Dr. Ebraheim animated educational video describing current concepts of foot and ankle injuries. I.Ankle fractures a.Supination-external rotation i.Vertical fractures of medial malleolus is bad ii.Differentiate between supination/external rotation and pronation/external rotation by lateral x-ray to see the direction of the fracture b.Isolated lateral malleolar fracture i.Nondisplaced with no talar shift can be treated conservatively. ii.Displaced fracture with talar shift will require surgery. c.Weber C fractures i.Syndesmotic injuries are common II.Ankle fractures & diabetes a.Surgery is better in diabetics III.Pilon fracture (tibial plafond) a.Axial load, high energy injury. Can occur due to a fall or from a car accident. i.medial malleolar fragment ii.Anterolateral fragment: chaput fracture iii.Posterolateral fragment: Volkman fracture (posterior inferior tibiofibular ligament is attached to this fragment) IV.Treatment of displaced fractures: a.Delay open reduction internal fixation until the skin condition improves. b.Soft tissue complications: you need to get skin wrinkles before you do internal fixation. c.Joint fusion surgery (arthrodesis) for arthritis: not commonly used or needed. V.Navicular fractures a.Stress fracture of the navicular is the important one and usually occurs in the central third. b.Treatment: Cast and non-weight bearing. Do ORIF in athletes, if there is a nonunion, or failure of conservative treatment and also in displaced fractures of the navicular. VI.5th metatarsal base fractures a.Zone I: proximal tubercle avulsion fracture. Treatment of zone I proximal tubercle fracture Is usually nonoperative (use a boot or a fracture shoe). b.Zone II (jones fracture) at the 4th and 5th metatarsal articulation which is the junction between the metaphysis and the diaphysis. c.Zone III proximal diaphysis fracture VII. Open calcaneal fractures a.Open fractures of the calcaneus may lead to amputation. There are two basic fragments: i.anteromedial (sustentacular) fragment ii.posterolateral (tuberosity) fragment VIII.Talus fractures (Hawkin’s classification) a.Type I: non-displaced. 10% AVN b.Type II: fracture with subtalar dislocation or subluxation. 50% AVN. c.Type III: fracture with subtalar and tibiotalar subluxation or dislocation. 90% AVN. d.Type IV: fracture with subtalar and tibiotalar dislocation and talonavicular subluxation. 90-100% AVN. Follow me on twitter: https://twitter.com/#!/DrEbraheim_UTMC Donate to the University of Toledo Foundation Department of Orthopaedic Surgery Endowed Chair Fund: https://www.utfoundation.org/foundation/home/Give_Online.aspx?sig=29
Views: 57051 nabil ebraheim
Dr.Mohamed Wahdan Lectures http://docdro.id/9wq1cgz
Views: 346 Dr.Wahdan Lectures
Dr. Ebraheim’s educational animated video describes conditions and treatment methods associated with pain of the ankle. High ankle sprain •A high ankle sprain is a sprain of the syndesmotic ligaments that connect the tibia and fibula at the ankle. •Diagnosis of syndesmotic injury is usually done by the use of external rotation stress view examination or CT scan. This patient may require surgery. Anterolateral impingment •Painful limitation of full range of ankle motion due to soft tissue or osseous (bony) pathology. •Soft tissue thickeneing commonly seen in athletes with prior trauama that extends into the ankle jint. •Arthroscopy of the ankle may be helpful . •Tibisl bone spur impinging on the talus can become a source of chronic ankle pain and limitation of ankle motion in athletes. Osseous (bony) spur on the anterior lip of tibia contacting the talus during dorsiflexion. The patient may need debridment of the spur. Ankle sprain •Pain that is anterior and around the fibula can usually be attributed to a ligament sprain. •Sprains result from the stretching and tearing (partial or complete) of small ligaments that can become damaged when the ankle is forced into an unnatural position. •Treatment includes immobilization, ice therapy, physical therapy and rarely surgery. •With ankle sprain, the patient will be able to walk, but it will be painful. With a fracture, the patient will be unable to walk. Pain that is posterior to the fibula can usually be attributed to an injury of the peroneal tendons. Lateral ankle pain •Patients with peroneal tendon problemes usually describe pain in the outer part of the ankle or just behind the lateral malleolus. •Problems mainly occus in the area where the tendons of the two muscles glide within a fibrous tunnel . Peroneal inflammation/ tendonitis •Tendons are subject to excessive repetitive forces causing pain and swelling. •Peroneal tendon subluxation •Usually occurs secondary to an ankle sprain with retinaculum injury. •Occurs with dorsiflexion and usually eversion of the ankle. Posterior anle pain Achilles tendonitis •Irritation and inflammation due to overuse. •Pain, swelling and tears within the tendon. •Achilles tendon can become prone to injury or rupture with age, lack of use or by aggressive exercises. •The Thompson test is performed to determine the presence of an Achilles tendon rupture. A positive result for the thompson’s test is determined by no movement of the ankle while squeezing of the calf muscles. Posterior ankle impingment •Os trigonum or large posterior process of talus (stieda syndrome) •Common among athletes such as ballet dancers. •May be seen in association with flexor hallucis longus tenosynovitis. Tarsal tunnel syndrome •Compression or squeezing on the posterior tibial nerve that produces symptoms of pain and numbness on the medial area of the ankle. •When conservative treatment methods fail, surgical treatment or tarsal tunnel release surgery may be needed. Posterior tibial tendon tears are one of the leading causes of failing arches (flatfoot) in adults. •Too many toes sign •Loss of medial arch height •Pain on the medial ankle with weight bearing Arthritis of the ankle joint •Commonly the result of a prior injury or inflammation to the ankle joint. •Can usually be easily diagnosed with an examination and x-ray. Osteochondral lesion of the talus •Arthroscopic debridment may be necessary. Please go to the following link and support the artist Johnny Widmer in his art contest - Sign to Facebook and click LIKE https://www.facebook.com/marlinmag/photos/a.10153261748858040.1073741838.134227843039/10153261754338040/?type=3&theater Thank you! https://www.facebook.com/JohnnyWidmerArt?fref=ts http://www.johnnywidmer.com/
Views: 630676 nabil ebraheim
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Views: 17 How to cure joints.
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Views: 114 How to cure joints.
Enroll in our online course: http://bit.ly/PTMSK This video shows jointplay assessment of the proximal tibiofibular joint. GET OUR ASSESSMENT BOOK ▶︎▶︎ http://bit.ly/GETPT ◀︎◀︎ OUR APP: 📱 iPhone/iPad: https://goo.gl/eUuF7w 🤖 Android: https://goo.gl/3NKzJX 🆕Merchandise: https://teespring.com/stores/physiotutors 🚨 HELP TRANSLATE THIS VIDEO 🚨 If you liked this video, help people in other countries enjoy it too by creating subtitles for it. Spread the love and impact. Here is how to do it: https://youtu.be/_3MMKHqoZrs 👉🏼 SUPPORT THIS CHANNEL 😊 : http://bit.ly/SPPRTPT 👈🏼 📚 ARTICLES: Visit our Website: http://bit.ly/web_PT Like us on Facebook: http://bit.ly/like_PT Follow on Instagram: http://bit.ly/IG_PT Follow on Twitter: http://bit.ly/Tweet_PT Snapchat: http://bit.ly/Snap_PT #physiotutors ------ This is not medical advice! The content is intended to be educational only for health professionals and students. If you are a patient, seek care of a health care professional.
Views: 1721 Physiotutors
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DID YOU KNOW? The Sacroiliac (SI) joint may be a pain generator in 15-30% of patients with chronic lower back pain and even higher (up to 43%) for patients with continued or new onset low back pain after a previous lumbar fusion.* Learn about SI joint diagnosis and treatment options from Dr. Weiss at Specialty Clinics of Georgia. Dr. David Weiss, M.D. http://www.scg-ortho.com *Rashbaum – Clin Spine Surg 2016 This event is co-sponsored by SI-BONE, Inc. Important Safety Information: https://si-bone.com/risks
Views: 182 SI-BONE iFuse
A tibial plateau fracture is a break of the bone at the top part of the tibia (shin bone). That bone makes up the bottom part of the knee. You typically suffer this fracture with a direct blow or impact to your foot that drives the tibial plateau into the rest of your knee, such as a fall. http://challenge.drdavidgeier.com/sf/2632f9c2 When it comes to a knee injury, there is no one-size-fits-all answer. But if you take a moment to tell me about your situation, I can give you the #1 thing you need to do next to overcome your knee injury, designed specifically for YOU (absolutely free). Click the link above! https://drdavidgeier.com/tibial-plateau-fracture-treatment-surgery Click the link above for more information about a tibial plateau fracture and other resources for your sports or exercise injury. Get The Serious Injury Checklist FREE! How can you know if your injury should get better in a few days or if it's more serious? This checklist can help you plan your next step to recover quickly and safely. http://www.sportsmedicinesimplified.com Please note: I don't respond to questions and requests for specific medical advice left in the comments to my videos. I receive too many to keep up (several hundred per week), and legally I can't offer specific medical advice to people who aren't my patients (see below). If you want to ask a question about a specific injury you have, leave it in the comments below, and I might answer it in an upcoming Ask Dr. Geier video. If you need more detailed information on your injury, go to my Resources page: https://www.drdavidgeier.com/resources/ The content of this YouTube Channel, https://www.youtube.com/user/drdavidgeier (“Channel”) is for INFORMATIONAL PURPOSES ONLY. The Channel may offer health, fitness, nutritional and other such information, but such information is intended for educational and informational purposes only. This content should not be used to self-diagnose or self-treat any health, medical, or physical condition. The content does not and is not intended to convey medical advice and does not constitute the practice of medicine. YOU SHOULD NOT RELY ON THIS INFORMATION AS A SUBSTITUTE FOR, NOR DOES IT REPLACE, PROFESSIONAL MEDICAL ADVICE, DIAGNOSIS, OR TREATMENT. You should consult with your healthcare professional before doing anything contained on this Channel. You agree that Dr. Geier is not responsible for any actions or inaction on your part based on the information that is presented on the Channel. Dr. David Geier Enterprises, LLC makes no representations about the accuracy or suitability of the content. USE OF THE CONTENT IS AT YOUR OWN RISK. TREATMENT OPTIONS AND SURGERY FOR A TIBIAL PLATEAU FRACTURE Occasionally, a tibial plateau fracture that is nondisplaced, and lines up perfectly, can heal without surgery. If it is out of place even a few millimeters, the surgeon will likely choose to fix it surgically. Most of the time, the surgeon opens the knee to put the fracture pieces back into good position. He then holds the fracture with screws or a plate and screws. REHAB AND RECOVERY FOR A TIBIAL PLATEAU FRACTURE Initially the surgeon might keep you from putting weight on your leg, so you might walk in a brace and with crutches. Then as the fracture heals, you add more weight and work on knee motion and strength. Working with a physical therapist can be helpful. As the fracture finishes healing, you should be able to start walking and jogging before progress back to exercise and sports. The entire process can take 4 to 6 months or more.
