Abstract:
BACKGROUND:The fibula is commonly used for bone grafts. Previous clinical and biomechanical studies have suggested that the length of the residual portion of the distal part of the fibula has an important effect on the long-term stability of the ankle joint. However, we cannot find clear-cut guidelines for the amount of bone that can be harvested safely. METHODS:Using six normal fresh-frozen cadaver legs, motions of the tibia, talus and calcaneus were measured. The fibula was cut sequentially 3 cm from the proximal tip of the fibula and distally 10 cm, 6 cm, and 4 cm from the distal tip of the lateral malleolus. The angular motion of each bone was measured while a medial and lateral traction force of 19.6 N was applied to the proximal tibia. Angles of the tibia, talus, and calcaneus were measured. RESULTS:Sequential resection of the fibula increased the inversion angles of the ankle joint. The proximal 3-cm cut increased the inversion angle from 42.1 +/- 6.2 degrees to 49.6 +/- 3.6 degrees, and the distal 4-cm cut increased the angle from 57.6 +/- 6.6 degrees to 67.4 +/- 5.9 degrees. The rotational angles were almost constant with sequential resections of the fibula; however, the distal 4-cm cut increased the rotational angle from 11.3 +/- 25.1 degrees to 78.7 +/- 37.5 degrees. CONCLUSIONS:The whole fibula including the head is essential for the stability of the ankle joint complex, and the distal fibula is responsible for stabilizing the ankle mortise during external rotation and inversion. We recommend fixation of the syndesmosis or bracing to prevent ankle joint instability with rotation of the talus in the mortise, especially when the distal fibula is shortened 6 cm or more.
journal_name
Foot Ankle Intjournal_title
Foot & ankle internationalauthors
Uchiyama E,Suzuki D,Kura H,Yamashita T,Murakami Gdoi
10.1177/107110070602700306keywords:
subject
Has Abstractpub_date
2006-03-01 00:00:00pages
185-9issue
3eissn
1071-1007issn
1944-7876pii
918973journal_volume
27pub_type
杂志文章abstract:BACKGROUND:The prevalence of obesity in the United States is staggering. Currently, the effect of obesity on third-generation total ankle replacement (TAR) is unknown. METHODS:We prospectively identified a consecutive series of 455 primary TARs operated between May 2007 and September 2013 who had a minimum follow-up o...
journal_title:Foot & ankle international
pub_type: 杂志文章
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abstract:BACKGROUND:Posttraumatic osteoarthritis (PTOA) of the subtalar joint is a serious, disabling, and frequent complication following intra-articular calcaneal fractures (IACFs). Using plain radiographs to assess the subtalar joint for PTOA is imprecise and insensitive, hindering progress toward improving treatment and ass...
journal_title:Foot & ankle international
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journal_title:Foot & ankle international
pub_type: 杂志文章
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journal_title:Foot & ankle international
pub_type: 杂志文章,评审
doi:10.1177/107110079601700509
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journal_title:Foot & ankle international
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abstract::The intrachondral microvasculature of the growing talus of human was studied in 16 fetuses aged from 15 to 44 weeks of gestation, using interrupted serial sections and vascular injection of ink. The cartilage model of the talus was shown to be well vascularized throughout by cartilage canals. The cartilage canal conta...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110079701800604
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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
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journal_title:Foot & ankle international
pub_type: 杂志文章
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abstract:BACKGROUND:Metatarsus adductus (MA) increases the risk of developing symptomatic hallux valgus (HV). This study aimed to determine the prevalence of MA in patients with symptomatic HV and to evaluate how it affected the functional outcome after scarf osteotomy. METHODS:Between January 2007 and June 2012, a total of 20...
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abstract::Achilles tendinosis is a degenerative overuse tendinopathy involving the primary ankle plantarflexors, namely the soleus and gastrocnemius muscles forming the tendo Achilles. The Orthopaedic Research Institute-Ankle Strength Testing System (ORI-ASTS) was designed to record objective measurements of force generated wit...
journal_title:Foot & ankle international
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Foot & ankle international
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journal_title:Foot & ankle international
pub_type: 杂志文章
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abstract::This article describes a patient with a 10-year history of persistent ankle pain. Differential diagnosis included osteoid osteoma and anterior ankle impingement. This patient subsequently underwent arthroscopic excision of a lesion on the talar neck following a complete radiographic work-up, which was nondiagnostic. T...
journal_title:Foot & ankle international
pub_type: 杂志文章,评审
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更新日期:1995-04-01 00:00:00
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journal_title:Foot & ankle international
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pub_type: 杂志文章
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更新日期:2012-12-01 00:00:00