Is early operative fixation of unstable ankle fractures cost effective? Comparison of the cost of early versus late surgery
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Joint space narrowing is the first roentgenologic sign of osteoarthrosis of the ankle. In this report the dependence of ankle joint width on plantar flexion was investigated. In 30 adult volunteers without ankle symptoms, standardized anteroposterior views of the left ankle joint in neutral position and in 25 degrees plantar flexion were obtained. The average width of the joint space in neutral position was 2.7 mm in women, and 3.0 mm in men. A 25 per cent increment of the joint width following 25 degrees plantar flexion was observed. Accurate standardized positioning of the ankle appears to be decisive for the estimation of ankle joint width.
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The ranges of motions of the ankle have been studied only rarely in children. The authors examined the mobility of the ankle joint complex of 245 healthy children. The mean age was 10.2 years. In healthy children ages 7 to 14 years, the variation of the ankle joint complex range of motion was wide. The largest gender-related difference was recorded for passive plantarflexion, which was greater in girls. Other statistically significant gender differences do exist, but they are small and probably lack clinical meaning. Some of the children had remarkable left–right difference in the range of motions of the ankle joint complex. This means that the "healthy ankle" cannot necessarily be used in clinical practice as a reference when evaluating, for example, treatments of foot and ankle injuries in children.
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Objective To evaluate the outcome of the surgical-treated ankle fractures. Methods We reviewed the outcomes of 92 cases of ankle fracture which had complete follow-up data from January 2000 to April 2008. The outcomes were assessed by AOFAS (American Orthopaedic Foot & Ankle Society) scoring scale, VAS scale, satisfaction degree of patients and range of ankle motion. The differences in AOFAS scoring and ankle motive range between involved and contralateral extremity, AO fracture types, involved positions (solemaleolar, bimaleolar, trimaleolar), follow-up timing were statistically analyzed. Results Follow-ups averaged 55 months. All cases had fracture healed. The average AOFAS score was 93.6 points. The excellent to good rate was 100%. VAS score was 0.17 points on average. Satisfaction score was 9.62 points on average. Statistical analysis showed that the motive range of ankle joint between involved and con-tralateral extremity had a significant difference, but there were no significant differences in AOFAS scores and range of ankle dorsiflexion-plantarflexion between AO fracture types, involved positions and different follow-up durations, Conclusion Surgical treatment for ankle fractures can have a good clinical result.
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Ankle joint; Fractures; Operation
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Physiological effects of use of sand bags during walking exercise are verified, while there is no quantitatively verification of various attaching position. Therefore, the purpose of this study was to compare the differences of attaching position(wrist & ankle) of sand bags on lower extr emities dynamics during walking. The partici -pants of this study were fifteen male college students(year, height, weight). The results are as follows. First, the range of motion of ankle joint was decreased, while knee and hi p joints were increased attached to the ankle joint. Second, the eccentric work of ankle joint was increased, while the concentric work of ankle joint was decreased attached to the ankle joint. Third, rate of concentric work of ankle joint was decreased, while hip joint was increased. Our findings implies that sand bag attached to the ankle joint has a high efficiency of exercise, however has increasing the compensation in knee and hip joints. Therefore, we recommended attached to the wrist during walking exercise.
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Objective:To explore the curative effect of operation on the ankle joint fracture in supination-external rotation type(S-E-R type).Methods:Eighty-two cases with ankle joint fracture in S-E-R type were processed with operation from January 2006 to September 2010.The ankle joint functions were compared between the diseased side and the healthy side at the 6th and the 12th months after the operation respectively,The ankle joint functions at the 6th months after the operation were compared with that at the 12th months after the operation.Results:Six months after the operation,the ankle joint function of diseased side was worse than that of the healthy side,and there was statistical difference between them(t=-8.286,P=0.000).Twelve months after the operation,the ankle joint function of diseased side was close to that of the healthy side,and there was no statistical difference between them(t=1.179,P=0.240).Ankle joint function of diseased side at the 12th months after the operation was improved a lot compared with that at the 6th months after the operation,and there was statistical difference between them(t=-10.769,P=0.000);and the same situation also occurred in the healthy side(t=-6.819,P=0.000).Conclusion:It can improve the curative effects of operation on ankle joint fracture in S-E-R type and effectively recover the ankle joint functions through the following methods as accurate evaluation of the injuries,proper operation opportunity and fixation methods,the recovery of the complete articular surface and the stable ankle joints,effective functional exercises after the operation.
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This article presents a series of case reports to describe the technique of ankle joint manipulation and its effects on common problems of the foot and ankle. The relationship between motion and pain is described, as are the effects of muscular inhibition on the presence of joint restriction and their association with pain in various joints remote to the ankle joint. (J Am Podiatr Med Assoc 94(4): 395–399, 2004)
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Use of the ankle distractor with ankle arthroscopy is well known to allow improved evaluation of the intraarticular surfaces. A less common application of the ankle distractor is for the treatment of complex ankle fractures. We evaluated the use of the ankle distractor in the treatment of six patients with ankle trauma. Five of these cases involved comminuted intraarticular fractures of the distal tibia, and one case involved a malunion of an ankle fracture with widening of the mortise. In each case, the ankle distractor increased the exposure of the ankle joint and allowed better access for fracture fragment reduction. There were no complications associated with the use of the distractor. The technique of using the ankle distractor in these situations is described.
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An investigation into the immediate effects of ankle joint mobilisation in people with ankle equinus
Ankle equinus is a limitation in ankle dorsiflexion, which has been clinically associated with impaired balance and lower limb pathology in adults. This thesis investigated the immediate effects of ankle mobilisation on balance performance, plantar pressures, muscle activity and ankle movement in people with ankle equinus. Through a series of carefully controlled studies, this thesis identified considerable variation in the force applied during ankle mobilisation. Although the findings suggest that mobilisation may result in improvements in patient-reported outcomes, it also questions the rationale behind the use of ankle mobilisation as an intervention in ankle equinus.
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Two thousand five hundred and sixty-two participants in a college intramural basketball program were studied during two successive intramural "seasons" with regard to the frequency of ankle and knee sprains, as related to the use of external ankle support. The influence on injury rates of high- and low-top shoes and the use of prophylactic ankle taping were examined, and an additional group of players was supported with a disposable elastic material during the second season of study. The use of both high-top shoes and prophylactic ankle taping appeared to decrease the frequency of ankle sprains. This decrease was particularly marked in those subjects who had suffered previous ankle sprains. The size of the additional group was too small to permit valid comparisons. No increase in the frequency of occurrence of knee sprains was observed to result from the use of high-top shoes and/or prophylactic ankle taping.
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