Abstract:
:Although most authors recommend either 3.5-mm or 4.5-mm cortical screws for syndesmosis fixation, the optimum screw size has yet to be defined. The present study was designed to biomechanically compare syndesmosis fixation with 3.5-mm and 4.5-mm stainless steel screws. Simulated pronation external rotation ankle injuries were created in twelve paired, fresh-frozen cadaveric leg specimens. One limb from each pair received a 3.5-mm tricortical stainless steel screw for syndesmosis fixation (group I), while the contralateral specimen was stabilized using a 4.5-mm screw (group II). Sub-maximal axial ramp (0 to 1200 N) and external rotation/torsional ramp (0 to 5 N-m) loading was performed on each specimen prior to ligament division, following ligament division and following syndesmosis fixation. Axial fatigue testing was then performed at 1.5 Hz for a total of 100,000 cycles (0 to 900 N), and each specimen was subsequently tested to failure in external rotation. Ligament division resulted in syndesmosis widening (p<0.001) and reduced stiffness (p<0.001) during torsional ramp loading. Subsequent syndesmosis screw placement reduced syndesmosis widening (p<0.05) and increased stiffness (p<0.05). Following screw fixation, however, widening remained greater (p<0.005) and stiffness less (p<0.001) than pre-injury levels. No differences between groups I and II were observed during submaximal testing. In external rotation to failure testing, group I failed at a greater angle (38.9 degrees +/- 4.1 degrees vs. 32.0 degrees +/- 3.8 degrees in group II; p<0.05). Failure torque was slightly higher in group I; however, the difference was not statistically significant (17.8 +/- 2.0 N-m vs. 14.3 +/- 2.6 N-m in group II; p=0.082). Five specimens in group I failed by screw pullout and five specimens in group II failed by fibula fracture (p=0.061). The present results suggest that there is no biomechanical advantage of a 4.5-mm screw over a 3.5-mm in fixation of the syndesmosis.
journal_name
Foot Ankle Intjournal_title
Foot & ankle internationalauthors
Thompson MC,Gesink DSdoi
10.1177/107110070002100904keywords:
subject
Has Abstractpub_date
2000-09-01 00:00:00pages
736-41issue
9eissn
1071-1007issn
1944-7876journal_volume
21pub_type
杂志文章abstract::The purpose of this study was to evaluate the clinical results of Osteochondral Autograft Transfer System (OATS) for the treatment of symptomatic osteochondral defects of the talus using standardized outcome analysis. Nineteen patients with symptomatic osteochondral defect (OCD) of the talus were treated with autologo...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110070202300502
更新日期:2002-05-01 00:00:00
abstract::Proximal chevron first metatarsal osteotomy with lateral capsulotomy, adductor tenotomy, and binding of the first and second metatarsals was reviewed in 88 consecutive cases. Seventy-two cases in 55 patients are reported, with an average clinical follow-up of 41 months. The hallux valgus angle improved an average of 1...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110079801900703
更新日期:1998-07-01 00:00:00
abstract::The purpose of this study was to quantify tibiotalar translation and rotation under various stages of fibular displacement and injury to the syndesmotic and deltoid ligaments. Ten unpaired specimens amputated below the knee were studied using an unconstrained testing apparatus. The specimens were moved through a dorsi...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110079902001110
更新日期:1999-11-01 00:00:00
abstract::The purpose of this study was to determine whether modification of a surgical practice by using regional anesthesia and local bone grafting would yield the same surgical results as traditional anesthesia and iliac crest bone graft, with a cost reduction. All patients were matched by preoperative disease and were asses...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110079801901104
更新日期:1998-11-01 00:00:00
abstract:UNLABELLED:We developed a continuous lateral sciatic nerve infusion technique for postoperative analgesia. METHODS:A 10-cm insulated Tuohy needle connected to a nerve stimulator was introduced posteriorly between the biceps femoris and vastus lateralis groove 10 cm cephalad from the tip of the patella. After proper po...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110070202300812
更新日期:2002-08-01 00:00:00
abstract:BACKGROUND:Flexible suture-button devices are used to stabilize the distal tibiofibular joint after syndesmotic rupture, but little is known about how they affect fibular motion during cyclic physiological loading. This study examined how much fibular motion occurs during cyclic loading of ankles repaired with suture-b...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.3113/FAI.2009.0346
更新日期:2009-04-01 00:00:00
abstract::The purpose of this study was to evaluate the biomechanical properties of commonly used autogenous transplants for the surgical stabilization of chronic lateral ankle instability. We dissected the transplants (peroneus longus, peroneus brevis, Achilles and plantaris tendon, periosteal flap, fascia, corium) and the ant...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110070202300714
