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Ankle Pain, ankle ligaments sprain - Everything You Need To Know - Dr. Nabil Ebraheim
 
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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: 605698 nabil ebraheim
Ankle Fractures and the Syndesmosis - Everything You Need To Know - Dr. Nabil Ebraheim
 
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Dr. Ebraheim’s educational animated video describing fractures of the ankle fractures - syndesmotic injury. Educational video describing fractures of the 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. 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.
Views: 21297 nabil ebraheim
Anatomy of lower limb 56 (  tibiofibular joints  ) , by Dr  Wahdan .
 
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Dr.Mohamed Wahdan Lectures http://docdro.id/9wq1cgz
Views: 191 Dr.Wahdan Lectures
SCREAM! Ligament pain recovery with Chiropractor Dr. Alex Hernandez using strange technique Part 1
 
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PART 1: After the #ragnarrace #Adirondacks and doing 5k runs at #crossfitECF my ankles are taking a toll, here Dr Alex Hernandez is helping me recover so I can go out and play some more! Lmaoo this video is for the people who would love to see me in pain...if I've ever annoyed you or made fun of you this is a video for you...I am in pain in this video lol I sprained or twisted my ankle from all the activities that I've been doing the last month-and-a-half going hard each workout and at each event (ex: Ragnar Relay #RagnarADK was in September, then then 2 weeks after that did a 5k at #crossfitECF, but my body isn't taking it well especially my ankles... a couple of days before the #olgcbasketball I twisted my ankle again and I went to my chiropractor again to do another exercise and this time I was going to record the pain smh ...here you learn more about my chiropractor Alex Hernandez and how he can help you with your sports injuries, he goes into detail and educates you on what's going on and how he will help fix/heal you! Make sure you go like his business page, also thanks for Maria Martinez who is always nice and courteous as soon as you walk in the door! I love coming here #bniinfinity #bniinfinitynorthbergenchapter #TuesdaysAtBoulevardDiner #GizzyCredit LIKE THE PAGE ON FACEBOOK HERE: https://www.facebook.com/ChiropractorInNorthBergen/?fref=ts Website: http://dralexhernandez.com/ #gizzycredit #gizzycreditteam
Views: 235231 #GizzyCredit
Self mobilization of fibular head
 
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Anterior and posterior self mobilizations of proximal tibiofibular joint
Views: 20027 Justin Pezick
Tibial Pilon Fracture  - Everything You Need To Know - Dr. Nabil Ebraheim
 
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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: 14145 nabil ebraheim
Tibiofibular Ligament Injury | Joint Instability Test | Orthopedic Surgeon | Vail Greater Denver CO
 
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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: 4171 Robert LaPrade
Imaging of the Ankle joint -DRE 5 - Prof. Dr. Mamdouh Mahfouz
 
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Imaging of the Ankle joint -DRE 5 - discussed by Prof. Dr. Mamdouh Mahfouz
Views: 9818 Mamdouh Mahfouz
Ankle Ligaments Anatomy - Everything You Need To Know - Dr. Nabil Ebraheim
 
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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: 66437 nabil ebraheim
Structures Inserted Into The Fibular Head  - Everything You Need To Know - Dr. Nabil Ebraheim
 
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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: 7950 nabil ebraheim
Knee Pain Caused By Fibular Head :: WODdoc :: Project365 :: Episode 474
 
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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
Views: 43268 WOD doc
The Talar Tilt Test | Lateral Ankle Sprain
 
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DOWNLOAD OUR APP: 📱 iPhone/iPad: https://goo.gl/eUuF7w 🤖 Android: https://goo.gl/3NKzJX GET OUR ASSESSMENT BOOK ▶︎▶︎ http://bit.ly/GETPT ◀︎◀︎ This is not medical advice. The content is intended as educational content for health care professionals and students. If you are a patient, seek care of a health care professional. The Talar Tilt Test may be used to assess a lateral ankle sprain and the integrity of the talofibular and deltoid ligaments. Article: www.ncbi.nlm.nih.gov/pubmed/10589849 Visit our Website: http://bit.ly/29xmSzV Like us on Facebook: http://bit.ly/29GyogP Follow on Instagram: http://bit.ly/29HN0Lp
Views: 126607 Physiotutors
Imaging of the Knee joint ( part III ) -DRE 3 - Dr Mamdouh Mahfouz
 
