Bimalleolar Ankle Fracture Open Reduction and Internal Fixation
Kiran J. Agarwal-Harding, MD, MPH; Michael Akodu, MBBS; Miles Batty, MD; Elyse J. Berlinberg, MD; Michael McTague, MPH
Beth Israel Deaconess Medical Center
Ankle injuries are common, occurring most often among young males and older females. The ankle joint is crucial for stability and gait, making these injuries a significant source of disability.
Ankle injuries are usually treated operatively when there is loss of joint congruity and stability, and in this video, Dr. Agarwal-Harding takes us through the operative fixation of a bimalleolar ankle fracture. He talks about understanding why operative intervention is recommended, techniques involved, and other considerations.
Five-Month Patient Results Following Ankle Ligament Reconstruction
William B. Hogan1; Eric M. Bluman, MD, PhD2
1Warren Alpert Medical School of Brown University
2Brigham and Women’s Hospital
This article present the case of a female patient in her early 20’s who was seen for follow up after 5 months of rehabilitation following surgical procedures to address instability in both the medial and lateral sides of her right ankle. This patient reported achieving an excellent outcome, and her subjective sense of significant improvement after rehabilitation was aligned with her physical exam and radiographic evaluation. This case documents the improvements made by the patient during the rehabilitation process and outlines essential steps to be performed by the practitioner in the clinical examination and radiographic follow up after surgery for ankle instability.
Deltoid Ligament Repair
William B. Hogan1; Eric M. Bluman, MD, PhD2
1Warren Alpert Medical School of Brown University
2Brigham and Women’s Hospital
Injury to the medial deltoid ligament complex is rare as it is the strongest of the ankle ligaments. However, damage to this structure can occur, often in association with an avulsion fracture of the medial malleolus due to the ligamentous strength of the complex. Deltoid ligament repair remains a primary option for patients with severe acute injuries, or patients with chronic instability who have failed conservative measures.
Repair of the medial ankle ligaments provides improved stability with reduced risk of recurrent sprains and potential damage to local cartilage. This article presents a case of a young woman with concomitant medial and lateral ankle instability who successfully underwent deltoid ligament repair for her medial ligament injury.
Brostrom-Gould Procedure for Lateral Ankle Instability
William B. Hogan1; Eric M. Bluman, MD, PhD2
1Warren Alpert Medical School of Brown University
2Brigham and Women’s Hospital
Acute ankle sprains are most frequently treated conservatively, although some surgeons may advocate acute repairs in certain situations. Surgery is indicated for chronic sprains with persistent ankle instability despite well-designed conservative management. Several anatomic and nonanatomic operative procedures are available. The Broström-Gould procedure is a widely-used operative intervention for the treatment of chronic lateral ankle sprains. It consists of an anatomic repair or reconstruction of the injured lateral ankle ligament complex (Broström procedure), followed by suturing of the inferior extensor retinaculum to the periosteum of the distal fibula (Gould modification).
This article describes the standard Broström-Gould procedure starting with the identification of the anatomic landmarks. The skin incision follows the anterior border of the distal fibula, and careful subcutaneous dissection is carried out to expose the extensor retinaculum and the torn ligaments. This is followed by bone preparation and ligament repair utilizing a box stitch technique while holding the ankle in an appropriate position. Finally, the Gould portion of the procedure is demonstrated.
Five Month Patient Follow-Up following Ankle Ligament Reconstruction
Eric Bluman, MD, PhD
Associate Orthopedic Surgeon, Brigham and Women’s Hospital
Lecturer on Orthopedic Surgery, Harvard Medical School
Deltoid Ligament Repair
Eric Bluman MD, PHD
Associate Orthopedic Surgeon, Brigham and Women’s Hospital
Lecturer on Orthopedic Surgery, Harvard Medical School
Brostrom-Gould Procedure for Lateral Ankle Instability
Eric Bluman, MD, PhD
Associate Orthopedic Surgeon, Brigham and Women’s Hospital Lecturer on Orthopedic Surgery, Harvard Medical School
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