The Hip book

Syme’s Amputation

– Discussion:     – includes ankle disarticulation, removal of malleoli, & anchoring heel pad to the wt bearing surface) allows execellent gait with a cosmetic             prosthesis;     – symes amputations will not heal w/o palpable posterior artery pulse;     – surgery may be performed in 2 stages;     – most common … Read more

Syndesmotic Injuries of the Ankle

    – See: syndesmotic sprain – Anatomy:     – syndesmosis is made up of anterior-inferior tibiofibular ligament, interosseous ligament, and             posterior-inferior fibular ligaments, inferior transverse tibiofibular ligament, and interosseous ligament;             – these stabilize the mortise by opposing the fibula in the fibular notch (incisura fibularis tibiae);     … Read more

Syndesmotic Sprain

– See: Technique of Snydesmotic Fixation – Discussion:     – if only syndesmotic ligaments are divided (w/ fibula & collateral ligaments intact) there will be no widening of mortise or lateral displacement of talus;     – compressing the fibula and tibia above the ankle elicits tenderness at the syndesmosis, implies injury to the … Read more

Sustentaculuum Tali Fractures

– Discussion:  – fractures of the sustentaculum tali result from landing on the heel combined with severe inversion of the foot; – inversion of foot produces acute pain just below the medial malleolus;  – pain may be accentuated by passive hyperextension of the great toe;  – this fracture may be mistaken for an ankle fracture;  … Read more

Swing Phase of Gait

– See: Gait Menu: and Muscle Activity During Gait – Discussion:     – during swing, the ankle dorsiflexes by the concentric contraction of anterior tibialis muscle;     – all other muscles are silent;     – momentum generated by the gastrocsoleus and hip flexors at terminal stance carries the leg forward     – during initial swing … Read more

Sustentaculum Talus Fracture

– Discussion:      – fractures of the sustentaculum tali result from landing on the heel combined with severe inversion of the foot;      – inversion of foot produces acute pain just below the medial malleolus;      – pain may be accentuated by passive hyperextension of the great toe;      – this fracture may be mistaken … Read more