Ankle Fracture in the Athlete: Should I scope? What about the Deltoid? Do I have to repair?
|
|
- Christal Conley
- 6 years ago
- Views:
Transcription
1 Ankle Fracture in the Athlete: Should I scope? What about the Deltoid? Do I have to repair? DAVID A PORTER, MDPHD METHODIST SPORTS MEDICINE/THE ORTHOPEDIC SPECIALISTS 201 PENNSYLVANIA PKWY INDIANAPOLIS, IN F/A CONSULTANT TO: INDIANAPOLIS COLTS, INDIANA U, PURDUE U, U OF INDPLS DPORTER@METHODISTSPORTS.COM Should I scope the ankle when fixing ankle fractures? Purpose: Do I need to scope all ankle fractures? 1. If you are proficient with ankle arthroscopy, then scope 2. If not, no study to date has shown clear advantage in outcomes with scope 3. Visualization is 1 o advantage 4. Learning curve, Sports MD know scope, Trauma docs do more fractures. 5. Sports F/A scope more ankle fx PROS - More extensive and better visualization - Chondral and fx reduction - Can treat loose bodies, OCL and soft tissue CONS - more time consuming min extra - Technically demanding Introduction: Ankle fractures in the Athlete to15% of all athletic injuries occur at the ankle joint 2. Ankle fractures result from higher energy sports trauma 3. Fractures require displacement of the joint including dislocation 4. The risk for associated cartilage injury is high with fractures 5. Little has been written re: ankle fractures in the Athlete* 6. High rate of disability possible after ankle frx in the Athlete
2 *Porter, et al. Functional Outcome after Operative Treatment for Distal Fibula and Tibia Fractures in Young Athletes: FAI 2008 What does the Literature say? 1. Thordardson, 9 pts FAI control group not scoped -8/9 fractures had chondral injury 89% -Compared to fracture tx without scope (n=10) -No difference in outcome, scope/no-scope 2. Ferkel, 48 pts Arthroscopy 02-63% chondral or OCL lesions -Treatment of lesion at time of surgery -Inc cartilage injury with synd tear 3. Ono, 105 pts Arthroscopy 04-20% chondral injuries -Shaving and loose body removal -Arthroscopic visualization of fx reduction -No true outcome eval undertaken 4. Leontaritis, 83 pts JBJS 09 More severe fracture pattern more intra-articular diagnostic value and better intra-articular frature pattern and severity, visualize reduction -20%-89% chondral injury with ankle fracture -Higher incidence with dislocation w/ fracture Scope Pictures, can see better than open
3 How do I scope the ankle with fracture care? 1. Can use leg holder and do scope and fx -Unilateral lithotomy leg 2. Can do set up for ankle fracture and then scope -Large bump under knee 3. I still use pump, quick scope, min deb, visualization and tx OCL 4. Remove loose bodies, cartilage 5. Standard anterior portals, posterior portals not typically necessary 6. Video What about the Deltoid? Do I have to repair it with ankle fractures? 1. More interest in fixing now. 2. If not, no study to date has shown clear advantage in outcomes with repair of the deltoid vs cast and non-weight bearing for non-op tx Deltoid 3. Sports F/A doing more 1 o repair 4. Trauma literature shows interest in early WB and early ROM 5. Repair may allow more early ROM/WB 6. Must suture deep deltoid before fixing lateral side, access, +/- anchors A PROS 1. More assurance of healing and stability-poor reconstruction of deltoid if chronic 2.? Earlier ROM and WB, interest 3. Dec stiffness with early ROM 4. Can visualize medial joint surface 5. Can treat loose bodies, OCL
4 B CONS 6. more time consuming, min extra 7. Technically demanding for the deep deltoid 8. Must repair deep deltoid before lateral ORIF 9. Another incision EXTERNAL ROTATION LIGAMENT INJURY 1. Hinterman Medial Ankle Instability - Stage I-nonoperative Stage II- Brostrom - Stage III- II tx plus correct pron and PTT adv - Stage IV- TN arthrodeses 2. Why Deltoid does bad? 3. MCL knee = ATFL & CFL ankle 4. LCL knee = Deltoid ankle (tension side) 5. Varus knee thrust with ambulation, valgus ankle stress with weight-bearing midstance 6. Pronation of foot/ankle is normal 1. Baird JBJS 87 and Stromsoe 95 JBJS Not necessary to repair deltoid????? Casted? 2. Hsu FAI, Jones JOT, Yu, JFAS all 2015 HSU repair super. Deltoid in NFL ankle fractures Jones repair deltoid better than Synd screw in ankle fx Yu multicenter study repair effect way to avoid late instab. 3. Again, if. cast may not have advantage 4. If want to do early ROM and WB repair may protect for late instability 5. No clear science on approach, F/A sports tending toward repair. ANTERIOR DELTOID 1. CAN HAVE CONCOMMITANT MEDIAL AND LATERAL INSTABILITY BUT NOT COMMON with ligaments but common with ankle fracture (bony instab laterally) 2. MRI can visulaize DELTOID FIBERs medially and determine if rutpure 3. ANTERIOR DELTOID RESPONSIBLE FOR ER STABILTY 4. CAN BE REPAIRED, EVEN IF LATERAL SIDE OK 5. EXAM AND MECHANISM OF INJURY IMPORTANT TO HELP DISTINGUISH 6. STRESS XRAYS IF ANY DOUBT
