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Related Concept Videos

Fractures: Bone Repair01:27

Fractures: Bone Repair

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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
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Ankle Joint01:10

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The ankle is formed by the talocrural joint (crural = leg). It consists of the articulations between the talus bone of the foot and the distal ends of the tibia and fibula of the leg. The superior aspect of the talus bone is square-shaped and has three areas of articulation. The top of the talus articulates with the inferior tibia. This is the portion of the ankle joint that carries the body weight between the leg and foot. The sides of the talus are firmly held in position by the articulations...
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Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
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Realignment Surgery for Malunited Ankle Fracture.

Chang-Jun Guo1,2, Xing-Cheng Li1, Mu Hu1

  • 1Department of Orthopaedics, Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Orthopaedic Surgery
|March 10, 2017
PubMed
Summary

Realignment surgery for malunited ankle fractures improves ankle function and reduces pain. However, postoperative talar tilt and advanced arthritis are risk factors for surgical success.

Keywords:
Clinical outcomesMalunited anklesReconstruction operation

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Area of Science:

  • Orthopedic Surgery
  • Traumatology
  • Radiology

Background:

  • Malunited ankle fractures can lead to chronic pain and functional limitations.
  • Reconstructive surgery aims to correct deformities and restore ankle function.

Purpose of the Study:

  • To evaluate the outcomes of realignment surgery for malunited ankle fractures.
  • To identify potential risk factors associated with the surgical procedure.

Main Methods:

  • Retrospective review of 33 patients undergoing realignment surgery for malunited ankle fractures.
  • Radiographic measurements included tibial anterior surface angle (TAS), tibiotalar tilt angle (TTA), malleolar angle (MA), and tibial lateral surface angle (TLS).
  • Clinical outcomes assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) scale and visual analogue scale (VAS); osteoarthritis staged with the modified Takakura classification.

Main Results:

  • Significant improvements observed in TAS, TTA, and MA post-surgery.
  • Mean AOFAS scores increased significantly (44.5 to 78.0), and mean VAS scores decreased significantly (6.76 to 2.03).
  • No significant change in Takakura osteoarthritis grade; one patient experienced increased talar tilt, and another developed progressive osteoarthritis requiring joint distraction.

Conclusions:

  • Realignment surgery effectively reduces pain and enhances function in patients with malunited ankle fractures.
  • The procedure can potentially delay the need for ankle arthrodesis or total ankle replacement.
  • Elevated postoperative talar tilt and advanced ankle arthritis are identified as risk factors for suboptimal surgical outcomes.