Thomas O Clanton - Academia.edu (original) (raw)

Papers by Thomas O Clanton

Foot & Ankle International, 2018

Background: The evidence supporting best practice guidelines in the field of cartilage repair of ... more Background: The evidence supporting best practice guidelines in the field of cartilage repair of the ankle are based on both low quality and low levels of evidence. Therefore, an international consensus group of experts was convened to collaboratively advance toward consensus opinions based on the best available evidence on key topics within cartilage repair of the ankle. The purpose of this article is to report the consensus statements on “Diagnosis: History, Physical Examination, Imaging, and Arthroscopy” developed at the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. Methods: Seventy-five international experts in cartilage repair of the ankle representing 25 countries and 1 territory were convened and participated in a process based on the Delphi method of achieving consensus. Questions and statements were drafted within 11 working groups focusing on specific topics within cartilage repair of the ankle, after which a comprehensive literature review was per...

Foot & Ankle International, 2018

Background: The evidence supporting best practice guidelines in the field of cartilage repair of ... more Background: The evidence supporting best practice guidelines in the field of cartilage repair of the ankle are based on both low quality and low levels of evidence. Therefore, an international consensus group of experts was convened to collaboratively advance toward consensus opinions based on the best available evidence on key topics within cartilage repair of the ankle. The purpose of this article is to report the consensus statements on Rehabilitation and Return to Sports developed at the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. Methods: Seventy-five international experts in cartilage repair of the ankle representing 25 countries and 1 territory were convened and participated in a process based on the Delphi method of achieving consensus. Questions and statements were drafted within 11 working groups focusing on specific topics within cartilage repair of the ankle, after which a comprehensive literature review was performed and the available evidence...

Orthopaedic Journal of Sports Medicine, Jul 1, 2016

Knee Surgery, Sports Traumatology, Arthroscopy, Nov 15, 2014

Orthopedics and Sports Medicine Open Access Journal, 2020

Foot & Ankle Orthopaedics, 2018

Category: Ankle, Ankle Arthritis Introduction/Purpose: Ankle arthritis is a debilitating disorder... more Category: Ankle, Ankle Arthritis Introduction/Purpose: Ankle arthritis is a debilitating disorder which significantly limits activities of daily living and can lead to reduced quality of life. Total ankle arthroplasty(TAA) and ankle arthrodesis are common treatments for ankle arthritis; however, patient indications may differ based on individual patient needs. Few studies compare proportional hazard modeling, survivorship and patient-centered outcomes following these two procedures, which may be useful in determining the appropriate procedure for end-stage ankle arthritis in different patient populations. The purpose of this study was to determine proportional hazards for the risk of failure in patients who underwent TAA vs. arthrodesis, as well as survivorship and outcomes. Methods: All patients >18 years, between January 2009 and November 2013, who underwent TAA or ankle arthrodesis by a single surgeon for treatment of ankle arthritis were included. Patients completed a subject...

Foot & Ankle Orthopaedics, 2018

Category: Ankle Arthritis Introduction/Purpose: The ankle joint is unique in epidemiological, ana... more Category: Ankle Arthritis Introduction/Purpose: The ankle joint is unique in epidemiological, anatomic, and biomechanical characteristics compared to other lower extremity joints. While primary hip and knee arthritis is common, approximately 70% of ankle arthritis is generally a result of another initiating event or underlying pathologic process. Post-traumatic arthritis is the most common indication for ankle arthrodesis and total ankle replacement. Few studies have documented the relationship between preoperative tibiotalar joint space and outcomes. Understanding this relationship may aid in preoperative patient counseling of expectations, and proper patient selection. The purpose of this study was to determine whether patients with narrow joint space (<2.0 mm vs. > 2.0 mm) preoperatively had inferior outcomes, as measured by the Foot and Ankle Ability Measure (FAAM) score, at a postoperative minimum of two years. Methods: All patients who underwent ankle surgery and a preop...

