Ebook Imaging of orthopaedic fixation devices and prostheses: Part 2
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Ebook Imaging of orthopaedic fixation devices and prostheses: Part 2
8The Foot and Ankletiers requiring orthopaedic instrumentation including trauma, common orthopaedic procedures, and joint replacement. Clinical evalua Ebook Imaging of orthopaedic fixation devices and prostheses: Part 2ation, treatment options, anil complications will be reviewed. Proopcrativc imaging and imaging of complications will be emphasized..'Vsociated soft tissue or ligament injuries are also important to detect for appropriate management of the injur}'. When evaluating ankle injuries, it is helpful to co Ebook Imaging of orthopaedic fixation devices and prostheses: Part 2nsider the bones and ligaments as a ring-like structure. The ring is made of the medial malleolus, tibtal plafond, distal tibiofibular ligaments (TFl.Ebook Imaging of orthopaedic fixation devices and prostheses: Part 2
s) andTraumaThe management of loot and ankle fractures is a common problem for orthopaedic surgeons, emergency physicians, family physicians, and radi8The Foot and Ankletiers requiring orthopaedic instrumentation including trauma, common orthopaedic procedures, and joint replacement. Clinical evalua Ebook Imaging of orthopaedic fixation devices and prostheses: Part 2instituted.Discussion of specific injuries is most easily accomplished by anatomic regions. 'Therefore. ankle, hind foot, mid foot, and forefoot injuries will be discussed separate!}'.Ankle FracturesApproximately 10% of emergency department visits are related to ankle injuries, typically presenting Ebook Imaging of orthopaedic fixation devices and prostheses: Part 2as sprains. The number of ankle injuries in adults (especially those older than 50 years) has been constantly increasing. The highest incidence is 111Ebook Imaging of orthopaedic fixation devices and prostheses: Part 2
women aged 75 to 84 years. Most fractures involve the lateral malleolus with isolated malleolar fractures accounting for 67% of ankle fractures. Most8The Foot and Ankletiers requiring orthopaedic instrumentation including trauma, common orthopaedic procedures, and joint replacement. Clinical evalua Ebook Imaging of orthopaedic fixation devices and prostheses: Part 2alleolar and about 7% trimalleolar. Approximately 2% of adult ankle fractures are open injuries. In children, ankle fractures account for 5% of all skeletal fractures and 15% of physeal injuries. Adult and pediatric ankle fractures are managed somewhat differently and will be reviewed separately.Adu Ebook Imaging of orthopaedic fixation devices and prostheses: Part 2lt Ankle FracturesWhen evaluating ankle fractures, an accurate assessment of fracture locution, appearance, and displacement is critical.b Fig. 8-1 AnEbook Imaging of orthopaedic fixation devices and prostheses: Part 2
teroposterior (AP) radiograph demcostrating the ring concept created by bones and ligaments of the ankle. Common breaks in the ring are (7) the latera8The Foot and Ankletiers requiring orthopaedic instrumentation including trauma, common orthopaedic procedures, and joint replacement. Clinical evalua Ebook Imaging of orthopaedic fixation devices and prostheses: Part 2tle fracture in the lateral malleolus (arrow).355IMAGING OF ORTHOPAEDIC FIXATION DEVICES AND PROSTHESESI Fig. 8-2 Anteroposterior (AP) radiograph demonstrating widening of the medial ankle mortise (1) due to medial ligament tear, widening of the syndesmosis (2) due to distal tibiofibular ligament an Ebook Imaging of orthopaedic fixation devices and prostheses: Part 2d syndesmotic tears, and a subtle (arrow) distal fbular fracture.syndesmosis, the lateral malleolus, lateral ligament complex, talus, and medial ligamEbook Imaging of orthopaedic fixation devices and prostheses: Part 2
ents. Breaks in the ring commonly occur at five sites, cither alone or in combination (see Fig. 8-1). Breaks in the ring resulting in asymmetry in the8The Foot and Ankletiers requiring orthopaedic instrumentation including trauma, common orthopaedic procedures, and joint replacement. Clinical evalua Ebook Imaging of orthopaedic fixation devices and prostheses: Part 2kle injuries arc the result of inversion (supination) or eversion (pronation) forces. However, the mechanism of injury is rarely pure with rotational, abduction, or adduction forces to the foot and axial loading occurring as well (see Figs. 8-J, 8-4.8-5, and 8-6). 'Hicrc arc multiple classification Ebook Imaging of orthopaedic fixation devices and prostheses: Part 2systems, but the l.augc-llanscn, Danis-Weber, and Orthopaedic Trauma Association systems will be reviewed. Common fracture eponyms will also be listedEbook Imaging of orthopaedic fixation devices and prostheses: Part 2
