1
|
Nishimura A, Senga Y, Fujikawa Y, Takegami N, Akeda K, Ogura T, Sudo A. Prevalence and risk factors of ankle osteoarthritis in a population-based study. Foot Ankle Surg 2024; 30:389-393. [PMID: 38453588 DOI: 10.1016/j.fas.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/14/2024] [Accepted: 02/22/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND This study aimed to investigate the prevalence of radiographic ankle osteoarthritis (AOA) in Japan and identify its risk factors. METHODS The analysis included data from the population-based cohort study, radiographs of the knees and ankles, ultrasonography of the ankle to examine chronic ankle instability (CAI), and questionnaires on ankle pain, job history, height, and body weight. A total of 597 individuals aged > 50 years were included in the study. The risk factors for AOA were calculated using multivariate logistic regression analysis. RESULTS The study revealed a 13.9% prevalence of radiographic AOA among the participants, with 1.2% reporting painful AOA. Female sex, aging, history of ankle fractures, and CAI were identified as the risk factors associated with AOA. CONCLUSIONS This cross-sectional study highlights the significant prevalence of radiographic AOA in a rural Japanese population, emphasizing the importance of considering ankle fractures and CAI as potential risk factors for AOA development. LEVELS OF EVIDENCE Level II, prospective cohort study.
Collapse
Affiliation(s)
- Akinobu Nishimura
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Mie, Japan; Departments of Orthopaedic and Sports Medicine, Mie University Graduate School of Medicine, Mie, Japan.
| | - Yoshiyuki Senga
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Mie, Japan
| | - Yuki Fujikawa
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Mie, Japan
| | - Norihiko Takegami
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Mie, Japan
| | - Koji Akeda
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Mie, Japan
| | - Toru Ogura
- Clinical Research Support Center, Mie University Hospital, 2-174 Edobashi, Tsu City, Mie 514-8507, Japan
| | - Akihiro Sudo
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Mie, Japan
| |
Collapse
|
2
|
Anastasio AT, Adams SB. Addressing the Need for a Better Understanding of Foot and Ankle Pathology Relevant to the Adolescent Athlete. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1342. [PMID: 37628340 PMCID: PMC10453569 DOI: 10.3390/children10081342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 08/02/2023] [Indexed: 08/27/2023]
Abstract
Foot and ankle pathology in the adolescent athlete is a growing area of basic science, translational, and clinical research [...].
Collapse
Affiliation(s)
- Albert T. Anastasio
- Department of Orthopaedic Surgery, Division of Foot and Ankle Surgery, Duke University, Durham, NC 27710, USA;
| | | |
Collapse
|
3
|
Schlickewei C, Krähenbühl N, Rolvien T, Stürznickel J, Yarar-Schlickewei S, DeKeyser G, Frosch KH, Barg A. Surgical outcome of avulsion fractures of the distal fibula: a systematic literature review. Arch Orthop Trauma Surg 2023; 143:1275-1291. [PMID: 34820695 DOI: 10.1007/s00402-021-04256-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 11/11/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To provide a systematic overview of clinical and radiographic outcomes in patients who underwent surgical treatment of a painful avulsion fragment of the distal fibula also known as posttraumatic os subfibulare. METHODS A systematic literature search across two major sources (PubMed and Scopus) was performed. Twenty-seven studies were included and analyzed using the modified Coleman score to assess the methodologic quality. RESULTS The surgical treatment of symptomatic os subfibulare, with or without concomitant ankle instability, generally results in substantial improvement in clinical and radiographic outcomes with relative low complication rates. Clinical outcome measures may not be affected by the presence of ankle instability or by the fragment size. The methodological quality of analyzed studies was satisfactory. CONCLUSION Posttraumatic os subfibulare may result in chronic pain and ankle instability. If surgery is indicated, ankle instability should be concomitantly addressed when present. Based on available literature, satisfactory postoperative outcomes can be reliably expected following surgical treatment. LEVEL OF EVIDENCE Systematic Review of Level III and Level IV Studies, Level IV.