Scientific Journal of the Foot & Ankle, 2019

This study presents a case report of a 52-year-old female patient with a superficial acral fibrom... more This study presents a case report of a 52-year-old female patient with a superficial acral fibromyxoma (SAF) of her left foot fifth toe. This is a very uncommon soft tissue tumor that affects mainly hands and feet, with a special predilection for toes, with the hallux most frequent. The tumor in this case was 3cm long and 2.5cm wide, which was unusually large. Few cases are larger than 2cm long and localized on the fifth toe. Thetreatment was wide resection of the tumor through amputation of the fifth toe. Level of Evidence V; Therapeutic Studies; Expert Opinion.

The Journal of Bone & Joint Surgery, 1980

Orthopaedic review, 1989

An example of a spontaneous spiral fracture of the humerus in a healthy softball player is presen... more An example of a spontaneous spiral fracture of the humerus in a healthy softball player is presented. This rare injury is discussed, addressing the mechanisms of injury, the treatment, and the types of sports in which this type of fracture has been reported to occur.

Foot & Ankle International, 2018

Background: The evidence supporting best practice guidelines in the field of cartilage repair of ... more Background: The evidence supporting best practice guidelines in the field of cartilage repair of the ankle are based on both low quality and low levels of evidence. Therefore, an international consensus group of experts was convened to collaboratively advance toward consensus opinions based on the best available evidence on key topics within cartilage repair of the ankle. The purpose of this article was to report on the consensus statements on “Revision and Salvage Management” developed at the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. Methods: Seventy-five international experts in cartilage repair of the ankle representing 25 countries and 1 territory were convened and participated in a process based on the Delphi method of achieving consensus. Questions and statements were drafted within 11 working groups focusing on specific topics within cartilage repair of the ankle, after which a comprehensive literature review was performed and the available eviden...

Foot & Ankle International, 2018

Background: The evidence supporting best practice guidelines in the field of cartilage repair of ... more Background: The evidence supporting best practice guidelines in the field of cartilage repair of the ankle are based on both low quality and low levels of evidence. Therefore, an international consensus group of experts was convened to collaboratively advance toward consensus opinions based on the best available evidence on key topics within cartilage repair of the ankle. The purpose of this article is to report the consensus statements on “Conservative Management and Biological Treatment Strategies” developed at the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. Methods: Seventy-five international experts in cartilage repair of the ankle representing 25 countries and 1 territory were convened and participated in a process based on the Delphi method of achieving consensus. Questions and statements were drafted within 11 working groups focusing on specific topics within cartilage repair of the ankle, after which a comprehensive literature review was performed ...

Foot & Ankle International, 2009

Background: Mobile-bearing ankle replacements have become popular outside of the United States ov... more Background: Mobile-bearing ankle replacements have become popular outside of the United States over the past two decades. The goal of the present study was to perform a prospective evaluation of the safety and efficacy of a mobile-bearing prosthesis to treat end stage ankle arthritis. We report the results of three separate cohorts of patients: a group of Scandanavian Total Ankle Replacement (STAR) patients and a control group of ankle fusion patients (the Pivotal Study Groups) and another group of STAR total ankle patients (Continued Access Group) whose surgery was performed following the completion of enrollment in the Pivotal Study. Materials and Methods: The Pivotal Study design was a non-inferiority study using ankle fusion as the control. A non-randomized multi-centered design with concurrent fusion controls was used. We report the initial perioperative findings up to 24 months following surgery. For an individual patient to be considered an overall success, all of the followi...