5 BIBLIOGRAPHY Arthroscopy with Ankle fractures: Amendola, A, et al Ankle Arthroscopy: Outcomes in 79 consecutive patients. Arthroscopy vol 12 (5): Atesok, K, et al Arthroscopy-assisted fracture fixation. Knee Surg Sports Traumatol Arthrosc 19: , 2011 Bonasia, D, et al. the Role of Arthroscopy in the Management of Fractures about the Ankle. JAAOS: , 2011 Loren, G and Ferkel, R, Arthroscopic Assessment of Occult Intra-articular Injury in Acute Ankle Fractures. Arthroscopy 18(4): , 2002 Leontartius, N, et al. Arthroscopically detected intra-articular lesions associated with acute ankle fractures. JBJS Am 91: , 2009 Nosewiscz, T, et al Prospective Computed Tomography Analysis of Osteochondral Lesions of the Ankle Joint Associated with Ankle Fractures. FAI 37(8): , Ono, A, et al. Arthroscopically assisted treatment of ankle fractures: arthroscopic findings and surgical outcomes. Arthroscopy 20: , 2004 Thordardson, DB, et al. The role of ankle arthroscopy on the surgical management of ankle fractures. FAI 22: Deltoid Repair with ankle Fractures
6 Baird, R and Jackson, ST, Fractures of the dial part of the fibula with associated disruption of the deltoid ligament. Treatment without repair of the deltoid ligament. JBJS Am 69(9): , 1987 Hsu, A, et al. Repair of acute superficial deltoid complex avulsion during ankle fracture fixation in National Football League Players. FAI 36(11):1272-8, 2015 Jones, C and Nunley, J Deltoid ligament repair versus sundesmotic fixation in bimalleolar equivalent ankle fractures. J Ortho Trauma 29(5):245-9, Stromsoe, K, et al. The repair of a ruptured deltoid ligament is not necessary in ankle fractures. JBJS 77(6):920-1, 1995 Stufkens, S, et al. the diagnosis and treatment of deltoid ligament lesions in supination-external rotation ankle fractures: a review. Strat Traum Limb Recon 7:73-85, 2012 Yu, G, etal. Repair of the acute deltoid ligament complex rupture associated with ankle fractures: A multicenter study. J Foot Ankle Surg54(2): , 2015
Sequalae of Ankle Sprains: Peri Articular Fractures of the Ankle in Sports Medicine.
Sequalae of Ankle Sprains: Peri Articular Fractures of the Ankle in Sports Medicine www.fisiokinesiterapia.biz Chronic Ankle Pain The most common cause of chronic pain following an ankle sprain is a missed
More informationDisclosures. OTA Resident Advanced Trauma Techniques Course: Ankle Fractures. No relevant disclosures. William H. Harvin, MD Dallas, TX
OTA Resident Advanced Trauma Techniques Course: Ankle Fractures William H. Harvin, MD Dallas, TX January 31, 2017 Disclosures No relevant disclosures 1 Ankle Anatomy: Lateral ankle ligaments Ankle Anatomy:
More informationDisclosures. Syndesmosis Injury. Syndesmosis Ligaments. Objectives. Mark M. Casillas, M.D.
Disclosures Syndesmosis Injury No relevant disclosures Mark M. Casillas, M.D. 1 Objectives Syndesmosis Ligaments Understand the syndesmosis anatomy and function Classify syndesmosis injuries Describe treatment
More informationIncidence of Occult Chondral Lesions in Weber C Ankle Fractures in Athletes and Their Effect on Time to Return to Play
Incidence of Occult Chondral Lesions in Weber C Ankle Fractures in Athletes and Their Effect on Time to Return to Play Jefferson B. Sabatini M.D. 1, Kyle T. Aune M.P.H. 2, Norman E. Waldrop III M.D. 3
More informationAnkle Ligament Injury: Don t Worry- It s Only a Sprain Wes Jackson MD Orthopaedic Foot & Ankle
Ankle Ligament Injury: Don t Worry- It s Only a Sprain Wes Jackson MD Orthopaedic Foot & Ankle Outline I. Epidemiology II. Classification and Types of Sprains III. Anatomy IV. Clinical Assessment and Imaging
More informationIsolated Syndesmotic Instability The High Ankle Sprain Robert B. Anderson, MD
Isolated Syndesmotic Instability The High Ankle Sprain Robert B. Anderson, MD Chief, Foot & Ankle Service Carolinas Medical Center OrthoCarolina Team Orthopaedist, Carolina Panthers Charlotte, North Carolina
More informationPeggers Super Summaries: Foot Injuries
Lisfranc Injury ANATOMY Roman arch with recessed 2 nd MT base AP medial side of intermediate cuneiform to 2 nd MT base Oblique medial side of lateral cuneiform with 3 rd MT base and 4 th with medial boarder
More information5 COMMON INJURIES IN THE FOOT & ANKLE
5 COMMON INJURIES IN THE FOOT & ANKLE MICHAEL P. CLARE, MD FLORIDA ORTHOPAEDIC INSTITUTE TAMPA, FL USA MECHANISM OF INJURY HOW DID IT HAPPEN? HIGH ENERGY VS LOW ENERGY DIRECTION OF FORCES INVOLVED LIVING
More informationPaul Alley MD,DPM,MS,FACS,FAAOS,BFD Eby Orthopaedics,Jasper,Indiana
Paul Alley MD,DPM,MS,FACS,FAAOS,BFD Eby Orthopaedics,Jasper,Indiana Very common Bone=fractures Description (cracked,broke,busted,or smashed) A=anatomic area of bone eg: head,neck,shaft B=bone involved
More informationMedial Meniscal Root Tears: When to rehab? When to repair? When to debride. Christopher Betz, DO Orthopedics Sports Medicine Bristol, CT
Medial Meniscal Root Tears: When to rehab? When to repair? When to debride Christopher Betz, DO Orthopedics Sports Medicine Bristol, CT Disclosure Consultant Mitek Smith and Nephew-biologic patch Good
More informationClinical evaluation where no obvious fracture a. Squeeze test
7:43 am The Syndesmotic Injury: From Subtle to Severe Robert B. Anderson, MD Chief, Foot and Ankle Carolinas Medical Center OrthoCarolina (Charlotte, North Carolina) 7:30-8:25 am Symposium 1: Management
More informationAnkle Pain After a Sprain.
