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Custom-made alumina ceramic total talar prosthesis for idiopathic aseptic necrosis of the talus
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Abstracts from the 6th IFFAS Triennial Meeting / Foot and Ankle Surgery 23(S1) (2017) 29–154
were no related to results. The lesion size increased in only 13 patients (17.3%). Conclusion: The sufficiently non-operative treatment was recommended to OLT patients because of improvement of pain and rare progression of osteoarthritis. http://dx.doi.org/10.1016/j.fas.2017.07.402
314 Custom-made alumina ceramic total talar prosthesis for idiopathic aseptic necrosis of the talus I. Tonogai ∗ , D. Hamada, K. Wada, T. Takasago, T. Goto, K. Sairyo Department of Orthopedics, Institute of Biomedical Science, Tokushima University Graduate School, Japan Two women aged 65 years and 78 years presented to our center with idiopathic necrosis of the talus. In both cases, imaging examinations showed collapse and sclerotic changes of the talar body caused by the necrosis. Both women underwent resection and placement of a third-generation custom-made alumina-ceramic total talar prosthesis. Immobilization of the ankle a short leg cast for 3 weeks was followed by early rehabilitation. One year after surgery, both women were able to walk without pain. Their Japanese Society for Surgery of the Foot ankle-hindfoot scale scores improved from 22 and 29/100 points to 90 and 95/100 points, respectively. To the best of our knowledge, the successful treatment of these two rare cases of idiopathic necrosis of the talus are among only a few reported cases of using a third-generation alumina ceramic prosthesis. http://dx.doi.org/10.1016/j.fas.2017.07.403
315 Novel algorithm using the specialized anatomical locking plate for isolated weber B ankle fracture J. Cho 1,∗ , D.I. Chun 2 1 Chuncheon Sacred Heart Hospital, Hallym University, South Korea 2 Soonchunhyang University Seoul Medical Center, South Korea
Isolated Weber type B fractures often require surgical stabilization. Nevertheless, controversy remains with regard to the optimal method of fixation. The aims of this study were to present a new, useful, and efficient surgical technique with early weightbearing protocol and to evaluate the follow-up results after surgery using a specialized anatomical locking plate without interfragmentary lag screw. The study included 29 patients (17 males and 12 females; mean age 41, range 18–82 years) with a minimum 1-year follow-up period. Surgery was performed as fixation without interfragmentary lag screw using specialized locking plate that was pre-anatomically contoured on the outline of the fibula. Tolerable weightbearing was permitted at the second week postoperatively. Fractures were examined clinically and radiologically in comparison to the injured side and were rated according to the criteria reported by McLennon and Ungersma. Also, Foot and Ankle Outcome Score (FAOS) was the used to evaluate functional outcome.
In all patients, union achieved without any loss of reduction or malunion. There were no infections or wound complications. According to McLennon and Ungersma’s criteria, all patients were rated good radiologically; whereas, two were rated fair and 27 were good functionally. The mean FAOS score was 83.0 (range 61.0–97.8) at 1-year. The fixation method without interfragmentary lag screw using specialized anatomical locking plate and early postoperative weightbearing has the advantages of being an easy procedure with greater stability and provides good functional and radiological outcomes in patients with isolated Weber B ankle fractures. http://dx.doi.org/10.1016/j.fas.2017.07.404
316 Controversy around ankle fractures: Is the foot and ankle surgeon’s view different? G. González-Lucena ∗ , D. Pérez-Prieto, A. López-Alcover, J. Amestoy, P. Serrano, A. Ginés Parc de Salut Mar, Barcelona, Spain Introduction: The broad spectrum of ankle fractures involves a great variability in its diagnostic and therapeutic aspects, some of which continue to be the subject of debate in current clinical practice. The purpose of our study was to analyze the differences between general orthopaedic surgeons and specialists in foot and ankle surgery in ankle fracture management. Methods: A survey was emailed to orthopaedic surgery departments in 7 hospitals throughout the country. The information requested included demographic data and management preferences for five different fracture cases. General questions about surgical treatment and tibio-peroneal syndesmosis injury management were included. Results: 72 out of 297 surgeons (24.2%) responded to the survey, 37 Foot and Ankle specialists (51.4%) and 35 general orthopaedic surgeons (48.6%). For trimalleolar fractures, 40.5% of the specialists would request a CT scan compared to 14% of the orthopaedic surgeons (p = 0.01). Some 94% of the respondents would synthesize the posterior malleolus, with no differences between groups. However, the specialists used a greater variety of systems for synthesis. Relative to a transindesmal fracture of a displaced fibula with signs of medial instability, 54% of the orthopaedic surgeons would review the medial collateral ligament versus 32% of the specialists (p = 0.06). With syndesmotic injuries, no differences between the groups in the responses were seen. Conclusion: Foot and Ankle specialists request additional complementary tests to diagnose ankle fractures. They prefer conservative treatment for the medial collateral ligament and use a wider range of surgical techniques for fracture fixation. http://dx.doi.org/10.1016/j.fas.2017.07.405
Abstracts from the 6th IFFAS Triennial Meeting / Foot and Ankle Surgery 23(S1) (2017) 29–154
were no related to results. The lesion size increased in only 13 patients (17.3%). Conclusion: The sufficiently non-operative treatment was recommended to OLT patients because of improvement of pain and rare progression of osteoarthritis. http://dx.doi.org/10.1016/j.fas.2017.07.402
314 Custom-made alumina ceramic total talar prosthesis for idiopathic aseptic necrosis of the talus I. Tonogai ∗ , D. Hamada, K. Wada, T. Takasago, T. Goto, K. Sairyo Department of Orthopedics, Institute of Biomedical Science, Tokushima University Graduate School, Japan Two women aged 65 years and 78 years presented to our center with idiopathic necrosis of the talus. In both cases, imaging examinations showed collapse and sclerotic changes of the talar body caused by the necrosis. Both women underwent resection and placement of a third-generation custom-made alumina-ceramic total talar prosthesis. Immobilization of the ankle a short leg cast for 3 weeks was followed by early rehabilitation. One year after surgery, both women were able to walk without pain. Their Japanese Society for Surgery of the Foot ankle-hindfoot scale scores improved from 22 and 29/100 points to 90 and 95/100 points, respectively. To the best of our knowledge, the successful treatment of these two rare cases of idiopathic necrosis of the talus are among only a few reported cases of using a third-generation alumina ceramic prosthesis. http://dx.doi.org/10.1016/j.fas.2017.07.403
315 Novel algorithm using the specialized anatomical locking plate for isolated weber B ankle fracture J. Cho 1,∗ , D.I. Chun 2 1 Chuncheon Sacred Heart Hospital, Hallym University, South Korea 2 Soonchunhyang University Seoul Medical Center, South Korea
Isolated Weber type B fractures often require surgical stabilization. Nevertheless, controversy remains with regard to the optimal method of fixation. The aims of this study were to present a new, useful, and efficient surgical technique with early weightbearing protocol and to evaluate the follow-up results after surgery using a specialized anatomical locking plate without interfragmentary lag screw. The study included 29 patients (17 males and 12 females; mean age 41, range 18–82 years) with a minimum 1-year follow-up period. Surgery was performed as fixation without interfragmentary lag screw using specialized locking plate that was pre-anatomically contoured on the outline of the fibula. Tolerable weightbearing was permitted at the second week postoperatively. Fractures were examined clinically and radiologically in comparison to the injured side and were rated according to the criteria reported by McLennon and Ungersma. Also, Foot and Ankle Outcome Score (FAOS) was the used to evaluate functional outcome.
In all patients, union achieved without any loss of reduction or malunion. There were no infections or wound complications. According to McLennon and Ungersma’s criteria, all patients were rated good radiologically; whereas, two were rated fair and 27 were good functionally. The mean FAOS score was 83.0 (range 61.0–97.8) at 1-year. The fixation method without interfragmentary lag screw using specialized anatomical locking plate and early postoperative weightbearing has the advantages of being an easy procedure with greater stability and provides good functional and radiological outcomes in patients with isolated Weber B ankle fractures. http://dx.doi.org/10.1016/j.fas.2017.07.404
316 Controversy around ankle fractures: Is the foot and ankle surgeon’s view different? G. González-Lucena ∗ , D. Pérez-Prieto, A. López-Alcover, J. Amestoy, P. Serrano, A. Ginés Parc de Salut Mar, Barcelona, Spain Introduction: The broad spectrum of ankle fractures involves a great variability in its diagnostic and therapeutic aspects, some of which continue to be the subject of debate in current clinical practice. The purpose of our study was to analyze the differences between general orthopaedic surgeons and specialists in foot and ankle surgery in ankle fracture management. Methods: A survey was emailed to orthopaedic surgery departments in 7 hospitals throughout the country. The information requested included demographic data and management preferences for five different fracture cases. General questions about surgical treatment and tibio-peroneal syndesmosis injury management were included. Results: 72 out of 297 surgeons (24.2%) responded to the survey, 37 Foot and Ankle specialists (51.4%) and 35 general orthopaedic surgeons (48.6%). For trimalleolar fractures, 40.5% of the specialists would request a CT scan compared to 14% of the orthopaedic surgeons (p = 0.01). Some 94% of the respondents would synthesize the posterior malleolus, with no differences between groups. However, the specialists used a greater variety of systems for synthesis. Relative to a transindesmal fracture of a displaced fibula with signs of medial instability, 54% of the orthopaedic surgeons would review the medial collateral ligament versus 32% of the specialists (p = 0.06). With syndesmotic injuries, no differences between the groups in the responses were seen. Conclusion: Foot and Ankle specialists request additional complementary tests to diagnose ankle fractures. They prefer conservative treatment for the medial collateral ligament and use a wider range of surgical techniques for fracture fixation. http://dx.doi.org/10.1016/j.fas.2017.07.405