Collapse
Affiliation(s)
- Carsten Schlickewei
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20251, Hamburg, Germany
| | - Nicola Krähenbühl
- Department of Orthopaedic and Trauma Surgery, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland
| | - Tim Rolvien
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20251, Hamburg, Germany
| | - Julian Stürznickel
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20251, Hamburg, Germany
| | - Sinef Yarar-Schlickewei
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20251, Hamburg, Germany
| | - Graham DeKeyser
- Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT, 84108, USA
| | - Karl-Heinz Frosch
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20251, Hamburg, Germany
- Department of Trauma and Orthopaedic Surgery, BG Hospital Hamburg, Bergedorfer Str. 10, 21033, Hamburg, Germany
| | - Alexej Barg
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20251, Hamburg, Germany.
- Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT, 84108, USA.
- Department of Trauma and Orthopaedic Surgery, BG Hospital Hamburg, Bergedorfer Str. 10, 21033, Hamburg, Germany.
| |
Collapse
|
4
|
Lalevée M, Anderson DD, Wilken JM. Current Challenges in Chronic Ankle Instability: Review and Perspective. Foot Ankle Clin 2023; 28:129-143. [PMID: 36822682 DOI: 10.1016/j.fcl.2022.11.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Chronic ankle instability (CAI) is common, disabling, and represents a significant socioeconomic burden. Current treatment options are not adequately efficacious. CAI is multifaceted, yet it is commonly addressed in terms of either mechanical instability or functional impairment. Both are inherently linked. Basic research must be conducted to foster reliable translational research encompassing both mechanical and functional aspects. A review was conducted to identify CAI risk factors for inclusion in future studies, and we offer here opinions and perspectives for future research.
Collapse
Affiliation(s)
- Matthieu Lalevée
- CETAPS EA3832, Research Center for Sports and Athletic Activities Transformations, University of Rouen Normandy, F-76821 Mont-Saint-Aignan, France; Department of Orthopedic Surgery, Rouen University Hospital, 37 Bd Gambetta, Rouen 76000, France
| | - Donald D Anderson
- Department of Orthopedics and Rehabilitation, The University of Iowa, Iowa City, IA 52242, USA; Department of Biomedical Engineering, The University of Iowa, Iowa City, IA 52242, USA; Department of Industrial and Systems Engineering, The University of Iowa, Iowa City, IA 52242, USA
| | - Jason M Wilken
- Department of Physical Therapy and Rehabilitation Science, The University of Iowa, 500 Newton Road, 1-249 Medical Education Building, Iowa City, IA 52242-1089, USA.
| |
Collapse
|
5
|
[Comparison of short-term effectiveness of metal screws and absorbable screws in repair of distal tibiofibular syndesmosis]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2022; 36:989-994. [PMID: 35979791 PMCID: PMC9379451 DOI: 10.7507/1002-1892.202201101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To compare the short-term effectiveness of repairing distal tibiofibular syndesmosis with metal screws and absorbable screws. METHODS A retrospective analysis was performed on the clinical data of 63 patients with ankle fracture combined with injury of the distal tibiofibular syndesmosis admitted between January 2017 and January 2020. Among them, 31 patients were treated with absorbable screw fixation of the distal tibiofibular syndesmosis (research group) and 32 patients were treated with metal screw fixation of the distal tibiofibular syndesmosis (control group). There was no significant difference in gender, age, cause of injury, surgical side, time from injury to operation, fracture type, preoperative visual analogue scale (VAS) score, and American Orthopaedic Foot & Ankle Society (AOFAS) score between the two groups ( P>0.05). The operation time and fracture healing time were recorded and compared between the two groups. X-ray film was taken to evaluate the effect of ankle joint reduction and fixation. Olerud-Molander ankle fracture