POSTER ABSTRACTS - ISAKOS

tibial - for 14, stop subluxation-for 9 patients.
Preferred early (per the maiden 3 day after a
trauma) surgical treatment - deleting of a
hematoma, precise confrontation of fragments
and fixing them by 2-3 Kirshner's wires. The bend
ends of wires left under a skin. At subluxations
stops restored full congruence intra-articular
surfaces of an ankle joint. Gypsum longine up to a
mean third of anticnemion. The junctures
removed on 9-10 day. Plaster bandage for 2
months. The wires extracted after 2, 5-3 months.
Conducted in a full volume a medical and
sporting aftertreatment.
Long term results are studied for 40 patients in
terms from 2 till 7 years after operation. For all
inspected - true adnation of fragments, full
congruence intra-articular surfaces and
accelerated synostosis. A full volume of motions
in an ankle joint. Prolong successfully to be
engaged in a selected kind of sports.
Adequate treatment for the young sportsmen with
avulsion distal fractures tibial epiphysis is early
operating. The testimony to that - excellent
anatomic-functional parameters and favourable
sporting forecast.
E-poster #104
Arthroscopic-Assisted Tibiotalocalcaneal
Arthrodesis Using Intramedullary Nail
Tomoko Horii, Tochigi, JAPAN
Yusei Kariya, Tochigi, JAPAN
Jichi Medical School, Tochigi, JAPAN
Due to poor long-term results and a high rate of
complications, indications for total ankle
arthroplasty have remained limited. Arthrodesis
of the tibiotalar, talocalcaneal joint and
tibiotalocalcaneal joint are widely accepted for
the treatment of osteoarthritis or rheumatoid
arthritis of the foot and ankle. Aggravation at the
talocalcaneal joint after tibiotalar arthrodesis had
been reported in cases of both osteoarthritis and
rheumatoid arthritis. Fixation of both the
tibiotalar and talocalcaneal joints simultaneously
seems reasonable in ankles displaying
polyarthritic disease, such as rheumatoid ankle.
We performed arthroscopic-assisted arthrodesis
of the tibiotalocalcaneal joint using
intramedullary nails with fins for four cases.
Intramedullary nails with fins allow stable fixation
even in osteoporotic bone without distal
transfixation. In addition, even in cases with poor
skin condition, this arthroscopic combined
technique is readily indicated.
E-poster #105
Combined Anterior and Posterior Impingement
Syndrome of the Ankle
Ian J Henderson, East Melbourne, VIC
AUSTRALIA, Presenter
David P La Valette, Leeds, Yorkshire, UNITED
KINGDOM
St Vincents & Mercy Private Hospital, Melbourne,
Victoria, AUSTRALIA
Aim:
To identify patients with symptoms of both
anterior and posterior ankle impingement, and to
document their findings and response to
treatment
Methods:
Between January 1990 and December 2003 we
identified 62 consecutive patients with symptoms
and signs of both anterior and posterior
impingement of the ankle. 58 of these patients
recorded a single injury or multiple ankle sprains.
The most common mechanism of injury was
inversion or plantar flexion. All patients failed
initial conservative treatment and underwent
anterior arthroscopy and open posterior
clearance.
Results:
62 patients were identified. All patients showed
synovitis at arthroscopy and 48 also had other
arthroscopically detected lesions such as anterior
tibial plafond lesions, ossicles or soft tissue
impingement. The posterior arthrotomy revealed a
bony cause for impingement in all but four cases.
This was usually an os-trigonum or a long
posterior process of the talus.
Three patients had anterolateral tenderness
following arthroscopy and three had tenderness of
the posterior arthrotomy scar. There were no
persistent neurological complications in this
series.
58 patients were available for follow-up. 81% of
patients had excellent or good outcomes, and
15.5% had fair outcomes and 3.5% were graded as
poor.
Discussion:
We have identified a group of patients who have
symptoms and signs of both anterior and
posterior ankle impingement, which has not been
published previously. We postulate that a single
inversion injury mechanism is responsible for this
syndrome. We have treated these with a combined
arthroscopic and open procedure, and we feel this
gives good predictable results with minimal
complications.