Foot & Ankle International

Background: The treatment of posterior malleolar fractures (PMFs) is debated, including the need ... more Background: The treatment of posterior malleolar fractures (PMFs) is debated, including the need for surgery and method of fixation. Recent literature has suggested that fracture pattern, rather than fragment size, may be an important predictor for ankle biomechanics and functional outcome. Biomechanical studies have been conducted to provide evidence-based treatment on the effects of fracture and fixation on contact pressure and stability. The objective of this scoping review is to summarize the methodologies used in biomechanical studies on PMFs and assess whether they are sufficient to test the need for surgery and method of fixation. Methods: A scoping review of publications before January 2022 was performed. PubMed/Medline and Embase Ovid were searched for cadaver or finite element analysis (FEA) studies that created and tested the effects of PMFs in ankle fractures. Both cadaver and FEA studies were included. Data about fragment characteristics, mode of testing, and outcomes w...

Foot & Ankle Orthopaedics

Category: Ankle; Sports Introduction/Purpose: The Broström procedure is indicated for lateral ank... more Category: Ankle; Sports Introduction/Purpose: The Broström procedure is indicated for lateral ankle instability in the setting of acute or chronic ankle sprains, with injury of the anterior talofibular ligament (ATFL) being the most common. While the procedure is anatomically favorable, one disadvantage of the Broström procedure is significantly reduced strength of the repair when compared with the native ligament. Broström repair with augmentation of an InternalBrace (Arthrex, Naples, FL), nonabsorbable suture tape fixed directly to the bone, has demonstrated increased strength and stiffness of the repaired ATFL; however, there is a paucity of literature published on clinical outcomes. The purpose of this study is to compare clinical outcomes following treatment of ATFL injuries with Broström repair alone versus Broström repair with InternalBrace augmentation. Methods: Between January 2009 and December 2017, patients 18-75 years old who underwent surgical treatment for an ATFL inju...

Foot & Ankle Orthopaedics

This second of a 2-part series of articles recounts the key points presented in a collaborative s... more This second of a 2-part series of articles recounts the key points presented in a collaborative symposium sponsored jointly by the Arthritis Foundation and the American Orthopaedic Foot & Ankle Society with the intent to survey current treatment options for osteoarthritis (OA) of the foot and ankle. A meeting was held virtually on December 10, 2021. A group of experts were invited to present brief synopses of the current state of knowledge and research in this area. Topics were chosen by meeting organizers, who then identified and invited the expert speakers. Part 2 overviews the current treatment options, including orthotics, non–joint destructive procedures, as well as arthroscopies and arthroplasties in ankles and feet. Opportunities for future research are also discussed, such as developments in surgical options for ankle and the first metatarsophalangeal joint. The OA scientific community, including funding agencies, academia, industry, and regulatory agencies, must recognize t...

http://ajs.sagepub.com/content/42/2/412 The online version of this article can be found at: DOI: ... more http://ajs.sagepub.com/content/42/2/412 The online version of this article can be found at: DOI: 10.1177/0363546513509963 2014 42: 412 originally published online November 26, 2013 Am J Sports Med Thomas O. Clanton, Nicholas A. Viens, Kevin J. Campbell, Robert F. LaPrade and Coen A. Wijdicks Ligament Reconstruction Using Semitendinosus Allografts With the Intact Ligament Anterior Talofibular Ligament Ruptures, Part 2: Biomechanical Comparison of Anterior Talofibular

Orthopaedic Journal of Sports Medicine, 2016

Objectives: Historically, unstable injuries to the distal tibiofibular syndesmosis have been repa... more Objectives: Historically, unstable injuries to the distal tibiofibular syndesmosis have been repaired with syndesmotic screws. However, newer repair techniques with inherently flexible implants, including suture-button constructs, may be less susceptible to malreduction and more reliably restore the native anatomy. The purpose of this study was to compare the anatomic accuracy of reduction between a syndesmotic screw and suture-button constructs for syndesmosis repair using a pre-injury and postoperative 3-D model assessment. We hypothesized significant differences would be observed among repair techniques and suture-button constructs would most accurately restore the pre-injury syndesmotic volume. Methods: Twelve matched pairs of cadaveric specimens were dissected to identify the syndesmotic ligaments. Specimens were imaged with CT prior to the creation of a complete syndesmosis injury. The disrupted syndesmosis of each specimen was subsequently reduced using one of three randomly ...

