28th March - post-traumatic ankle problems
Venue - Burnley General Hospital, starting 2:15pm
Leader - Mr JL Barrie
Guest lecturer: Mr N Makwana (Oswestry)
Topic: post-traumatic ankle problems
Ankle ligament injuries and instability
Common injury and chronic problems may be commoner than we think. Fortunately most patients do well with a rehabilitation approach.
Aiming to cover:
- anatomy and biomechanics
- why do acute injuries become chronic
- clinical assessment
- does imaging tell us anything useful?
- non-surgical and surgical management
Suggested reading
Pijnenburg et al (Operative and functional treatment of rupture of the lateral ligament of the ankle. A randomised, prospective trial. JBJS 2003;85B:525-30). Discuss this paper and its implications in more depth
Karlsson J et al. Reconstruction of the lateral ligaments of the ankle for chronic lateral instability. JBJS 1988; 70A:581-8
Beynnon, BD, Renstrom, PA, et al. (2006). A prospective, randomized clinical investigation of the treatment of first-time ankle sprains. Am J Sports Med 34(9): 1401-12.
Impingement
Mainly anterior impingement as we’re hoping to have Prof Bill Ribbans give his excellent talk on posterior ankle pain at a future session.
aiming to cover:
- causes
- clinical assessment
- does imaging tell us anything useful?
- non-surgical and surgical management
Suggested reading
Molloy S et al. Synovial impingement in the ankle. A new physical sign. JBJS 2003; 85B:330-3
Tol JL et al. Arthroscopic treatment of anterior impingement in the ankle JBJS 2001; 83B:9-13
Chondral and osteochondral injuries
Mr Makwana will talk to us from the perspective of the unit at Oswestry who have done a lot of clinical and basic science work on resurfacing techniques in the ankle.
I’ve asked him to cover:
- basic science
- clinical features
- classification
- imaging
- management
Suggested reading
Gobbi, A, Francisco, RA, et al. (2006). Osteochondral lesions of the talus: randomized controlled trial comparing chondroplasty, microfracture, and osteochondral autograft transplantation. Arthroscopy 22(10): 1085-92.
Baums, MH, Heidrich, G, et al. (2006). Autologous chondrocyte transplantation for treating cartilage defects of the talus. J Bone Joint Surg Am 88(2): 303-8.
Verhagen, RA, Maas, M, et al. (2005). Prospective study on diagnostic strategies in osteochondral lesions of the talus. Is MRI superior to helical CT? J Bone Joint Surg Br 87(1): 41-6. This paper is worth reading because it explains the statistics of diagnostic tests (for the exam!!) reasonably clearly