更新日期:2002-07-01 00:00:00
abstract:BACKGROUND:Arthroscopic arthrodesis has been used mainly for in situ fusion of arthritic ankles without deformity. This paper presents the application of arthroscopic arthrodesis of ankles with marked deformity. METHODS:The results of 78 consecutive cases of arthroscopic ankle arthrodeses, performed in 74 patients, we...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.3113/FAI.2007.0695
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:The time at which patients typically present with surgical site infections (SSI) following foot and ankle surgery has not been characterized. The primary aim of this study was to quantify the time to definitive treatment of SSIs. METHODS:We performed a retrospective review of 1933 foot and ankle procedures ...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100718777468
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:Subtalar bone-block distraction arthrodesis using structural autograft carries the risk of donor site morbidity. Recent reports suggest that structural allograft may be an attractive alternative to structural autograft in subtalar arthrodesis. This prospective study analyzes subtalar distraction arthrodesis ...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.3113/FAI.2008.0561
更新日期:2008-06-01 00:00:00
abstract::The plantar plate is a rarely seen, yet central structure to the lesser metatarsal phalangeal (MP) joint. Thirty cadaver lesser MP joints were studied to obtain a detailed description of the plate, including its dimensions, connections, and histology. The plate was found to be made of fibrocartilage with fiber orienta...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110079501600804
更新日期:1995-08-01 00:00:00
abstract:BACKGROUND:The etiology of navicular stress fractures is a topic of interest due to the implications in high-level athletes. Previous studies suggest an avascular zone in the central one-third of the bone as a potential causative factor. This study investigated the extraosseous and intraosseous arterial anatomy of the ...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.3113/FAI.2012.0857
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:There are no comparative studies of proximal and distal osteotomy for treatment of moderate to severe hallux valgus. Our purpose was to compare the surgical outcomes of modified proximal Ludloff (oblique diaphyseal) osteotomy with modified distal Bösch (distal linear) osteotomy by a single surgeon in moderat...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.3113/FAI.2012.0479
更新日期:2012-06-01 00:00:00
abstract:BACKGROUND::The current work sought to quantify pronation of the first metatarsal relative to the second metatarsal and of the proximal phalanx of the great toe relative to the first metatarsal. METHODS::Three-dimensional models were reconstructed from weightbearing computed tomography (CT) images (10 hallux valgus, 1...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100718793391
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Although metatarsophalangeal (MTP) arthrodesis has been advocated by many authors, implant arthroplasty appears to be successful option in advanced hallux rigidus (HR). The aim of our study was to evaluate the early results of the ToeFit-Plus prosthesis for the treatment of HR. METHODS:Between December 2007...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100713496770
更新日期:2013-11-01 00:00:00
abstract:RECOMMENDATION:Several studies support the effect of peripheral vascular disease (PVD) on wound healing and surgical site infection (SSI). Despite this, there have been no specific studies proving the beneficial effect of revascularization on SSI prior to operative intervention in the setting of traumatic or elective f...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100719859343
更新日期:2019-07-01 00:00:00
abstract::The subtalar, talonavicular, and calcaneocuboid joints were internally fixed to simulate triple arthrodesis was performed on eight matched pairs of human cadaver feet. Feet were randomly assigned such that one specimen in each pair was internally fixed with cobalt-chrome staples and one specimen with stainless steel s...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110079601701209
更新日期:1996-12-01 00:00:00
abstract:BACKGROUND:The surgical management of brachymetatarsia remains controversial, and choice is based on potential complications. We report a classification of complications based on severity, and we hypothesized that use of a semicircular external fixator would minimize severe complications in lateral metatarsal lengtheni...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100715593373
