Search Results
You are looking at 1 - 6 of 6 items for
- Author or Editor: Noriyuki Kanzaki x
- Refine by access: All Content x
Peroneal tendon dislocation is often overlooked because the mechanism of injury is similar to that of lateral ligament sprains and the frequency of the disease is low. Therefore, it is difficult to treat peroneal tendon dislocation when diagnosed in the chronic state. Furthermore, because irreducible peroneal tendon dislocation has multiple causes, treatment is much harder. Herein, we present a rare case of irreducible dislocation caused by a complex pathogenesis. Surgical treatment yielded good results. Orthopedic surgeons should be aware of this issue and consider it in the preoperative simulation.
Background: It remains controversial whether satisfactory outcomes can be obtained following total ankle arthroplasty (TAA) without osteotomy in patients with severe varus ankle deformities. This study aimed to examine outcomes following TAA without concomitant osteotomies in patients with severe varus ankle alignment by comparing them with those in patients with neutral alignment.
Methods: Fifty-one patients (53 ankles; mean age, 71.4 ± 5.6 years) who underwent TAA using the TNK ankle prosthesis were examined (mean follow-up, 36.8 ± 17.8 months). Patients were allocated into groups according to the preoperative talar tilt (TT) angle: the neutral group (preoperative TT angle <10°; n = 37) and the varus group (preoperative TT angle ≥10°; n = 16). Outcome measures, including the Japanese Society for Surgery of the Foot scale, Self-Administered Foot Evaluation Questionnaire, ankle range of motion, and radiographic parameters, were assessed before surgery and at the final follow-up.
Results: Significant improvements were observed in clinical and radiographic outcomes in both groups after surgery. Postoperative Japanese Society for Surgery of the Foot scale and subscale scores of pain and shoes in the Self-Administered Foot Evaluation Questionnaire were not significantly different between the groups, whereas subscale scores of function, social, and health were greater in the varus group than in the neutral group at the final follow-up. Radiographic parameters, including TT angle and tibial axis-medial malleolus (TMM) angle, improved postoperatively and were not significantly different between the neutral (mean TT angle, 0.5 ± 0.7°; mean TMM angle, 16.0 ± 4.6°) and varus (meanTT angle, 0.4 ± 0.7°; meanTMM angle, 17.0 ± 5.3°) groups at the final follow-up. To achieve neutral alignment, adjunctive procedures were required more often in the varus group.
Conclusions: Outcomes of TAA using the TNK ankle prosthesis were favorable in patients with severe varus ankle and in those with neutral ankle without concomitant osteotomy. Satisfactory outcomes could be achieved in patients with severe varus ankle alignment after TAA without concomitant osteotomy.
Simple bone cysts compose approximately 3% of all primary bone tumors and most commonly occur in the metaphyseal regions of the proximal humerus and femur. The percentage of the talus with suspected bone tumors is reported to be 0.003%. Therefore, talar cysts are rare but sometimes present as aggressive lesions, and they can affect any of the tarsal bones. Recently, an arthroscopic approach to these lesions has been developed that is less invasive than conventional open surgery. In the present case study, we profile a 65-year-old female patient who received arthroscopic debridement of a bone cyst from the medial aspect of the talus with the osteochondral autograft transfer system (OATS). By using the OATS core harvester, we penetrated into the tumor. After the cylindrical bone plug was pulled out, the tumor was removed and artificial bone granules were firmly packed into the cavity with intralesional arthroscopy. Then, the cylindrical bone plug previously harvested by OATS was implanted at the site with careful precision. This intervention resulted in a relative restoration of talar dome anatomy and ultimately restored the patient to activity with minimal discomfort. Therefore, arthroscopic debridement with OATS has the potential to be a useful option in dealing with debilitating osteochondral cystic lesions.
The peroneus quartus muscle is an accessory muscle seen in the lateral compartment of the lower leg. Although the peroneus quartus muscle is asymptomatic in general, it sometimes becomes pathologic. We present the rare case of bilateral ankle pain with crepitation caused by the peroneus quartus muscle. Magnetic resonance imaging should be considered to assist with diagnosing this condition. Foot and ankle surgeons should consider it in the preoperative differential diagnosis when patients present with posterior ankle pain.
