Ota - Orthopedics - Fractures Of Tibia, Ankle And Foot (Ny!)

Front 1

The mortise projection in the diagnosis of ankle injuries:
- is a standard part of the ankle X-ray examination
- is the AP projection in 20° of ankle external rotation
- use only as an additional screening
- is the AP projection in 20° of ankle internal rotation

Back 1

The mortise projection in the diagnosis of ankle injuries:
- is a standard part of the ankle X-ray examination+
- is the AP projection in 20° of ankle internal rotation+

Front 2

Fractures of the diaphysis of the tibia:
- are treated fundamentally conservative by reduction and plaster fixation
- the most common type of osteosynthesis is intramedullary nailing
- ere often open
- development of compartment syndrome is never seen

Back 2

Fractures of the diaphysis of the tibia:
- the most common type of osteosynthesis is intramedullary nailing+
- ere often open+

Front 3

Diagnosis of fractures of the tibia diaphysis:
- is often already evident from the clinical examination – crepitations, pathological movement, swelling, pain, possibly a breach of the skin cover
- the need is always to do a CT scan
- X-ray diagnosis is usually enough by native frame in 2 perpendicular projections with capture of the need and ankle joint
- we usually make at the operating room

Back 3

Diagnosis of fractures of the tibia diaphysis:
- is often already evident from the clinical examination – crepitations, pathological movement, swelling, pain, possibly a breach of the skin cover+
- X-ray diagnosis is usually enough by native frame in 2 perpendicular projections with capture of the need and ankle joint+

Front 4

Fractures of the ankle joint:
- are a combination of bony and ligamentous injury
- one of the most common fractures of the lower limb
- are the most typical fracture in osteoporosis
- patients in middle age are almost absent

Back 4

Fractures of the ankle joint:
- are a combination of bony and ligamentous injury+
- one of the most common fractures of the lower limb+

Front 5

Fractures of the ankle joint:
- divided into three groups according to Weber
- always treat conservatively by reduction and plaster fixation
- division into types A, B and C is given by the relationship between the height of the fibular fracture line and the fibular syndesmosis
- due to the nerve supply are not accompanied by pain

Back 5

Fractures of the ankle joint:
- divided into three groups according to Weber+
- division into types A, B and C is given by the relationship between the height of the fibular fracture line and the fibular syndesmosis+

Front 6

Treatment of fractures of the ankle joint:
- we strive for conservative treatment of reduction and fixation in plaster fixation in reduction position+
- in the case of conservative treatment, control X-rays during treatment are not performed
- for unstable fractures, especially type B and C, and injuries of syndesmosis we treat by open reduction and osteosynthesis+
- the method of choice is nailing via calcaneus

Back 6

Treatment of fractures of the ankle joint:
- we strive for conservative treatment of reduction and fixation in plaster fixation in reduction position+
- for unstable fractures, especially type B and C, and injuries of syndesmosis we treat by open reduction and osteosynthesis+

Front 7

Pilon fractures of the tibia:
- it is a compression fracture of the distal tibia extending into the ankle joint
- the balance sheet is a necessity preoperative CT scans to verify the amount and location of fragments
- it is a low-energy trauma
- account for 20% of all fractures of the lower extremity

Back 7

Pilon fractures of the tibia:
- it is a compression fracture of the distal tibia extending into the ankle joint+
- the balance sheet is a necessity preoperative CT scans to verify the amount and location of fragments+

Front 8

Ankle sprains:
- ligament injuries are divided into three levels – distension, partial rupture, complete rupture
- always treat surgical revision and suture ligaments
- is the most typical injury of women in the postmenopausal period
- in most cases are treated with conservative plaster fixation with fixation length proportional to the degree of injury

Back 8

Ankle sprains:
- ligament injuries are divided into three levels – distension, partial rupture, complete rupture+
- in most cases are treated with conservative plaster fixation with fixation length proportional to the degree of injury+

Front 9

Rupture of the Achilles tendon:
- rupture is most commonly located in the sinewy parts about 3–5 cm above the insertion on the calcaneus
- the most common site of injury is musculotendinous transition
- there is always a bit of separation from calcaneus bone
- usually are treated with revision, suture and plaster fixation or the suture and fixation brace

Back 9

Rupture of the Achilles tendon:
- rupture is most commonly located in the sinewy parts about 3–5 cm above the insertion on the calcaneus+
- usually are treated with revision, suture and plaster fixation or the suture and fixation brace+

Front 10

Fractures of the talus:
- a serious injury with risk of development of bone necrosis
- it is the most common fracture in foot
- fracture luxation and / or strong fragments dislocations are indicated for the most urgent surgical treatment
- always treat conservatively with early mobilization and full weight bearing

Back 10

Fractures of the talus:
- a serious injury with risk of development of bone necrosis+
- fracture luxation and / or strong fragments dislocations are indicated for the most urgent surgical treatment+