Views: 4002 Dr. David Geier
Ann Hoke, senior faculty member and senior examiner of NAIOMT, is shown here demonstrating a very thorough assessment and treatment of the superior tib-fib joint complex. This demonstration is part of a series of lectures and demonstrations aimed at the Level II NAIOMT curriculum. Full details can be found at www.naiomt.com
Views: 12191 NAIOMT1
Dr. Ebraheim’s educational animated video describes the anatomy of the ankle ligaments. The ankle joint is made of three bones, the tibia, the fibula and the talus. The tibia is the major bone of the lower leg which bears the majority of the body weight. At the angle, the bump of the tibia forms the medial malleolus. The fibula is the smaller of the two bone of the leg. The lateral end of the fibula forms the lateral malleolus. In the ankle joint the talus articulates with the tibia. The talus is involved in multiple movements of the foot. There are ligaments in the ankle that provide connections between the bones. Injury to any of these ligaments may occur when the foot twists, rolls or turns beyond its normal motion. An ankle sprain is a common injury that occurs in sports as basketball and soccer. The deltoid ligament is on the medial side. It is formed of four parts: anterior tibiotalar part, tibionavicular part, tibiocalcaneal part and the posterior tibiotalar. The superficial deltoid arises from the anterior colliculus. The deep deltoid arises form the posterior colliculus and the intercollicular groove. The deltoid ligament is the main stabilizer of the ankle joint during the stance phase. The deltoid ligament is rarely injured by itself and it is usually associated with fractures. There are 3 lateral ligaments of the ankle joint: The anterior talofibular ligament (weakest): origin: 10 mm proximal to the tip of the fibula. Extends from the anterior inferior border of the fibula to the neck of the talus. The posterior talofibular ligament ( strongest): origin from the posterior border of the fibula. Inserts into posterolateral tubercle of the talus Calcaneofibular ligament: origin anterior border of the fibula 1 cm proximal to the distal tip. Inserts into the calcaneus distal to the subtalar joint and deep to the peroneal tendon sheath. The lateral ligaments are the most commonly injured ligaments in the ankle. The ligament of the syndesmosis •Anterior inferior tibiofibular ligament •Interosseous ligament •Posterior inferior tibiofibular ligament The connection of the tibia and fibula is called the syndesmosis. High ankle sprain = syndesmosis injury 5-10%. Injury of the ligaments above the ankle. Become a friend on facebook: http://www.facebook.com/drebraheim Follow me on twitter: https://twitter.com/#!/DrEbraheim_UTMC
Views: 72119 nabil ebraheim
Dr. Ebraheim’s educational animated video describing fractures of the ankle fractures - syndesmotic injury. how do we know if we have a syndesmotic injury? By getting the intra-operative stress exam, external rotation of the talus within the ankle mortise, this test determine if syndesmotic instability is present, you will do that test after fixation of the other fractures. The abduction external rotation of the talus will try to displace fibula from the incisura fibularis, the talus will move laterally and displaces the fibula. The ankle will show a valgus talar tilt or increase in the medial clear space. Before you do syndesmotic reduction and fixation, it is important to restore the length and rotation of the fibula. When instability is present, you have to do syndesmotic screw fixation. How do you know if there is instability? Always have a high index of suspicion. Syndesmotic fixation is more required when the fibular fracture is high and there is a deltoid ligament injury. Be skeptical about some of the statements such as fixation is not typically required when the fibular fracture is within 4.5 cm from the joint because that is not true. Just remember: Weber C is commonly associated with syndesmotic injury. So we get the stress views and look at certain measurements to determine if the syndesmosis is injured or not. At 1 cm above the joint we will measure the tibulofibular overlap which will be decreased if there is a syndesmotic injury. We also measure the tibiofibular clear space which will be more than 5 mm if there is a syndesmotic injury. Then we look at the medial clear space which will be increased, normally it should be less than 4 mm. Some people believe that the instability of the ankle appears more in the AP plain. The medial clear space can be increased preoperatively due to injury to the deltoid ligament. This is used to differentiate between supination – external rotation stage II and stage IV injuries. The medial clear space can be helpful intraoperatively after fixation of the fibula to diagnose syndesmotic injury on stress view radiographs. Syndesmosis fixation techniques: - You must restore the length and rotation of the fibula, which is not good enough by itself. - An Accurate reduction of the syndesmosis is required and direct inspection of the syndesmotic reduction is helpful, and this should be supported by x-rays. - Check for widening. - Check for the chenton’s line, dime sign, and that will be done after reduction and after using the reduction clamp. - This is the time to get an AP view and lateral view radiographs, and you assess before you place your screws. Try to use multiple techniques to check on the syndesmosis injury, one of them is the external rotation view the intraoperative one. The other one is the cotton test, get a hook and pull on the fibula and see the movement. The third one is direct inspection of the syndesmosis, make sure the crural fascia may be intact and covering a major syndesmotic injury. After that we go to the technique: 1- You dorsiflex the ankle. 2- Directly inspect and reduce the fibula. 3- Use reduction clamp. 4- Get x-rays to prove that the syndesmosis is reduced and then you put the screws, about 2-4 cm above the joint, with an angle of 20° to 30° posteriorly to anteriorly. Do not use lag screws and do not over compress the syndesmosis with the position of the talus in planter flexion, although a lot of people think it is not possible. Screws are really controversial ad no consensus about them. But there are a few important points about the screws: 1- The 4.5 mm are not used a lot nowadays. 2- When the widening is bad you are going to use more screws and more cortices, the more the better. 3- When you put the screws proximally and you don’t aim anteriorly you may miss the tibia. 4- Make sure when you go from cortex 1 to 2 and 3 in the tibia that you don’t miss cortex number 3 in the tibia. 5- Try to elevate the ankle a little bit so your hand will be allowed to do some anterior direction of the screws, so the screws will be angled a little bit. 6- Occasionally I cross the screws, so will be one direct straight forward and the other one will be oblique. 7- Screw removal: it’s controversial but you will not remove the screws before 3 months. What are the problems with the syndesmosis? • Missing the injury: Reading the x-ray, I use the 5 mm for reading the x-rays, whatever it is in the medial clear space or tibiofibular clear space as my mark, 5 mm is abnormal. • Malreduction of the syndesmosis: I want to make sure the fibula is anatomically reduced to the incisura before inserting the syndesmotic screws; I want to make sure and get an x-ray to check the talus both in the AP and lateral planes. Dr. Ebraheim is an orthopedic surgeon at the University of Toledo Medical Center.
