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Posterior Ankle Arthroscopic Reduction With Internal Fixation.

ABSTRACT: Current surgical techniques in ankle fracture management now include arthroscopic-assisted reduction and internal fixation. The need for minimally invasive fracture reduction techniques, which preserve soft tissue envelops and assists in overall anatomic reduction, can be refined and improved. The ankle is an ideal anatomic location for arthroscopic-assisted reduction and internal fixation due to the high incidence of intra-articular pathology and the poor long-term sequela of nonanatomic reduction. Thus, we propose using prone posterior ankle arthroscopic reduction internal fixation for posterior ankle fracture variants.

SUBMITTER: Martin KD

PROVIDER: S-EPMC5263098 | biostudies-literature | 2016 Dec

REPOSITORIES: biostudies-literature

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Posterior Ankle Arthroscopic Reduction With Internal Fixation.

Martin Kevin D KD Unangst Alicia M AM Englert Cody R CR

Arthroscopy techniques 20161107 6

Current surgical techniques in ankle fracture management now include arthroscopic-assisted reduction and internal fixation. The need for minimally invasive fracture reduction techniques, which preserve soft tissue envelops and assists in overall anatomic reduction, can be refined and improved. The ankle is an ideal anatomic location for arthroscopic-assisted reduction and internal fixation due to the high incidence of intra-articular pathology and the poor long-term sequela of nonanatomic reduct ...[more]

PMID: 28149723

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Posterior Malleolus Arthroscopic Reduction and Internal Fixation Technique.

Project description:Adequate reduction of posterior malleolar fractures leads to better outcomes. Arthroscopic reduction and internal fixation presents an opportunity for excellent reduction with a minimally invasive approach. Herein, we present a technique with some discussion on outcomes.

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Arthroscopic Reduction and Internal Fixation in Patients with Acetabular Posterior Wall Fractures.

Project description:BackgroundThis study aimed to access the radiologic and clinical outcomes after arthroscopic reduction and internal fixation with screws in patients with posterior wall fractures of the acetabulum.MethodsFrom May 2013 to December 2019, 13 patients (11 men and 2 women) with posterior wall fractures of the acetabulum were treated with arthroscopic reduction and internal fixation with screws at two medical centers. The mean age at the index operation was 39 years (range, 22-58 years). The mean duration of follow-up was 23 months (range, 12-46 months). Clinical assessment was performed using the modified Merle d'Aubigné and Postel functional scoring system. The maximum displacement of acetabular or femoral head fragments detected on radiographs was used as radiographic results. Secondary osteoarthritis, osteonecrosis, or heterotrophic ossification was assessed at the latest follow-up.ResultsBony union was shown at 12 weeks of follow-up in all patients. The radiologic outcomes showed an anatomical reduction in 11 patients and a satisfactory reduction in 2 patients. The modified Merle d'Aubigné and Postel functional score was excellent in 7 patients, good in 5 patients, and fair in 1 patient. Two patients had transient pudendal nerve palsy after hip arthroscopy. However, no sciatic nerve palsy occurred. At the latest follow-up, there was no heterotopic ossification, osteonecrosis of the femoral head, or posttraumatic osteoarthritis.ConclusionsArthroscopic reduction and internal fixation with cannulated screws can be good alternative options with good radiographic and clinical outcomes, convenient removal of intra-articular loose body, and low complication rates.

| S-EPMC10551686 | biostudies-literature

Arthroscopically Assisted Open Reduction-Internal Fixation of Ankle Fractures: Significance of the Arthroscopic Ankle Drive-through Sign.

Project description:Standalone open reduction-internal fixation (ORIF) of unstable ankle fractures is the current standard of care. Intraoperative stress radiographs are useful for assessing the extent of ligamentous disruption, but arthroscopic visualization has been shown to be more accurate. Concomitant arthroscopy at the time of ankle fracture ORIF is useful for accurately diagnosing and managing syndesmotic and deltoid ligament injuries. The arthroscopic ankle drive-through sign is characterized by the ability to pass a 2.9-mm shaver (Smith & Nephew, Andover, MA) easily through the medial ankle gutter during arthroscopy, which is not usually possible with both an intact deltoid ligament and syndesmosis. This arthroscopic maneuver indicates instability after ankle reduction and fixation and is predictive of the need for further stabilization. Furthermore, when this sign remains positive after fracture fixation, it may guide the surgeon to further evaluate the adequacy of fixation for the possible need for further fixation of the syndesmosis or deltoid. We present the case of an ankle fracture managed with arthroscopy-assisted ORIF and describe the clinical utility of the arthroscopic ankle drive-through sign.

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Tibial Plateau With Arthroscopic Reduction-Internal Fixation.

