1/6. Bicycle spoke fracture.Twenty-nine children were treated for bicycle spoke injury, which occurred while they were sitting behind their riding parents. Their feet were caught in between the bicycle spoke and the frame rod. Five of these children suffered supramalleolar fracture. These fractures had a similar radiographic pattern, namely a greenstick fracture of the distal end of the tibia and fibula, buckling into varus and usually also into anterior angulation. Healing of the fractures was uneventful. These injuries are preventable by rigid plastic net covers for the rear wheel of the bicycle.- - - - - - - - - - ranking = 1keywords = behind (Clic here for more details about this article) |
2/6. Bosworth fracture-dislocation of the ankle. A case report and review of the literature.The Bosworth fracture-dislocation is a rare fracture-dislocation of the ankle where the proximal fibular fragment lodges behind the tibia, rendering it irreducible by routine closed manipulations. Clinically the patient's foot is in severe external rotation. This external rotation makes the initial roentgenograms difficult to interpret. Consequently, the diagnosis is often overlooked, resulting in inappropriate treatment and a disastrous outcome. If properly recognized, these injuries can be successfully treated by closed or open techniques with return of near-normal ankle function. The problem is illustrated in a case involving a 40-year-old woman, as related to a review of the literature and discussion of the treatment rationale.- - - - - - - - - - ranking = 1keywords = behind (Clic here for more details about this article) |
3/6. Fracture dislocation of the ankle with the fibula trapped behind the tibia. A case report.The authors present a case of fracture dislocation of the ankle with the fibula entrapped behind the tibia--Bosworth's fracture. It is often unrecognized as such because it is so rare and because radiographs are not correctly interpreted. A stable reduction can be obtained by closed treatment when promptly recognized.- - - - - - - - - - ranking = 5keywords = behind (Clic here for more details about this article) |
4/6. Fracture-dislocation of the ankle with posterior entrapment of the fibula behind the tibia.Fracture-dislocation of the ankle with entrapment of the fibula behind the tibia is a rare condition. Prompt recognition and treatment are necessary to prevent permanent disability. In three of four patients, the injury was managed by closed reduction. If the injury is accurately diagnosed and if traction and medial rotation are applied to the foot while the fibular shaft is pushed laterally, a stable, satisfactory reduction may be achieved. If closed reduction fails, a lateral approach through a small vertical incision directly over the fractured fibular malleolus is sufficient to allow open reduction of the fibula.- - - - - - - - - - ranking = 5keywords = behind (Clic here for more details about this article) |
5/6. Traumatic focal posterior tibialis muscle denervation.The purpose of this case presentation is to demonstrate posterior tibialis muscle (PTM) denervation as a cause of traumatic plantarflexion inversion weakness. In a 42-year-old woman, severe pain, swelling, and ecchymosis over the medial aspect of her left ankle developed after she twisted it while playing tennis. Plantarflexion inversion weakness developed (grade 3/5). The strength of all other muscle groups of the lower extremity was normal. Her pin and light touch sensation were normal in the left lower extremity. Deep tendon reflexes were equal and active at both knees and ankles. A magnetic resonance image of the left leg, ankle, and foot performed 1 month after injury demonstrated an intact posterior tibialis tendon behind the medial malleolus and edema-like increased signal intensity in the PTM on the T1-weighted image consistent with denervation. On electromyographic testing, there were continuous fibrillation and positive sharp wave potentials in every site tested in the PTM without any voluntary motor unit activity. The left extensor hallucis, left gastrocnemius, and lumbar paraspinal muscles were normal. In conclusion, combined magnetic resonance imaging and electromyographic studies supported denervation of the PTM as the cause of plantarflexion inversion weakness, rather than posterior tibialis tendon rupture in this patient.- - - - - - - - - - ranking = 1keywords = behind (Clic here for more details about this article) |
6/6. Fracture-dislocation of the ankle with fixed displacement of the fibula behind the tibia.Fracture-dislocation of the ankle with fixed displacement of the fibula behind the tibia (Bosworth fracture-dislocation) is infrequently encountered in clinical practice. The diagnosis of this entity is often overlooked due to an inability to correlate clinical findings with roentgenographic data. The mismanagement that follows an incorrect diagnosis may render a patient permanently disabled. The authors report a case of Bosworth fracture-dislocation and describe the steps leading to proper diagnosis and treatment of this rare injury.- - - - - - - - - - ranking = 5keywords = behind (Clic here for more details about this article) |