Ankle Pain After a Sprain www.fisiokinesiterapia.biz Anterior Drawer Stress Test Talar Tilt Talar Tilt (CFL) Difficult to isolate from subtalar ROM Slight plantar flexion (dorsi = relative subtalar isolation)
More informationBIOMECHANICS OF ANKLE FRACTURES
BIOMECHANICS OF ANKLE FRACTURES William R Reinus, MD MBA FACR Significance of Ankle Fractures Most common weight-bearing Fx 70% of all Fxs Incidence is increasing Bimodal distribution Men 15-24 Women over
More informationThis presentation is the intellectual property of the author. Contact them for permission to reprint and/or distribute.
43 rd Annual Symposium on Sports Medicine UT Health Science Center San Antonio School of Medicine January 22-23, 2016 Intra-articular / Extra-synovial 38 mm length / 13 mm width Fan-shaped structure narrowest-midportion
More informationDisclosures! The Syndesmosis. Syndesmosis: How and When to Reduce. Boston Medical Center. Indications. Technique.
Syndesmosis: How and When to Reduce Paul Tornetta III Professor Boston Medical Center Boston Medical Center Publications: Disclosures! Rockwood and Green, Tornetta and Einhorn; Subspecialty series, Court-Brown,
More informationemoryhealthcare.org/ortho
COMMON SOCCER INJURIES Oluseun A. Olufade, MD Assistant Professor, Department of Orthopedics and PM&R 1/7/18 GOALS Discuss top soccer injuries and treatment strategies Simplify hip and groin injuries in
More information9/22/2017. I am a local. Born at Desert Samaritan
I am a local Born at Desert Samaritan 1 MOUNTAIN VIEW HIGH SCHOOL ASU U OF IOWA MED SCHOOL PHOENIX FOR RESIDENCY 2 Discuss the 5 most controversial topics in foot and ankle Injuries that are routinely
More informationBurwood Road, Concord Dora Street, Hurstville Lethbridge Street, Penrith 160 Belmore Road, Randwick
www.orthosports.com.au 47 49 Burwood Road, Concord 29 31 Dora Street, Hurstville 119 121 Lethbridge Street, Penrith 160 Belmore Road, Randwick Update on Syndesmosis Ankle Sprains By Todd Gothelf Foot,
More informationMEDIAL EPICONDYLE FRACTURES
MEDIAL EPICONDYLE FRACTURES Demographic 20% of elbow fractures 60% of which are associated with elbow dislocation. 75% in boys between 6-12 years 20% of elbow dislocation with ME fracture, the ME is incarcerated
More informationV E R I TAS MGH 1811 MGH 1811 V E R I TAS. *Gerber JP. Persistent disability with ankle sprains. Foot Ankle Int 19: , 1998.
MGH 1811 Management of Ankle Instability Richard J. de Asla, M.D. V E R I TAS MGH 1811 I have no potential conflicts with this presentation. V E R I TAS It s just a sprain Lateral Ankle Sprains Most common
More informationDisclosures. Outline. The Posterior Cruciate Ligament 5/3/2016
The Posterior Cruciate Ligament Christopher J. Utz, MD Assistant Professor of Orthopaedic Surgery University of Cincinnati Disclosures I have no disclosures relevant to this topic. Outline 1. PCL Basic
More informationSports Injuries of the Ankle and Ankle Arthritis. Mr Amit Amin Consultant Foot and Ankle Surgeon Parkside Hospital
Sports Injuries of the Ankle and Ankle Arthritis Mr Amit Amin Consultant Foot and Ankle Surgeon Parkside Hospital Impingement Painful mechanical limitation of full ankle movement secondary to osseous
More informationEvidenced-Based Medicine: Where Does it Fit in Foot and Ankle Surgery?