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Arthroscopic Reduction and Internal Fixation of Posterior Cruciate Ligament Avulsion Fracture Using an Adjustable-Length Loop Device.

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Project description:Femoroacetabular impingement is uncommonly associated to a rim fracture. Complete resection of the fragment might result in iatrogenic instability or poor femoral head coverage. In this report, we describe the step-by-step surgical technique of arthroscopic partial resection of a rim fracture, reduction and internal fixation of the remaining fragment to correct the impingement, and preserve the adequate acetabular coverage.

| S-EPMC5765539 | biostudies-literature

ORV Arthroscopic Reduction and Internal Fixation of Tibial Eminence Fractures.

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| S-EPMC3882680 | biostudies-literature

Arthroscopic Posterior Ankle Ligament Anatomy.

Project description:BackgroundThe purpose of this article is to document the normal arthroscopic appearance of the posterior ankle capsular and ligamentous structures, and variations in their anatomical relationships.Methods102 ankle arthroscopy videotapes were evaluated retrospectively for the configuration of the posterior capsuloligamentous structures. Based on these observations, the variations in the appearance and position of the posterior tibiofibular ligament (PTFL) and transverse (tibiofibular) ligament (TTFL) were documented. In addition, differences in the appearance of the flexor hallucis longus (FHL) were also noted.ResultsAll patients had evidence of both a PTFL and TTFL, which formed a labrum or meniscus-like addition to the posterior distal tibia. No patients demonstrated disruption of the PTFL; 3 had tears of the TTFL. We noted 4 distinct patterns of the PTFL and the TTFL. Thirty-four patients (33%) had a gap of ≥2 mm between the 2 ligamentous structures. Thirty-three (32.4%) had a gap <2 mm between the PTFL and TTFL. Twenty-six (25.5%) had a confluence of the 2 ligaments without a gap. Nine (9%) demonstrated a sizable gap between the 2 ligaments, and the TTFL appeared as a "cord-like" structure.ConclusionTo our knowledge, this is the first article to describe the variations in the arthroscopic normal posterior capsuloligamentous structures and FHL of the ankle.Level of evidenceLevel IV, case series.

| S-EPMC8564934 | biostudies-literature

Arthroscopic Reduction and Internal Fixation of Proximal Humerus Greater Tuberosity Fracture.

Project description:Proximal humerus fractures are common fractures that may occur after ground level falls or other traumatic events resulting in a direct injury to the shoulder. Depending on the fracture morphology and the age of the patient, anatomic reduction can vastly improve outcomes, especially in fracture patterns that involve the greater tuberosity. In this case example, we performed a minimally invasive, arthroscopic reduction and fixation of a proximal humerus fracture that involved significant displacement of the greater tuberosity. The technique employed is reproducible and avoids the morbidity of a large open incision while simultaneously providing compression of the fracture fragment for excellent healing potential.

| S-EPMC7528626 | biostudies-literature

Open Reduction and Internal Fixation of the Posterior Malleolus Fragment in Ankle Fractures Improves the Patient-Rated Outcome: A Systematic Review.

Project description:BackgroundThe best treatment strategy for fractures to the posterior malleolus (PM) is still intensively debated. The aim of this systematic review was to compare the patient-rated outcome following open reduction and internal fixation (ORIF) for fractures of the PM to either closed reduction using AP screws (CRIF) or no treatment in bi- or trimalleolar ankle fractures.MethodsSystematic literature research (MEDLINE (PubMed), CINAHL, Scopus, Central and EMBASE) according to the PICOS and PRISMA guidelines. Eligible were studies comparing the outcome following ORIF to any other treatment strategy for fractures to the posterior malleolus in isolated bi- or trimalleolar ankle fractures.ResultsTwelve studies were eligible for a qualitative analysis and 6 for a quantitative analysis. Overall, a considerable heterogeneity among the studies was observed. The most commonly used outcome score was the American Orthopaedic Foot & Ankle Society ankle-hindfoot score (AOFAS). The final follow-up ranged from 12 to 160 months. Four studies compared ORIF to CRIF of the PM. The quantitative analysis revealed significantly better AOFAS scores for ORIF (90.9 vs 83.4 points; P < .001; I2 = 0%). Three studies compared ORIF to untreated PM fragment. The quantitative analysis again revealed superior AOFAS scores for ORIF (92.0 vs 82.5 points; P < .001; I2 = 99%). A similar trend was observed for the Ankle Fracture Scoring System and American Academy of Orthopaedic Surgeons Foot and Ankle Questionnaire scores as well as the quality of reduction.ConclusionDespite a considerable heterogeneity, the data available point to a superior outcome following ORIF for fractures to the PM when compared to CRIF or no treatment.

| S-EPMC10394961 | biostudies-literature

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