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Imaging of the Knee joint ( part III ) -DRE 3 - Dr Mamdouh Mahfouz
Views: 9938 Mamdouh Mahfouz
Ankle Fractures - Everything You Need To Know - Dr. Nabil Ebraheim
 
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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: 66449 nabil ebraheim
Sprained Ankle Ligaments  *Home Treatment Guide!*
 
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http://www.michiganfootdoctors.com/twisted-ankle-recovery-time/ ‎ Curious to know what exactly you injured in your ankle? Well these are the types of injuries you can have and exactly what to do about them! http://www.michiganfootdoctors.com/
Views: 27645 Michigan Foot Doctors
Syndesmosis Injury - When Is It Necessary To Refer For Surgery
 
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Dr. Pieter D'Hooghe, Orthopaedic Surgeon in Aspetar is talking about Syndesmosis Injury - When Is It Necessary To Refer For Surgery during Aspetar/ACSM New Developments in Sports Medicine Symposium & Workshops
Views: 1652 Aspetar سبيتار
Ankle Ligament Injury Tests & Assessment - Everything You Need To Know - Dr. Nabil Ebraheim
 
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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: 96006 nabil ebraheim
Lateral Sprained Ankle Stretches & Exercises - Ask Doctor Jo
 
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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: 94793 AskDoctorJo
Chronic Lateral Ankle Instability - Everything You Need To Know - Dr. Nabil Ebraheim
 
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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: 65175 nabil ebraheim
Exercises for Ankle Joint Ligament Injury & It's Recovery Period
 
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For the Ankle Joint Ligament Injury to heal completely and in the fastest possible time, it is imperative to do the following exercises, which is shown in the video diligently. In post ankle joint ligament injury, there is substantial swelling and reduced range of motion of the ankle. Learn about the exercises and recovery time for ankle joint ligament injury. Also Read: https://www.epainassist.com/sports-injuries/ankle-injuries/ankle-joint-ligament-injury Follow us: Facebook: https://www.facebook.com/Epainassistcom-370683123050810/?ref=hl Twitter: https://twitter.com/ePainAssist G+: https://plus.google.com/+Epainassist Linkedin: https://www.linkedin.com/in/epainassist
Views: 51945 ePainAssist
Proximal Tibiofibular Chronic Subluxation Palpation by Dr. Scott Sheldon,DC
 
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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: 7165 AHEHealth
Ankle Fractures & X Rays - Everything You Need To Know - Dr. Nabil Ebraheim
 
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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: 20108 nabil ebraheim
Fix Your Joint Subluxation, Best Chiropractor for Injury Treatment, Tampa
 
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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
Current Concepts In Foot & Ankle Injuries - Everything You Need To Know - Dr. Nabil Ebraheim
 
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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: 50986 nabil ebraheim
Acromioclavicular AC Joint Instability
 
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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: 297 Jerry Hesch
Syndesmosis Injury - Signs & Symptoms
 
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DOWNLOAD OUR APP: 📱 iPhone/iPad: https://goo.gl/eUuF7w 🤖 Android: https://goo.gl/3NKzJX GET OUR ASSESSMENT BOOK ▶︎▶︎ http://bit.ly/GETPT ◀︎◀︎ This is not medical advice. The content is intended as educational content for health care professionals and students. If you are a patient, seek care of a health care professional. Following Ankle inversion trauma, it is essential to screen for signs & symptoms of possible syndesmosis injury as they will dramatically slow down recovery. 🚨 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/b9cKgwnFIAw 👉🏼 SUPPORT US 😊 : http://bit.ly/SPPRTPT 👈🏼 ARTICLES: Sman et al. (2015): https://www.ncbi.nlm.nih.gov/pubmed/24255766 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
Views: 8654 Physiotutors
Common Foot And Ankle Injections - Everything You Need To Know - Dr. Nabil Ebraheim
 
