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Orthopaedic Proceedings
Vol. 106-B, Issue SUPP_7 | Pages 12 - 12
8 May 2024
Miller D Stephen J Calder J el Daou H
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Background

Lateral ankle instability is a common problem, but the precise role of the lateral ankle structures has not been accurately investigated. This study aimed to accurately investigate lateral ankle complex stability for the first time using a novel robotic testing platform.

Method

A six degrees of freedom robot manipulator and a universal force/torque sensor were used to test 10 foot and ankle specimens. The system automatically defined the path of unloaded plantar/dorsi flexion. At four flexion angles: 20° dorsiflexion, neutral flexion, 20° and 40° of plantarflexion; anterior-posterior (90N), internal-external (5Nm) and inversion-eversion (8Nm) laxity were tested. The motion of the intact ankle was recorded first and then replayed following transection of the lateral retinaculum, Anterior Talofibular Ligament (ATFL) and Calcaneofibular Ligament (CFL). The decrease in force/torque reflected the contribution of the structure to restraining laxity. Data were analysed using repeated measures of variance and paired t-tests.


Orthopaedic Proceedings
Vol. 84-B, Issue SUPP_III | Pages 273 - 273
1 Nov 2002
Kwon Y Bruce W van der Wall H Stephen J
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Introduction: Spondylolysis is amongst the commonest causes of low back pain in the athletic child. We observed increased uptake in the pedicles of the affected segment and a triangular pattern of uptake in the sagittal projection of tomographic studies of fractures of the pars interarticularis. The hypothesis that these observations were specific for fractures of the pars interarticularis was tested in a variety of spinal disorders.

Methods:. A retrospective study of 25 young athletes with a variety of spinal disorders was undertaken (17males, 8 females; average age 13.5 years [range: nine to16 years]). The patients were referred from a specialised sports clinic. Back pain was present for an average of four months (Range six weeks to 11 months). All children had planar and tomographic scintigraphic bone scans with special reconstruction. The diagnosis was confirmed by radiological studies and/or response to treatment.

Results:. All 15 children with spondylolysis had evidence of increased uptake in the ipsilateral (12/15) or contra-lateral pedicle (3/15). None of the cases of muscle insertion injury, facet joint or disc disease demonstrated this pattern. A triangular shaped pattern of uptake was only seen in the sagittal view of the tomographic studies in patients with fractures of the pars interarticularis.

Conclusion:. We have described two unique features of spondylolysis that add to the confidence with which the scintigraphic diagnosis may be made.


The Journal of Bone & Joint Surgery British Volume
Vol. 72-B, Issue 4 | Pages 670 - 674
1 Jul 1990
Cundy P Paterson D Hillier T Sutherland A Stephen J Foster B

We have studied 34 consecutive patients receiving Cotrel- Dubousset instrumentation for a single and flexible thoracic scoliotic curve, evaluating the rib hump deformity from a single CT scan through the apical vertebra of the curve. Using two measures of rotation we found a mean improvement of 25% in the rotation of the vertebra after operation. Any, usually minor, deterioration occurred in the first six months postoperatively, and there was no significant further deterioration in 19 patients assessed over two years after surgery. Cotrel-Dubousset instrumentation can produce a significant correction of vertebral rotation and of the associated rib hump deformity.