“…Among those patients, 4 achieved a full ROM of the ankle joint without pain at 1 year after surgery. Ribbans et al 19 demonstrated that distal tibiofibular fusions were rare, with the following indications being the most common: salvage following syndesmotic injury with a chronic, symptomatic diastasis following Weber B and C and ankle fractures or, more rarely, isolated chronic syndesmotic injuries with instability. Miyamoto and Takao 13 recommended arthrodesis of the distal tibiofibular joint for chronic cases.…”
Section: Discussionmentioning
confidence: 99%
“… 3 , 24 Despite the fact that many surgical techniques have been described in the literature, little evidence is available with regard to the indications, procedures, and outcomes of fusion techniques or how to manage with combined disorders. 19 As for postoperative rehabilitation protocol, it remains controversial that if it should be related to screw removal decision: some authors advocate removal of the screws before weightbearing, 1 , 4 while others suggest no significant difference in outcome between the retained and removed screws. 8 , 16 On the other hand, chronic syndesmosis injury presents a significant challenge for athletes especially, where early return to sport is of great importance.…”
Background: Questions regarding surgical fusion techniques, postoperative treatment, and indications for return to sport after chronic syndesmosis injury or its comorbidities remain unanswered. Purpose: An international group of experts representing the field of injuries in the foot and ankle area was invited to collaboratively advance toward consensus opinions based on the best available evidence regarding chronic syndesmosis injury. All were members of the Asia-Pacific Knee, Arthroscopy and Sports Medicine Society (APKASS). Study Design: Consensus statement. Methods: From November to December 2020, a total of 111 international experts on sports medicine or ankle surgery participated in a 2-stage Delphi process that included an anonymous online survey and an online meeting. A total of 13 items with 38 statements were drafted by 13 core authors. Of these, 4 items with 6 clinical questions and statements were related to surgical fusion techniques, comorbidity treatments, postoperative rehabilitation, and return-to-sports indications and are presented here. Each statement was individually presented and discussed, followed by a general vote. The strength of consensus was characterized as follows: consensus, 51% to 74%; strong consensus, 75% to 99%; and unanimous, 100%. Results: Of the 6 questions and statements, 5 achieved unanimous support and 1 reached strong consensus. Conclusion: This APKASS consensus statement, developed by international experts in the field, will assist surgeons and physical therapists with surgical and postoperative treatment strategies for chronic syndesmosis injury.
“…Among those patients, 4 achieved a full ROM of the ankle joint without pain at 1 year after surgery. Ribbans et al 19 demonstrated that distal tibiofibular fusions were rare, with the following indications being the most common: salvage following syndesmotic injury with a chronic, symptomatic diastasis following Weber B and C and ankle fractures or, more rarely, isolated chronic syndesmotic injuries with instability. Miyamoto and Takao 13 recommended arthrodesis of the distal tibiofibular joint for chronic cases.…”
Section: Discussionmentioning
confidence: 99%
“… 3 , 24 Despite the fact that many surgical techniques have been described in the literature, little evidence is available with regard to the indications, procedures, and outcomes of fusion techniques or how to manage with combined disorders. 19 As for postoperative rehabilitation protocol, it remains controversial that if it should be related to screw removal decision: some authors advocate removal of the screws before weightbearing, 1 , 4 while others suggest no significant difference in outcome between the retained and removed screws. 8 , 16 On the other hand, chronic syndesmosis injury presents a significant challenge for athletes especially, where early return to sport is of great importance.…”
Background: Questions regarding surgical fusion techniques, postoperative treatment, and indications for return to sport after chronic syndesmosis injury or its comorbidities remain unanswered. Purpose: An international group of experts representing the field of injuries in the foot and ankle area was invited to collaboratively advance toward consensus opinions based on the best available evidence regarding chronic syndesmosis injury. All were members of the Asia-Pacific Knee, Arthroscopy and Sports Medicine Society (APKASS). Study Design: Consensus statement. Methods: From November to December 2020, a total of 111 international experts on sports medicine or ankle surgery participated in a 2-stage Delphi process that included an anonymous online survey and an online meeting. A total of 13 items with 38 statements were drafted by 13 core authors. Of these, 4 items with 6 clinical questions and statements were related to surgical fusion techniques, comorbidity treatments, postoperative rehabilitation, and return-to-sports indications and are presented here. Each statement was individually presented and discussed, followed by a general vote. The strength of consensus was characterized as follows: consensus, 51% to 74%; strong consensus, 75% to 99%; and unanimous, 100%. Results: Of the 6 questions and statements, 5 achieved unanimous support and 1 reached strong consensus. Conclusion: This APKASS consensus statement, developed by international experts in the field, will assist surgeons and physical therapists with surgical and postoperative treatment strategies for chronic syndesmosis injury.
This case report describes distal tibiofibular arthrodesis as a technique for achieving increased confluent bone support for the placement of oversized arthroplasty components for talocrural arthroplasty in an 18-month-old Labrador Retriever with talocrural osteoarthritis secondary to talar osteochondrosis. Computed tomography assessment for suitability for BioMedtrix canine ankle replacement surgery revealed the tibia to be undersized relative to the tibial component. Distal tibiofibular arthrodesis was performed to increase lateral bone support to permit placement of an otherwise oversized prosthesis. Subjective assessment of outcome with owner Liverpool Osteoarthritis in Dogs questionnaire to 6 months postoperatively as well as radiological assessment to 4 months postoperatively documented significant improvement in lameness in the operated limb with no complications. Distal tibiofibular arthrodesis is a means by which to achieve increased bone support prior to BioMedtrix canine total ankle replacement surgery. The surgical technique described herein permitted placement of an oversized talocrural prosthesis in this patient with good clinical function. This technique may permit use of this arthroplasty system in otherwise undersized patients until such a time that smaller implants are available from the manufacturer.
Background:
Osteochondromas are benign osseous tumors encountered most routinely by physicians responsible for diagnosing musculoskeletal disorders. Often, these osseous lesions are identified following symptoms related to their impingement on adjacent soft tissue or bone.
Methods:
This article presents a unique case of an asymptomatic osteochondroma of the distal fibula in a 29-year-old Caucasian woman that manifested clinically as an impingement on the tibial nerve.
Results:
After resection of the osteochondroma, the patient's tarsal tunnel syndrome symptoms resolved.
Conclusions:
This case report demonstrates a never-before-described osteochondroma of the distal fibula traversing posterior to the ankle joint and impinging on the tibial nerve. After resection, the patient's symptoms resolved.
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