scholarly journals Spiral Plaque on the Left Ankle

2021 ◽  
Vol 108 (3) ◽  
Author(s):  
Sherman Chu
Keyword(s):  
Left Ankle

scholarly journals Standard Value of Lower Extremity Muscle Strength of 8 Years Old Children and Its Correlation with Body Weight and Height

1970 ◽  
Vol 2 (01) ◽  
pp. 45-54
Author(s):  
Sarifitri FH Hutagalung ◽  
Ferial Hadipoetro Idris, ◽  
Keyword(s):  
Body Weight ◽  
Muscle Strength ◽  
Lower Extremity ◽  
Body Height ◽  
Knee Extensor ◽  
Left Knee ◽  
Knee Flexor ◽  
Lower Extremity Muscle ◽  
Left Ankle ◽  
Hip Flexor

Objectives: to know the standard value of lower extremity muscle strength of eight year old children and furthermore to explore the correlation of the muscle strength and body height and weight.Methods: The study design is cross sectional. The target is eight year old children in public elementary school in Jakarta Pusat. The subjects’ characteristics are normal nutritional state, and no neurological normusculoskeletal disorders. Sampling was done by cluster randomization to determine the location and simple randomization on site to determine subjects. There were 171 boys and 180 girls in this tudy. Independentvariables are age, sex, body weight, body height and nutritional state that was determine with Z-score of body mass index. Dependent variables are lower extremity muscle strength that classify as torque. This study usedhand-held dynamometer for muscle strength measurement. Statistical analysis was done with descriptive statistic and Pearson and Spearman correlation test.Results: Standard values of eight year old boy’s lower extremity muscle strength are: right hip flexor 21.86 Nm (SD 3.40), left hip flexor 19.64 Nm (SD 3.19), right hip extensor 17.05 Nm (SD 3.66), left hip extensor16.08 Nm (SD 3.56), right knee extensor 18.19 Nm (SD 3.60), left knee extensor 16.09 Nm (SD 3.55), right knee flexor 15.18 Nm (SD 4.23), left knee flexor 14.48 Nm (SD 3.97), right ankle dorsiflexor 6.58 Nm (SD1.53), left ankle dorsiflexor 6.05 Nm (SD 1.42), right ankle plantarflexor 10.08 Nm (SD 1.69), left ankle plantar flexor 9.13 Nm (SD 1.90).Standard values of eight year old girl’s lower extremity muscle strength are: right hip flexor 21.60 Nm (SD 3.62), left hip flexor 19.62 Nm (SD 3.37), right hip extensor 16.66 Nm (SD 4.06), left hip extensor 15.81 Nm(SD 3.94), right knee extensor 17.43 Nm (SD 3.79), left knee extensor 15.20 Nm (SD 3.38), right knee flexor 14.61 Nm (SD 4.28), left knee flexor 13.51 Nm (SD 4.00), right ankle dorsiflexor 6.34 Nm (SD 1.45), leftankle dorsiflexor 5.97 Nm (SD 1.52), right ankle plantarflexor 9.55 Nm (SD 1.98), left ankle plantar flexor 8.69 Nm (SD 1.83). The boy’s lower extremity muscle strength are stronger than the girl’s in left knee extensor,left knee flexor, right ankle plantarflexor and left ankle plantarflexor. The boy’s muscle strength are moderately correlated to body height except for right hip extensor, left hip extensor and right ankle dorsiflexorthat weakly correlated. The boy’s muscle strength are moderately correlated to body weight except for left hip extensor that weakly correlated. The girl’s muscle strength are moderately correlated to body height. Thegirl’s muscle strength are moderately correlated to body weight except for left hip flexor and left hip extensor that weakly correlated.Conclusions: The muscle strength pattern of boys and girls is similar; the strongest are right hip flexor and the weakest are left ankle dorsiflexor.Keywords: Muscle strength, standard values of eight year old children, torque, hand-held dynamometer

scholarly journals Extra-articular distal tibia fibula fracture managed with single posterolateral approach: a case report

2021 ◽  
Vol 7 (3) ◽  
pp. 683
Author(s):  
Neetin P. Mahajan ◽  
Prasanna Kumar G. S. ◽  
Tushar C. Patil ◽  
Kartik P. Pande ◽  
Harish Pawar
Keyword(s):  
Distal Tibia ◽  
Posterolateral Approach ◽  
Anterolateral Approach ◽  
Ankle Motion ◽  
Fibula Fracture ◽  
Left Ankle ◽  
Alternative Approach ◽  
Soft Tissue Problems ◽  
Tibia Fractures ◽  
Distal Tibia Fractures