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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: 112128 nabil ebraheim
Ankle Pain Complete Overview - Everything You Need To Know - Dr. Nabil Ebraheim
 
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Dr. Ebraheim’s educational animated video describes the anatomy of the anterior compartment of the foot, and the injuries and conditions associated with the ankle. There are many structures present at the anterior aspect of the ankle. These structures are often susceptible to injury. Common injuries and conditions around the anterior ankle 1-Anterolateral impingement: Painful limitation of full range of ankle motion due to soft tissue or osseous pathology. Soft tissue thickening commonly seen in athletes with prior trauma that extends into the ankle joint. Tibial bone spur impinging on the talus can become a source of chronic ankle pain and limitation of ankle motion in athletes. 2-Arthritis of the ankle joint: Commonly the result of a prior injury or inflammation to the ankle joint. Can be usually diagnosed with an examination and x-ray. 3-Osteochondritis dissecans of the talus: Chip type fracture that usually occurs with severe ankle sprains. Causes pain, swelling, and stiffness of the ankle joint. X-rays, Ct scan or MRI are commonly used for the diagnosis. 4-Tibialis anterior tendonitis 5-Anterior tibialis tendonitis: It is an overuse condition common in runners. Common injury that usually accompanies anterior shin splints. If this tendon is strained, pain and tenderness will be felt upon active dorsiflexion or when the tendon is touched. There are many structures present at the medial aspect of the ankle. These structures are often susceptible to injury. Common injuries and conditions around the medial ankle 1-Posterior tibial tendonitis or rupture: Posterior tibial tendon problems can occur from overuse activities, degeneration and trauma. The posterior tibial tendon is one of the major supporting structure of the foot. The tendon helps to keep the arch of the foot in its normal position. When there is insufficiency or rupture of the tendon, the arch begins to sag and a flatfoot deformity can occur with associated tight achilles tendon. This occurs distal to the medial malleolus. This area is hypovascular. It presents with painful swelling on the posteromedial aspect of the ankle. Patient is unable to perform a single leg toe raise. 2-Tarsal tunnel syndrome: It is compression of the tibial nerve in the tarsal tunnel. The flexor retinaculum covers the nerve. Tarsal tunnel syndrome is similar to compression of the median nerve in the carpal tunnel. Causes include ganglia, accessory muscle and soft tissue mass. 3-Flexor hallucis tendonitis: Pain, swelling, weakness posterior to the medial malleolus. Dorsiflexion of the big toe may be reduced when the ankle is placed in dorsiflexion. Triggering and pain along the tendon sheath may also occur with toe flexion. It often occurs in activities such as ballet dancing, in which plantar flexion is necessary. 4-Rupture of the deltoid ligament: The deltoid ligament are the primary stabilizers of the ankle joint. The deltoid ligaments provide support to prevent the ankle from everting. An isolated eversion sprain with tear of the deltoid ligaments is a rare injury. There are many structures present at the posterior aspect of the ankle. These structures are often susceptible to injury. Common injuries and conditions around the posterior ankle 1-Posterior ankle impingment (os trigonum): It is nonunited piece of accessory bone seen posterior to the talus. It is common among athletes such as ballet dancers. Tenderness in the posterolateral aspect of the ankle posterior to the peroneal tendon especially with passive plantar flexion. May be seen in association with flexor hallucis longus tenosynovitis. 2-flexor hallucis longus tenosynovitis: It is a condition associated with ballet dancing, in which extreme plantar flexion is necessary. Swelling and pain posterior to the medial malleoulus. Triggering with toe flexion. Dorsiflexion of the big toe is less when the ankle is dorsiflexed. 3-Achilles tendonitis: Irritation and inflammation due to overuse. Pain, swelling and tears within the tendon. Usually treated with therapy and injection. Do not inject inside the tendon, rarely treated with surgery. 4-Achilles tendon rupture: Achilles tendon can become prone to rupture with age lack of use, or by aggressive exercise. Rupture is diagnosed by the Thompson test and MRI. Treatment may be conservative without surgery by using a cast or a boot , however the rerupture rate is high. Surgery is done by approximation of the torn ends, however there is a risk of infection, skin and wound complications with surgery. There are many structures present at the lateral side of the ankle. These structures are often susceptible to injury. Diagnosis of these injuries can be confusing and many of these injuries can be missed.
Views: 450510 nabil ebraheim
What is Prolotherapy? Ankle sprain sample treatment Dr MacMillan Dr Vizniak
 