Jeffrey R. Baker, DPM, AACFAS Weil Foot & Ankle Institute Des Plaines, IL Evidenced-Based Medicine: Where Does it Fit in Foot and Ankle Surgery? MODULE: Bimalleolar Equivalent Ankle Fracture Evidence-Based
More informationGeneral Concepts. Growth Around the Knee. Topics. Evaluation
General Concepts Knee Injuries in Skeletally Immature Athletes Zachary Stinson, M.D. Increased rate and ability of healing Higher strength of ligaments compared to growth plates Continued growth Children
More informationInvestigation of the factors to affect the duration to return sports after the surgery of anterior talofibular ligament repair with arthroscopy
Investigation of the factors to affect the duration to return sports after the surgery of anterior talofibular ligament repair with arthroscopy Hamamatsu University School of Medicine Mitsuru Hanada, Shoichi
More informationPRONATION-ABDUCTION FRACTURES
C H A P T E R 1 2 PRONATION-ABDUCTION FRACTURES George S. Gumann, DPM (The opinions of the author should not be considered as reflecting official policy of the US Army Medical Department.) Pronation-abduction
More informationPrinciples Starting Point Trajectory L/A/R Stable Construct. DISCLOSURES Hassan R. Mir, MD, MBA, FACS 5/16/2017
DISCLOSURES Hassan R. Mir, MD, MBA, FACS Medical/Orthopaedic Publications Editorial/Governing Board OTA Newsletter Editor OsteoSynthesis, The JOT Online Discussion Forum Editor JOT Associate Editor JAAOS
More informationSlide 1. Slide 2. Slide 3. The Thrower s Elbow: When to Operate. Medial Elbow Pain in the Athlete. Goal of This Talk
Slide 1 The Thrower s Elbow: When to Operate Luke S. Oh, MD Massachusetts General Hospital Team Physician, Boston Red Sox Team Physician, New England Revolution Consultant, Harvard University Athletics
More informationOutline. Ankle/Foot Anatomy Ankle Sprains Ottawa Ankle Rules DDx: The Sprain That Wasn t
Ankle Injuries Outline Ankle/Foot Anatomy Ankle Sprains Ottawa Ankle Rules DDx: The Sprain That Wasn t Anatomy: Ankle Mortise Bony Anatomy Lateral Ligament Complex Medial Ligament Complex Ankle Sprains
More informationObjective. Reducing a displaced Syndesmosis 2/11/2016. Ankle Fractures Common Misconceptions. Common Myths in ankle fracture management
Ankle Fractures Common Misconceptions Jackson Lee, MD Associate Professor Clinical Orthopedics Keck School of Medicine of the University of Southern California Objective Common Myths in ankle fracture
More informationMCL Injuries: When and How to Repair Scott D. Mair, MD
MCL Injuries: When and How to Repair Scott D. Mair, MD Professor and Team Physician: Orthopaedic Surgery University of Kentucky School of Medicine Disclosure Institution: Research/Education Smith-Nephew
More informationACL AND PCL INJURIES OF THE KNEE JOINT
ACL AND PCL INJURIES OF THE KNEE JOINT Dr.KN Subramanian M.Ch Orth., FRCS (Tr & Orth), CCT Orth(UK) Consultant Orthopaedic Surgeon, Special interest: Orthopaedic Sports Injury, Shoulder and Knee Surgery,
More informationKnee Injuries. PSK 4U Mr. S. Kelly North Grenville DHS. Medial Collateral Ligament Sprain
Knee Injuries PSK 4U Mr. S. Kelly North Grenville DHS Medial Collateral Ligament Sprain Result from either a direct blow from the lateral side in a medial direction or a severe outward twist Greater injury
More informationRehabilitation after Total Elbow Arthroplasty
Rehabilitation after Total Elbow Arthroplasty Total Elbow Atrthroplasty Total elbow arthroplasty (TEA) Replacement of the ulnohumeral articulation with a prosthetic device. Goal of TEA is to provide pain
More informationManagement of Knee Dislocations
Management of Knee Dislocations Thomas J. Gill, MD Chief, Sports Medicine Service Massachusetts General Hospital Associate Professor of Orthopedic Surgery Harvard Medical School Complex Challenging Multi-Ligament
More informationReconstruction of the Ligaments of the Knee
Reconstruction of the Ligaments of the Knee Contents ACL reconstruction Evaluation Selection Evolution Graft issues Notchplasty Tunnel issues MCL PCL Posterolateral ligament complex Combined injuries Evaluation
More informationFinancial Disclosure. Medial Collateral Ligament
Matthew Murray, M.D. UTHSCSA Sports Medicine Financial Disclosure Dr. Matthew Murray has no relevant financial relationships with commercial interests to disclose. Medial Collateral Ligament Most commonly
More informationACL Athletic Career. ACL Rupture - Warning Features Intensive pain Immediate swelling Locking Feel a Pop Dead leg Cannot continue to play
FIMS Ambassador Tour to Eastern Europe, 2004 Belgrade, Serbia Montenegro Acute Knee Injuries - Controversies and Challenges Professor KM Chan OBE, JP President of FIMS Belgrade ACL Athletic Career ACL
More informationCombined Reconstruction of the Deltoid and Spring Ligament Complex in an Acute Ligamentous Injury
Combined Reconstruction of the Deltoid and Spring Ligament Complex in an Acute Ligamentous Injury Samuel Hammer-Nahman, DPM Philip Wrotslavsky, DPM INTRODUCTION The deltoid ligament complex and the spring
More informationSports Injuries of the Foot and Ankle Dominic Nielsen. Parkside Hospital Ashtead Hospital St George s
Sports Injuries of the Foot and Ankle Dominic Nielsen Parkside Hospital Ashtead Hospital St George s Themes Ankle instability Ankle impingement Stress fractures 5 th MT fractures Peroneal subluxation Ankle
More informationDonald Stewart, MD. Lateral ligament injuries Chronic lateral ligament instability Syndesmosis Injuries
Donald Stewart, MD Arlington Orthopedic Associates Lateral ligament injuries Chronic lateral ligament instability Syndesmosis Injuries Anatomy Mechanism of Injury Classification Diagnostic Tests Management
More informationYoung Uk Park, M.D., Ph.D.. Young Wook Seo, M.D. Hyuk, Jegal, M.D.,* Kyung Tai Lee, M.D.,Ph.D.