Views: 26303 nabil ebraheim
http://drrobertlaprademd.com 1 (970) 479-5881 Dr. Robert LaPrade, an Orthopedic Surgeon at the Steadman Clinic in Vail, CO (Greater Denver) demonstrates a procedure that assesses the extent of a Tibiofibular Ligament Injury in the Clinical Knee Exam. Pain along the medial or lateral joint lines may be indicative of a joint capsule tear, joint capsule irritation, meniscus tear, among other possibilities. When applying a varus or valgus stress across the joint, one should place their fingers directly over the joint line to assess for joint line pain. It is important to discern from the patient if the pain is coming from directly below one's fingers of if it feels like it is deeper inside the joint to determine if it is a joint capsule injury, or if it is a meniscus or cartilage injury. Were you looking for Valgus Stress Test? http://youtu.be/a2YqD2MdGJc Valgus Stress Test for the MCL: http://youtu.be/xlD0tawW_uE Range of Motion after Knee Injury: http://youtu.be/FvQ9jn8NDek For additional information: http://drrobertlaprademd.com/clinical-exam http://thesteadmanclinic.com http://sprivail.org
Views: 4954 Robert LaPrade
Lateral ankle sprains can be very painful and cause your ankle to become unstable. These stretches and exercises should help the healing process. See Doctor Jo’s blog post about this at: http://www.askdoctorjo.com/lateral-sprained-ankle The first stretch will be a calf stretch. Start off with your legs out in front of you. You can bend up the leg you aren’t using towards you in a comfortable position. Keep the leg you want to stretch out in front of you. Take a stretch strap, dog leash, belt, or towel and wrap it around the ball of your foot. Relax your foot, and pull the strap towards you stretching your calf muscle. You should feel the stretch under your leg. Hold the stretch for 30 seconds, and do three of them. Now prop your ankle up on a roll or hang your foot off the bed or table so your heel doesn't touch the floor. Put the band around the ball of your foot for good resistance. First, push your foot down and up. This is called ankle plantarflexion. Next you are going to cross your foot over the foot with the band as seen in the video, and pull your foot inward. This is ankle inversion. Now you want to wrap the band around your other foot. This time you will have resistance pulling out. This is ankle eversion. The next exercise will be standing up. You want to lean against a wall or something sturdy. Place the foot you want to stretch behind you. Make sure to keep your heel down and your toes forward pointing towards the wall. With the other foot in front of you, like you are in a lunge position, bend your knee towards the wall until you feel a stretch through your back leg. Try to keep your back leg as straight as possible. Hold the stretch for 30 seconds, and do it three times. Now is a heel raise off the ground. Stand with your feet about shoulder width apart, come up on your toes as high as you can. Try not to lean forward, but bring your body straight up and slowly come back down. Push off as much as you can so your heel leaves the ground. Start off with ten and work your way up to 20-25. The last exercise will be a balance series. Stand on one foot, but hold onto something sturdy. Try to balance for 30 seconds to a minute. When that becomes easy, just use one finger one each side. Then just one finger for balance, and finally try balancing without holding on at all. Related Videos: Sprained Ankle Treatment with Ankle/Foot AROM: https://youtu.be/UYM-_k_dWZw?list=PLPS8D21t0eO9JGYS958XUh2mkV8Sa2sAq Sprained Ankle - How to Wrap an Ankle Sprain: https://youtu.be/BPbUH4rdKPo?list=PLPS8D21t0eO9JGYS958XUh2mkV8Sa2sAq =========================================== SUBSCRIBE for More Videos: http://www.youtube.com/subscription_center?add_user=askdoctorjo ======================================= Doctor Jo is a Doctor of Physical Therapy. http://www.AskDoctorJo.com http://www.facebook.com/AskDoctorJo http://www.pinterest.com/AskDoctorJo https://www.instagram.com/AskDoctorJo http://www.twitter.com/AskDoctorJo http://plus.google.com/+AskDoctorJo ======================================= Lateral Sprained Ankle Stretches & Exercises: https://www.youtube.com/watch?v=3JJayVC0-20 DISCLAIMER: This content (the video, description, links, and comments) is not medical advice or a treatment plan and is intended for general education and demonstration purposes only. This content should not be used to self-diagnose or self-treat any health, medical, or physical condition. Don’t use this content to avoid going to your own healthcare professional or to replace the advice they give you. Consult with your healthcare professional before doing anything contained in this content. You agree to indemnify and hold harmless Ask Doctor Jo, LLC and its officers for any and all losses, injuries, or damages resulting from any and all claims that arise from your use or misuse of this content. Ask Doctor Jo, LLC makes no representations about the accuracy or suitability of this content. Use of this content is at your sole risk.
Views: 112649 AskDoctorJo
see my website: www.fibularpain.com for blog on Chronic Proximal Tibiofibular Posterior/Inferior Subluxation palpation by Dr. Scott Sheldon - Dwyer Chiropractic, Clarkston, WA describing pain symptoms, As an out of state patient, I made this video on 4/26/13 originally for Dr. D. Christopher Main, DO at Midwest Bone & Joint Center, Macon, MO a board certified Orthopedic Surgeon who then did an Arthrex TightRope Stabilization Surgery 5-14-13
Views: 7814 AHEHealth
Dr. Ebraheim’s educational animated video describes the ligaments of the Ankle. An ankle sprain is usually low ankle sprain, but occasionally high ankle sprain. Other conditions associated: •Osteochondral lesion •Peroneal tendon subluxation •Lateral process fracture of the talus •Anterior process fracture of the calcaneus •High syndesmotic injury Tests for injury of these ligaments: •Anterior drawer test •Squeeze test •External rotation stress test •Talar tilt test (inversion test). If the patient can’t bear weight on the ankle, the patient should get an x-ray. Injury to the deltoid ligament occurs on the medial side of the ankle joint and usually associated with fracture. Injury to the lateral side ligament is referred to as ankle sprain. The anterior tibiofibular ligament is the west on the lateral side. Anterior drawer test: is done to test the competency of the anterior tibiofibular ligament. The test is done in 20 degrees of plantar flexion and compares it to the other side. A shift of an absolute value of 9 mm on the lateral x-ray or 5mm compared to the other side is positive. The calcaneofibular ligament is usually injured after the anterior talofibular ligament. talar tilt test: less than 5 degrees of tilt is usually normal. A high ankle sprain may require surgery. Always track the fibula proximally to avoid missing a Maisonneuve fracture. Squeeze test is used to diagnose high ankle sprain. By squeezing the tibia and fibula at the mid-calf this causes pain at the syndesmosis if high ankle sprain is present. External rotation stress test: place the ankle in a neutral position, then apply external rotation stress and get a mortise view radiograph. The positive result if the tibiofibular clear space is more than 5 mm. there is also a positive result if the medial clear space is more than 4 mm. Become a friend on facebook: http://www.facebook.com/drebraheim Follow me on twitter: https://twitter.com/#!/DrEbraheim_UTMC
Views: 101744 nabil ebraheim
For more episodes and additional information about this post visit www.thewoddoc.com www.thewoddoc.com Subscribe Now.... New Episodes Daily Check WODdoc out on Facebook, Instagram, Twitter, & SnapChat: https://www.facebook.com/thewoddoc
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Biomechanic Reference: http://astore.amazon.com/nichogiovi-20 Popular Running Shoes: http://astore.amazon.com/nichogiovi-20?_encoding=UTF8&node=2 Dr. Glass DPM Podiatry Resource Network [email protected] www.drglass.org This video illustration depicts the ankle joint complex which includes the tibial talar and subtalar joint in human anatomy. Dr. Glass DPM - This is an illustration that depicts the cardinal plane movements of the lower extremity. This is a biomechanical demonstration of the functional orthopedic nature of podiatry
Views: 678103 DrGlassDPM
Dynamic sagittal 12-5 MHz US demonstrates concomitant tibiotalar joint effusion and a partial tear of the talonavicular ligament following ankle sprain. Tib= tibia. Tal= talus. Asterisk= tibiotalar joint effusion. Injuries to the dorsal talonavicular ligament are rare and occur following forced plantar flexion of the foot. They are typically depicted by target evaluation because of point tenderness over the talonavicular joint. In the acute setting, tibiotalar joint effusion is a common associated finding.
Views: 485 ShoulderUS.com
An AC Joint Sprain or Separation is often the result of falling with an outstretched arm. Movement of the joint will help increase the healing and decrease scarring. See Doctor Jo’s blog post about this at: http://www.askdoctorjo.com/ac-joint-sprain The AC (acromioclavicular) joint is where the acromion and the clavicle come together. The first stretches are called pendulums. Use a chair or counter top for balance, and lean over so your arm hangs down towards the ground. Move your body, not your arm in circles so your arm swings around like a pendulum. You can also rock front to back and side to side. Start off with 10 of each and work your way up to a minute of each. The next stretches you can use a Swiss/therapy ball, or if you don’t have one, you can use a table or counter top. This is an active assisted stretch, which means you are moving the arm now, but the ball will support the weight. You will slide your arm forward with your thumb facing upward towards the ceiling and lean your body forward until you feel a stretch. You can stabilize the ball with your other hand. Hold it for 3-5 seconds, and start off with 10-15. Next you will do isometric exercises for internal and external rotation of your shoulder. Isometrics are when you are activating the muscles, but not actually making the movement. You can use your other hand to push into, or you can do these exercises against a wall. You want to keep your elbow by your side. Bend your elbow with your fist out in front of you. Push your fist into your other hand gently towards your stomach and hold for 3-5 seconds. Then put your other hand on the outside of your fist, and push out gently for 3-5 seconds. You don’t have to push hard. You just want to feel a little pressure in your shoulder area. Do each of these 10-15 times. For the last exercise, you will do a shoulder external rotation with a resistive band. Try to keep your elbows by your sides through out the exercise. If you want to roll up a small towel and place it between your side and your elbow for each side, this will keep your arms close to your side through out the exercise. Keep your elbows at about a 90 degree angle and your thumbs up towards the ceiling. Also try to keep your wrists in a neutral position. You don’t want to over stress your wrists, and then have a wrist injury. Slowly pull both arms out away from each other keeping your elbows at your side, and then slowly come back in. Start off with 10 of these, and then work your way up to 20-25. If that becomes easy, then move up with resistive bands. Related Videos: Shoulder Pain Treatment & Rehab Stretches: https://youtu.be/DJvQ3ZGWUfQ?list=PLPS8D21t0eO_Ny9ors3aP4K1P_91a2-yw Shoulder Pain Top 3 Exercises: https://youtu.be/vbUm5rsPt5Y?list=PLPS8D21t0eO_Ny9ors3aP4K1P_91a2-yw =========================================== SUBSCRIBE for More Videos: http://www.youtube.com/subscription_center?add_user=askdoctorjo ======================================= Doctor Jo is a Doctor of Physical Therapy. http://www.AskDoctorJo.com http://www.facebook.com/AskDoctorJo http://www.pinterest.com/AskDoctorJo https://www.instagram.com/AskDoctorJo http://www.twitter.com/AskDoctorJo http://plus.google.com/+AskDoctorJo ======================================= AC Joint Sprain Stretches & Exercises: https://www.youtube.com/watch?v=hc4QDSqpw-k DISCLAIMER: This content (the video, description, links, and comments) is not medical advice or a treatment plan and is intended for general education and demonstration purposes only. This content should not be used to self-diagnose or self-treat any health, medical, or physical condition. Don’t use this content to avoid going to your own healthcare professional or to replace the advice they give you. Consult with your healthcare professional before doing anything contained in this content. You agree to indemnify and hold harmless Ask Doctor Jo, LLC and its officers for any and all losses, injuries, or damages resulting from any and all claims that arise from your use or misuse of this content. Ask Doctor Jo, LLC makes no representations about the accuracy or suitability of this content. Use of this content is at your sole risk.