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Learn more at https://prohealthsys.com/ Non-Surgical Ligament and Tendon Reconstruction and Regenerative Joint Injection, orthopedic procedure that stimulates the body’s healing processes to strengthen and repair injured connective tissue. Each patient must be evaluated thoroughly with patient history and physical exam; when indicated, radiographs and laboratory work, should be ordered or evaluated prior to treatment. In appropriate patients, prolotherapy has a high success rate.
Views: 284 prohealthsys
Anatomy and injuries of The Lateral Ankle - Everything You Need To Know - Dr. Nabil Ebraheim
 
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Dr. Ebraheim’s educational animated video describes the anatomy of the lateral ankle, the bony structure, muscles, and nerves, and the injuries of the lateral ankle area. Ligaments around the ankle •Anterior talofibular ligament •Posterior talofibular ligament •Calcaneofibular ligament Peroneal tendons •Peroneus Brevis tendon •Superior & inferior peroneal retinacula •Peroneus longus tendon There are many structures present on the lateral side of the ankle. These structures are often susceptible to injury. Diagnosis of these injuries can be confusing and many of these injuries can be missed. Diagnosis of a sprained ankle may be the wrong diagnosis. Common injuries and conditions around the lateral ankle. 1-Ankle Sprain 2-High ankle sprain (syndesmotic injury). 3-Peroneal tendon subluxation. 4-Rupture of the peroneus longus tendon 5-Peroneal tendonitis 6-Anterior process of the calcaneus fracture. 7-Lateral process of the talus fracture 8-Achilles tendonitis
Views: 45782 nabil ebraheim
Ankle Fractures , Special Situations - Everything You Need To Know - Dr. Nabil Ebraheim
 
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Dr. Ebraheim’s educational animated video describing fractures special situations, describing fractures of the ankle X – rays and ankle fracture classification, ankle fracture dislocation . It also describes ankle fracture treatment and ankle fracture surgery and ankle fracture recovery Ankle fractures and driving: Normal base line breaking time is about 9 weeks after surgery. For total hip is about 6 weeks. For long bone and periarticular fractures of the lower extremity, the breaking time is significantly reduced up to 6 weeks after initiation of weight bearing. Diabetes: in patients with diabetes, the first thing we have to check is if the patient have peripheral neuropathy, or Charcot- fracture. Diabetic patient has also high risk of infection, hardware failure, and delayed healing; the bone takes more time to heal. You have to do more percutaneous fixation, a lot of screws from the fibula to the tibia; it gives you more strength of the fixation because the screws are engaged into the tibia, so they are stronger than the small little screws in the fibula. Then delay weight bearing time and half more than the normal so usually you delay the weight bearing for about 3 months. Remember: surgery in displaced fracture in the ankle in diabetics is better than no surgery, but the complication rate is high. Ankle malunion: Usually the fibula is short and malreduced, and the syndesmosis is disrupted, usually you correct that by corrective osteotomy of the fibula to restore the fibular length, alignment, and rotation. You have to do anatomic reduction of the fibula and the Mortise, you have to do the plating of the fibula, and bone graft if needed, in addition to syndesmotic reconstruction. And you do ankle reconstruction to prevent arthritis by reducing the talus to the ankle mortise. Fibular fracture and unstable ankle mortise will allow the talar shift. 1mm shift of the talus will decrease the tibiotalar contact area by 42%. What are the fracture variants? - Maisonneuve fracture: it is a fracture of the proximal fibula with syndesmodic disruption, you can miss this fracture because you may think the patient has an ankle sprain, especially if the injury of the deltoid ligament is not apparent on the x-ray, you probably need to get long leg films to diagnose the fracture. So you need to fix the syndesmosis because in these patients the syndesmosis is disrupted, so you need to restore the fibular length and alignment before the insertion of the syndesmotic screws. Accurate reduction of the syndesmosis is needed. - Volkmann fracture: it is a fracture of the posterolateral aspect of the tibial attachment of the posterior inferior tibiofibular ligament. - Tillaux fracture: it is a salter type III fracture, it is a fracture of the tibial attachment of the anterior inferior tibiofibular ligament in the young. - Wagstaffe’s fracture: it is a fracture of the medial part of the fibula with that part being avulsed at the insertion of the anterior- inferior tibiofibular ligament. The anterior- inferior tibulofibular ligament remains intact. - Chaput’s Tubercle fracture: it is a fracture of the anterolateral part of the tibia in adults. It is similar to Tillaux fracture. Chaput’s tubercle fracture is different from Chaput’s fracture which is mid tarsal joint injury. So the ligament remains intact with: - Tillaux fracture - Wagstaffe’s fracture - Chaput’s Tubercle fracture The ligament is avulsed from the tibia in: - Tillaux fracture in the young - Chaput’s Tubercle fracture in adults The ligament is avulsed from the fibula in: - Wagstaffe’s fracture Bosworth fracture dislocation: rare fracture of the ankle, the fibula become trapped behind the tibia and become irreducible. The posterolateral ridge of the distal tibia will block reduction of the fibula. 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: 18319 nabil ebraheim
Ankle Fractures , Anatomical Considerations - Everything You Need To Know - Dr. Nabil Ebraheim
 
