Background. The search for an optimal method to assess the amplitude of ankle joint dorsiflexion remains topical for scientific discussions. The purpose of the research was to analyze the validity of goniometric and inclinometric methods for measuring the scope of ankle joint (AJ) dorsiflexion compared to radiological data. Materials and methods. The research included 25 healthy and physically active people (50 ankle joints), 18 men and 7 women with an average age of 25.8 ± 5.2 years; their mean body mass index was 25.01 ± 5.01 kg/m2. Ankle dorsiflexion measures were obtained in a weight-bearing lunge position using a double-plane goniometer and inclinometer, then compared with X-ray data. The measurement results were evaluated by descriptive statistics. Results. Mean values of AJ dorsiflexion obtained with a double-plane goniometer were 37.62 ± 5.56°; with an inclinometer — 40.61 ± 5.15°; radiological results — 23.69 ± 7.25°. Their difference was significant (p < 0.001). The mean variability index for the radiological method was 0.31 prevailing over goniometric (0.15) and inclinometric (0.13) methods (p < 0.001). X-ray ima-ging of a weight-bearing AJ at its maximum dorsiflexion raises the indicator of a talus-first metatarsal angle. Conclusions. The values of the dorsiflexion angle parameters of an AJ, measured using goniometric and inclinometric methods, significantly exceed those obtained by X-ray imaging. Higher variation index for radiological imaging demonstrates better reproducibility of inclinometry and goniometry when evaluating AJ dorsiflexion. A weight-bearing AJ radiogram at maximum extended position demonstrates an increase in a talus-first metatarsal angle compared to normal values that should be considered when interpreting the results of X-ray imaging of an AJ dorsiflexion.
Summary. The problem of posterior malleolus (PM) fractures osteosynthesis remains the subject of scientific debate, despite extensive experience in surgical treatment and a large number of biomechanical and clinical studies. Objective: to analyze current literary concepts of surgical treatment of PM in patients with ankle fractures. Results and Сonclusions. The available literature does not provide a complete understanding of the problem of surgical treatment of PM fractures. The current consensus suggests that restoring the anatomy of the articular surface of the tibial plateau and concomitant damage to the medial and lateral structures of the ankle joint, along with ensuring its stability, is the key to the successful treatment of РМ injuries. The lack of high-quality recommendations and a unified protocol for the choice of treatment tactics, as well as a sufficiently high percentage of unsatisfactory results determine the need to improve the existing principles of surgical treatment.
Summary. The number of mistakes and complications in the diagnostics and treatment of malleolus fractures is still significant. Objective. The retrospective analysis of mistakes and complications in the diagnostics and treatment of malleolus fractures. Materials and Methods. 385 patients with consequences of malleolus fractures (AO/OTA 44) from March 2000 to August 2020. There were 280 men and 105 women aged 18-87 years. The time from the injury was 3–408 months (on average 29.9±6.8 months). The analysis was carried out according to the recommendations of AO and AUPO “Ukrainian Association of Orthopedists-Traumatologists”. Results. Mistakes in the diagnosis and treatment amounted to 57.4% (221 cases); in 164 cases (42.6%) the severity of initial trauma and the time from the injury were objective factors for the development of deforming arthrosis of stages 3-4. Diagnostic defects took place in 40 cases (10.4%). The unproved conservative treatment was used in 47 cases (12.2%). Defects in surgical technique were noted in 174 cases (45.2%): failure to perform osteosynthesis of the fibula in “С” fractures – 24 cases (6.2%), improper surgical approach – 45 cases (11.7%), improper fixator choice – 45 cases (11.7%), transcutaneous wire fixation as the main osteosynthesis – 14 cases (3.6%), and improper tibiofibular stabilization – 49 cases (12.7%). Malreduction of broken bones in operated on patients was registered in 114 cases. Conclusions. Our results may be useful at the planning of future clinical and epidemiological investigations.
Summary. The assessment of foot and ankle function still remains an actual issue of the modern orthopedics. Objective: comparative qualitative analysis of the most common assessment systems of foot and ankle function. Materials and Methods. The search from PubMed databases from 1946 to 2021 was done. 8898 publications were detected in which assessment systems of foot and ankle function have been used. 12 assessment systems presented in 5705 publications were selected for analysis (inclusion criterion – no less than 40 publications): AOFAS scale, VAS, SF-36 EQL, FFI, FAOS, FAAM, FADI, BFS, MOFAQ, FFI-R, Roles&Maudsley scale, VAS FA. The analysis predicted the assessment system philosophy: numerical estimate, VAS, Likert scale, patient- or investigatororiented, and reliability evidence. Results. Most of the analized assessment systems meet criteria of reliability (r>0.8; Kronbach’s α≥0.9). For Roles&Maudsley scale and VAS, FA reliability has not been established. The validity fluctuates widely. Conclusions. The choice of an assessment system must meet the research tasks. The consideration of strong and weak sides of assessment systems promotes their adequate combinations to avoid the bias effect.
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