Views: 74994 AskDoctorJo
Dr. Ebraheims animated educational video describing the condition of chronic lateral ankle instability Ankle sprain is a common injury that occurs with sports activities and the lateral ligaments are the most commonly injured ligaments in the ankle. Three ligaments on the ankle joint on the lateral side: 1- Anterior talofibular ligament: is the weakest ligament of all three of them, the integrity of this ligament is tested by preforming the anterior drawer test. 2- The posterior talofibular ligament: is the strongest of the three ligaments. 3- Calcaneofibular ligament: injury to this ligament usually occurs after injury to the anterior talofibular ligament, the integrity of this ligament is tested by preforming the talar tilt test. If the patient cannot bear weight after what is suspected ankle sprain, then you need to get an x-ray to check if the patient has a fracture. Acute ankle sprains are usually treated by: • Immobilization • Ice • Physical therapy • Surgery (rare) Sometimes these ligaments do not heal and become incompetent. Incompetence of these ligaments may create chronic lateral ankle instability. You may want to examine the hindfoot for varus malalignment. Occult varus may lead to treatment failure. Check for peroneal muscles and tendon weakness which is a frequent cause of lateral ankle instability. If you find that there is hindfoot varus, you may need to do the coleman block test to differentiate between fixed and flexible hindfoot varus. The treatment will be different. Treatment: The majority of ankle sprains will heal with time and are treated with: • Rest • Physical therapy - Peroneal muscle strengthening with proprioception and range of motion of the ankle. In some cases the patient may not get better and may have: • Mechanical instability or functional instability • Patient may not improve with conservative treatment - Patient may require surgery What type of surgery may be necessary? • Anatomic repair (Brostrom procedure). Direst repair of the attenuated ligament. OR • Anatomis repair (Modified Brostrom procedure). • Direct ligament repair with augmentation using the inferior extensor retinaculum. • A graft can be used if the Brostrom technique fails. For chronic lateral ankle instability, we also need to look for other conditions such as peroneal tendon pathology, fractures, joint lesions, or arthritis. There are a lot of differential diagnosis for this area that can create ankle instability. These are some of the other causes that can create the same symptoms of pain and instability of the lateral ankle. When pain is located posterior to the fibula, you can blame this on peroneal tendon pathology. The peroneal tendons are subjected to excessive repetitive forces causing pain, swelling, and instability of the lateral ankle. Treated by injection or possibly surgery (synovectomy). The superior peroneal retinaculum is usually holding two peroneal tendons behind the fibula. The inferior peroneal retinaculum is not as important as the superior peroneal retinaculum. Superior peroneal retinaculum tear: - Tear may lead to subluxation of the peroneal tendons. - Do physical therapy or reconstruction of the superior peroneal retinaculum. Peroneal tendon subluxation occurs with dorsiflexion and inversion; however it is tested with dorsiflexion and eversion against resistance. Peroneus longus or brevis tendon rupture or tear: - Tear of the peroneus longus tendon may occur at the peroneal tubercle with the Os Peroneum migrationg proximally. - Tears of the peroneus brevis may occur with peroneal tendon subluxation. - In these cases you will do repair or tenodesis of the torn tendon. Lesions inside the joint: - Osteochondral lesion of the talus (OCD): they are 2 types: • Posteromedial • Anterolateral Treatment: • NSAIDS • Physical therapy • Surgical treatment: ankle arthroscopy. - If the OCD lesion is less than 1 cm then you will do excision, curettage, or drilling of the lesion. - Anterolateral Impingement: painful limitation of full range of ankle motion due to asseous (bony) or soft tissue pathology. - Treatment: • physical Therapy • injection • arthroscopic debridement of the impingment - ankle synovitis: you do synovectomy. - Ankle arthritis: ankle arthritis of the ankle joint usually results from prior injury or inflammation to the ankle joint. - It can be diagnosed by an exam or by an x-ray. - We start with conservative treatment, brace, injection, if nothing works do arthrodesis or total ankle surgery if conservative treatment fails. - If there is loose bodies inside the ankle, remove it. - There may be some fractures that cause instability of the ankle, like lateral process fracture of the talus, anterior process fracture of the calcaneus. - Jones fracture or Pseudo- Jones fracture. - The treatment is specific for the type of fracture. - This needs to be diagnosed and treated accordingly. - Osteal coalition: may cause frequent ankle instability.
Views: 80144 nabil ebraheim
Dr. Ebraheim animated educational video describing the common tests used to diagnose injuries of the foot and ankle.ankle examination for ankle sprain ,ankle fracture and ankle injury.ankle examination orthopedic is explained and the ankle tests are shown.thompson test ,squeeze test and stress test of the ankle is shown .sprain ankle ,Achilles tendon rupture and fracture ankle are common .ligament ankle injury should be diagnosed .ankle pain from running ,ankle pain and swelling .diagnosis of ankle pain .ankle pain tests ankle pain examination . Ankle pain exercises and ankle pain treatment .ankle anatomy and Peroneal tendon subluxation, ankle instability .ankle fractures and ankle stress fractures. • The Anterior Drawer Test: This test is used to test the integrity of the anterior talofibular ligament, which is the weakest and the most commonly injured ligament in ankle sprains (lateral collateral ligament). • The Talar Tilt Test: Is used to test the calcaneofibular ligament, and is probably testing the anterior talofibular ligament and the calcaneofibular ligament. • The Squeeze Test: - High ankle sprain - At the calcaneus to check for stress fracture of the calcaneus. - At the metatarsals: to check for morton’s neuroma. In addition to the squeeze test, you can use the external rotation test or the gravity test to check for syndesmotic injury. • Thompson Test: will test tear of the Achilles tendon. • The best test of all is the ability to bear weight, if you cannot bear weight, then there probably is an ankle fracture. Become a friend on facebook: http://www.facebook.com/drebraheim Follow me on twitter: https://twitter.com/#!/DrEbraheim_UTMC Donate to the University of Toledo Foundation Department of Orthopaedic Surgery Endowed Chair Fund: https://www.utfoundation.org/foundation/home/Give_Online.aspx?sig=29
Views: 13413 nabil ebraheim
Dr. Ebraheim’s educational animated video describes the ligaments of the ankle - injury and tests. Follow me on twitter: https://twitter.com/#!/DrEbraheim_UTMC
Views: 5064 nabil ebraheim
http://www.bestchiropractortampa.com, SF Chiropractic and Rehab center, (813) 350-9100 What is joint vertebral subluxation, joint misalignment, vertebral dislocation, partial or complete joint dislocation, or dysfunctional biomechanical spinal segment? Can back injury, auto accident injury or joint injury cause joint misalignment, joint dislocation or vertebral subluxation? How to relieve vertebral subluxation, joint misalignment, vertebral dislocation, partial or complete joint dislocation, or dysfunctional biomechanical spinal segment? How best chiropractor helps vertebral subluxation, joint misalignment, vertebral dislocation, partial or complete joint dislocation, and dysfunctional biomechanical spinal segment. How to treat vertebral subluxation, joint misalignment, vertebral dislocation, partial or complete joint dislocation, or dysfunctional biomechanical spinal segment Will epidural steroids work for vertebral subluxation, joint misalignment, vertebral dislocation, partial or complete joint dislocation, or dysfunctional biomechanical spinal segment? Can vertebral subluxation, joint misalignment, vertebral dislocation, partial or complete joint dislocation, or dysfunctional biomechanical spinal segment cause muscle weakness? Can exercise help vertebral subluxation, joint misalignment, vertebral dislocation, partial or complete joint dislocation, dysfunctional biomechanical spinal segment How long does vertebral subluxation, joint misalignment, vertebral dislocation, partial or complete joint dislocation, dysfunctional biomechanical spinal segment last? How to heal vertebral subluxation, joint misalignment, vertebral dislocation, partial or complete joint dislocation, dysfunctional biomechanical spinal segment? Why is vertebral subluxation, joint misalignment, vertebral dislocation, partial or complete joint dislocation, dysfunctional biomechanical spinal segment worse in the morning? Will exercise relieve treat vertebral subluxation, joint misalignment, vertebral dislocation, partial or complete joint dislocation, dysfunctional biomechanical spinal segment? Can vertebral subluxation, joint misalignment, vertebral dislocation, partial or complete joint dislocation, dysfunctional biomechanical spinal segment be caused by auto accident injury? Can vertebral subluxation, joint misalignment, vertebral dislocation, partial or complete joint dislocation, or dysfunctional biomechanical spinal segment cause numbness and pain in the feet or hands? SF Chiropractic and Rehab Center, provides care and treatment for your ankle pain/arthritis, ankle sprain and strain, foot pain, toe pain, knee pain or arthritis, hip pain/arthritis, car accident injury, sports injury, whiplash injury, headaches, neck pain, low back pain, neck sprain and strain, back sprain and strain, shoulder sprain and strain. You might have injury, damage, contusion or traumatic loss to the bones, joints, muscles, ligaments and tendons of the neck and back. Auto accident injuries include cervical, thoracic, and lumbar or joints sprains and strains, bulging disks, herniated disks, fractured vertebrae, muscle spasm, headaches, dizziness, traumatic brain damage, shoulder pain, wrist pain, ankle pain, body pain, swelling, bruising and functional loss. Common symptoms with traumatic brain injuries are dizziness and giddiness due to vestibular dysfunction, impaired balance or unsteadiness during walking, dizziness, vertigo, and blurred vision due to damage to the peripheral vestibular system or head concussion, post-traumatic headache associated with cervical muscle tenderness and postural abnormalities, temporomandibular joints (TMJ) dysfunction with ear pain, stuffiness, tinnitus, dizziness, neck and shoulder pain and headache, and unsteady or slow walking and attention deficit, etc. If you injured in car accidents, you will have only 14 days to seek initial treatment. If treatment is sought after two weeks, nothing will be reimbursed by the insurance company. Please contact us for best results from your injuries in car accident. Best Chiropractic Treatment in Tampa, FL Armenia Ave and Martin Luther King Blvd. 4602 N Armenia Ave, suite D-3, Tampa, FL 33603 Tel: (813) 350-9100 http://www.aahachiro.com http://www.bestchiropractortampa.com