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Dr. Ebraheim’s educational animated video describing fractures of the ankle, anatomical considerations, this video also explains fractures of the ankle X-rays. It describes ankle fracture classification, ankle fracture dislocation. It also describes ankle fracture treatment, ankle fracture surgery, and ankle fracture recovery. The talus is wider anteriorly than posteriorly. When the ankle dorsiflexes, the fibula rotates externally through the syndesmosis to accommodate the wider anterior part of the talus. The fibula is connected to the tibia by the interosseous membrane proximally, and then around the ankle you have ligaments: - The anterior inferior tibiofibular ligament - Posterior inferior tibiofibular ligament - Interosseous ligament These are the ligaments that are involved in the stability of the syndesmosis, responsible for stability of the ankle in external rotation, and they are different from the lateral collateral ligament. The lateral collateral ligaments that are involved in ankle sprains are: - Anterior talofibular ligament - Posterior talofibular ligament - Calcaneofibular ligament These are restrains to the inversion of the ankle and anterior translation of the talus. Then you have the medial malleolus with a groove for the posterior tibial tendon. So when posterior collicular fracture occurs, this tendon of the tibialis muscle supports the fracture so the fracture doesn’t displace. The medial malleolus has 2 collicular parts: • Anterior colliculus: is about 5mm longer than the posterior colliculus • Posterior colliculus The anterior and posterior collicular parts are separated by the intercollicular groove. The deltoid ligament supplies the medial support to the ankle. It’s composed of 2 parts: • The superficial deltoid: arises from the anterior colliculus. • Deep deltoid: arises from the posterior colliculus and intercollicular groove. It is an intra-articular ligament that can’t be repaired but we can debride it. When a fracture in the medial malleolus occurs, it can be one of these types: • The Supracollicular fracture: above both of the anterior and posterior colliculus, plus the deep deltoid ligament. • Anterior collicular fracture When fracture of the medial malleolus occurs, it can be one of these types: • The supracollicular fracture: above both the anterior and posterior colliculus • Anterior collicular fracture: involves anterior colliculus alone, or involves anterior colliculus plus the deep deltoid ligament. • Posterior colliculus fracture: needs an external rotation to see, it’s an AP external rotation view which is different from the posterior malleolus fracture which you get lateral external rotation view. If you have a vertical fracture of the medial malleolus which is supination and adduction, make sure you don’t have anterior medial marginal impaction. Make sure you put the screws parallel to the joint or use anti-glide plate. If you have an anterior intercollicular fracture, the fragment may be too small to fix with screws and you may want to use tension band technique. If it is posterior collicular, it’s probably stable, you may not need to fix. If it is supracollicular you probably need to use the screws that you use routinely, which is perpendicular to the fracture, and make sure they are not being placed inside the joint by getting an AP view of the ankle itself. The Nerves around the ankle: 1- The Saphenous nerve: is at risk of injury when you fix the medial malleolus, its usually superior and anterior to the tip of the medial malleolus. 2- The Superficial Peroneal nerve: it crosses from the lateral to the anterior compartment and this crossing may vary, and its vulnerable to injury during lateral plating of the fibula, it crosses the ankle anterior to the fibula and it is usually about 10 cm from the fibula tip, and it runs above the extensor retinaculum. 3- The Sural nerve: it’s vulnerable to injury distally, especially when you do posterolateral plating or posterior plating of the fibula, and the superior peroneal retinaculum also could be injured when you do posterior plating of the fibula. 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: 9915 nabil ebraheim
Tibial Plafond Fracture Classification - Everything You Need To Know - Dr. Nabil Ebraheim
 
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Dr. Ebraheim’s educational animated video describes tibial plafond fracture classifications. Ruedi –Allgower classification Type I •No significant joint incongruity. •Cleavage fracture with no displacement of the fractured fragments. Type II •Significant incongruity. •Minimal metaphyseal comminution or impaction. Type III •Significant articular comminution and metaphyseal impaction (bad injury). AO/OTA classification 1-A extra-articular 2-B partial-articular 3-C complete articular I don’t think you can go wrong with classifying any fracture that involves or close to a joint as an extra-articular, partial-articular or complete articular. A extra-articular •A1 metaphyseal simple •A2 metaphyseal wedge •A3 metaphyseal complex All of these extra-articular fractures are named A based upon the complexity of the fracture. B partial articular •B1 pure split •B2 split depression: Supination/abduction fracture of the ankle will have a vertical fracture of the medial malleolus. The anteromedial portion of the plafond may also be impacted. This fracture shows up in classic orthopedic examinations. This impaction or depression can be missed. What would you do after fixation of this fracture and the impaction fracture is missed? You probably need to revise the fixation and make sure to elevate the impaction or depression. Restore the joint congruity before fixing the fracture. When you fix the fracture, fix it with a plate or with screws. oThe screws have to be parallel to the joint to compress the fracture. Plate fixation should be done with an antiglide plate. •B3 multi-fragmentary depression C complete articular •C1 articular simple, metaphysis simple •C2 articular simple, metaphysis multi-fragmentary •C3 articular multi-fragmentary, metaphysis multi-fragmentary. Difficult fracture with the worse prognosis. Classically, there is a typical pilon fracture fragments. Usually, there are three main joint fragments. The three fragments are: 1-Medial malleolus: attached to the deltoid ligament. 2-Anterolateral fragment: Chaput fragment (attached to the anterior inferior tibiofibular ligament). 3-Volkman 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 joint impaction. When the fibula is intact, the lateral collateral ligament of the ankle may rupture (fibula is intact in 20% of the cases) Follow me on twitter: https://twitter.com/#!/DrEbraheim_UTMC
Views: 3194 nabil ebraheim
Ankle examination ,ankle sprain ,ankle pain - Everything You Need To Know - Dr. Nabil Ebraheim
 
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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: 11644 nabil ebraheim
FIBULAR HEAD AND KNEE PAIN Part I
 
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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: 62936 Jerry Hesch
Ankle Fracture , Stress View Radiographs - Everything You Need To Know - Dr. Nabil Ebraheim
 
