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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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The human leg comprises an intricate system of muscles that facilitate the movement of feet and toes. Within this system, the muscles are categorized into the anterior, lateral, and posterior compartments, each with a unique set of muscles carrying out specific functions.
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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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The femur is the body's longest and strongest bone spanning the thigh region. Its head articulates with the acetabulum of the hip bone to form the hip joint. A minor indentation on the medial side of the femoral head, called the fovea capitis, serves as the site of attachment for the ligament of the head of the femur. This weak ligament spans the femur and acetabulum and supports the hip joint. The narrowed region below the head is the neck of the femur. The inclination angle between the...
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Pulse assessment sites are crucial in evaluating a patient's cardiovascular health. By assessing the pulsations of arteries at specific anatomical locations, healthcare professionals can gather valuable information about blood flow, heart rate, and peripheral circulation. Understanding these pulse assessment sites is essential for conducting comprehensive cardiovascular evaluations and monitoring patients' overall health. These sites are strategically chosen due to the accessibility and...
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Related Experiment Video

Updated: Jul 17, 2025

Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
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Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach

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Posterior malleolus exposure.

Brad Meulenkamp1,2,3, Hakim Louati1,4, John Morellato1,2

  • 1Division of Orthopaedic Surgery, The Ottawa Hospital.

OTA International : the Open Access Journal of Orthopaedic Trauma
|September 4, 2023
PubMed
Summary

The modified posteromedial surgical approach provides significantly greater exposure and screw fixation options for posterior malleolus (PM) fractures compared to the posterolateral approach.

Keywords:
Haraguchiankleapproachbiomechanicalcadaverexposuremodified posteromedialposterior malleolusposterolateralscrew trajectory

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Area of Science:

  • Orthopedic Surgery
  • Traumatology
  • Anatomy

Background:

  • Posterior malleolus (PM) fractures are common injuries associated with ankle trauma.
  • These fractures present significant surgical challenges regarding exposure and fixation.
  • Understanding ankle and syndesmotic stability is crucial for evolving surgical indications.

Purpose of the Study:

  • To compare the posterolateral versus modified posteromedial surgical approaches for posterior malleolus fractures.
  • To determine the maximal surface area exposed by each approach.
  • To define the maximal screw trajectory obtainable for fixation in cadaveric models.

Main Methods:

  • A biomechanical study using twelve fresh-frozen cadaver limbs.
  • Performed posterolateral and modified posteromedial approaches on each limb.
  • Measured exposed bony surface area and maximal screw trajectory using CT scans and laser surface scanning.

Main Results:

  • The modified posteromedial approach yielded a significantly larger exposed surface area (99% vs. 64%, P < .05).
  • This approach allowed for greater instrumentation of the posterior distal tibia (77% vs. 46%, P < .05).

Conclusions:

  • The modified posteromedial approach offers superior exposure and wider instrumentation access for PM fractures.
  • This approach is recommended for complex PM fractures, especially Haraguchi type 2 patterns.