Surgical repair or reconstruction of a ruptured tibialis anterior produced uniformly good results... more Surgical repair or reconstruction of a ruptured tibialis anterior produced uniformly good results with return to preinjury activity in almost all reported cases. Only one case in which surgery had been performed was noted to have persistent disability. Persistent symptoms have been reported in patients treated nonoperatively, although they seem to do well overall because of their low level of activity. Most investigators recommend surgical repair for the symptomatic patient, with a moderate to high activity level unless otherwise contraindicated.'-' n Although no significant complications have been reported, Mann outlined potential risks of surgical intervention: to prevent adhesions the incision should not lie directly over the tendon, and if possible, should lie slightly medial to it; the pull-out wire should draw the tendon beneath the extensor retinaculum, otherwise the wire will tent the tendon, resulting in a difficult wound closure.

Foot & Ankle International, 2021

Background: The purposes of this study were to determine (1) if cartilage thicknesses on the tala... more Background: The purposes of this study were to determine (1) if cartilage thicknesses on the talar dome and medial/lateral surfaces of the talus were similar, (2) whether there was sufficient donor cartilage surface area on the medial and lateral talar surfaces to repair talar dome cartilage injuries of the talus, and (3) whether the cartilage surface could be increased following anterior talofibular ligament (ATFL) and sectioning of the tibionavicular and tibiospring portion of the anterior deltoid. Methods: Medial and lateral approaches were utilized in 8 cadaveric ankles to identify the accessible medial, lateral, and talar dome cartilage surfaces in 3 conditions: (1) intact, (2) ATFL release, and (3) superficial anterior deltoid ligament release. The talus was explanted, and the cartilage areas were digitized with a coordinate measuring machine. Cartilage thickness was quantified using a laser scanner. Results: The mean cartilage thickness was 1.0 ± 0.1 mm in all areas tested. I...

Foot & Ankle International, 2018

Background: The evidence supporting best practice guidelines in the field of cartilage repair of ... more Background: The evidence supporting best practice guidelines in the field of cartilage repair of the ankle are based on both low quality and low levels of evidence. Therefore, an international consensus group of experts was convened to collaboratively advance toward consensus opinions based on the best available evidence on key topics within cartilage repair of the ankle. The purpose of this article is to report the consensus statements on “Diagnosis: History, Physical Examination, Imaging, and Arthroscopy” developed at the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. Methods: Seventy-five international experts in cartilage repair of the ankle representing 25 countries and 1 territory were convened and participated in a process based on the Delphi method of achieving consensus. Questions and statements were drafted within 11 working groups focusing on specific topics within cartilage repair of the ankle, after which a comprehensive literature review was per...

Foot & Ankle International, 2018

Background: The evidence supporting best practice guidelines in the field of cartilage repair of ... more Background: The evidence supporting best practice guidelines in the field of cartilage repair of the ankle are based on both low quality and low levels of evidence. Therefore, an international consensus group of experts was convened to collaboratively advance toward consensus opinions based on the best available evidence on key topics within cartilage repair of the ankle. The purpose of this article is to report the consensus statements on Rehabilitation and Return to Sports developed at the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. Methods: Seventy-five international experts in cartilage repair of the ankle representing 25 countries and 1 territory were convened and participated in a process based on the Delphi method of achieving consensus. Questions and statements were drafted within 11 working groups focusing on specific topics within cartilage repair of the ankle, after which a comprehensive literature review was performed and the available evidence...