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Dr. Ebraheim’s educational animated video describing fractures of the ankle - external rotation stress view radiographs. Educational video describing fractures of the 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. You will do the stress view of the ankle before surgery to check the medial clear space. Check to see if the medial clear space is greater than 5mm which is a sign of a deltoid ligament injury. The injury is supination external rotation type IV and not type II, and this one will need surgery. The truth is, an isolated femoral fracture without talar displacement is a difficult problem, ans clinical examination is unreliable in predicting medial injury. Swelling, tenderness or ecchymosis is of limited value in predicting ankle instability. So we do 1 of 2 things, either: (both of them are more sensitive in predicting ankle instability): 1- external rotation stress radiograph: do external rotation of the foot with the ankle in dorsiflexion. Check the ankle in the mortise view. I personally like to inject the ankle with numbing medicine in order to make this less painful for the patient. The whole idea with abduction and external rotation of the talus is to attempt to displace the fibula from the incisura fibularis. When the talus moves laterally, freely because the deltoid is injured and it displaces the fibular fracture that will cause an increase in the medial clear space. 2- gravity stress test: support the leg with pillow and allow the ankle to rotate with gravity. Occasionally I get a CT scan of the syndesmosis and compare both sides. Magnify the view and measure it by the computer. So the most predictive factor of the medial side ankle injury is the presence of a high fibular fracture at or above the joint level. If you have a stress radiograph showing the medial clear space 4-5 mm or 1mm greater than the superior joint space. That means there is a deltoid ligament incompetence, & the talus is free, and it is probably a supination- external rotation injury type IV not II. Also look for any talar subluxation, it means that the ankle is unstable. The most important point in assessing ankle for surgery is the position of the talus within the mortise. The deltoid ligament is the primary stabilizer of the ankle point under physiological loading conditions. During surgery, you can use the stress views or cotton test. You want to make sure you don’t have syndesmotic injury, and you can use the criteria that decrease tibiofibular overlap or decrease in the medial clear space which should be less than 4mm. Or increase in the tibulofibular clear space more than 5 mm, which you will measure 1 cm above the joint. You do stress view after fixing the malleoli, just remember: you will need more syndesmotic screws in weber c, especially if the deltoid itself is injured. I have never seen an exam that doesn’t have something about assessing the stability by abduction, external rotation, stress view of the ankle, either before surgery or during surgery. 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: 8320 nabil ebraheim
Ankle & Subtalar Joint Motion Function Explained Biomechanic of the Foot - Pronation & Supination
 
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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: 652394 DrGlassDPM
Anterior Drawer Test of the Ankle | Chronic Ankle Laxity & Anterior Talofibular Ligament Rupture
 
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DOWNLOAD OUR APP: 📱 iPhone/iPad: https://goo.gl/eUuF7w 🤖 Android: https://goo.gl/3NKzJX GET OUR ASSESSMENT BOOK ▶︎▶︎ http://bit.ly/GETPT ◀︎◀︎ This is not medical advice. The content is intended as educational content for health care professionals and students. If you are a patient, seek care of a health care professional. The anterior drawer test has limited diagnostic ability for chronic ankle laxity but performs well in an acute situation to diagnose ruptures of the anterior talofibular ligament commonly injured after ankle inversion trauma  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/b9cKgwnFIAw  SUPPORT US  : http://bit.ly/SPPRTPT  ARTICLES: Croy (2013): https://www.ncbi.nlm.nih.gov/pubmed/24175608 Van Dijk (1996): https://www.ncbi.nlm.nih.gov/pubmed/9065068 Miller (2016): https://www.ncbi.nlm.nih.gov/pubmed/26660862 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
Views: 70767 Physiotutors
How to tape for lateral knee pain - sports taping series
 
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A taping technique to glide the superior tib-fib joint to reduce lateral knee pain - MWM. athletic / sports / strapping / mulligan / rugby / football / physiotherapy www.motion-physiotherapy.co.uk
Views: 7429 Joey Hayes
Ankle Joint - 3D Anatomy Tutorial
 
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http://www.anatomyzone.com 3D anatomy tutorial on the ankle joint using the Zygote Body Browser (http://www.zygotebody.com). Join the Facebook page for updates: http://www.facebook.com/anatomyzone Follow me on twitter: http://www.twitter.com/anatomyzone Subscribe to the channel for more videos and updates: http://www.youtube.com/subscription_center?add_user=theanatomyzone
Views: 238856 AnatomyZone
Dr. Eugene Curry, M.D. performs an open ankle fusion with Arthrex 6.7 mm screws/compression staple
 