<p class="abstract">Extra-articular distal tibia fractures involve distal tibia approximately 4 cm within tibia plafond with no articular extension. The proper preoperative care, planning and selection of surgical approach is very essential to prevent postoperative wound-related complications. We present a case of a 29 year female patient, presented with left ankle pain and swelling with a wound over the medial aspect of the ankle. X-ray of the left ankle showed extra-articular distal tibia fibula fracture with no neurovascular deficit. We managed both the fractures with open reduction and internal fixation using a single posterolateral approach. At present 1 year follow-up, the patient is having a good range of ankle motion with radiological union with no implant failure and wound-related complications. Extra-articular distal tibia fibula fracture fixation using single posterolateral approach is a viable alternative approach to medial or anterolateral approach in cases of medial or anterior soft tissue problems. It helps in getting a better functional outcome, early mobilisation with less wound-related complications.</p>

scholarly journals Caso Clínico: Cirugía Reconstructiva de Tobillo

2018 ◽  
Vol 10 (2) ◽  
pp. 170-174
Author(s):  
Fulvio Enrique Zuñiga Cabrera ◽  
Jaime Santiago Clavijo Jaramillo ◽  
Adriana Abigail Guzmán Villa
Keyword(s):  
Diabetes Mellitus ◽  
Reverse Flow ◽  
Public Health Problem ◽  
Lower Limbs ◽  
World Health ◽  
Major Public Health Problem ◽  
Sural Flap ◽  
Advantages And Disadvantages ◽  
Left Ankle ◽  
Osteosynthesis Material

BACKGROUND: Diabetes mellitus is a major public health problem, according to the World Health Organization, 422 million adults worldwide in 2014. In 2012, it caused 1.5 million deaths worldwide. Diabetes is the leading cause of non-traumatic amputation in lower limbs and foot infections occur with high frequency in poorly controlled patients. This case shows the reconstruction of soft tissue defects in the lower third leg, heel, malleoli and foot through the description of the reverse sural flap. In this study the advantages and disadvantages of the use of this technique are discussed. CASE REPORT: A 56-year-old female patient with a poorly controlled history of Diabetes Mellitus type 2, who suffered a fracture of the left ankle treated with osteosynthesis, and who during the postoperative period attended emergency orthopedics and traumatology, due to severe pain in the left ankle, fever, dehiscence of surgical wound, accompanied by serous secretion. EVOLUTION: The patient, after several surgical cleanings and changes in closure therapy assisted by negative pressure, manages to control the infection, with persistence of the bone coverage defect and the osteosynthesis material. There were additional complications such as joint stiffness, muscle atrophy; it was decided to reconstruct the distal third of the foot using a reverse flow sural fasciocutaneous flap, which evolved satisfactorily, managing to cover the defect with biological tissue. CONCLUSIONS: The sural flap of reverse flow is a reproducible technique that allows to cover coverage defects in the distal third of the leg and ankle; shorten hospitalization times, especially when there is bone exposure or osteosynthesis material.

scholarly journals Efek Injeksi Plasma Kaya Platelet Terhadap Tenosinovitis Tendon Tibialis Posterior: Sebuah Studi Kasus

2019 ◽  
Vol 5 (1) ◽  
pp. 60-65
Author(s):  
Henry Ricardo Handoyo ◽  
Andryan Hanafi Bakri ◽  
Andri Primadhi Primadhi
Keyword(s):  
Platelet Rich Plasma ◽  
Tibialis Posterior ◽  
Medial Malleolus ◽  
Posterior Tibial Tendon ◽  
Foot And Ankle ◽  
Posterior Tibial Tendon Dysfunction ◽  
Flat Foot ◽  
Posterior Tibial ◽  
Left Ankle ◽  
History Of

Introduction: Posterior tibial tendon dysfunction is one of the most common, problems of the foot and ankle. Tenosynovitis of the posterior tibial tendon (PTT) is an often unrecognized form of PTT dysfunction. Case: A 54-year-old woman presented with left ankle pain that began while morning walk three days prior. She noted that the left ankle hurt with even light touch and the pain was unrelieved with sodium diclofenac. She denied any history of trauma. She was seen in the outpatient clinic for this condition. On examination, a three centimeter area of pain was found posterior to the medial malleolus and parallel to the PTT. She also had a stage I flat foot and mild soft tissue swelling around medial malleolus region on her radiograph examination. Ultrasound examination was done with the result of anechoic fluid visible in the peritendinous space around the PTT. The patient received diagnosis of PTT tenosynovitis, with the foot and ankle disability index (FADI) score was 58.7. Platelet rich plasma (PRP) injection was done twice with an interlude of two weeks. The pain subsided and the following FADI score was 84.6. Outcome: Patient showed improvement in her left ankle PTT tenosynovitis after two PRP injection. Conclusion: This case report highlights the efficacy of PRP as a modality in managing PTT tenosynovitis.

