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Paediatric and adolescent foot disorders
Published in Maneesh Bhatia, Essentials of Foot and Ankle Surgery, 2021
Plain x-ray radiography is the imaging standard to evaluate paediatric ankle injuries. Anteroposterior, lateral, and mortise views of the ankle should be obtained. The mortise radiograph is particularly helpful in identifying subtle intra-articular fracture patterns, such as a triplane or Tillaux fracture. Physeal widening is an important sign to look for as it could be suggestive of SH type 1 injury. Weight-bearing views to assess for syndesmotic injury and full-length tibia radiograph to rule out Maisonneuve-type high fibula fracture should be considered if any clinical suspicion. Good knowledge of normal anatomical variants, such as Os Subtibiale and Os Subfibulare, is key to avoid false-positive diagnoses.
Treatment of distal intra-articular/extra-articular tibial fractures
Published in Peter V. Giannoudis, Thomas A. Einhorn, Surgical and Medical Treatment of Osteoporosis, 2020
Vasileios P. Giannoudis, Peter V. Giannoudis
Most of the distal tibial fractures present with an associated fibula fracture. Fixing the fibula and restoring its length facilitates improved control of the length and rotational alignment and reduction of the tibia.
SBA Answers and Explanations
Published in Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury, SBAs for the MRCS Part A, 2018
Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury
In a neck of fibula fracture, the common peroneal nerve is most likely to be damaged as it surrounds the neck as part of its course. The common peroneal nerve supplies muscles in the lateral and anterior compartment of the leg, allowing ankle dorsiflexion and foot eversion. If damaged, the patient is unable to dorsiflex or evert the foot, causing a foot drop and a high-stepping gait.
Comparison of pediatric sports fracture outcomes based on provider type
Published in The Physician and Sportsmedicine, 2021
Emily A. Sweeney, David R. Howell, Morgan N. Potter, Alexia G Gagliardi, Jay C. Albright, Aaron J. Provance
We also used injury location-specific patient-reported functional outcome measures. Participants who sustained a tibia or fibula fracture completed the Foot and Ankle Ability Measure (FAAM) [26]. For this questionnaire, participants answered 21 questions about activities of daily living and eight questions specific to sports regarding their condition in the previous week. Responses were given a numeric value from 0 (no difficulty) to 4 (unable to do) and all responses were summed to provide an overall value. Similarly, participants who sustained a radius or ulna fracture completed the Disabilities of the Arm, Shoulder, and Hand (DASH) Scale [27]. They completed 30 questions pertaining to symptoms and ability to perform activities of daily living related to upper extremity function. Scores were calculated as the sum of responses, which were rated from 0 (no difficulty) to 4 (unable to perform). Therefore, 0 indicates the least upper extremity disability and 100 indicates the most disability.
The intersection of cerebral fat embolism syndrome and traumatic brain injury: a literature review and case series
Published in Brain Injury, 2020
Taron Davis, Alan Weintraub, Michael Makley, Eric Spier, Jeri Forster
A 63-year-old female, pedestrian struck by a motor vehicle. Her initial GCS rating was 12 and her head CT scan showed small subdural hematomas and cortical contusions. Additional injuries include severe skull trauma, thoracic and lumbar spine fractures, pelvic, and retroperitoneal hematoma, left tibia fracture, left fibula fracture, and left ulna and distal radius fracture. She underwent ORIF of left tibia and left ulnar fractures. She had an acute prolonged disorder of consciousness postoperatively, and subsequent serial neuroimaging as part of the work up. On post-injury day three, MRI demonstrated innumerable foci of supratentorium and infratentorial restricted diffusion. CT scan showed a diffuse axonal injury, hemorrhagic contusions in bilateral inferior frontal hemispheres, subdural hemorrhage, and subarachnoid hemorrhage. Her admission and discharge FIM scores were 12 and 38, respectively. She was discharged home to the care of her family. At 6 months her GOS was a 3 indicative of severe disability.
Orthopedic treatment for open fracture of lower extremities and soft tissue defects in young children and rapid rehabilitation after operation
Published in The Physician and Sportsmedicine, 2020
Paerhati Rexiti, Tie-Cheng Zhang, Chugulike Batuer, Li Cao
After an operation for tibia and fibula fracture, tendon injury and peripheral nerve injury in the lower limbs, young children usually require to be immobilized and fixed for approximately three weeks, in order to protect tissues and promote bone healing. After approximately three weeks of early rehabilitation treatment, children can cooperate with the physical rehabilitation physician on resistance training, step by step from light to heavy, according to the healing of fracture revealed by the X-ray film of their lower limbs. Furthermore, muscles are forced to contract at the greatest ability to enhance muscle force, increase the range and sense of joint activity, improve the ability of coordination, and attempt to use auxiliary braces, in order to promote and consolidate the treatment effect [15].