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Surgery to fuse (perform an arthrodesis) an ankle in a patient with posttraumatic arthritis of the left ankle joint.
Views: 28644 Gene Curry
Best Ankle Rehabilitation Exercises For Those Recovering From Ankle Injury
 
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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: 1251884 FlexWell
Osteopathic Manipulation (Chiropractic Adjustment) of the TIbiotalar Joint HVLA
 
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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: 543 StefanDuell
Concomitant tibiotalar joint effusion and a partial tear of the talonavicular ligament at US.
 
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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: 474 ShoulderUS.com
Ankle Palpation
 
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http://www.p2sportscare.com 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: 37211 Sebastian Gonzales
Dr. Arthur Arand discusses sacroiliac joint pain
 
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Dr. Arthur Arand discusses sacroiliac joint pain. Learn more about SI joint pain at http://www.mayfieldclinic.com/PE-SIjointPain.htm
Dr. Lew Schon: Foot and Ankle Syndesmotic Measurements for Clinical Assessment
 
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Dr. Lew Schon from Medstar Union Memorial Hospital presents how syndesmotic measurements from weight-bearing CT exams using the OnSight 3D Extremity System can help improve clinical assessment of the outcomes of orthopaedic foot and ankle surgery compared to traditional 2D X-ray images. Dr. Schon presents examples of images from his practice and discusses how treatment plans are affected and the assessment of outcomes are enhanced utilizing weight-bearing 3D CT extremity images. Learn more at: https:\\www.Carestream.com/Onsight Dr. Schon is an orthopaedic surgeon, fellowship trained in foot and ankle reconstruction. He is an internationally recognized expert and innovative designer of new surgical techniques and orthopaedic devices. Dr. Schon also serves as an Assistant Professor of Orthopaedic Surgery at The Johns Hopkins University School of Medicine. In addition to his clinical practice, Dr. Schon is an award-winning researcher and investigator. He founded the Orthobiologic Laboratory, supported by the Innovation Fund, where he and his team work together toward the singular goal of improving patient care and outcomes through research, education, and discovery. Dr. Schon's special interests include tendon disorders, deformities, fractures and ligament injuries, sports injuries and dance medicine. #CBCT #extremityimaging #Carestream #Onsight #orthopaedic
Views: 108 Carestream Health
tibiofibular joint pain treatment
 
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http://vivaint.biz/net/azol FO FREE! It seems you can hardly get through your day without something hurting. Finally, there's a natural solution to those annoying aches and pains with Eazol. Order your free trial today! Limited supp;y! Hurry up!
Tibial Pilon Fracture With Intact Fibula - Everything You Need To Know - Dr. Nabil Ebraheim
 
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Dr. Ebraheim’s educational animated video describes tibial pilon / plafond fracture, the etiology, diagnosis, imaging, and treatment options. A pilon fracture ( or tibial plafond fracture) is a fracture of the distal tibia involving the ankle joint and it typically fractures the fibula. Pilon is a French term of the injury mechanism meaning “hammer” or “pestle”. A pilon fracture is a high energy trauma with articular impaction and comminution. There will be significant associated soft tissue injury and metaphyseal bone loss with associated muscloskeletal injuries. Usually the fibula is fractured along with the pilon fracture but occasionally remains intact. Fracture usually occurs with an anterolateral fragment that subluxes or dislocates from the joint and remains attached to the fibula. The syndesmosis is injured. There will be talofibular joint incongruity due to disruption of the talofibular ligament. The fibula appears longer and moving laterally. Oblique views show the direction of the force. Become a friend on facebook: http://www.facebook.com/drebraheim Follow me on twitter: https://twitter.com/#!/DrEbraheim_UTMC Background music provided as a free download from YouTube Audio Library. Song Title: Every Step
Views: 12518 nabil ebraheim

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