scholarly journals Masquelet Technique for Hindfoot Fusion of Gustilo IIIA Open Ankle Dislocation with Complete Talar Extrusion and Loss

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0030
Author(s):  
Sandra A. Miskiel ◽  
Steven A. Caruso ◽  
Andre J. Pagliaro
Keyword(s):  
Femoral Shaft ◽  
High Energy ◽  
Fracture Dislocation ◽  
Cement Spacer ◽  
Complication Rates ◽  
Residual Pain ◽  
Left Ankle ◽  
Masquelet Technique ◽  
Hindfoot Fusion ◽  
Cancellous Allograft

Category: Hindfoot, Trauma, Ankle Introduction/Purpose: Complete talar extrusion is a rare injury resulting from high-energy trauma, with dissociation of the talus from surrounding bony and soft-tissue structures. Complications after complete talar extrusion include infection, osteonecrosis, posttraumatic osteoarthritis, and leg-length discrepancy. There is a lack of consensus on the optimal treatment algorithm for complete talar extrusion, due in part to high complication rates associated with injury and treatment. Thus, we report a staged treatment method utilizing the Masquelet Technique with temporary cement spacer, followed by bone grafting with use of femoral shaft autograft and bulk cancellous allograft. Methods: 44-year-old male status post high-speed motorcycle collision presented with left ankle Gustilo IIIC open fracture dislocation with complete talar extrusion and loss, concomitant ipsilateral tibial plateau fracture and metatarsal shaft fractures. Twelve weeks post-injury, after multiple staged debridements, external fixation and extensive wound vac treatments, removal of the left leg multi-planar external fixator was performed with left distal tibial, fibular, navicular and calcaneal articular and subchondral bone debridement in preparation for Masquelet procedure and pantalar fusion. Open reduction and realignment of left ankle and foot with intramedullary fixation with hindfoot fusion nail was performed, with placement of antibiotic cement spacer for development of secondary reactive periosteal membrane. After nine weeks, intramedullary bone reaming aspiration tool was utilized for removal of left femur intramedullary bone marrow for autograft. Hindfoot pantalar fusion was performed using ipsilateral femoral shaft autograft and bulk cancellous allograft in place of antibiotic spacer. Results: Patient went on successfully to fusion and had one transfixation screw removed during the course of his recovery. Patient was also treated using a long leg ankle foot orthosis brace as a stress shielding device during heavy labor. Patient returned back to work and heavy labor as a landscaper and has had no residual pain. At 24 months postoperative, patient achieved an AOFAS ankle-hindfoot score of 83/100 (good). Conclusion: To our knowledge, this is the first case of complete talar extrusion treated with a Masquelet procedure with ipsilateral femoral shaft autograft and bulk cancellous allograft. While chronic pain is reported in as many as 75% of patients post- complete talar extrusion, and infection rates as high as 88%, our patient reports no residual pain and did not experience a postoperative infection. This technique represents a reasonable approach and warrants consideration for the treatment of this rare, complex injury.

scholarly journals Ganglion Cyst Contiguity of the Flexor Hallusis Longus Tendon in a National Swimmer

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0021
Author(s):  
Esra Çirci ◽  
Osman Nuri Özyalvaç ◽  
Tolga Tüzüner ◽  
Cenk Ermutlu
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Conservative Treatment ◽  
Training Program ◽  
Ganglion Cyst ◽  
Flexor Hallucis Longus ◽  
Resonance Imaging ◽  
Longus Tendon ◽  
Left Ankle

Objectives: Tendinopathy of the flexor hallusis longus tendon is common in the athletes. This case is intended to be reported diagnose and treatment ganglion cyst contiguity of the flexor hallucis longus tendon that located atypical region and adversely affect the athlete's training program. Methods: 25-year-old male national swimmer was assessed with a left ankle pain. He had an intensive training program in the pool using pallets at the everyday. Pain in the left ankle was localized posterior and distal of the medial malleolus . Ankle range of motion and muscle strength was full. Neurovascular examination was normal. Radiography with anterior posterior, lateral and oblique analysis was not any unusual finding. In the evaluation with magnetic resonance imaging, thickening of the tendon sheath and effusion around the flexor hallucis longus was revealed and tendon integrity was exact. Results: Conservative treatment was planned. It was applied non-steroidal anti-inflammatory medicine, modification of the training (without or low weight pallet), platelet rich plasma (two weeks, two times peer weeks). During the six-month follow-up the patient's symptoms improved, but with the increased intensity of training at follow-up complaints started again. Professional athletes who did not respond adequately to conservative treatment surgical exposure were planned. Patient is approached the flexor hallucis longus musculotendinous junction from the posteromedial ankle at the level of the posterior talar tubercles. During the tendon exposure cyst was found at the level of talocalcaneal joint. Excision of the cyst was achieved; its size was 5x5 mm, looking transparent, well defined and soft consistency. Tenolysis is accomplished from superior to inferior to the level of the superior calcaneus. A histopathologic examination result of the cyst consistent with ganglion cyst was detected. Sport-specific training program started at the 6 weeks. There was no recurrence during the 6 months follow-up. Conclusion: Tendon associated ganglion cyst is not usual although flexor hallucis longus tendinopathy is common in athletes. External pressure causes in addition to the overuse injuries should be remembered in the differential diagnosis of posterior ankle and medial arch pain. Clinical suspicion and magnetic resonance imaging are valuable in establishing the diagnosis. Tenolysis and excision of the associated mass has proven to be a relatively safe and successful procedure especially in highly demanded elite athletes.