Orthopaedic Journal of Sports Medicine, Jul 1, 2016

Knee Surgery, Sports Traumatology, Arthroscopy, Nov 15, 2014

Orthopedics and Sports Medicine Open Access Journal, 2020

Foot & Ankle Orthopaedics, 2018

Category: Ankle, Ankle Arthritis Introduction/Purpose: Ankle arthritis is a debilitating disorder... more Category: Ankle, Ankle Arthritis Introduction/Purpose: Ankle arthritis is a debilitating disorder which significantly limits activities of daily living and can lead to reduced quality of life. Total ankle arthroplasty(TAA) and ankle arthrodesis are common treatments for ankle arthritis; however, patient indications may differ based on individual patient needs. Few studies compare proportional hazard modeling, survivorship and patient-centered outcomes following these two procedures, which may be useful in determining the appropriate procedure for end-stage ankle arthritis in different patient populations. The purpose of this study was to determine proportional hazards for the risk of failure in patients who underwent TAA vs. arthrodesis, as well as survivorship and outcomes. Methods: All patients >18 years, between January 2009 and November 2013, who underwent TAA or ankle arthrodesis by a single surgeon for treatment of ankle arthritis were included. Patients completed a subject...

Foot & Ankle Orthopaedics, 2018

Category: Ankle Arthritis Introduction/Purpose: The ankle joint is unique in epidemiological, ana... more Category: Ankle Arthritis Introduction/Purpose: The ankle joint is unique in epidemiological, anatomic, and biomechanical characteristics compared to other lower extremity joints. While primary hip and knee arthritis is common, approximately 70% of ankle arthritis is generally a result of another initiating event or underlying pathologic process. Post-traumatic arthritis is the most common indication for ankle arthrodesis and total ankle replacement. Few studies have documented the relationship between preoperative tibiotalar joint space and outcomes. Understanding this relationship may aid in preoperative patient counseling of expectations, and proper patient selection. The purpose of this study was to determine whether patients with narrow joint space (<2.0 mm vs. > 2.0 mm) preoperatively had inferior outcomes, as measured by the Foot and Ankle Ability Measure (FAAM) score, at a postoperative minimum of two years. Methods: All patients who underwent ankle surgery and a preop...

Scientific Journal of the Foot & Ankle, 2019

This study presents a case report of a 52-year-old female patient with a superficial acral fibrom... more This study presents a case report of a 52-year-old female patient with a superficial acral fibromyxoma (SAF) of her left foot fifth toe. This is a very uncommon soft tissue tumor that affects mainly hands and feet, with a special predilection for toes, with the hallux most frequent. The tumor in this case was 3cm long and 2.5cm wide, which was unusually large. Few cases are larger than 2cm long and localized on the fifth toe. Thetreatment was wide resection of the tumor through amputation of the fifth toe. Level of Evidence V; Therapeutic Studies; Expert Opinion.

The Journal of Bone & Joint Surgery, 1980

Orthopaedic review, 1989

An example of a spontaneous spiral fracture of the humerus in a healthy softball player is presen... more An example of a spontaneous spiral fracture of the humerus in a healthy softball player is presented. This rare injury is discussed, addressing the mechanisms of injury, the treatment, and the types of sports in which this type of fracture has been reported to occur.

Foot & Ankle International, 2018

Background: The evidence supporting best practice guidelines in the field of cartilage repair of ... more Background: The evidence supporting best practice guidelines in the field of cartilage repair of the ankle are based on both low quality and low levels of evidence. Therefore, an international consensus group of experts was convened to collaboratively advance toward consensus opinions based on the best available evidence on key topics within cartilage repair of the ankle. The purpose of this article was to report on the consensus statements on “Revision and Salvage Management” developed at the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. Methods: Seventy-five international experts in cartilage repair of the ankle representing 25 countries and 1 territory were convened and participated in a process based on the Delphi method of achieving consensus. Questions and statements were drafted within 11 working groups focusing on specific topics within cartilage repair of the ankle, after which a comprehensive literature review was performed and the available eviden...

