Dataset Information

Endoscopically Assisted Reduction and Screw Fixation of Acute Fracture of the Posteromedial Talar Process (Cedell Fracture).

ABSTRACT: Fracture of the posteromedial talar process (Cedell fracture) is a rare injury and is usually associated with other injuries such as medial subtalar dislocation. Diagnosis of the fracture necessitates a heightened clinical suspicion, and computed tomography should be performed in any suspicious cases. Timely treatment is important for restoration of proper anatomy and function of the subtalar joint. Significant morbidity is associated with an undiagnosed or nonoperatively treated fracture of the posteromedial talar process, especially in a larger fracture that is intra-articular at both the ankle and subtalar joints. In this Technical Note, the technical details of endoscopically assisted reduction and screw fixation of acute posteromedial talar fracture is described. This can allow fracture reduction and fracture fixation under endoscopic visualization.

SUBMITTER: Li CHC

PROVIDER: S-EPMC7451441 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Endoscopically Assisted Reduction and Screw Fixation of Acute Fracture of the Posteromedial Talar Process (Cedell Fracture).

Li Churk Hang Charles CHC Lui Tun Hing TH

Arthroscopy techniques 20200722 8

Fracture of the posteromedial talar process (Cedell fracture) is a rare injury and is usually associated with other injuries such as medial subtalar dislocation. Diagnosis of the fracture necessitates a heightened clinical suspicion, and computed tomography should be performed in any suspicious cases. Timely treatment is important for restoration of proper anatomy and function of the subtalar joint. Significant morbidity is associated with an undiagnosed or nonoperatively treated fracture of the ...[more]

PMID: 32874895

Similar Datasets

Project description:IntroductionIn locked plate fixation of proximal humerus fractures, the calcar is an important anchor point for screws providing much-needed medial column support. Most locking plate implants utilize a fixed-trajectory locking screw to achieve this goal. Consequently, adjustments of plate location to account for patient-specific anatomy may result in a screw position outside of the calcar. To date, little is known about the consequences of "missing" the calcar during plate positioning. This study sought to characterize the biomechanics associated with proximal and distal placement of locking plates in a two-part fracture model.Materials and methodsThis experiment was performed twice, first with elderly cadaveric specimens and again with osteoporotic sawbones. Two-part fractures were simulated and specimens were divided to represent proximal, neutral, and distal plate placements. Non-destructive torsional and axial compression tests were performed prior to an axial fatigue test and a ramp to failure. Torsional stiffness, axial stiffness, humeral head displacement and stiffness during fatigue testing, and ultimate load were compared between groups.ResultsCadavers: Proximal implant placement led to trends of decreased mechanical properties, but there were no significant differences found between groups. Sawbones: Distal placement increased torsional stiffness in both directions (p = 0.003, p = 0.034) and axial stiffness (p = 0.018) when compared to proximal placement. Distal placement also increased torsional stiffness in external rotation (p = 0.020), increased axial stiffness (p = 0.024), decreased humeral head displacement during fatigue testing, and increased stiffness during fatigue testing when compared to neutral placement.DiscussionThe distal and neutral groups had similar mechanical properties in many cadaveric comparisons while the proximal group trended towards decreased construct stiffness.Resultsfrom the Sawbones model were more definitive and provided further evidence that proximal calcar screw placements are undesirable and distal implant placement may provide improved construct stability.ConclusionSuccessful proximal humerus fracture reconstruction is inherent upon anatomic fracture reduction coupled with medial column support. Results from this experiment suggest that missing the calcar proximally is deleterious to fixation strength, while it is safe, and perhaps even desirable, to aim slightly distal to the intended target.

Dataset Information

Endoscopically Assisted Reduction and Screw Fixation of Acute Fracture of the Posteromedial Talar Process (Cedell Fracture).

Publications

Endoscopically Assisted Reduction and Screw Fixation of Acute Fracture of the Posteromedial Talar Process (Cedell Fracture).

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets