Lateral process fractures of talus are rare injuries with a potential to cause significant morbidity if misdiagnosed. The appropriate management of these fractures is still controversial and only a few reports are avai- lable on this subject. We presented a case of a 37-year-old male with neglected fracture on the lateral process of talus which was misdiagnosed at the time of injury. The patient presented to 7 months after misdiagnosis with a chronic ankle pain. Our case is unique in the sense that it is a rare case of neglected fracture on the lateral process of talus which presented as a loose body in sinus tarsi. However, a surgery with an excision of the loose body presented a satis- factory outcome along with 2 years' follow-up. To our knowledge, it ought to be the first case reported in the English literature. Through this case report, we highlight the importance of high index of suspicion for such rare bony injuries while evaluating trauma to the lateral side of ankle and discuss the principles of management of these fractures.
Ankle Fractures ; Ankle Injuries ; surgery ; Ankle Joint ; surgery ; Diagnostic Errors ; Fractures, Bone ; surgery ; Humans ; Joint Dislocations ; Talus ; injuries

Deltoid ligament injury is common in the daily activities, unlike some other diseases, mechanism of deltoid ligament injury is relatively clear with less controversies, but the consistent standard for its diagnosis and treatment has not yet formed. Whether the stress X-ray as the main basis for diagnosis, MRI check for early application, and the indications of surgical exploration and so on, these are not unified. In the international, especially the conservative treatment and surgical treatment has been existing two major differences. In the choice of surgical treatment, domestic and foreign experts have respective preference. In recent years, domestic researchers emphasis to repair with suture anchors, while abroad it has been mainly to reconstruct the deltoid ligament.
Ankle Injuries ; diagnosis ; surgery ; Arthroscopy ; Humans ; Ligaments, Articular ; injuries

OBJECTIVETo evaluate the clinical effect of arthroscopic excision of the os subfibulare in anterior-lateral ankle pain.

METHODSFrom December 2005 to Augest 2014, 16 patients suffering from pain associated with an os subfibulare in the anterior-lateral side of their ankles were reviewed. Among the patients,11 patients were male and 5 were female, with a mean age of (33.5 ± 15.6) years old. The mean maximum diameter of os subfibulare was (0.70 ± 0.26) cm. All the patients underwent excision of the osseous fragments, and had anatomic reconstruction of the anterior talofibular ligament if the anterior-lateral ankle was instable. The average follow-up period was (18.0 ± 4.5) months. To analyze the surgical outcome, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot pain and function scales,visual analogue scale (VAS) and Tegner activity scale were assessed preoperatively and postoperatively.

RESULTSAOFAS scales were preoperative 60.15 ± 14.52 and postoperative 92.35 ± 5.73. There was a significant difference between them (t = -8.251, P = 0.000). The mean VAS score were preoperative 7.35 ± 0.46 and postoperative 2.45 ± 0.98. Statistical significance was also notable (t = 18.105, P = 0.000). Tegner score was significantly increased from preoperative 2.87 ± 1.12 to postoperative 5.78 ± 1.06 (t= -7.548, P = 0.000).

CONCLUSIONIrrespective of the size of os subfibulare, in patients with pain or instability associated with the os subfibulare, arthroscopic excision combined with reconstruction of ther anterior talofibular ligament or not was effective in restoring ankle function and eliminating pain.

Adult ; Ankle Injuries ; surgery ; Ankle Joint ; surgery ; Arthroscopy ; methods ; Female ; Fibula ; surgery ; Humans ; Lateral Ligament, Ankle ; surgery ; Male ; Middle Aged

Ankle Injuries ; diagnosis ; surgery ; therapy ; Ankle Joint ; surgery ; Humans ; Joint Instability ; diagnosis ; surgery ; therapy

Ankle Fractures/surgery* ; Ankle Injuries ; Ankle Joint ; Bone Cysts/surgery* ; Fracture Fixation, Internal ; Fractures, Bone ; Humans ; Talus/surgery*

The distal tibiofibular syndesmosis is important for ankle mortise stability, weight transmission and walking. Incorrect treatment is correlate with chronicd ankle instability, long-term pain and the development of osteoarthritis. Some controversy still exists regarding the evaluation and treatment of syndesmotic injuries with screws. The goal of this review was to collect evidence on the technical aspects for the treatment of distal tibiofibular syndesmosis injuries with screw and to formulate some recommendations for clinical practices.
Ankle Injuries ; surgery ; Bone Screws ; Fibula ; injuries ; surgery ; Fracture Fixation, Internal ; methods ; Humans ; Joint Instability ; surgery ; Tibia ; injuries ; surgery