Young Uk Park, M.D., Ph.D.. Young Wook Seo, M.D. Hyuk, Jegal, M.D.,* Kyung Tai Lee, M.D.,Ph.D. Department of Orthopedic Surgery, Ajou University Hospital, Ajou University School of Medicine, Suwon, Gyeonggi-do,
More informationPatellofemoral Pathology
Patellofemoral Pathology Matthew Murray, MD UT Health Science Center/UT Medicine Sports Medicine and Arthroscopic Surgery I have disclosed that I am a consultant for Biomet Orthopaedics. Anterior Knee
More informationKnee Dislocation: Spectrum of Injury, Evolution of Treatment & Modern Outcomes
Knee Dislocation: Spectrum of Injury, Evolution of Treatment & Modern Outcomes William M Weiss, MD MSc FRCSC Orthopedic Surgery & Rehabilitation Sports Medicine, Arthroscopy & Extremity Reconstruction
More informationJacques Menetrey, MD, PD. Uniklinik Balgrist. Unité d Orthopédie et Traumatologie du Sport (UOTS)
Acute patellar dislocation: conservative or surgical treatment Jacques Menetrey, MD, PD Unité d Orthopédie et Traumatologie du Sport (UOTS) Service de chirurgie orthopédique et traumatologie de l appareil
More informationAnterior Cruciate Ligament Surgery
Anatomy Anterior Cruciate Ligament Surgery Roger Ostrander, MD Andrews Institute Anatomy Anatomy Function Primary restraint to anterior tibial translation Secondary restraint to internal tibial rotation
More informationNo Disclosures. Topics. Pediatric ACL Tears
Knee Injuries in Skeletally Immature Athletes No Disclosures Zachary Stinson, M.D. 2 Topics ACL Tears and Tibial Eminence Fractures Meniscus Injuries Discoid Meniscus Osteochondritis Dessicans Patellar
More informationSyndesmotic Ankle Injuries: Diagnosis and Treatment
Syndesmotic Ankle Injuries: Diagnosis and Treatment John A. Scolaro, M.D., M.A. Assistant Professor of Orthopaedic Surgery University of California, Irvine California Orthopaedic Association - 2016 Disclosures
More informationW. Dilworth Cannon, M.D. Professor of Clinical Orthopaedic Surgery University of California San Francisco
Knee Pain And Injuries In Adults W. Dilworth Cannon, M.D. Professor of Clinical Orthopaedic Surgery University of California San Francisco Pain Control Overview Narcotics rarely necessary after 1 st 1-2
More informationSOFT TISSUE INJURIES OF THE KNEE: Primary Care and Orthopaedic Management
SOFT TISSUE INJURIES OF THE KNEE: Primary Care and Orthopaedic Management Gauguin Gamboa Australia has always been a nation where emphasis on health and fitness has resulted in an active population engaged
More informationANTERIOR CRUCIATE LIGAMENT INJURY
ANTERIOR CRUCIATE LIGAMENT INJURY WHAT IS THE ANTERIOR CRUCIATE LIGAMENT? The anterior cruciate ligament (ACL) is one of four major ligaments that stabilizes the knee joint. A ligament is a tough band
More information40 th Annual Symposium on Sports Medicine. Knee Injuries In The Pediatric Athlete. Disclosure
40 th Annual Symposium on Sports Medicine Travis Murray, MD Assistant Professor University of Texas Health Science Center San Antonio Knee Injuries In The Pediatric Athlete Disclosure Dr. Travis Murray
More information42 nd Annual Symposium on Sports Medicine. Knee Injuries In The Pediatric Athlete. Disclosure
42 nd Annual Symposium on Sports Medicine Travis Murray, MD Assistant Professor University of Texas Health Science Center San Antonio January 23, 2015 Knee Injuries In The Pediatric Athlete Disclosure
More informationLateral knee injuries
Created as a free resource by Clinical Edge Based on Physio Edge podcast episode 051 with Matt Konopinski Get your free trial of online Physio education at Orthopaedic timeframes Traditionally Orthopaedic
More informationArthroscopic reconstruction of lateral ligaments of the ankle (Anti-Roll) via three portals: A new technique
Arthroscopic reconstruction of lateral ligaments of the ankle (Anti-Roll) via three portals: A new technique Kentaro Matsui 1,2, Mark Glazebrook 2,Wataru Miyamoto 1, Ken Innami 1, Masato Takao 1 Department
More informationKNEE EXAMINATION. Tips & Tricks from an Emergency Physician Perspective. EM Physicians Less Exposed to MSK Medicine
KNEE EXAMINATION Tips & Tricks from an Emergency Physician Perspective Dr P O CONNOR Emergency Medicine Physician EUSEM 10/09/2018 EM Physicians Less Exposed to MSK Medicine Musculoskeletal Medicine becoming
More informationArthroscopy Of the Ankle.