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:There is no consensus regarding participation in sports and recreational activities following total ankle replacement (TAR) and ankle arthrodesis (AA). This systematic review summarizes the evidence on return to sports and activity after operative management with either TAR or AA for ankle osteoarthritis (OA...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100720927706
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:The reported fusion rates of revision arthrodesis for hindfoot nonunions are relatively low compared to primary procedures. Exogenous ultrasound has been shown to accelerate the healing process of acute fractures and fracture nonunions but has not been previously evaluated for the treatment of hindfoot pseud...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110070602700401
更新日期:2006-04-01 00:00:00
abstract:BACKGROUND:A recent publication reported preoperative Patient-Reported Outcomes Measurement Instrumentation System (PROMIS) scores to be highly predictive in identifying patients who would and would not benefit from foot and ankle surgery. Their applicability to other patient populations is unknown. The aim of this stu...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100718765225
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:The superficial peroneal nerve (SPN) and its branches are at risk during surgical exposures. Our study aimed to demonstrate the distribution of the SPN on the dorsum of the foot to aid in surgical procedures close to this nerve. METHODS:The SPN was dissected in 30 cadaver lower limbs (13 male and two female...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110070602700609
更新日期:2006-06-01 00:00:00
abstract:BACKGROUND:Suture anchors have been developed for the fixation of ligaments, capsules, or tendons to bone. These devices have led to improved fixation, smaller incisions, earlier limb mobility, and improved outcomes. They were originally developed for use in shoulder reconstructions but are now used in almost all extre...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110070502600703
更新日期:2005-07-01 00:00:00
abstract::The purpose of this study is to report our experience with the Vacuum Assisted Closure (VAC) negative pressure technique in patients with non-healing wounds of the foot, ankle, and lower limb. We retrospectively reviewed 17 patients with non-healing wounds of the lower extremity who underwent treatment using the Vacuu...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110070202301002
更新日期:2002-10-01 00:00:00
abstract::We conducted magnetic resonance imaging of the posterior tibial (PT) and flexor digitorum longus (FDL) muscle bellies in 12 patients undergoing surgical treatment for unilateral posterior tibial tendon (PTT) dysfunction. All patients had atrophy of the PT muscle compared to the normal leg (mean 10.7%, p = 0.008). In t...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110070302400409
更新日期:2003-04-01 00:00:00
abstract:BACKGROUND:Understanding the plantar nerve anatomy is crucial for safe endoscopic surgery of the sole. We aimed to anatomically dissect the lateral aspect and soles of cadaveric feet to investigate the safety of peroneus longus tendoscopy with a plantar lateral portal and the safe zones for plantar portals. METHODS:We...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100715607964
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:Sufficient inter-fragmentary compression is helpful to achieve successful bony fusion in hindfoot arthrodesis using internal fixation by screws. Beside bone quality, the design of a screw influences inter-fragmentary compression. Compressive force is achievable for any kind of screw system; however, the prim...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.3113/FAI.2008.0225
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND:The flexor to extensor transfer of the flexor digitorum longus (FDL) tendon has been a relatively common operative procedure for the treatment of a flexible hammer toe deformity and chronic metatarsophalangeal (MTP) joint dislocation. A possible complication of using the tunnel technique rather than the tend...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100714565927
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:Ankle replacement and ankle arthrodesis are standard treatments for treating end-stage ankle arthritis when conservative treatment fails. Comparing patient-reported outcome scores to the instrument's minimal important difference (MID) helps physicians and researchers infer whether a meaningful change in heal...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100720977842
更新日期:2021-01-27 00:00:00
abstract:BACKGROUND:Subtalar instability, which may cause persistent symptoms after severe inversion ankle sprains, often involves failure of the interosseous talocalcaneal ligament (ITCL). While several clinicians have reported surgical treatment for this pathology, nonsurgical management policy has not been well considered. P...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110070302400811
更新日期:2003-08-01 00:00:00