Adolescent ; Adult ; Ankle Injuries ; surgery ; Ankle Joint ; surgery ; Female ; Humans ; Ligaments, Articular ; injuries ; Male ; Middle Aged ; Young Adult

OBJECTIVE: To study the effectiveness of TightRope elastic fixation combined with functional total repair of the inferior tibiofibular ligament in the treatment of distal tibiofibular syndesmosis injury. METHODS: The clinical data of 34 patients with distal tibiofibular syndesmosis injury who met the selection criteria between January 2020 and January 2022 were retrospectively analyzed, and they were divided into improved group (TightRope elastic fixation combined with functional total repair of inferior tibiofibular ligament) and control group (distal tibiofibular screw fixation) according to the surgical methods, with 17 cases in each group. There was no significant difference in age, gender, body mass index, fracture type, and other baseline data between the two groups (P>0.05). The operation time, intraoperative blood loss, and complications were recorded in the two groups. The American Orthopaedic Foot and Ankle Society (AOFAS) score, ankle metatarsal flexion and dorsal extension range of motion were used to evaluate the ankle function. The patient satisfaction survey was conducted at last follow-up. RESULTS: All 34 patients were followed up 8-20 months, with a median of 13 months. The operation time and intraoperative blood loss in the improved group were significantly longer than that in the control group (P<0.05). In the improved group, no infection or poor reduction occurred, and only 1 patient had TightRope knot reaction at 6 months after operation. In the control group, there were 2 cases of poor reduction, 1 case of lower tibiofibular screw rupture, and 1 case of subcutaneous infection (cured after anti-infection treatment). There was no significant difference in the incidence of complications between the two groups (P>0.05). At last follow-up, the AOFAS score and ankle metatarsal flexion and dorsal extension range of motion of the improved group were significantly better than those of the control group (P<0.05). The satisfaction rates of patients in the improved group and the control group were 94.1% and 82.4%, respectively, showing significant difference (P<0.05). CONCLUSION TightRope elastic fixation combined with functional total repair of inferior tibiofibular ligament in the treatment of distal tibiofibular syndesmosis injury has sufficient fixation strength, and can achieve better effectiveness and joint function compared with traditional screw fixation.
Humans ; Ankle Joint/surgery* ; Blood Loss, Surgical ; Ligaments/surgery* ; Plastic Surgery Procedures ; Retrospective Studies ; Ankle Injuries/surgery*

OBJECTIVEConventional fixation of syndesmotic injuries with screws remains problematic. A novel fibrewire device (Tightrope® has suggested advantages. However, small case series have reported high soft tissue complication rates. The purpose of our study was to quantify complication rates and further procedures in patients treated with Tightropes. A secondary objective was to determine incidence of complications and further procedures in those treated with syndesmotic screws over the same period.

METHODSAll patients undergoing syndesmotic fixation for ankle fracture between May 2008 and October 2009 were retrospectively reviewed. Incidence of complications, secondary procedures, maintenance of syndesmotic reduction and time spent on non-weight bearing were recorded. Family doctors were contacted for those treated with Tightropes to check for any complications managed elsewhere.

RESULTSThirty-five patients required syndesmotic fixation, in which 12 were treated with Tightropes. They were followed up in clinic for a mean of 12.4 weeks. Family doctors were contacted at mean 14.6 months after treatment to determine any complications suffered. There were no complications attributable to method of fixation. In this series, 12 patients underwent 13 procedures and no patient had recurrent diastasis at discharge; 23 patients treated with screw fixation underwent 45 procedures (19 were screw removals). There was 1 case of syndesmotic diastasis. Screw removal resulted in 2 minor complications.

CONCLUSIONTightrope fixation provideds effective syndesmotic fixation that is maintained at discharge. We do not experience soft tissue complications reported elsewhere.

Ankle Fractures ; Ankle Injuries ; surgery ; Bone Screws ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Postoperative Complications

Ankle Injuries ; surgery ; Evidence-Based Medicine ; methods ; Foot Injuries ; surgery ; Humans