Arthroscopy Of the Ankle www.fisiokinesiterapia.biz Ankle Arthroscopy Anatomy Patient setup Portal placement Procedures Complications Anatomy Portals Anterior Anteromedial Anterolateral Anterocentral Posterior
More informationTreatment of Acute Traumatic Knee Dislocations
Treatment of Acute Traumatic Knee Dislocations Angelo J. Colosimo, MD Head Orthopaedic Surgeon University of Cincinnati Athletics Director of Sports Medicine University of Cincinnati Medical Center Associate
More informationTreatment of Acute Traumatic Knee Dislocations
Treatment of Acute Traumatic Knee Dislocations Angelo J. Colosimo, MD Head Orthopaedic Surgeon University of Cincinnati Athletics Director of Sports Medicine University of Cincinnati Medical Center Associate
More informationSurgery-Ortho. Fractures of the tibia and fibula. Management. Treatment of low energy fractures. Fifth stage. Lec-6 د.
Fifth stage Lec-6 د. مثنى Surgery-Ortho 28/4/2016 Indirect force: (low energy) Fractures of the tibia and fibula Twisting: spiral fractures of both bones Angulatory: oblique fractures with butterfly segment.
More informationMohammad Ayati,M.D Department of Orthopaedics, Yazd University of Medical Science.
IN THE NAME OF GOD Mohammad Ayati,M.D Department of Orthopaedics, Yazd University of Medical Science. Devastating injury resulting from : high-energy usually from MVC or fall from height commonly a dashboard
More informationOn Field Assessment and Management of Acute Knee Injuries: A Physiotherapist s Perspective
On Field Assessment and Management of Acute Knee Injuries: A Physiotherapist s Perspective Jessica Condliffe Physiotherapist / Clinic Manager TBI Health Wellington Presentation Outline Knee anatomy review
More informationPediatric Anterior Cruciate Ligament Injuries Is non operative treatment t t an option?
I have no disclosures Pediatric Anterior Cruciate Ligament Injuries Is non operative treatment t t an option? John F. Lovejoy III, MD Chair, Department of Orthopaedics and Sports Medicine Nemours Children
More informationSUBTLE CAVUS IN SPORTS INJURIES
SUBTLE CAVUS IN SPORTS INJURIES MICHAEL P. CLARE, MD FLORIDA ORTHOPAEDIC INSTITUTE TAMPA, FL USA NON-NEUROMUSCULAR NORMAL VARIANT: 20-25% INCIDENCE LEDOUX, ET AL. FAI 24, 2003 FOREFOOT-DRIVEN / MORE SUBTLE
More informationAnkle Sprains and Their Imitators
Ankle Sprains and Their Imitators Mark Halstead, MD Dr. Mark Halstead is the Associate Professor of the Departments of Orthopedics and Pediatrics at Washington University School of Medicine; Director of
More informationLower Extremity Sports Injuries
Lower Extremity Sports Injuries AAP Musculoskeletal Boot Camp Sigrid F. Wolf, MD Pediatric Sports Medicine Fellow Northwestern University Lurie Children s Hospital Disclosure I have no relevant financial
More informationWhat to Expect from your Anterior Cruciate Ligament (ACL) Reconstruction Surgery A Guide for Patients
What to Expect from your Anterior Cruciate Ligament (ACL) Reconstruction Surgery A Guide for Patients Sources of Information: http://orthoinfo.aaos.org http://www.orthoinfo.org/informedpatient.cfm http://www.sportsmed.org/patient/
More informationCOMMON KNEE AND SHOULDER INJURIES IN THE YOUNG ATHLETE. Outline 5/11/2017
COMMON KNEE AND SHOULDER INJURIES IN THE YOUNG ATHLETE IRVING RAPHAEL MD Syracuse Orthopedic Specialists Former S.U. Head Team Physician May 19, 2017 Meniscal Injuries anatomy Exam Treatment ACL Injuries
More information7/23/2018 DESCRIBING THE FRACTURE. Pattern Open vs closed Location BASIC PRINCIPLES OF FRACTURE MANAGEMENT. Anjan R. Shah MD July 21, 2018.