efficacy score (short for OM score), AOFAS score, and VAS score were used to evaluate the effectiveness. RESULTS There was no significant difference in operation time between the two groups ( t=-0.683, P=0.497). In the control group, 1 case of delayed healing and 1 case of poor healing occurred in the lateral incision after operation, which healed after dressing change; the rest of the patients had primary healing of the incision. Patients in both groups were followed up 12-24 months, with an average of 13.8 months. In the control group, 1 patient with fracture of pronation and external rotation walked with full weight bearing after removing the metal screw of the distal tibiofibular syndesmosis at 8 weeks after operation, the anatomical plate of the lateral malleolus was broken, and the lateral malleolus was fixed again and recovered after 5 months; 1 patient had mild ankle pain after operation, and the pain disappeared after removing the metal screw of the distal tibiofibular syndesmosis at 8 weeks. No complication such as nerve and blood vessel injury occurred in all patients. There was no significant difference in fracture healing time between the two groups ( t=-1.128, P=0.264). The AOFAS and VAS scores significantly improved in both groups at 12 months after operation ( P<0.05). There was no significant difference between the two groups in the OM scores, and the difference of AOFAS and VAS scores between before and after operation ( P>0.05). CONCLUSION Using absorbable screws to repair the distal tibiofibular syndesmosis can effectively restore the ankle acupoint structure, prevent ankle instability, and restore good ankle function. There is no significant difference in effectiveness between absorbable screws and metal screws, and there is no need for secondary operation to remove screws.
Collapse
|
6
|
Rougereau G, Noailles T, Khoury GE, Bauer T, Langlais T, Hardy A. Is lateral ankle sprain of the child and adolescent a myth or a reality? A systematic review of the literature. Foot Ankle Surg 2022; 28:294-299. [PMID: 33965308 DOI: 10.1016/j.fas.2021.04.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Ankle trauma in children and adolescents is the most common orthopedic injury encountered in pediatric trauma. It has long been recognized that a lateral ankle injury in this population is often a Salter and Harris type I fracture of the distal fibula (SH1). The purpose of this study is to confirm the existence of a lateral ankle sprain and to report the incidence of each pathology of the lateral ankle compartment: SH1 fracture, ATFL injury, and osteochondral avulsions. METHODS A systematic review of the literature is done using the database provided by PubMed and Embase. All articles reporting the incidence of imaging modality-confirmed lateral ankle injury (SH1, ATFL injury, osteochondral avulsion) in children and adolescents were included. Exclusion criteria were the following: case reports or articles with less than ten subjects, unspecified imaging modality and articles unrelated to lateral ankle lesions. Thus, 237 titles and abstracts were selected, 25 were analyzed thoroughly, and 11 articles were included for final analysis. RESULTS SH1 fractures were found in 0-57.5% of the cases in all series and 0-3% in the most recent series. A diagnosis of an ATFL injury was found in 3.2-80% and an osteochondral avulsion of the distal fibula in 6-28.1%. The most recent series report 76-80% and 62% for ATFL injury and osteochondral avulsion respectively. CONCLUSIONS There is a non-negligible incidence of ATFL sprains and fibular tip avulsions in patients with a suspected SH1 fracture of the distal fibula. According to recent evidence and MRI examinations, the most common injuries of the pediatric ankle are ATFL sprain and osteochondral avulsions. This should be taken into consideration in daily practice when ordering radiological examination and deciding on treatment modalities.
Collapse
Affiliation(s)
- Grégoire Rougereau
- Department of Orthopedics and Traumatology, Pitié-Salpêtrière Hospital, AP-HP, Sorbonne University, 47-83 Boulevard de l'Hôpital, 75013 Paris, France.
| | - Thibaut Noailles
- Department of Orthopedic Surgery, Polyclinique Bordeaux Nord Aquitaine, 33 Rue du Dr Finlay, 33300 Bordeaux, France
| | - Georges El Khoury
- Department of Orthopedics and Traumatology, Pitié-Salpêtrière Hospital, AP-HP, Sorbonne University, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - Thomas Bauer
- Department of Orthopedics and Traumatology, Ambroise-Paré Hospital, AP-HP, Île-de-France Ouest University, 9 Avenue Charles de Gaulle, 92100 Boulogne-Billancourt, France
| | - Tristan Langlais
- Department of Pediatric Orthopedics, Children's Hospital, Purpan, University of Toulouse, Toulouse, France; Department of Pediatric Orthopedics, Armand-Trousseau Hospital, Sorbonne University, 26 Avenue du Dr-Arnold-Netter, 75012 Paris, France
| | - Alexandre Hardy
- Department of Orthopedics and Traumatology, Ambroise-Paré Hospital, AP-HP, Île-de-France Ouest University, 9 Avenue Charles de Gaulle, 92100 Boulogne-Billancourt, France; Department of Orthopedic Surgery, Clinique du Sport, 36 Boulevard Saint-Marcel, 75005 Paris, France
| |
Collapse
|
7
|
Du M, Li J, Jiao C, Guo Q, Hu Y, Jiang D. Distal insertion rupture of lateral ankle ligament as a predictor of weakened and delayed sports recovery after acute ligament repair: mid-term outcomes of 117 cases. BMC Musculoskelet Disord 2022; 23:294. [PMID: 35346150 PMCID: PMC8961918 DOI: 10.1186/s12891-022-05260-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 03/22/2022] [Indexed: 11/10/2022] Open
Abstract
Background For lateral ankle ligament rupture, surgical repair has been considered for patients requiring return to high-demanding sports. However, there is a lack of systematic research regarding arthroscopic treatment followed by ligament repair for severe acute ankle sprain. The purpose of this study was to analyze the mid-term outcomes of arthroscopy followed by open anatomic lateral ankle ligament repair surgery for acute lateral ankle sprain and the impact of ligament rupture site on the outcomes. Methods Professional or amateur athletes with clinically- and radiologically-confirmed grade III acute lateral ankle ligament injuries undergoing ankle arthroscopy followed by open anatomic ligament repair between June 2007 and May 2017 were reviewed. Intra-articular lesions and the location of rupture were first examined under arthroscopy. Simple suture repair was performed for mid- substance ligament rupture (middle group), while suture repair with anchors were used for the ruptures near the ligament attachment site on the fibular (proximal group), talar or the calcaneal side (distal group). Outcomes were evaluated at final follow-up, including visual analog scale (VAS) pain score, American Orthopaedic Foot & Ankle Society (AOFAS) score, Tegner score, time to return to sports, resumption of pre-injury sports level, sprain recurrence and range of motion (ROM). Results A total of 117 patients were included for analysis, with a mean follow-up duration of 46.4 ± 16.1 months. There were 48 (41%) cases in the proximal group, 41 (35%) cases in the middle group and 28 (24%) cases in the distal group respectively. At final follow-up, all of the VAS score, AOFAS score and the Tegner score were significantly improved from the pre-operative level (p < 0.001). 12 (10%) patients complained of sprain recurrence during follow-up. 14 (12%) patients reported mild ROM restriction and 7 (6%) patients experienced transient skin numbness. The average time to return to pre-injury sports was 4.34 ± 1.11 months. The smallest proportion (86% ± 13%) of resumption of pre-injury sports level was reported from the distal group, compared with 93% ± 12% for the proximal group and 89% ± 14% for the middle group (p = 0.037). Time to return to sports was significantly longer for the distal group, with an average of 4.59 ± 1.27 months compared to 3.99 ± 1.09 months for the proximal group and 4.58 ± 0.90 months for the middle group (p = 0.009). Conclusions Ankle arthroscopy followed by open anatomic ligament repair is a reliable procedure for patients requiring return to high demanding sports after severe acute ankle sprains. Distal rupture near the talar or calcaneal end was associated with delayed return-to-sport and inferior performance in resuming pre-injury sports level.
Collapse
|
8
|
Sugimoto K, Isomoto S, Samoto N, Matsui T, Tanaka Y. Comparison of symptomatic unstable ankle with and without os subfibulare. J Orthop Sci 2022; 28:603-606. [PMID: 35144867 DOI: 10.1016/j.jos.2022.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 10/25/2021] [Accepted: 01/16/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND This study aimed to compare the patients background, clinical scores, condition of the lateral ligament, mechanical instabilities, and chondral lesions in ankles with symptomatic os subfibulare compared to those in ankles with chronic lateral instability without os subfibulare. METHODS Of the 212 ankles with a chronic lateral instability that were surgically treated, 72 ankles had an os subfibulare. All ankles were examined by arthroscopy during surgery. Age, sex, preoperative American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale scores, remnant condition of the lateral ligaments, and chondral lesions were compared between ankles with symptomatic os subfibulare and ankles with chronic lateral instability without os subfibulare. RESULTS There were no statistically significant differences between the groups in terms of the sex ratio (males: females, 35:37 vs. 53:87, n.s.) and the AOFAS Ankle-Hindfoot Scale scores (median; 75 vs. 77, n.s.). There were statistically significant differences in patient age (median: 20 vs. 24.5 years, p < 0.01), talar tilt angle (median: 9.0° vs 12.0°, p < 0.01), anterior drawer distance (6.2 vs. 7.0 mm, p < 0.01), chondral lesions (G0:G1:G2:G3, 35:21:66:5 vs. 40:44:27:29, p < 0.01), condition of the anterior talofibular ligament (intact: repairable remnant: poor remnant, 0:70:2 vs. 1:112:27, p < 0.01), and condition of the calcaneofibular ligament (intact: repairable remnant: poor remnant, 44:26:2 vs. 77:35:28, p < 0.01) between the groups. CONCLUSION This study suggests that the condition of the lateral ligaments including mechanical instability and cartilage of the ankle were less severe in the ankles with symptomatic os subfibulare than in those with chronic lateral instability without os subfibulare. The patients' age was lower in the ankles with symptomatic os subfibulare than in those with chronic lateral instability without os subfibulare. The clinical scores and gender ratio were not statistically different between the group.
Collapse
Affiliation(s)
- Kazuya Sugimoto
- Nara Prefecture General Medical Center, Narshi, Nara, 6308581 Japan.
| | - Shinji Isomoto
- Nara Prefecture General Medical Center, Narshi, Nara, 6308581 Japan
| | | | - Tomohiro Matsui
- Imperial Gift Saiseikai Nara Hospital, Nara-shi Nara, 6308145 Japan
| | - Yasuhito Tanaka
- Nara Medical University, School of Medicine, Kashihara-shi, Nara, 6348522 Japan
| |
Collapse
|
9
|
唐 一, 梁 晓, 赵 宏, 张 言. [Progress in diagnosis and treatment of fibular fracture in ankle fracture]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2022; 36:117-121. [PMID: 35038809 PMCID: PMC8844619 DOI: 10.7507/1002-1892.202108091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 11/11/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To summarize the diagnosis and treatment of fibular fracture in ankle fracture. METHODS Relevant literature at home and abroad in recent years was widely consulted, and various types of fractures were discussed and summarized according to Danis-Weber classification. RESULTS Conservative treatment is not an ideal treatment for type A avulsion fracture. The operation method should be determined according to the position and size of bone mass. For simple type B fracture, both conservative treatment and surgical treatment can achieve good results. When the position of type C fracture is high and does not affect the stability of ankle joint, it can be treated conservatively, while when the position is low and affects the stability of ankle joint, it needs surgical treatment. CONCLUSION First of all, whether the fibular fracture in the ankle fracture is stable or not should be determined. Whether it is treated surgically or not, the purpose is to restore the tibiofibular syndesmosis and restore the motor function of the ankle.
Collapse
Affiliation(s)
- 一丁 唐
- 西安医学院附属红会医院足踝外科(西安 710054)Department of Foot and Ankle Surgery, Honghui Hospital Affiliated to Xi’an Medical College, Xi’an Shaanxi, 710054, P. R. China
| | - 晓军 梁
- 西安医学院附属红会医院足踝外科(西安 710054)Department of Foot and Ankle Surgery, Honghui Hospital Affiliated to Xi’an Medical College, Xi’an Shaanxi, 710054, P. R. China
| | - 宏谋 赵
- 西安医学院附属红会医院足踝外科(西安 710054)Department of Foot and Ankle Surgery, Honghui Hospital Affiliated to Xi’an Medical College, Xi’an Shaanxi, 710054, P. R. China
| | - 言 张
- 西安医学院附属红会医院足踝外科(西安 710054)Department of Foot and Ankle Surgery, Honghui Hospital Affiliated to Xi’an Medical College, Xi’an Shaanxi, 710054, P. R. China
| |
Collapse
|
10
|
Feng SM, Sun QQ, Wang AG, Zhang ZY, Hao L. Long-term functional outcomes of all-inside arthroscopic repair of anterior talofibular ligament avulsion fracture. Foot Ankle Surg 2021; 27:156-161. [PMID: 32414701 DOI: 10.1016/j.fas.2020.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 02/26/2020] [Accepted: 03/22/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND The main purpose of this study was to describe the all-inside arthroscopic technique for repairing anterior talofibular ligament (ATFL) avulsion fractures at the attachment points of the fibula and talus, and to evaluate the functional outcomes during long-term follow-up. METHODS The data of 78 patients with ATFL avulsion fracture treated in our hospital from August 2013 to November 2016 were analyzed retrospectively. All patients underwent surgery. Patients were divided into two groups according to whether they had undergone all-inside arthroscopic treatment or open treatment. The American Orthopedic Foot and Ankle Society (AOFAS) score, Karlsson Ankle Functional Score (KAFS), Foot and Ankle Outcome Score (FAOS) and a 36-item Short Form Health Survey questionnaire (SF-36) were used to evaluate functional outcomes. RESULTS The postoperative follow-up period was 24-48 months. All patients reported subjective improvements to ankle stability without any nerve, blood vessel or tendon complications. At the final follow-up, there was no significant difference in the AOFAS, SF-36 or sport participation rate between the arthroscopic group and the open group; however, the KAFS and FAOS were significantly higher in the arthroscopic group than in the open group. CONCLUSIONS For ATFL avulsion fractures, the all-inside ankle arthroscopic procedure produced better outcomes than did the open procedure. The all-inside ankle arthroscopic procedure provides a minimally invasive technique with acceptable long-term functional outcomes.
Collapse
Affiliation(s)
- Shi-Ming Feng
- Hand and Foot Microsurgery Department, Xuzhou Central Hospital, Xuzhou Clinical College of Xuzhou Medical University, Xuzhou, Jiangsu, 221009, PR China; Professor of Medicine, Xuzhou Clinical College of Xuzhou Medical University, Xuzhou, Jiangsu, 221009, PR China.
| | - Qing-Qing Sun
- Hand and Foot Microsurgery Department, Xuzhou Central Hospital, Xuzhou Clinical College of Xuzhou Medical University, Xuzhou, Jiangsu, 221009, PR China; Professor of Medicine, Xuzhou Clinical College of Xuzhou Medical University, Xuzhou, Jiangsu, 221009, PR China
| | - Ai-Guo Wang
- Hand and Foot Microsurgery Department, Xuzhou Central Hospital, Xuzhou Clinical College of Xuzhou Medical University, Xuzhou, Jiangsu, 221009, PR China
| | - Zai-Yi Zhang
- Hand and Foot Microsurgery Department, Xuzhou Central Hospital, Xuzhou Clinical College of Xuzhou Medical University, Xuzhou, Jiangsu, 221009, PR China
| | - Lin Hao
- Professor of Medicine, Xuzhou Clinical College of Xuzhou Medical University, Xuzhou, Jiangsu, 221009, PR China; Surgical Department, Xuzhou Central Hospital, Xuzhou Clinical College of Xuzhou Medical University, Xuzhou, Jiangsu, 221009, PR China.