following the classification section.The Lauge-I lanscn classification is based on the position of the foot and direction of the forces at the time o8The Foot and Ankletiers requiring orthopaedic instrumentation including trauma, common orthopaedic procedures, and joint replacement. Clinical evalua Ebook Imaging of orthopaedic fixation devices and prostheses: Part 2he fibular fracture and position of the talus. T able 8-1 describes the stages of injury and radiographic features of the Lauge-I lanscn classification.The Danis-Weber classification is based on the location of the iibular fracture. Type A fractures are below the level of the ankle joint. T ype li f Ebook Imaging of orthopaedic fixation devices and prostheses: Part 2ractures are at the level of the ankle with the distal TFLs intact. Type c fractures arc above the ankle joint with disruption of the ligaments and syEbook Imaging of orthopaedic fixation devices and prostheses: Part 2
ndesmosis (sec Fig. 8-7).The Orthopaedic Trauma .Association classification expands upon the Weber, Ijauge-Hansen, and AO (ArbeitsgemeinslwftI Fig. 8-8The Foot and Ankletiers requiring orthopaedic instrumentation including trauma, common orthopaedic procedures, and joint replacement. Clinical evalua Ebook Imaging of orthopaedic fixation devices and prostheses: Part 2al malleolus or dehod ligament tear. State II: posterior tibial fracture of distal tibiofibular ligament tear. Stage HI: Oblique fibular fracture beginning at the joint level and best seen on the anteroposterior (AP) radiograph. Traction forces cause the medial injury and impaction the lateral fract Ebook Imaging of orthopaedic fixation devices and prostheses: Part 2ure 8: AP and lateral radiographs demonstrate widening of the ankle mortrse medially (f) with no ftoular fracture but disruption of the distal tibiofiEbook Imaging of orthopaedic fixation devices and prostheses: Part 2
bular ligaments (stage II).356CHAPTER 8 •The Foot and AnkleI Fig. 8-4 Prcnation (eversKoyiauol rotat-on injuiy. A- Illustration of the four stages of 8The Foot and Ankletiers requiring orthopaedic instrumentation including trauma, common orthopaedic procedures, and joint replacement. Clinical evalua Ebook Imaging of orthopaedic fixation devices and prostheses: Part 2al tibofibular ligament and syndesmosrị Stage III: high fibular fracture typically >6 cm above the joEbook Imaging of orthopaedic fixation devices and prostheses: Part 2
a high fibular fracture (j).fur Osteosynthesefragen) classifications with three major groups (A to C) divided into three subgroups with multiple addit8The Foot and Ankletiers requiring orthopaedic instrumentation including trauma, common orthopaedic procedures, and joint replacement. Clinical evalua Ebook Imaging of orthopaedic fixation devices and prostheses: Part 2ill be included in Table 8-2.Chapter 2 contains common fracture eponyms for fractures and ligament injuries involving the ankle.Tibial Plafond FracturesTibial plafond fractures do not fit neatly into the commonly used ankle fracture classifications mentioned earlier. Most (77%) occur in patients you Ebook Imaging of orthopaedic fixation devices and prostheses: Part 2nger than 50 years. Fractures are the result of axial loading after falls from significant heights or high-velocity motor vehicle accidents. FracturesEbook Imaging of orthopaedic fixation devices and prostheses: Part 2
usually extend up the tibial shaft in an oblique or spiral manner. Severe comminution with multiple articular f ragments (pilon fracture) is common. 8The Foot and Ankletiers requiring orthopaedic instrumentation including trauma, common orthopaedic procedures, and joint replacement. Clinical evalua Ebook Imaging of orthopaedic fixation devices and prostheses: Part 2th subgroups,but Table 8-3 and the illustrations (see Figs. 8-11 through 8-13) demonstrate the complexity of these in juries.Isolated dislocations of the ankle without fractures arc rare. Most occur with plantar flexion and inversion resulting in posteromedial dislocations.Suggested ReadingArimoto H Ebook Imaging of orthopaedic fixation devices and prostheses: Part 2R. Forrester DM. Classification of ankle fractures: An algorithm. AJR Am J Roentgenol. 1980:135:1057-1063.Berquist TH. Rddiologf of the foot andankle,Ebook Imaging of orthopaedic fixation devices and prostheses: Part 2
2nd ed. Philadelphia: Lippincott Williams & Wilkins; 2000:171-280.Laugc-I lansen N. Fractures of the ankle. II. Combined experimental-surgical and ex8The Foot and Ankletiers requiring orthopaedic instrumentation including trauma, common orthopaedic procedures, and joint replacement. Clinical evalua8The Foot and Ankletiers requiring orthopaedic instrumentation including trauma, common orthopaedic procedures, and joint replacement. Clinical evaluaGọi ngay
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