BASIC PRINCIPLES OF FRACTURE MANAGEMENT Anjan R. Shah MD July 21, 2018 DESCRIBING THE FRACTURE Pattern Open vs closed Location POLL OPEN HOW WOULD YOU DESCRIBE THIS FRACTURE PATTERN? 1 Spiral 2 Transverse
More informationAdam J. Seidl, MD Assistant Professor University of Colorado School of Medicine Shoulder & Elbow Surgery Division of Sports Medicine and Shoulder
Adam J. Seidl, MD Assistant Professor University of Colorado School of Medicine Shoulder & Elbow Surgery Division of Sports Medicine and Shoulder Surgery Division of Hand, Wrist, and Elbow Surgery Anatomy
More informationMeniscal Root Tears: Evaluation, Imaging, and Repair Techniques
Meniscal Root Tears: Evaluation, Imaging, and Repair Techniques R O B E R T N A S C I M E N TO, M D, M S C H I E F OF S P O RT S M E D I C I N E & SH O U L D E R S U R G E RY N E W TO N- W E L L E S L
More informationSTATE OF THE ART OF ACL SURGERY (Advancements that have had an impact)
STATE OF THE ART OF ACL SURGERY (Advancements that have had an impact) David Drez, Jr., M.D. Clinical Professor of Orthopaedics LSU School of Medicine Financial Disclosure Dr. David Drez has no relevant
More informationMary Lloyd Ireland, M.D. Associate Professor University of Kentucky Dept. of Orthopaedic Surgery and Sports Medicine Lexington, Kentucky
Common Ankle Injuries: Diagnosis and Treatment Mary Lloyd Ireland, M.D. Associate Professor University of Kentucky Dept. of Orthopaedic Surgery and Sports Medicine Lexington, Kentucky Disclaimer Slide
More informationAnterior Cruciate Ligament (ACL) Injuries
Anterior Cruciate Ligament (ACL) Injuries Mark L. Wood, MD The anterior cruciate ligament (ACL) is one of the most commonly injured ligaments of the knee. The incidence of ACL injuries is currently estimated
More informationACL RECONSTRUCTION HAMSTRING METHOD. Presents ACL RECONSTRUCTION HAMSTRING METHOD. Multimedia Health Education
HAMSTRING METHOD Presents HAMSTRING METHOD Multimedia Health Education Disclaimer Stephen J. Incavo MD This movie is an educational resource only and should not be used to make a decision on Anterior Cruciate
More informationX-Ray Rounds: (Plain) Radiographic Evaluation of the Ankle.
X-Ray Rounds: (Plain) Radiographic Evaluation of the Ankle www.fisiokinesiterapia.biz Anatomy Complex hinge joint Articulations among: Fibula Tibia Talus Tibial plafond Distal tibial articular surface
More informationDoron Sher. 160 Belmore Rd, Randwick Burwood Rd, Concord. MBBS, MBiomedE, FRACS FAOrthA
Doron Sher MBBS, MBiomedE, FRACS FAOrthA 160 Belmore Rd, Randwick 47 49 Burwood Rd, Concord www.kneedoctor.com.au www.orthosports.com.au Medial PatelloFemoral (MPFL) And AnteroLateral Ligament (ALL) Reconstruction
More informationLateral Ankle Instability: The Predictive Value of Ankle Stress Radiographs vs MRI
Lateral Ankle Instability: The Predictive Value of Ankle Stress Radiographs vs MRI Natalie R. Danna, MD Rachel J. Shakked, MD Steven C. Sheskier, MD Lateral Ankle Instability: The Predictive Value of DISCLOSURES
More informationStress radiographs under anesthesia for painful chronic lateral ankle instability
Stress radiographs under anesthesia for painful chronic lateral ankle instability Department of Orthopedic Surgery, Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, South Korea *W Institute
More informationImpingement Syndromes of the Ankle. Noaman W Siddiqi MD 5/4/2006
Impingement Syndromes of the Ankle Noaman W Siddiqi MD 5/4/2006 Ankle Impingement Overview Clinical DX Increasingly recognized cause of chronic ankle pain Etiology can be soft tissue or osseous Professional
More informationRehabilitation after ankle injuries
Rehabilitation after ankle injuries Ahmed Thabet, M.D. Assistant Professor Department of Orthopaedic Surgery & Rehabilitation Texas Tech University Health Sciences Center El Paso What are our objectives?