Views: 1710 Dr. Kim and Associates
https://www.p2sportscare.com/ankle-pain-runners/ Huntington Beach CA 714-502-4243 to learn prevention methods. We specialize in sports injuries and getting athletes back to their sports fast (running injuries, shoulder tendonitis, IT Band, Runners Knee, Hip Flexor tightness). We see athletes anywhere from baseball, triathletes, golfers, basketball, cyclist, runners and so on. We provide Active Release Techniques (ART), chiropractic care, strength training and corrective exercises. The Performance Place Sports Care is located in Huntington Beach, CA. 714-502-4243 Ankle impingement by an osseous growth, spur, can be the main source of pain with many biomechanical and functional movements. Anatomically the ankle is composed of three joints: talocrural joint, subtalar joint, and inferior tibiofibular joint. The ankle joint is special in that all surfaces of the joint are covered in articular cartilage, which can be a mechanical disadvantage if injured. Cartilage as a whole does not have neural or vascular supply, therefore any injury to the cartilage will not be able to heal properly. If enough cartilage damage is done to the level of the subchondral bone, an area of vascularity, it is possible that some of the articular cartilage may be healed with fibrocartilage. Although fibrocartilage indicates healing in the ankle joint, it has decreased biomechanical benefits and can lead to impingement. Typically articular cartialge will not induce pain, due to the lack of neural input. However, if pain is felt after the ankle swelling has reduced, it is likely the pain is referred from another source such as an osseous spur. The ankle joint is surrounded by many ligaments that hold all of the boney attachments together. Functionally speaking, the ankle is a joint of mobility and is the key player in determining the functionality for all the other major joints of the body. Athletes who have difficulty moving their ankle through ranges of motion or have pain upon movement can possibly have a restricted ankle joint, but the main cause is due to poor biomechanics from a previous overuse injury and fatiguing of the soft tissue. Among the ligaments found in the ankle, the strongest ligament of the ankle joint is the deltoid ligament, found on the inside. The other three ligaments, anterior and posterior talofibular ligaments, and calcaneofibular ligaments are found laterally and the area of insult with a classic inversion ankle sprain. Once the ankle is malpositioned, the ligaments become lax and unstable in efforts of preventing dysfunctional movement. Ankle sprains are usually caused by intense, repetitive movements applying too much pressure to the muscles and joints. The ankle is found to be most stable in the closed pack position, dorsiflexion, and most injuries are attained with plantar flexion. Running, ice skating, plyometric exercise are all activities with repetitive ankle motion and can lead to injury. When observing the ankle for motion, the patient may experience pain through the ranges of motion, which is a good indicator of an impingement and there is some sort of restriction in the soft tissue or in the joint. To fully diagnose a healed ankle with dyskinesis or pain imaging should also be considered in diagnosis to rule out any osseous fracture, joint degeneration, impingement from an osseous structure, or arthritis in the joint. The best source of imaging for the ankle joint is an arthroscopy. If a sprain is concluded another source of imaging would be a musculoskeletal ultrasound to further evaluate the scar tissue in the soft tissue preventing full range of motion in addition to pain upon exertion. Possible treatments for ankle impingement: - Active Release Technique - Graston - Eccentric rehabilitative exercises - Stretching - RICE (rest, ice, compress, elevate) - Surgery based on the severity of the tear to reattach the muscle tendon - Steroid injections - Non-Steroidal Anti-Inflammatory medications ankle impingement, impingement of ankle, impingement syndrome, ankle pain, pinch in ankle, ankle sprain, sprained ankle, rolled ankle, ankle therapy, ankle treatment, ankle physiotherapy, physiotherapy, chiropractic, sports chiropractor, huntington beach chiropractor, physiotherapist, peroneal tendonitis, atfl, ligament tear, tibialis positerior, tibialis anterior
Views: 39720 Sebastian Gonzales
Dr. Ebraheim’s educational animated video describes injection techniques for painful conditions of the foot and ankle. Conditions which cause pain and inflammation are treatable with the use of diagnostic and therapeutic injection. Ankle joint The ankle joint is formed by the articulation of the tibia and talus. Injection is done to alleviate pain occurring from trauma, arthritis, gout or other inflammatory conditions. Anterolateral ankle impingement •Can occur due to the build-up of scar tissue in the ankle joint or from the presence of bony spurs. •With the ankle in a neutral position, mark the injection site just above the talus and medial to the tibialis anterior tendon. •The injection site is disinfected with betadine. •The needle is inserted into the identified site and directed posterolaterally. •Injection of the solution into the joint space should flow smoothly without resistance. •Pulling on the foot to distract the ankle joint is helpful. First metatarsophalangeal joint •The MTP joint is a common injection site frequently affected by gout and osteoarthritis. •The injection site is disinfected with betadine. •The needle is inserted on the dorsomedial or dorsolateral surface. •The needle is angled to 60-70 degrees to the plane of the match the slope of the joint. •Injection of the solution into the joint space should flow smoothly without resistance. •Pulling on the big toe is sometimes helpful in distraction of the joint. Peroneal tendonitis •Peroneal tendonitis is an irritation to the tendons that run on the outside area of the ankle, the peroneus longus and peroneus brevis. •The injection site is disinfected with betadine. •Insert the needle carefully in a proximal direction when injecting the peroneus brevis and longus tendon sheath. •Advance the needle distally to inject the peroneus brevis alone at its bony insertion. Achilles tendonitis •Achilles tendonitis is irritation and inflammation of the large tendon in the back of the ankle. Achilles tendonitis is a common overuse injury that occurs in athletes. •Injection of steroid should be given around the tendon, not through the tendon. •Injections directly into the tendon is not recommended due to increased risk of tendon rupture. •Platelets injection can be done through the tendon with needling and fenestration. Tarsal tunnel syndrome •The condition of pain and paresthesia caused by irritation to the posterior tibial nerve. •Feel the pulse of the posterior tibial artery, the nerve is posterior, find the area of maximum tenderness, 1-2 cm above it will be the injection site that is marked on the medial side of the foot and disinfected with betadine. •The solution is injected at an angle of 30 degrees and directed distally. •Warn the patient that the foot may become numb. •Care should be taken In walking an driving. •Usually performed after a treatment program which can include rest, stretching and the use of shoe inserts. Plantar fasciitis •The plantar fascia is a band of connective tissue deep to the fat pad on the plantar aspect of the foot. •Patients with plantar fascia complain of chronic pain symptoms that are often worse in the morning with walking. •The injection site is identified and marked on the medial side of the foot and betadine used. •Avoid injecting through the fat pad at the bottom of the foot to avoid fat atrophy. •The needle is inserted in a medial to lateral direction one finger breathe above the sole of the foot in a line that corresponds to the posterior aspect of the tibia. •The solution is injected past the midline of the width of the foot.
Views: 120211 nabil ebraheim
Surgery to fuse (perform an arthrodesis) an ankle in a patient with posttraumatic arthritis of the left ankle joint.
Views: 31819 Gene Curry
Dr.Mohamed Wahdan Lectures http://docdro.id/9wq1cgz
Views: 495 Dr.Wahdan Lectures
Jerry demonstrates treatment for knee pain that is actually related to the joint located below the knee. At one end of the fibula is the ankle joint, and the top end is just below the knee joint but is not part of the knee joint. On rare occasions, dysfunction in this joint is misdiagnosed and mis-treated as "knee joint injury". Dr. Jerry Hesch, MHS, PT, DPT lives in Aurora Colorado and additional information can be found at www.HeschInstitute.com
Views: 63987 Jerry Hesch
Views: 127 How to cure joints.
