Search Results

You are looking at 1 - 3 of 3 items for

  • Author: Stefan Rammelt x
Clear All Modify Search
Stefan Rammelt University Center of Orthopaedics & Traumatology, University Hospital Carl Gustav Carus, Dresden, Germany

Search for other papers by Stefan Rammelt in
Google Scholar
PubMed
Close

  • The incidence and severity of ankle fractures in elderly patients is increasing steadily. These injuries are challenging to treat and prone to complications.

  • Individual fracture treatment is tailored depending on bone quality, skin conditions, comorbidities, and functional demand of the patient. This article provides a review of current techniques to obtain stable fixation despite poor bone quality. To avoid complications, it is imperative to consider and treat comorbidities such as diabetes and osteoporosis.

  • In the absence of severe systemic comorbidities, the results after open reduction and internal fixation of malleolar fractures in patients above and below 60 years of age are nearly identical, while nonoperative treatment of unstable fractures leads to significantly inferior outcomes. Therefore, the general indications for surgery in elderly patients should not differ from those in younger patients.

  • However, it is essential to detect severe conditions such as Charcot neuro-osteoarthropathy because these require a completely different treatment regime, and standard internal fixation will invariably fail in these patients.

Cite this article: Rammelt S. Management of ankle fractures in the elderly. EFORT Open Rev 2016;1:239-246. DOI: 10.1302/2058-5241.1.000023.

Open access
Jan Bartoníček Department of Orthopaedics, First Faculty of Medicine, Charles University and Military University Hospital Prague, U Vojenské Nemocnice, Prague, Czech Republic

Search for other papers by Jan Bartoníček in
Google Scholar
PubMed
Close
,
Stefan Rammelt University Center for Orthopaedics, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus at TU Dresden, Fetscherstrasse, Dresden, Germany

Search for other papers by Stefan Rammelt in
Google Scholar
PubMed
Close
, and
Michal Tuček Department of Orthopaedics, First Faculty of Medicine, Charles University and Military University Hospital Prague, U Vojenské Nemocnice, Prague, Czech Republic

Search for other papers by Michal Tuček in
Google Scholar
PubMed
Close

  • Bosworth fracture (BF) is a special type of locked ankle fracture-dislocation, characterized by displacement of a fragment of the fractured fibula from the fibular notch behind the posterior surface of the distal tibia.

  • BF is a complex injury affecting multiple structures of the ankle joint, which is still frequently misjudged even today, potentially leading to severe complications.

  • CT examination, including 3D reconstructions, should be the diagnostic standard in BF, as it provides a complete picture of the fracture pathoanatomy, most prominently the morphology of the frequently associated posterior malleolar fracture.

  • BF requires early reduction of the displaced fibular fragment without repeated attempts on closed reduction. Non-operative treatment of BF almost always fails. The standard treatment procedure is early open reduction internal fixation.

  • Due to the relative severity and paucity of the injury, BF seems to be particularly prone to soft tissue complications, including compartment syndrome.

  • The results of operative treatment are mixed. Many studies report persistent pain even after a short time interval, with limitations of the range of motion or even stiffness of the ankle joint, and development of degenerative changes. Larger studies with long-term results are still missing.

Open access
Hagen Fritzsche University Center for Orthopaedics, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus, TU Dresden, Fetscherstrasse, Dresden, Germany

Search for other papers by Hagen Fritzsche in
Google Scholar
PubMed
Close
,
Anne Weidlich University Center for Orthopaedics, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus, TU Dresden, Fetscherstrasse, Dresden, Germany

Search for other papers by Anne Weidlich in
Google Scholar
PubMed
Close
,
Klaus-Dieter Schaser University Center for Orthopaedics, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus, TU Dresden, Fetscherstrasse, Dresden, Germany

Search for other papers by Klaus-Dieter Schaser in
Google Scholar
PubMed
Close
,
Elisabeth Mehnert University Center for Orthopaedics, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus, TU Dresden, Fetscherstrasse, Dresden, Germany

Search for other papers by Elisabeth Mehnert in
Google Scholar
PubMed
Close
,
Doreen Winkler University Center for Orthopaedics, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus, TU Dresden, Fetscherstrasse, Dresden, Germany

Search for other papers by Doreen Winkler in
Google Scholar
PubMed
Close
, and
Stefan Rammelt University Center for Orthopaedics, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus, TU Dresden, Fetscherstrasse, Dresden, Germany

Search for other papers by Stefan Rammelt in
Google Scholar
PubMed
Close

  • Musculoskeletal tumours of foot or ankle make up about 4–5% of all musculoskeletal tumours. Fortunately, about 80% of them are benign. However, due to the rarity and low prevalence of each single tumour entity, diagnosis is often difficult and delayed.

  • Ultrasonography is an important diagnostic tool to safely recognize ganglion cysts as a frequently encountered ‘bump’ in the foot.

  • In suspicious lesions, malignancy must be excluded histologically in a tumour center by biopsy after imaging procedures using x-ray, computed tomography (CT) and magnetic resonance imaging (MRI).

  • Most of the benign tumours do not require any further surgical therapy. Resection should be performed in the case of locally aggressive tumour growth or local symptoms of discomfort. In contrast to malignant tumours, the primary purpose in the resection is the least possible loss of function.

Open access