Width of the Medial Tibiotalar Joint

1997 ◽  
Vol 38 (4) ◽  
pp. 520-522 ◽  
Author(s):  
B. Fiirgaard ◽  
J. K. Iversen ◽  
A. de Carvalho
Keyword(s):  
Healthy Volunteers ◽  
Ankle Joint ◽  
Plantar Flexion ◽  
Joint Space ◽  
Neutral Position ◽  
Tibiotalar Joint ◽  
Joint Injuries ◽  
Left Ankle

Purpose: To determine the extent to which the width of the space in the medial tibiotalar joint depends on plantar flexion. Material and Methods: Thirty healthy volunteers were studied by means of a.p. roentgenograms of the left ankle both in a neutral position and in plantar flexion. Results: The medial joint space showed significant widening (average 0.65 mm) between the neutral position and plantar flexion. Conclusion: When ankle joint injuries are studied on radiographs, the position of the foot must be taken into consideration.

scholarly journals Recurrent diffuse-type tenosynovial giant cell tumor of the left ankle: a case report

2019 ◽  
Vol 3 ◽  
pp. 17-17
Author(s):  
Chun-Chieh Wu ◽  
Ying-Hsiang Chou ◽  
Wei-Jia Yang ◽  
Jeng-Dong Hsu ◽  
Hsien-Chun Tseng ◽  
...  
Keyword(s):  
Case Report ◽  
Giant Cell Tumor ◽  
Giant Cell ◽  
Cell Tumor ◽  
Diffuse Type ◽  
Tenosynovial Giant Cell Tumor ◽  
Left Ankle

scholarly journals TUBERCULOUS ARTHRITIS OF THE ANKLE MIMICKING SYNOVITIS IN CHILD - A CASE REPORT

2020 ◽  
Vol 9 (2) ◽  
pp. 63
Author(s):  
Erick Yudistira Christanto ◽  
Sulis Bayusentono
Keyword(s):  
Extrapulmonary Tuberculosis ◽  
Mantoux Test ◽  
Intensive Phase ◽  
Tuberculous Arthritis ◽  
Left Ankle ◽  
Appropriate Treatment ◽  
Diagnostic Difficulties ◽  
Ankle Movement ◽  
One Year ◽  
Specific Symptoms

Background: Extrapulmonary Tuberculosis is approximately 10% of all tuberculosis (TB) cases, and the musculoskeletal system’s involvement was only 2-4. The incidence of ankle TB was found to be less than 2% of all musculoskeletal TB. The rare occurrence, uncommon site, non-specific symptoms, lack of awareness frequently causes diagnosis difficulties.Case Report: A 2,5-year-old child came to the hospital with the main complaints of swelling and pain on the left ankle since one year ago. She was diagnosed with the ankle’s synovitis from the previous hospital and was given analgesics and a warm compress on the left ankle. However, the swelling of her left ankle increased during the last seven months, causing limitation of the left ankle movement, then she was admitted to the hospital for further examination. Radiologic examination revealed peripheral osseous erosions, reduced bone mineral content, and soft tissue swelling. A Mantoux test was positive with 15 mm induration and 25 mm erythema. Anti-tuberculous drugs (ATD) therapy was given with isoniazid 50 mg, rifampicin 75 mg, pyrazinamide 150 mg, and ethambutol 230 mg for two months, as an intensive phase therapy following rifampicin 75 mg and isoniazid 50 mg for ten months.Conclusion: Tuberculous arthritis of the ankle poses a diagnostic-difficulties, it should be considered especially in the endemic area. It is often misdiagnosed with other musculoskeletal conditions, which can delay the initiation of appropriate treatment. TB must be confirmed by histological pathology. A combination of ATD and surgery can lead to clinical improvement.

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