Dr. Ebraheim’s educational animated video describes about fractures of the ankle X - rays, ankle fracture classification,ankle fracture dislocation, it also describes ankle fracture treatment and ankle fracture surgery and ankle fracture recovery. The Mortise view is about 15° of internal rotation. The medial clear space should be 4-5 mm or less, and it should be equal to the superior clear space which is between the talus and the distal tibia on the mortise view. If the medial clear space appears widened before surgery, then there is a deltoid injury. If the medial clear space does not appear widened, then make sure that you do not have a supination- external rotation type 4 injury. You may need to do stress view x-rays before surgery in order to prove that the deltoid ligament is or is not injured. The tiblofibular clear space should be less than 6 mm on the mortise view and it is the distance between the medial border of the fibula and the tibial Incisura notch. If the tiblofibular clear space is widened and the ankle mortise is unstable, this allows the talus to shift because the syndesmosis is unstable. 1 mm of talar shift will give a 42% decrease in tibiotalar contact area. This will cause future, accelerated arthritis. The tiblofibular overlap is about 10 mm in the AP view and you measure that from the medial border of the fibula. In the mortise view, the tibiofibular overlap should be more than 1 mm. Talo-Crural Angle I don’t use this and find not much value in this measurement except on exam questions! The lateral malleolus is longer than the medial malleolus, if the fibula is short, I can rely on two other x-ray measures that can help me: 1- Shenton’s Line: The subcondylar bone of the tibia and fibula should form a continuous line around the talus, so if the fibula is short then the spike of the fibula will too proximal. - If the fibula is long then the spike of the fibula will too distal. - Always look for the broken line from the lateral part of the articular surface of the talus to the distal fibula. 2- Dime Test - Look for the sprung mortise. - Look for the spike of the fibula to proximal. - Look for the broken Shenton’s Line. - Look for the Dime Test. - Look for medial clear space widening. - Get a lateral x-ray to see if there is a posterior malleolus fracture. - See if there is any talar subluxation. - See if there is any other associated Injuries from the talus and the calcaneous. The most important thing you will see on the lateral view x-ray of the ankle is the type of fracture: is it a Pronation - External rotation or Supination - External rotation Injury. - you will see that from the direction of the fracture. or Is the fracture comminuted? So you can say this is Pronation - Abduction Injury. Become a friend on facebook: http://www.facebook.com/drebraheim Follow me on twitter: https://twitter.com/#!/DrEbraheim_UTMC Donate to the University of Toledo Foundation Department of Orthopaedic Surgery Endowed Chair Fund: https://www.utfoundation.org/foundation/home/Give_Online.aspx?sig=29
Views: 22528 nabil ebraheim
www.acuvids.com to register
Views: 750 Dr. Anthony Lombardi Hamilton Back Clinic
Dr. Ebraheim’s educational animated video describes fractures of the ankle, classifications and ankle X - rays. It describes ankle fracture classification, ankle fracture dislocation. It also describes ankle fracture treatment and ankle fracture surgery and ankle fracture recovery and ankle fracture cast and brace. There is a lot of important topics in ankle fractures. Classifications of ankle fractures: • Weber classification: it classifies the ankle fracture according to the level of the fibular fracture: - Type A: the fracture is below the syndesmosis, this fracture is rarely unstable, but it could have syndesmotic injury. - Type B: its common, the fracture occurs at the level of the syndesmosis, the fracture could be unstable. - Type C: the fracture is above the syndesmosis, and is usually unstable, if you have a fracture weber c and you have a deltoid injury, you most likely need a syndesmotic screws, because the syndesmosis will be unstable. • Lauge Hansen classification: depends on the mechanism of the injury: depend on 2 things: position of the foot, and the force applied: 1- Supination- Adduction: there is a vertical fracture of the medial malleolus, movement of the talus medially, possible anteromedial tibial plafond impaction, transverse fracture of the distal fibula. How you fix it: screws parallel to the joint or anti-glide plate. With the injury having also the plafond impaction: you probably need to open the joint and elevate and restore the joint surface, and also this is the one that you may want to start medially, not laterally as we do routinely for other ankle fractures. 2- Supination- External rotation injury: the most common injury. Look at the lateral x-ray look at the fibula too, look on the AP and the lateral view radiograph. So if you find the fracture start from anterior inferior going posterior superior, that is supination external rotation injury, this is the one that can give you trouble if the fibula appear as the only bone that is fractured, you want to make sure that you are not missing type 4 fracture type. This injury has 4 stages, 4 will be on the medial side. 3- Pronation- External rotation: in this case the fracture goes from anterior superiorly to posterior inferior, and the fracture usually above the joint interval, it usually is weber C. 4- Pronation- Abduction injury: fracture of the fibula is usually transverse or comminuted; the fractured ankle may have only to the syndesmosis with nothing else appearing on x-ray. This fracture will start medially and will cause deltoid ligament injury, and then it probably moves to the syndesmosis at the following stage and ends by fibula, so it may come a little earlier so you don’t see a fibular fracture because it never happened, but you have syndesmotic injury. Follow me on twitter: https://twitter.com/#!/DrEbraheim_UTMC Donate to the University of Toledo Foundation Department of Orthopaedic Surgery Endowed Chair Fund: https://www.utfoundation.org/foundation/home/Give_Online.aspx?sig=29
Views: 81157 nabil ebraheim
Ankle Rehab As someone who has engaged in exercise and athletic activity for most of my life, I've put quite a few miles on my feet. I'm sure I'm not alone when saying that decades of pounding and abuse have added up to more than a few ankle injuries. The same mantra I'm given by doctors and physical therapists is 'make sure you continue to do your exercises.’ However, what normally happens is people give it a day or two, the ankle feels a bit better, so they don’t continue with their rehab. As we grow older, and the ankles don't recover as quickly as they used to, it’s important to realize now the absolute importance of actually performing those rehab exercises. Chronic discomfort and stiffness in the ankle can certainly be alleviated (nearly eliminated) by following a regular schedule of ankle strengthening activities. Not only will strength and balance return, but flexibility will also begin to improve. The crux is this: strengthening exercises for the ankle joints are not just for injury recovery. Make the exercise routine listed below a part of a regular schedule -- maybe every morning while watching the news, maybe every night before bed, maybe both! The point is to always make sure the ankles are at their strongest, their most balanced, and most flexible. Doing so will prevent most issues that lead to injury.
Views: 1360417 FlexWell
Ankle joint Imaging part 1 - by Prof. Dr. Mamdouh Mahfouz (2018) Discussed in Arabic
Views: 3018 Mamdouh Mahfouz
In my experience (comparative radiological studies), the most common fibular head dysfunctions are: 1) Antero-superior (even if for classical osteopathy it would be impossible!). 2) Postero-superior.After reduction of a subluxation of the ANTERO-SUPERIOR or POSTERO-SUPERIOR fibular head = apply a flexible adhesive tension (STRAPPING) maintains the upper Tibio-fibular joint, a few days: avoids early recurrences. This strapping of the two most frequent fibular malpositions: antero-superior and postero-inferior (80%) can then be relayed by a velcro neoprene strap, normally intended for patellar tendinopathies! As its common in gonalgia, it would be great for a manufacturer to produce a specific orthosis for the upper Tibio-fibular ... Sometimes, when I doubt about the direction of the subluxation, applying these tapes serves as a diagnostic test!!! 3) For the strapping of an inferior subluxation: it is the same idea, but by raising the fibular head. And here, I avoid the "velcro" contention which tends to go down. https://osteopathie-adhesiolyse.com/en/joints/knee-osteopathy/
Views: 5321 HO-PUN-CHEUNG Thierry
Dr. Steve Herbst, Central Indiana Orthopaedics, performs a TTC Fusion Surgery using the DynaNail® on a patient with Charcot neuroarthropathy. Dr. Herbst explains how DynaNail’s unique NiTiNOL Compressive Element is activated during surgery to allow for post-operative compression to be maintained during healing.
Views: 1183 MedShape Inc.
http://www.facebook.com/StefanDuellSportsPhysiotherapy Regarding my previous post about myofascial treatment of the inversion trauma, it is very important to correct the tibiotalar joint if it is still in the wrong position. Usually if you do a proper myofascial release treatment it will correct itself but sometimes it can still stay in the wrong place. If so, there is a high chance to suffer from an ankle dorsiflexion range of motion (DO ROM) deficit which can be reduced significantly through this kind of manipulation! ⚠️But watch out: never do this manipulation in the acute phase of an inversion trauma as it can lead to an internal bleeding and edema. To be on the secure side you can apply the HVLA thrust technique 4-5 days after the injury happened‼️ . The tibiotalar joint involves the talus moving in the ankle mortise, the major motions of this joint are dorsiflexion and plantarflexion. Dorsiflexion is more functional, more stable because the talus is wider anteriorly and fits securely into the ankle mortise. Reduction in dorsiflexion usually indicates that the tibia is anterior on the talus. The talus usually subluxates anteriorly, superiorly with medial rotation. To reduce the talus subluxation your contact will be on the anterior medial neck of the talus, the elbows will be parallel to each other, the therapist stands in a stable position and applies an high velocity low amplitude thrust technique.