| |
Collapse
|
11
|
Murata K, Kumai T, Hirose N. Lateral Ankle Sprains and Their Association with Physical Function in Young Soccer Players. Open Access J Sports Med 2021; 12:1-10. [PMID: 33469390 PMCID: PMC7811480 DOI: 10.2147/oajsm.s283421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 12/03/2020] [Indexed: 12/26/2022] Open
Abstract
Purpose Lateral ankle sprain (LAS) in childhood can result in lateral malleolus avulsion fractures; additionally, bone nonunion may occur. Physical maturity relates to the development of bone morphology and physical functionality. It is unknown how changes in physical functionality attributable to physical maturity affect young soccer players with abnormal lateral malleolus (ALM) morphology. Hence, the present study aimed to investigate the bone morphology of the lateral malleolus in young soccer players and to examine its relationship with physical functionality at different maturity levels. Subjects and Methods Two hundred and ninety young soccer players aged 6–15 years were included. The presence of ALM was assessed using ultrasonography. The subjects were allocated to three groups based on physical maturity (Pre-, Mid-, and Post-peak height velocity age [PHVA]). The prevalence of ALM and the relationship between ALM and physical maturity were examined for body composition, foot pressure distribution, foot alignment, ankle mobility, and single-leg balance. Results The prevalence of ALM was 17.6%. For physical maturity, the post-PHVA group showed a decrease in ankle dorsiflexion and eversion and an increase in one-leg hop distance compared to the Pre-PHVA group (P < 0.05). In the ALM group, the center of pressure during heel raising was distributed laterally in the Post-PHVA (P < 0.01), and the weight-bearing dorsiflexion angle was decreased in the Mid- and Post-PHVA (P < 0.05). Conclusion In the Post-PHVA young soccer players, decreased ankle dorsiflexion and eversion and increased one-leg hop distance were observed. The ALM group exhibited lateral loading during heel raising in the Post-PHVA group and decreased weight-bearing ankle dorsiflexion angle in the Mid- and Post-PHVA groups. The findings indicate the importance of secondary prevention of LAS and ultrasonography. Prospective studies of LAS in young athletes are required in the future.
Collapse
Affiliation(s)
- Kenichiro Murata
- Graduate School of Sport Sciences, Waseda University, Nishi-tokyo, Japan
| | - Tsukasa Kumai
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Norikazu Hirose
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| |
Collapse
|
12
|
Takakura Y, Yamaguchi S, Akagi R, Kamegaya M, Kimura S, Tanaka H, Yasui T. Diagnosis of avulsion fractures of the distal fibula after lateral ankle sprain in children: a diagnostic accuracy study comparing ultrasonography with radiography. BMC Musculoskelet Disord 2020; 21:276. [PMID: 32345266 PMCID: PMC7189593 DOI: 10.1186/s12891-020-03287-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 04/13/2020] [Indexed: 12/26/2022] Open
Abstract
Background The purpose of this study was to determine the diagnostic accuracy of ultrasonography for the diagnosis of avulsion fractures of the distal fibula for lateral ankle sprain in children and compare it to that of radiography. Methods Children who sustained lateral ankle sprain were prospectively surveyed. They underwent both ultrasonography and radiography at the first clinic visit to diagnose any concomitant avulsion fractures of the distal fibula. The patients underwent follow-up radiography 4 weeks later to obtain the reference standard diagnosis. The measures of diagnostic accuracy (i.e., sensitivity, specificity, positive predictive value, and negative predictive value) of the initial ultrasonography and radiography were calculated; they were then compared using the McNemar test. Totally, 52 patients (with a median age of 9 years) were analyzed. Results On the reference standard (follow-up) radiographs, 32 patients (62%) were found to have avulsion fractures of the distal fibula. The sensitivity, specificity, positive predictive value, and negative predictive value for ultrasonography were 94, 85, 91, and 89% respectively; and 81, 100, 100, and 77% respectively for radiography at the first visit. There were no significant differences in sensitivity and specificity between the two diagnostic methods (P = 0.22, 0.25). Conclusions Ultrasonography has a high diagnostic accuracy, which is comparable to that of radiography, for the diagnosis of avulsion fracture of the distal fibula. Ultrasonography may be used as an option of imaging modality for lateral ankle sprain in children.
