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Related Concept Videos

Ankle Joint01:10

Ankle Joint

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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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Bones of the Lower Limb: Tibia and Fibula01:10

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The tibia is the main weight-bearing bone of the lower leg. It is larger than the fibula with which it is paired. The tibia is also the second longest bone in the body and is located right below the skin. The proximal end of the tibia forms the medial and the lateral condyle, which articulates with the condyles of the femur to form the knee joint. Between the articulating surfaces is the irregular elevated area known as the intercondylar eminence that serves as the inferior attachment point for...
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General Case of Eccentric Axial Loading01:12

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Unsymmetrical bending occurs when the bending moment applied to a structural member does not align with its principal axis. This misalignment leads to complex stress distributions and deflection patterns that differ from symmetrical bending, which are essential for designing structures to withstand different loading conditions.
Consider a member subjected to equal and opposite forces that are applied along a line that does not coincide with the member's neutral axis. In unsymmetrical...
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Related Experiment Video

Updated: Jul 23, 2025

Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
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Total Talar and Navicular Extrusions: A Case Report.

Gopal R Lalchandani1, Nicole J Hung2, Abhinav Janghala1

  • 1Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California.

JBJS Case Connector
|July 13, 2023
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Summary

Transtibial amputation is a viable option for severe talar and navicular extrusion injuries. This approach, combined with osteomyoplastic reconstruction and targeted muscle reinnervation, can improve outcomes and reduce pain.

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Area of Science:

  • Orthopedic Surgery
  • Trauma Surgery
  • Reconstructive Surgery

Background:

  • Severe foot and ankle trauma, including talar and navicular extrusions, presents significant reconstructive challenges.
  • Limb salvage may not always be feasible or lead to optimal functional outcomes in cases of extensive bone and soft tissue loss.

Observation:

  • A 15-year-old male sustained combined talar and navicular extrusions from a dirt-bike accident.
  • The extruded bones were debrided due to contamination, leading to significant bone loss and soft tissue injury.

Findings:

  • The patient underwent a transtibial amputation using the Ertl technique.
  • Simultaneous osteomyoplastic reconstruction and acute targeted muscle reinnervation were performed during the amputation procedure.

Implications:

  • Transtibial amputation is a suitable alternative for complex talar and navicular extrusions when limb salvage is not optimal.
  • Combined osteomyoplastic reconstruction and targeted muscle reinnervation may mitigate neuroma formation and phantom limb pain, enhancing functional recovery.