Front 11

Fractures of the calcaneus:
- are not serious, mostly injured do not seek treatment
- the most common mechanism of injury is a fall from a height and sprains
- we use in the diagnosis X-ray in one projection and CT scan is not necessary
- insufficient clinical and X-ray examination of fracture risk oversight and diagnostic conclusion as just ankle sprains

Back 11

Fractures of the calcaneus:
- the most common mechanism of injury is a fall from a height and sprains+
- insufficient clinical and X-ray examination of fracture risk oversight and diagnostic conclusion as just ankle sprains+

Front 12

Fractures of the calcaneus:
- it is the most common fracture in the tarsus
- always carry a native X-ray projections in 2 planes and CT scan
- due to structure of the calcaneus are almost absent
- does not cause future problems for the injured patient´s

Back 12

Fractures of the calcaneus:
- it is the most common fracture in the tarsus+
- always carry a native X-ray projections in 2 planes and CT scan+

Front 13

Therapy of the calcaneal fractures:
- is always conservative
- the current method of choice in young patients under 60 years of age is open reduction and plate osteosynthesis
- it is not burdened with development of complications
- in open fractures, fractures with strong comminution and in elderly patients we often perform closed reduction and pinning by Kirschner wires

Back 13

Therapy of the calcaneal fractures:
- the current method of choice in young patients under 60 years of age is open reduction and plate osteosynthesis+
- in open fractures, fractures with strong comminution and in elderly patients we often perform closed reduction and pinning by Kirschner wires+

Front 14

Metatarsal fractures:
- the most common mechanism of injury is subject to fall on dorsum of the forefoot
- fatigue fractures occur mostly in 2 to 4 metatarsal
- X-ray diagnosis is sufficient dorsoplantar native frame
- we never operate

Back 14

Metatarsal fractures:
- the most common mechanism of injury is subject to fall on dorsum of the forefoot+
- fatigue fractures occur mostly in 2 to 4 metatarsal+

Front 15

Injury to Lisfrank and Copart joint:
- most common type of injury is sprains with the necessity of fixation in plaster casts or brace for 4–6 weeks
- in the case of luxation is often luxation fracture
- in current practice do not occur
- are characterized by minimal pain without need to weight bearing reduction

Back 15

Injury to Lisfrank and Copart joint:
- most common type of injury is sprains with the necessity of fixation in plaster casts or brace for 4–6 weeks+
- in the case of luxation is often luxation fracture+

Front 16

Chopart joint:
- is the articulation between talus and cuboid
- has a sigmoid shape
- injury in this area do not occur
- it is a complex joint of the calcaneocuboid and talonavicular joint

Back 16

Chopart joint:
- has a sigmoid shape+
- it is a complex joint of the calcaneocuboid and talonavicular joint +

Front 17

Fractures of the phalanges:
- we treat mostly conservative by taping
- carry out internal fixation of fractures especially of the base phalang of the thumb
- operate substantially by plate fixation
- always perform fixation by Kirschner wires

Back 17

Fractures of the phalanges:
- we treat mostly conservative by taping+
- carry out internal fixation of fractures especially of the base phalang of the thumb +

Front 18

Metatarsal fractures:
- non dislocated fractures we treat conservatively by plaster fixation
- displaced fractures usually are treated with reduction and transfixation by Kirschner wires or by plate fixation
- the method of choice in the treatment is taping
- plaster fixation must intervene to gluteal furrow

Back 18

Metatarsal fractures:
- non dislocated fractures we treat conservatively by plaster fixation+
- displaced fractures usually are treated with reduction and transfixation by Kirschner wires or by plate fixation+

Front 19

In chronic ankle instability:
- it is usually the fibular ligament or the deltoid ligament insufficiency and in diagnosis we use magnetic resonance
- therapy is long-term fixation of plaster - a minimum of 6 months
- we provide raffia of damaged ligaments, eventually ligaments plasty
- after operational revisions and ligaments plasty we never use plaster cast and we recommend early full weight bearing

Back 19

In chronic ankle instability:
- it is usually the fibular ligament or the deltoid ligament insufficiency and in diagnosis we use magnetic resonance+
- we provide raffia of damaged ligaments, eventually ligaments plasty+

Front 20

Post-traumatic arthrosis of the ankle:
- we never see
- we solve by ankle arthrodesis or by total arthroplasty
- is an indication for amputation of the lower leg
- manifested by pain, limitation of joint movement in the TC joint with the development of compensatory mechanisms of other small foot joints, and by swelling and ankle joint disfiguration

Back 20

Post-traumatic arthrosis of the ankle:
- we solve by ankle arthrodesis or by total arthroplasty+
- manifested by pain, limitation of joint movement in the TC joint with the development of compensatory mechanisms of other small foot joints, and by swelling and ankle joint disfiguration+