Collapse
Affiliation(s)
- Yoshiyuki Takakura
- Takakura Orthopaedic & Sports Clinic, 5-4-21 Tokui-cho, Nada-ku, Kobe-shi, Hyogo, 657-0033, Japan
| | - Satoshi Yamaguchi
- Collage of Liberal Arts and Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan. .,Department of Orthopaedic Surgery, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan.
| | - Ryuichiro Akagi
- Department of Orthopaedic Surgery, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan
| | - Makoto Kamegaya
- Chiba C & A Orthopaedic Clinic, 3-24-2 Oyumino-minami, Midori-ku, Chiba-shi, Chiba, 266-0033, Japan
| | - Seiji Kimura
- Department of Orthopaedic Surgery, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan
| | - Hirofumi Tanaka
- Hyakutake Orthopedic Surgery and Sports Clinic, 4-2-15 Mizugae, Saga-shi, Saga, 840-0054, Japan
| | - Tetsuro Yasui
- Department of Orthopaedic Surgery, Teikyo University Mizonokuchi Hospital, 5-1-1 Futako, Takatsu-ku, Kawasaki-shi, Kanagawa, 213-8507, Japan
| |
Collapse
|
13
|
Carbonel AAF, Vieira MC, Simões RS, Lima PDA, Fuchs LFP, Girão ERC, Cicivizzo GP, Sasso GRS, de Moraes LOC, Soares Junior JM, Baracat EC, Simões MJ, Girão MJBC. Isoflavones improve collagen I and glycosaminoglycans and prevent bone loss in type 1 diabetic rats. Climacteric 2019; 23:75-83. [DOI: 10.1080/13697137.2019.1627314] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- A. A. F. Carbonel
- Department of Morphology and Genetics, Paulista School of Medicine/Federal University of São Paulo – EPM/UNIFESP, São Paulo, Brazil
| | - M. C. Vieira
- Department of Gynecology, Paulista School of Medicine/Federal University of São Paulo – EPM/UNIFESP, São Paulo, Brazil
| | - R. S. Simões
- Department of Obstetrics and Gynecology, Medicine Faculty of University of São Paulo – FMUSP, São Paulo, Brazil
| | - P. D. A. Lima
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Canada
| | - L. F. P. Fuchs
- Department of Gynecology, Paulista School of Medicine/Federal University of São Paulo – EPM/UNIFESP, São Paulo, Brazil
| | - E. R. C. Girão
- Department of Gynecology, Paulista School of Medicine/Federal University of São Paulo – EPM/UNIFESP, São Paulo, Brazil
| | - G. P. Cicivizzo
- Department of Morphology and Genetics, Paulista School of Medicine/Federal University of São Paulo – EPM/UNIFESP, São Paulo, Brazil
| | - G. R. S. Sasso
- Department of Gynecology, Paulista School of Medicine/Federal University of São Paulo – EPM/UNIFESP, São Paulo, Brazil
| | - L. O. Carvalho de Moraes
- Department of Morphology and Genetics, Paulista School of Medicine/Federal University of São Paulo – EPM/UNIFESP, São Paulo, Brazil
| | - J. M. Soares Junior
- Department of Obstetrics and Gynecology, Medicine Faculty of University of São Paulo – FMUSP, São Paulo, Brazil
| | - E. C. Baracat
- Department of Obstetrics and Gynecology, Medicine Faculty of University of São Paulo – FMUSP, São Paulo, Brazil
| | - M. J. Simões
- Department of Morphology and Genetics, Paulista School of Medicine/Federal University of São Paulo – EPM/UNIFESP, São Paulo, Brazil
| | - M. J. B. C. Girão
- Department of Gynecology, Paulista School of Medicine/Federal University of São Paulo – EPM/UNIFESP, São Paulo, Brazil
| |
Collapse
|