Foot & Ankle International, 2018

Background: The evidence supporting best practice guidelines in the field of cartilage repair of ... more Background: The evidence supporting best practice guidelines in the field of cartilage repair of the ankle are based on both low quality and low levels of evidence. Therefore, an international consensus group of experts was convened to collaboratively advance toward consensus opinions based on the best available evidence on key topics within cartilage repair of the ankle. The purpose of this article is to report the consensus statements on “Conservative Management and Biological Treatment Strategies” developed at the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. Methods: Seventy-five international experts in cartilage repair of the ankle representing 25 countries and 1 territory were convened and participated in a process based on the Delphi method of achieving consensus. Questions and statements were drafted within 11 working groups focusing on specific topics within cartilage repair of the ankle, after which a comprehensive literature review was performed ...

Foot & Ankle International, 2009

Background: Mobile-bearing ankle replacements have become popular outside of the United States ov... more Background: Mobile-bearing ankle replacements have become popular outside of the United States over the past two decades. The goal of the present study was to perform a prospective evaluation of the safety and efficacy of a mobile-bearing prosthesis to treat end stage ankle arthritis. We report the results of three separate cohorts of patients: a group of Scandanavian Total Ankle Replacement (STAR) patients and a control group of ankle fusion patients (the Pivotal Study Groups) and another group of STAR total ankle patients (Continued Access Group) whose surgery was performed following the completion of enrollment in the Pivotal Study. Materials and Methods: The Pivotal Study design was a non-inferiority study using ankle fusion as the control. A non-randomized multi-centered design with concurrent fusion controls was used. We report the initial perioperative findings up to 24 months following surgery. For an individual patient to be considered an overall success, all of the followi...

Foot & Ankle International

Background: The treatment of posterior malleolar fractures (PMFs) is debated, including the need ... more Background: The treatment of posterior malleolar fractures (PMFs) is debated, including the need for surgery and method of fixation. Recent literature has suggested that fracture pattern, rather than fragment size, may be an important predictor for ankle biomechanics and functional outcome. Biomechanical studies have been conducted to provide evidence-based treatment on the effects of fracture and fixation on contact pressure and stability. The objective of this scoping review is to summarize the methodologies used in biomechanical studies on PMFs and assess whether they are sufficient to test the need for surgery and method of fixation. Methods: A scoping review of publications before January 2022 was performed. PubMed/Medline and Embase Ovid were searched for cadaver or finite element analysis (FEA) studies that created and tested the effects of PMFs in ankle fractures. Both cadaver and FEA studies were included. Data about fragment characteristics, mode of testing, and outcomes w...

Foot & Ankle Orthopaedics

Category: Ankle; Sports Introduction/Purpose: The Broström procedure is indicated for lateral ank... more Category: Ankle; Sports Introduction/Purpose: The Broström procedure is indicated for lateral ankle instability in the setting of acute or chronic ankle sprains, with injury of the anterior talofibular ligament (ATFL) being the most common. While the procedure is anatomically favorable, one disadvantage of the Broström procedure is significantly reduced strength of the repair when compared with the native ligament. Broström repair with augmentation of an InternalBrace (Arthrex, Naples, FL), nonabsorbable suture tape fixed directly to the bone, has demonstrated increased strength and stiffness of the repaired ATFL; however, there is a paucity of literature published on clinical outcomes. The purpose of this study is to compare clinical outcomes following treatment of ATFL injuries with Broström repair alone versus Broström repair with InternalBrace augmentation. Methods: Between January 2009 and December 2017, patients 18-75 years old who underwent surgical treatment for an ATFL inju...