More informationAnterior ankle impingement in sports Hrefna Thorbjorg Hakonardottir
Anterior ankle impingement in sports Hrefna Thorbjorg Hakonardottir Anterior ankle impingement in sports Ankle impingement syndromes are classified by their anatomical location around the tibiotalar joint
More informationRadiographic assessment. Functional. Paul Tornetta III Professor 11/21/2016. Fracture not in coronal plane May need CT to evaluate
The Posterior Malleolus Paul Tornetta III Professor Boston Medical Center Publications: Disclosures! Rockwood and Green, Tornetta and Einhorn; Subspecialty series, Court-Brown, Tornetta; Trauma, AAOS;
More informationManagement of Humeral Bone Loss in Anterior Shoulder Instability. Scott D. Mair, MD University of Kentucky Sports Medicine
Management of Humeral Bone Loss in Anterior Shoulder Instability Scott D. Mair, MD University of Kentucky Sports Medicine Disclosure Smith and Nephew Endoscopy fellowship support Importance Bone loss (glenoid
More informationLower Extremity Dislocations: Management and Triage on the Field
Lower Extremity Dislocations: Management and Triage on the Field Scott J Tarantino, MD Towson Orthopaedic Associates, Towson, MD None Disclsures Purpose To provide you with knowledge which may guide you
More informationAnkle Fracture: Tips and Tricks
Ankle Fracture: Tips and Tricks Christiaan N. Mamczak, DO LCDR, MC, USN Naval Medical Center Portsmouth Department of Orthopaedic Surgery Assistant Professor Uniformed Services University of the Health
More informationCASE REPORT RARE CASE OF DELTOID LIGAMENT AVULSION WITH MEDIAL MALLEOLUS FRACTURE OF ANKLE JOINT: CASE REPORT
RARE CASE OF DELTOID LIGAMENT AVULSION WITH MEDIAL MALLEOLUS FRACTURE OF ANKLE JOINT: CASE REPORT Maruthi C.V 1, Roshan Pais 2 HOW TO CITE THIS ARTICLE: Maruthi CV, Roshan Pais. Rare case of deltoid ligament
More informationTop 10 Ortho Urgent Care Injuries. J.C. Clark, M.D. ORA Orthopedics
Top 10 Ortho Urgent Care Injuries J.C. Clark, M.D. ORA Orthopedics 10. Proximal Humerus Fractures Treatment Simple sling ICE, pain meds Button-down shirts Recliner to sleep in It will be up to the surgeon
More informationObjectives. Sprains, Strains, and Musculoskeletal Maladies. Sprains. Sprains. Sprains. Physical Exam 5/5/2010
Objectives, Strains, and Musculoskeletal Maladies Robert Hosey, MD University of Kentucky Sports Medicine Define sprains and strains Systematically evaluate and manage joint / muscle injuries When to refer
More informationHand Injuries in Baseball
Hand Injuries in Baseball Steven S. Shin, MD, MMSc Director of Hand Surgery, Kerlan-Jobe Orthopaedic Clinic Co-Director of Hand Surgery, Cedars-Sinai Health System Los Angeles, California Hand Consultant
More informationFoot and Ankle Update
Foot and Ankle Update 2019 Instructional Course Hiro Tanaka It s your on-call weekend Objectives We are going to apply evidence based treatment for 2 patients who are admitted under your care 1. Dislocated
More information3/21/2011 PCL INJURY WITH OPERATIVE TREATMENT A CASE STUDY PCL PCL MECHANISM OF INJURY PCL PREVALENCE
PCL PCL INJURY WITH OPERATIVE TREATMENT A CASE STUDY K. Anderson, S. Hjortedal, Y. Jingi, E. Sutcliffe & S. Witschen Washington State University Origin Posterior aspect of tibia Insertion Medial femoral
More informationYour Practice Online
Your Practice Online Disclaimer P R E S E N T S - PATELLAR TENDON This movie is an educational resource only and should not be used to make a decision on Anterior Cruciate Ligament (ACL) Reconstruction.
More informationA Guide to Common Ankle Injuries
A Guide to Common Ankle Injuries Learn About: Common ankle injuries Feet and Ankle Diagnosis and Treatment Ankle exercises Beginning your recovery Frequently asked questions Do s and Don t s Arthroscopy
More informationAnkle Arthroscopy PAULO ROCKETT, M.D. Porto Alegre Brazil
Ankle Arthroscopy PAULO ROCKETT, M.D. Porto Alegre Brazil Ankle sprains are among the most common injuries in sports and at work. Between 20 and 40% of patients treated with conservative therapy may have
More informationJune 2013 Case Study. Author: T. Walker Robinson, MD, MPH, Nationwide Children s Hospital
June 2013 Case Study Author: T. Walker Robinson, MD, MPH, Nationwide Children s Hospital Chief Complaint: Right ankle pain HPI: A 10 year old female dancer presents to the clinic with a five day history
More informationIntroduction Introduction Ankle Sprains Ankle Sprains ankl nkle
s/ Syndesmotic Injuries 21% of all athletic injuries are to the ankle 25% of NFL injuries are foot and ankle related Vast majority are simple inversion twisting types Classic sprains involve the lower
More informationA Patient s Guide to Arthroscopy of the Ankle
A Patient s Guide to Arthroscopy of the Ankle 6565 Fannin Street Houston, TX 77030 Phone: 713-790-3333 DISCLAIMER: The information in this booklet is compiled from a variety of sources. It may not be complete
More informationTreatment of Medial Malleolus or Pure Deltoid Ligament Injury in Patients with Supination- External Rotation Type IV Ankle Fractures
42 2017 CHINESE ORTHOPAEDIC ASSOCIATION AND JOHN WILEY &SONS AUSTRALIA, LTD CLINICAL ARTICLE Treatment of Medial Malleolus or Pure Deltoid Ligament Injury in Patients with Supination- External Rotation
More informationMeniscal Root Tears: A Silent Epidemic
Meniscal Root Tears: A Silent Epidemic TRIA Orthopedic and Sports Medicine Conference February 9 th, 2018 Robert F. LaPrade, M.D., Ph.D. Chief Medical Officer Steadman Philippon Research Institute Co-Director,
More information