Views: 621 StefanDuell
Dr.Mohamed Wahdan Lectures http://docdro.id/9wq1cgz
Views: 438 Dr.Wahdan Lectures
Dr. Ebraheim’s educational animated video describes fracture types of the Talus. Anatomy of the talus •Head •Neck •Body •Lateral process •Posterior process •Medial & lateral tubercle Posterior view of the ankle & hindfoot: Posterior process of the talus is made up of a smaller medial tubercle and a larger tibial tubercle that is separated by a groove for the flexor hallucis longus muscle. Fractures of the talus •Head fracture •Neck fracture •Body fracture •Lateral process fracture •Posterior process fracture •Osteochondral fracture The main blood supply of the talus is the artery of the tarsal canal. It comes from the posterior tibial artery and supplies the majority of the talar body. The deltoid branch from the posterior tibial artery is an important branch involving badly displaced fractures. It supplies the medial part of the talar body. Interruption of the blood supply causes death of the bone, AVN and nonunion. Head fracture: 5-10% of all talar fractures are head fractures. Neck fracture: the fracture line exits inferior surface anterior to the lateral process. There are four types of talar neck fractures. •Type I: non-displaced. 15% AVN •Type II: fracture with subtalar dislocation or subluxation. 50% AVN. •Type III: fracture with subtalar and tibiotalar dislocation. 90% AVN. •Type IV: fracture with subtalar and tibiotalar dislocation and talonavicular subluxation. 90-100% AVN. Body fracture The fracture line exists inferior surface behind the lateral process. 25% AVN & 25% AVN with subtalar dislocation. Lateral process fracture •CT scan is helpful for lateral process fractures. There are three types of lateral process fractures that are called “snowboarder’s injuries” . •Type I: avulsion •Type II: large fragment: especially involving the joint needs surgery. •Type III: comminuted. Small and comminuted fragments treated with a cast. Posterior process fracture •Rare injury •Usually missed on initial x-rays •Misdiagnosed as an ankle sprain •Mechanism of injury: usually forcible plantar flexion of the ankle (nutcracker injury). •Differential diagnosis: Os Trigonum. •Treatment: if fracture is missed, painful nonunion and instability of the subtalar joint may result. CT scan is helpful. Lateral view in 30 degrees external rotation may show the fracture. Larger fragment involving the joint requires surgery. Smaller fragment; immobilize in a cast or a boot. Osteochondral lesion: •Osteochondral lesions can occur in the talus. It may require surgical treatment. Can occur in severe trauma to the ankle or severe ankle sprain. Become a friend on facebook: http://www.facebook.com/drebraheim Follow me on twitter: https://twitter.com/#!/DrEbraheim_UTMC
Views: 52432 nabil ebraheim
Dr Donald A Ozello DC of Championship Chiropractic in Las Vegas, NV is the author of "Running: Maximize Performance & Minimize Injuries." He can be found on the web at http://www.championshipchiropractic.com/index.htm Dr Ozello's Sports Medicine Report is a weekly video that covers a different injury or body part each episode. Dr Ozello describes the anatomy & mechanism of injury in detail. He provides information on the intrinsic & extrinsic factors of the injury & discusses prevention & rehabilitation strategies to remove the sources of the condition. A playlist is available with videos demonstrating exercises & rehabilitation techniques. "Running: Maximize Performance & Minimize Injuries" is available in paperback & ebook. https://www.amazon.com/dp/1493618741/... A high ankle sprain is an injury to one of the ligaments that connects the two bones of the lower leg. The difference between a high ankle sprain & the more common lateral ankle sprain is the location. A high ankle sprain is located higher on the leg than a lateral ankle sprain. High ankle sprains make up about ten percent of ankle sprains. A high ankle sprain is a serious injury that requires a longer healing time period than lateral and medial ankle sprains. Extra precautions must be taken in returning to activity following a high ankle sprain. In medical terminology, a high ankle sprain is named a Syndesmotic Sprain. The tibia and the fibula are the two lower leg bones. The syndesmotic ligaments, also known as the high ankle ligaments, attach the tibia & fibula to each other. These ligaments function to hold the lower aspects of the tibia & fibula close to one another. These four ligaments are the Anterior inferior tibiofibular ligament (AITFL), Posterior inferior tibiofibular ligament (PITFL), Interosseous membrane (IO) (AKA Interosseous ligament) and the Transverse tibiofibular ligament. High ankle sprains most commonly they occur in football, soccer, lacrosse, basketball, hockey, skiing, hiking & trail running. The uneven terrain of trail running & hiking increases the possibility of suffering a high ankle sprain. High ankle sprains usually occur when the athlete pivots suddenly to the inside with the outside foot planted on the playing surface. An excessive amount of external rotation force on the fibula in respect to the tibia pulls the bones apart resulting in a ligament injury. Two main intrinsic factors exist for high ankle sprains. These are a prior high ankle sprain that did not heal properly & poor proprioception. Treatment of a high ankle sprain must be comprehensive & long-standing to help lessen the risk of recurrence. Proprioception is the body’s awareness of where it is at in nature. Training on an unstable surface such as a wobble board or a BOSU Ball improves proprioception. This type of training must be included in the prevention and management of a high ankle sprain. Pain located slightly higher than the ankle joint begins immediately. The athlete may feel and/or hear a snap, pop, tear or rip. Swelling and bruising may begin very quickly. Tenderness is usually present throughout the entire ankle, but it is worst directly over the injured ligament. Ankle motion is limited & weak in all directions. There is limited ability to bear weight on the injured leg & limited ability to push off the toes while walking. The result is an altered gait. Begin professional and self-treatment as soon as possible. The quicker the path to proper healing begins, the better chance of a positive outcome and quicker return to sport/activity. A professional evaluation, examination and x-rays help to formulate a correct diagnosis, treatment plan and rehabilitation plan. Work with a Doctor of Chiropractic for optimal results. Chiropractic treatment to the spine, hips and lower extremities re-establishes proper skeletal motion, optimizes nervous system communication and maximizes healing. For peak results and complete recovery, the treatment will be extensive and comprehensive. High ankle sprains are a frustrating injury. Patience and dedicated, persistent treatment and rehabilitation are required for complete recovery. Dr Donald A Ozello DC wishes you success in life and in your athletic endeavors. Train hard, train smart, stay injury free and accomplish your goals.
Views: 635 Dr Donald A Ozello DC
This is an example of acromioclavicular AC joint instability. This is presented by Dr. Jerry Hesch, DPT of Hesch institute in Aurora, Colorado. Website: www.HeschInstitute.com We treat complex injuries via a whole-body approach. We also provide distance education and workshops. Please follow us on You Tube and Facebook at "Hesch Institute"
Views: 360 Jerry Hesch
Learn Joint classification in easy way by Dr.Varun Kalia (PT). For more anatomy videos click on the link: 50 facts you don't know about your own body and body system (Part 1): https://www.youtube.com/edit?video_id=QRsh9EVUEI8 50 facts you don't know about your own body and body system (Part 2): https://www.youtube.com/watch?v=Wzn4zc6MQIc PREVENTION OF DISEASES BY ADDING FRUITS IN DIET: https://www.youtube.com/watch?v=XHhWc... Scapula Bone: https://www.youtube.com/watch?v=vhbOM... Humerus bone: https://www.youtube.com/watch?v=u4vie... Radius bone: https://www.youtube.com/watch?v=UKwzx... ULNA BONE: https://www.youtube.com/edit?video_id... Brachial Plexus: https://www.youtube.com/watch?v=0xefh... With Regards Dr. Varun Kalia (PT) PhD Scholar, MPT (Ortho), BPT, B.Sc Medical, CMT, MIAP Certified Practitioner of Dry Needling Certified Practitioner of NDT Certified in PT management of Spinal Cord Injury (Online) HOD, Assistant Professor, Department of Physiotherapy, St. Soldier Co-Ed College, Behind NIT (REC), Jalandhar city. India. email- [email protected] Joint is a junction between two or more bones or cartilages. It is a device to permit movements. There are more joints in a child than in an adult because as growth proceeds some of the bones fuse together. Example: Ilium, Ischium and pubis fused to form the pelvic bone. Synarthrosis are fixed joints at which there is no movement. The articular surfaces are joined by tough fibrous tissue. Often the edges of the bones are interlinked into one another as in the sutures of the skull. Amphiarthrosis are joints at which slight movement is possible. A pad of cartilage lies between the bone surfaces. The cartilages of such joints also act as shock absorbers. Examples: The intervertebral discs between the bodies of the vertebrae. Diarthrosis or Synovial joints are known as freely movable joints. A synovial joint has a fluid-filled cavity between articular surfaces. The fluid known as synovial fluid. Synovial fluid acts as a lubricant. Sutures: These are peculiar to skull, and are immovable. Syndesmosis: The bones are connected by the interosseous membrane. Example: Inferior Tibiofibular joint. Gomphosis: Peg and Socket Joint. Example: Tooth in the Socket. In this type of joints the bones are joined by cartilage. Synchondrosis: The bones are united by a plate of hyaline cartilage, so that the joint is immovable and strong. These joints are temporary in nature because after certain age the cartilaginous plate is replaced by bone. Example: Joint between epiphysis and diaphysis of a growing long bone. Symphyses: The articular surfaces are covered by a thin layer of hyaline cartilage and united by a disc of fibrocartilage. These joints are permanent and persist throughout life. Example: Pubis Symphysis, Intervertebral joints. They are most mobile type of joints. Ball & Socket joint: Articular surfaces include a globular head fitting into a cup-shaped socket. Example: Shoulder joint, Hip joint. Saddle (Sellar) Joint: Articular Surfaces are reciprocally concavoconvex. Example: First Carpometacarpal joint. Condylar (Bicondylar) joint: Articular Surfaces include two distinct condyles. One is having convex surface , which is fitting into another one concave surface. Ellipsoid joint: Articular surfaces include an oval convex surface fitting into an elliptical concave surface. Example: Wrist joint. Hinge joint: Example: Elbow joint. Pivot joint: Articular Surfaces comprise a central bony pivot surrounded by an osteoligamentous ring. Example: Radioulnar joint. Plane joint: Articular Surfaces are more or less flat (plane) Example: Intercarpal joints.
