Courtesy: Prof Nabil Ebraheim, University of Toledo, Ohio, USA 1. Location and Structure The Achilles tendon is located in the posterior ankle. It is the strongest and thickest tendon in the body. Formed from: Soleus muscle Gastrocnemius muscle Inserts into the calcaneus (heel bone). 2. Associated Bursae Subcutaneous Calcaneal Bursa Located superficial to the Achilles […]
-Foot and Ankle Trauma
Jones Fracture
Courtesy: Prof Nabil Ebraheim, University of Toledo, Ohio, USA Metatarsal Fractures Metatarsal fractures can involve: First metatarsal Fifth metatarsal Second, third, and fourth metatarsals (including stress fractures) 1. First Metatarsal Fractures Key Points Different from fractures of the second, third, and fourth metatarsals. The first metatarsal carries a greater load. Malunion may cause: Transfer lesions […]
Missed Lisfranc Injuries
Courtesy Dr Pradeep Moonot, Dr Ashok Shyam, Ortho TV Case Example A 30 year old female sustained a minor fall from stairs. Initial diagnosis: Midfoot sprain Fracture of the base of the fifth metatarsal Treatment: Cast immobilization for 6 weeks Outcome: Persistent pain and deformity Re-presented after 3 months Final diagnosis: Missed Lisfranc injury Why […]
Ankle Ligament Injury, Evaluation and Tests, Diagnosis and Treatment.
Courtesy: Prof Nabil Ebraheim, University of Toledo, Ohio, USA Ankle Sprain – Evaluation, Tests, Diagnosis, and Treatment General Concepts Ankle ligaments are complex stabilizers of the ankle joint Injury to these ligaments = ankle sprain Types of Ankle Sprain Low ankle sprain Lateral ligament injury (most common) High ankle sprain Syndesmotic injury (less common, […]
Ankle Fractures: Types, Symptoms and Treatment
Courtesy: Prof Nabil Ebraheim, University of Toledo, Ohio, USA Classification Unimalleolar Fracture • Lateral malleolus fracture • Medial malleolus fracture • Posterior malleolus fracture Bimalleolar Fracture • Medial + lateral malleolus fractures Trimalleolar Fracture • Medial + lateral + posterior malleolus fractures Important Point • Obtain CT scan in trimalleolar fractures for: • Posterior fragment […]
Ankle Fractures
Ankle Fractures – Classification Overview Classification of ankle fractures helps determine: Mechanism of injury Stability Treatment strategy Two Most Common Systems Weber Classification – Based on fracture level Lauge-Hansen Classification – Based on mechanism 1. Weber Classification Principle Based on level of fibular fracture relative to: Syndesmosis (distal tibiofibular joint) Weber Type A Fracture […]
Lisfranc Injuries
Courtesy: Ioannis Stavrakakis MD, Crete, Greece Introduction A Lisfranc injury involves the tarsometatarsal (TMT) joint complex of the midfoot. These injuries range from subtle ligament sprains to severe fracture dislocations and are frequently missed, leading to chronic pain, instability, and post traumatic arthritis. The injury is named after Jacques Lisfranc de St. Martin, who […]
Achilles Tendon Rupture
Courtesy: Lyndon Mason, FRCSOrth, Liverpool, UK Achilles Tendon Rupture – Key Orthopaedic Principles Introduction The Achilles tendon is formed by: Gastrocnemius Soleus (Together called triceps surae) Insertion Calcaneal tuberosity Fiber Orientation Tendon fibers rotate before insertion Medial gastrocnemius fibers insert more posteriorly Clinical Note Medial gastrocnemius release can improve tightness Blood Supply Segmental Supply […]
From MIS to mis: Evolution of Calcaneal Fracture Management
Courtesy: Alan Yan MD, Asst Professor, University of South Dakota, US
Talus Fractures and Dislocations
Courtesy: Lyndon Mason FRCSOrth, Liverpool Foot and Ankle, UK Overview Talar fractures are uncommon injuries There are no studies higher than Level III evidence The majority of available literature consists of Level IV and Level V studies Current management principles are therefore based largely on accepted clinical wisdom Accepted Principles (“Accepted Wisdom”) Management of talar […]
All about Ankle Fractures
Courtesy: Prof Nabil Ebraheim, University of Toledo, Ohio, USA
Posterior Malleolus Fractures
Courtesy: Prof Lyndon Mason, FRCSOrth, Liverpool, UK Background Historically, posterior malleolar fractures were treated according to the “one third rule”: Fix the fragment if it involves more than 25 to 30% of the articular surface. Leave smaller fragments untreated. Modern evidence has shown that: Fragment size alone does not determine outcome. Fracture morphology is more […]
Maisonneuve Fracture of Ankle
Courtesy: Prof Nabil EBraheim, University of Toledo, Ohio, USA Definition Maisonneuve fracture is a proximal fibular fracture associated with an unstable syndesmotic injury of the ankle. It is an important injury because the ankle injury may appear minor while significant instability exists at the syndesmosis. Why is it Commonly Missed? The injury may present without: […]
Fractures of the Calcaneus
Courtesy: Prof Nabil Ebraheim, University of Toledo, Ohio, USA
Skin & Soft Tissue Condition in Calcaneal Fractures
Courtesy: Prof Nabil Ebraheim, University of Toledo, Ohio, USA Introduction Calcaneal fractures are associated with a high risk of soft tissue complications because the heel has a thin soft tissue envelope and limited vascularity. The condition of the skin and soft tissues often determines: Timing of surgery Choice of surgical approach Final outcome High Risk […]