We re-examined clinically and radiologically 88 patients with a fracture of the lower leg at a mean follow-up of 15 years. Forty-three fractures (49%) had healed with malalignment of at least 5 degrees. More arthritis was found in the knee and ankle adjacent to the fracture than in the comparable joints of the uninjured leg. Malaligned fractures showed significantly more degenerative changes. E...

Thirteen patients suffering from rheumatoid arthritis had 19 stress fractures of the tibia or fibula. These patients characteristically presented with sudden, severe, unexplained pain with localised tenderness just below the knee or above the ankle. In seven patients examination of the adjacent joint indicated a flare-up of disease activity or a pyogenic arthritis. In six patients the diagnosis...

The ankle is a common site of sports injuries. Extreme violent inversion of the ankle associated with sports accidents, subjects it to traumas of varying degrees. Fractures of the medial and lateral malleoli, and tears of the ligaments are easily recognisable. When these are excluded on the X-ray examination, the diagnosis of ankle sprain is usually made and fast spontaneous recovery is expecte...

While it is well known that ankle sprains are one of the most common injuries in the United States, predictive factors regarding failure of conservative treatment are not well known. There are many biomechanical and epidemiological factors that play a role in recurrence and failure of conservative treatment, but most cases are able to be treated with immobilization and/or rest, ice, elevation, ...

OBJECTIVE To summarise the evidence on accuracy of the Ottawa ankle rules, a decision aid for excluding fractures of the ankle and mid-foot. DESIGN Systematic review. DATA SOURCES Electronic databases, reference lists of included studies, and experts. REVIEW METHODS Data were extracted on the study population, the type of Ottawa ankle rules used, and methods. Sensitivities, but not specif...

Introduction: The most common cause of ankle osteoarthritis (OA) is posttraumatic, with around 80% of all cases, followed by primary and secondary ankle OA. Patients often present wit asymmetric involvement of the tibiotalar joint, resulting in valgus or varus deformity of the ankle and hindfoot. The etiology of asymmetric arthritic ankles can be divided into 2 main etiologic and morphologic gr...

A retrospective survey of over 2000 patients with inversion injuries of the ankle joint was undertaken to examine the validity of criteria commonly used in an accident and emergency department to assess severity. Swelling alone is an unreliable indicator of the severity of the injury. Patients with severe pain and inability to weight bear show a high incidence of fractures and must be X-rayed. ...

A second defining difference is the absence of pain and discomfort in metabolic fractures. Traumatic fractures, in contrast, are almost always extremely painful. This is easily explained. It is well known that bone has no pain fibers, while surrounding connective tissues are abundantly supplied with pain fibers. In metabolic fractures, which can take place with ordinary infant handling, surroun...

Anterior or anterior-lateral dislocation of the ankle is a rare condition that can be treated conservatively as well as any other similar types of ankle dislocations without associated fractures. We present a case report of an anterior-lateral ankle dislocation with a concomitant avulsion injury of the ankle's anterior capsule in a diabetic patient that was treated conservatively. At the patien...

Fractures of the horizontal surface of the distal tibia are known commonly as pylon or plafond fractures, and represent 1–5% of lower extremity fractures, 7–10% of all tibial fractures. The protocol consisted of immediate (within eight to 24 hours) open reduction and internal fixation of the fibula, using a fibular plate or one third tubular plate and application of an external fixator spanning...