Views: 2955 Keshav Kalia Physioworld BY Dr. Varun Kalia
Dr. Ebraheim’s educational animated video describes the structures that insert into the fibular head is a simple and easy way and explains the anatomy of the region with simple and clear images that provides you with all you need to know. Become a friend on facebook: http://www.facebook.com/drebraheim Follow me on twitter: https://twitter.com/#!/DrEbraheim_UTMC Donate to the University of Toledo Foundation Department of Orthopaedic Surgery Endowed Chair Fund: https://www.utfoundation.org/foundation/home/Give_Online.aspx?sig=29
Views: 9866 nabil ebraheim
Did you know that 25,000 people sprain their ankle every single day? After the low back, the ankle is probably the second most common area of injury. In most cases, ankle sprains do not heal well without some treatment. That's a lot of clients who need you. Unraveling the Mystery of Ankle Pain 4-part webinar series worth 6 CE hours is available at: http://www.benbenjamin.com/webinarDescrip.php?id=S_881958787 When an ankle sprain does not heal properly, it can become a chronic problem. The ligament may have been stretched or may have developed poorly formed (and therefore weak) adhesive scare tissue, causing instability at the joint. Strenuous activities continually re-tear the scar tissue, resulting in a seemingly endless cycle of pain that comes and goes, with intermittent swelling. This can continue for many years if the injury is not properly treated. Learn to assess & treat 8 varieties of Ankle Sprains in this 4-part webinar series by Dr. Ben Benjamin. You'll come away understanding the relevant anatomy and assessment for each of these conditions, as well as therapeutic techniques for those you can treat and referral guidelines for those you cannot.
Views: 26380 Ben Benjamin
PROXIMAL TIBIOFIBULAR JOINT The following lecture comprehensively presents information regarding Tibiofibular Joint. Section one of this lecture focuses on Proximal Tibiofibular Joint. The educator puts forth the Definition of Proximal Tibiofibular Joint in the beginning and then explains its Articulation. Later, the educator explains what Type of joint a Proximal Tibiofibular Joint is. In addition to this, light is shed on the Capsule and Ligaments of this joint. SYNOVIAL MEMBRANE AND MOVEMENTS The prime focus of section two is the elucidation of Synovial Membrane and Movements of Proximal Tibiofibular Joint. The educator begins by demonstrating the Synovial Membrane. After this, the Nerve Supply is discussed. At the end of this section, the educator extensively talks about the Movements of Proximal Tibiofibular Joint. DISTAL TIBIOFIBULAR JOINT Section three covers the topic of Distal Tibiofibular Joint. The educator begins by explaining Tibiofibular Syndesmosis. Afterwards, the educator gives comprehensive information about Inferior Tibiofibular Joint and highlights its Articulation. Moreover, light is shed on the Type of joint the Distal Tibiofibular Joint is. At the end of this section, the Ligaments of this joint are explained in detail. NERVE SUPPLY AND FUNCTIONS Section four is about Nerve Supply and Functions of Distal Tibiofibular Joint. The educator gives a comprehensive overview of the Nerve Supply and talks extensively about Distal Tibiofibular Joint’s Movements. Later, the discussion shifts towards Function which is followed by an elucidation of Motions Available. The educator concludes this section by shedding light on Syndesmosis Ligaments Attachment. CLINICAL SIGNIFICANCE In section five, the educator reports Clinical Significance of Tibiofibular Joint. First of all, the educator focuses on the injuries of Proximal Tibiofibular Joint and provides a thorough overview of various Types of Dislocation that can occur in this case. Moreover, an insight into the Pathology/Injury of Distal Tibiofibular Joint is also provided. Apart from this, the educator talks about Clinical Conditions and brings the topic of Ankle Fracture under consideration. ------------------------------------------------------------- Watch complete lecture on sqadia.com: https://www.sqadia.com/programs/tibiofibular-joint Lecture Duration: 00:48:51 Released: October 2018 Full List of Medical Anatomy Lectures: https://www.sqadia.com/categories/anatomy ------------------------------------------------------------- So, what is sqadia.com? sqadia.com is the best global V-Learning™ platform for all medical students and clinical professionals. Already hundreds of lectures are available and new additions every single day! Try for FREE! https://www.sqadia.com/pages/freebies ------------------------------------------------------------- MEDICAL LECTURES IN BASIC AND CLINICAL COURSES https://www.sqadia.com/pages/courses Anatomy - Anatomy (Embryology) - Anatomy (Histology) - Biochemistry - Cell Biology - Dermatology - Ear, Nose and Throat - Genetics - Immunology - Medical Statistics - Medicine - Medicine (Cardiology) - Medicine (Forensic) - Microbiology - Obstetrics and Gynaecology - Pathology - Pharmacology - Physiology - Psychology - Surgery (General) - Surgery (Orthopaedics) ------------------------------------------------------------- MEDICAL V-LEARNING™ ON SOCIAL MEDIA Facebook: https://www.facebook.com/sqadiacom Instagram: https://www.instagram.com/sqadiacom Vimeo: https://vimeo.com/sqadiacom Twitter: https://twitter.com/sqadiacom LinkedIN: https://www.linkedin.com/showcase/sqadia-com Pinterest: https://www.pinterest.com/sqadiacom TumblR: https://sqadiacom.tumblr.com ------------------------------------------------------------- Anatomy is a basic course in the Medical sciences concerned with the identification and description of the human body structures. sqadia.com provide you detailed medical video lectures covering all aspects of anatomical features and syllabus for medical students, as per ''Grant's Atlas of Anatomy'' by Anne M.R. Agur. Gross Anatomy is the study of macroscopic structures that are visible to the eye without the help of an instrument. sqadia.com V-Learning™ improves student’s learning and helps to identify macroscopic structures using high quality images in PowerPoint presentations (PPT). From Meninges to Ankle, Subtalar and Foot Joints, video presentations cover both, regional and systemic approach. Anatomical position is the description of any region or part of the human body in a specific stance. Our engaging and passionate educators illustrate relationship of structure by the help of anatomical positions. Watch sqadia120 at sqadia.com, 2-Minute clips through which medical students will learn the concepts in a more advanced way and in a shorter time as well as Medical professionals can get a glimpse into Anatomy. -------------------------------------------------------------
Views: 127 sqadia.com
Dr. Ebraheim’s educational animated video describes tibial pilon fractures. High energy axial load injury. Soft tissue injury is bad. Closed or open fracture and ankle joint are usually involved. Metaphysis of the tibia is usually involved. No immediate open reduction and internal fixation because soft tissue is usually bad. Early ORIF is not recommended. Initially, the treatment is usually closed reduction and a splint followed by staged ORIF. In the operating room, start by applying external fixator. This decreases the incidence of wound complication and deep infection. When internal fixation is used, it is better to use minimally invasive fixation. Wait 1-3 weeks depending on the magnitude of the injury, the anticipated surgery and the presence of the wrinkle test. After application of the external fixator, get a CT scan to check the joint and the fragments. This will help you to select the best operative approach in the future after the soft tissue condition improves. The physician needs to be aware that the AP radiographs may look OK, however, it may be misleading. The joint usually has three fragments attached to ligaments. Because the ligaments are intact, the fragments can be pulled by the external fixator, which is called ligamentotaxis. The three fragments are: 1-Medial malleolus: attached to the deltoid ligament. 2-Anterolateral fragment: Chaput fragment (attached to the anterior inferior tibiofibular ligament). in children, this fragment is called Tillaux fracture. If the fracture involves avulsion of the fibula, it is called Wagstaffe fracture as rarely seen in some ankle fractures. 3-Volkmann fragment: posterolateral fragment attached to the posterior inferior tibiofibular ligament. In this CT scan, you can see the three fragments of the pilon fracture as well as the joint impaction. When the fibula is intact, the lateral collateral ligament of the ankle may rupture (fibula is intact in 20% of the cases). The break travel time in driving return to normal 6 weeks after initiation of weight bearing. In ankle fractures, it returns to normal 9 weeks after fixations (post-operatively). The goal of surgery is anatomic reduction and stabilization of the articular surface. May start with fixation of the fibula with a plate or with a screw ( in some cases the screw is better because it is minimally invasive). Fibular plate may add stability to the external fixator of the tibia, especially if there is a defect or comminution of the metaphysis of the tibia. Plating of the fibula adjunct to external fixation of the tibia. When there is a metaphyseal defect of the tibia, plating of the fibula can enhance the stiffness of the external fixator. Axial loading 2.2 times stiffer with plated fibula. Torsional force has no significant difference. Approaches are many and it varies between limited approach and extensile approach. Try to protect the superficial peroneal nerve. Dual incisions approach. Make sure that the distance between the incisions is no less than 7 cm. this is controversial. Everybody agrees that staged ORIF is the best. Significant disability in physical function was noted even with successful treatment in 36-item short form survey (SF-36). Improvement of function and pain may take up to 2 years and eventually, about 10-15% may need arthrodesis. Pilon fracture with a fracture of the tibial shaft: Do fixation of the articular surface (usually percutaneously) then do fixation of the tibial shaft, usually with IM rodding. Put external fixator calcaneal pins or talar pins. I usually put the calcaneal pin on the medial side of the ankle. Be aware of the location of the neurovascular structures, error in placement or the direction of the calcaneal pin can interfere with the neurovascular bundle. Avoid the bulge area. Application od the calcaneal traction pin is done at the posteromedial site. There is a ¾ distance between the palpable tip of the medial malleolus and the heel. The calcaneal transfixation pin is inserted in a transverse direction. It is better to keep the pin away from the area of future incisions. Talus pin insertion •Pin insertion should be medial to lateral. •Anterodistal to anterior colliculus. •Placement should be in 10 degrees anterocephalad direction. Three principles of pilon fracture: 1-Anatomical reduction 2-Stable internal fixation 3-Early range of motion. Achieving these three principles in every case of pilon fracture may not be possible. Become a friend on facebook: http://www.facebook.com/drebraheim Follow me on twitter: https://twitter.com/#!/DrEbraheim_UTMC
Views: 19411 nabil ebraheim