Foot & Ankle Orthopaedics

This second of a 2-part series of articles recounts the key points presented in a collaborative s... more This second of a 2-part series of articles recounts the key points presented in a collaborative symposium sponsored jointly by the Arthritis Foundation and the American Orthopaedic Foot & Ankle Society with the intent to survey current treatment options for osteoarthritis (OA) of the foot and ankle. A meeting was held virtually on December 10, 2021. A group of experts were invited to present brief synopses of the current state of knowledge and research in this area. Topics were chosen by meeting organizers, who then identified and invited the expert speakers. Part 2 overviews the current treatment options, including orthotics, non–joint destructive procedures, as well as arthroscopies and arthroplasties in ankles and feet. Opportunities for future research are also discussed, such as developments in surgical options for ankle and the first metatarsophalangeal joint. The OA scientific community, including funding agencies, academia, industry, and regulatory agencies, must recognize t...

http://ajs.sagepub.com/content/42/2/412 The online version of this article can be found at: DOI: ... more http://ajs.sagepub.com/content/42/2/412 The online version of this article can be found at: DOI: 10.1177/0363546513509963 2014 42: 412 originally published online November 26, 2013 Am J Sports Med Thomas O. Clanton, Nicholas A. Viens, Kevin J. Campbell, Robert F. LaPrade and Coen A. Wijdicks Ligament Reconstruction Using Semitendinosus Allografts With the Intact Ligament Anterior Talofibular Ligament Ruptures, Part 2: Biomechanical Comparison of Anterior Talofibular

Orthopaedic Journal of Sports Medicine, 2016

Objectives: Historically, unstable injuries to the distal tibiofibular syndesmosis have been repa... more Objectives: Historically, unstable injuries to the distal tibiofibular syndesmosis have been repaired with syndesmotic screws. However, newer repair techniques with inherently flexible implants, including suture-button constructs, may be less susceptible to malreduction and more reliably restore the native anatomy. The purpose of this study was to compare the anatomic accuracy of reduction between a syndesmotic screw and suture-button constructs for syndesmosis repair using a pre-injury and postoperative 3-D model assessment. We hypothesized significant differences would be observed among repair techniques and suture-button constructs would most accurately restore the pre-injury syndesmotic volume. Methods: Twelve matched pairs of cadaveric specimens were dissected to identify the syndesmotic ligaments. Specimens were imaged with CT prior to the creation of a complete syndesmosis injury. The disrupted syndesmosis of each specimen was subsequently reduced using one of three randomly ...

Surgical repair or reconstruction of a ruptured tibialis anterior produced uniformly good results... more Surgical repair or reconstruction of a ruptured tibialis anterior produced uniformly good results with return to preinjury activity in almost all reported cases. Only one case in which surgery had been performed was noted to have persistent disability. Persistent symptoms have been reported in patients treated nonoperatively, although they seem to do well overall because of their low level of activity. Most investigators recommend surgical repair for the symptomatic patient, with a moderate to high activity level unless otherwise contraindicated.'-' n Although no significant complications have been reported, Mann outlined potential risks of surgical intervention: to prevent adhesions the incision should not lie directly over the tendon, and if possible, should lie slightly medial to it; the pull-out wire should draw the tendon beneath the extensor retinaculum, otherwise the wire will tent the tendon, resulting in a difficult wound closure.

Foot & Ankle International, 2021

Background: The purposes of this study were to determine (1) if cartilage thicknesses on the tala... more Background: The purposes of this study were to determine (1) if cartilage thicknesses on the talar dome and medial/lateral surfaces of the talus were similar, (2) whether there was sufficient donor cartilage surface area on the medial and lateral talar surfaces to repair talar dome cartilage injuries of the talus, and (3) whether the cartilage surface could be increased following anterior talofibular ligament (ATFL) and sectioning of the tibionavicular and tibiospring portion of the anterior deltoid. Methods: Medial and lateral approaches were utilized in 8 cadaveric ankles to identify the accessible medial, lateral, and talar dome cartilage surfaces in 3 conditions: (1) intact, (2) ATFL release, and (3) superficial anterior deltoid ligament release. The talus was explanted, and the cartilage areas were digitized with a coordinate measuring machine. Cartilage thickness was quantified using a laser scanner. Results: The mean cartilage thickness was 1.0 ± 0.1 mm in all areas tested. I...