhibitor Valdecoxib versus tramadol in acute ankle sprain: a multicenter randomized, controlled trial.

BACKGROUND: The cyclooxygenase-2 specific inhibitor valdecoxib has not been approved in the United States for treatment of acute pain. HYPOTHESIS: Valdecoxib 20 mg twice daily or once daily (both with a 40-mg loading dose) is not clinically inferior to tramadol for treating the signs and symptoms of acute ankle pain. STUDY DESIGN: Randomized, controlled clinical trial; Level of evidence, 1. METHODS: Patients (N = 829) with acute first- or second-degree ankle sprain received 7 days' treatment with valdecoxib 20 mg either twice daily or once daily (both with 40-mg loading dose), tramadol 50 m…

Surgical treatment of mild hallux valgus deformity: the state of practice among academic foot and ankle surgeons.

BACKGROUND: The purpose of this study was to determine the operative procedure of choice among academic foot and ankle surgeons practicing in the United States for treatment of mild hallux valgus deformity. METHODS: A hypothetical patient was created: a 60-year-old woman with a mild hallux valgus deformity (first intermetatarsal angle of 11 degrees and hallux valgus angle of 22 degrees). The patient complained of pain around the bunion, nonoperative treatment had failed, and she desired operative correction. The case was sent to academic foot and ankle surgeons to identify their operative tre…

Arthroscopic findings in chronic lateral ankle instability: do focal chondral lesions influence the results of ligament reconstruction?

BACKGROUND: There are few studies that have assessed the influence of focal chondral lesions on the results of ligament reconstruction for chronic lateral ankle instability. HYPOTHESIS: Focal chondral lesions do not influence the results of ligament reconstruction. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Arthroscopic examination of the ankle was performed on 30 consecutive patients immediately before ligament reconstruction using the palmaris longus tendon. Clinical assessment was performed using the Karlsson scoring scale. A radiologic assessment was performed on stress r…

Recurrence rates of burn contracture ankle equinus and other foot deformities in children treated with Ilizarov fixation.

The purpose of this study was to determine recurrence rates of pediatric foot and ankle burn deformities treated with the Ilizarov method. A total of 19 patients with 29 foot and ankle deformities were studied. The most common deformity treated was equinus (23). Rocker-bottom and cavus foot deformities were each treated three times. The average age of the patient at the time of the burn injury was 3.2 years, and the average age at the time of fixation was 9.4 years. Equinus contractures averaged -34 degrees (34 degrees of plantarflexion) before surgery and +7 degrees (7 degrees of dorsiflexion…

The impact of chiropractic manipulative therapy on chronic recurrent lateral ankle sprain syndrome in two young athletes.

OBJECTIVE: To describe two cases of abrupt resolution of chronic, recurrent, inversion sprain to ankles in young recreational athletes. CLINICAL FEATURES: A 13-year-old, female, avid recreational soccer player with ankles that would spontaneously invert during various inconsistent points in the weight bearing gait cycle, sometimes with acute pain or sprain to the ankle. No intervention was attempted prior to her entry to the chiropractic office. A 17-year-old male avid skate- boarder and snowboarder whose left ankle routinely "gave out" into inversion upon mundane weight bearing activity, usu…

Substance P immunoreactive nerve fibres in the domestic chick ankle joint before and after acute urate arthritis.

Substance P immunoreactive (SP-IR) nerve fibres were identified using fluorescence immunohistochemistry and the length of the labelled individual nerve fibres was measured using confocal microscopy of whole mounts of the lateral wall of the ankle joint in 2-week-old domestic chicks. In the normal ankle there was an extensive network of SP-IR fibres in the synovial and subsynovial tissue of the joint capsule. Fours hours after injection of sodium urate into the joint space the joint was inflamed and there was a significant reduction in the labelled nerve fibres. These results demonstrate experi…

Stair locomotion in children with spastic hemiplegia: the impact of three different ankle foot orthosis (AFOs) configurations.

The purpose of this study was to investigate the impact of three different ankle foot orthoses (AFO) configurations on the function and kinematics of stair locomotion in children with spastic hemiplegia. Nineteen children were evaluated barefoot and with a hinged, posterior leaf spring (PLS) and solid AFO during stair ascent and descent. Stair specific items from the Pediatric Evaluation of Disability Inventory (PEDI) were used to evaluate function, while a motion measurement system was used to evaluate kinematics. The PEDI revealed no significant differences between AFOs and barefoot, althoug…

Serial plaster casting to correct equino-varus deformity of the ankle following acquired brain injury in adults.

PURPOSE: Proposed mechanisms via which serial casting might effect increased joint range, muscle extensibility and reduced reflex excitability are outlined in this review. Support for these mechanisms stems largely from animal experimental studies. The applicability of these data to human muscle is unknown. ISSUES: Equino-varus deformity of the ankle is a common secondary complication of acquired brain injury. It results from a combination of sequelae of the brain injury and subsequent immobility, including hypertonia, reduced muscle length and increased stiffness. Some evidence exists for th…