Treatment of syndesmotic disruptions with the Arthrex Tightrope (TM): A report of 25 cases
ABSTRACT The complexity of syndesmotic injuries, often with both bone and soft tissue injury mandates an expeditious diagnosis and treatment to avoid unfavorable long term outcomes. Various methods of fixation of the syndesmosis have been reported. We present the largest series evaluating the Arthrex Tightrope for management of syndesmotic injuries.
Twenty-five patients with disruption of the distal tibiofibular articulation underwent treatment with an Arthrex Tightrope. In 21 cases, a single tightrope was placed, and in four cases, two tightropes were utilized. Associated ankle fractures were treated using proper AO technique. Those patients with diabetes and/or neuroarthropathic changes foot or ankle were not included in this study. Postoperative evaluation parameters included radiographic measurements, a modified AOFAS scoring system and SF-12.
Average followup was 10.8 months. The mean time to full weightbearing was 5.5 (range, 2 to 8) weeks. Postoperative radiographic analysis of the mean distance from the tibial plafond to the placement of the tightrope(s), medial clear space, average postoperative tibiofibular overlap and the mean tibiofibular clear space demonstrated no evidence of re-displacement of the syndesmotic complex at an average of 10.8 (range, 6 to 12) months. The modified AOFAS hindfoot scoring scale and SF-12 both demonstrated significant improvements; preoperative values were assessed in the office with the first patient visit as they are incorporated into the patient intake form that each patient fills out at the initial visit.
Utilization of the tightrope in diastasis of the syndesmosis should be considered as a good option. The method of placement is quick, can be minimally invasive, and obviates the need for hardware removal. In this series, it maintained excellent reduction of the syndesmosis.
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ABSTRACT: Syndesmotic injuries or high ankle sprains in athletes can occur in elite and recreational athletes. They typically require a longer recovery and a significant delay in return to play compared with routine ankle sprains. Avoiding a misdiagnosis is important and is dependent on being aware of the mechanism of injury, a thorough physical examination, and careful interpretation of imaging studies. Management is guided by the severity of injury and the demands of the athlete. Many mild or stable injuries can be treated nonoperatively; however, acute surgical repair or stabilization in high-grade injuries can provide excellent results and an earlier return to play in selected cases.Current Sports Medicine Reports 01/2009; 8(5):228-33. DOI:10.1249/JSR.0b013e3181b7ec0c · 1.60 Impact Factor
Conference Paper: Fleet management with automatic vehicle location[Show abstract] [Hide abstract]
ABSTRACT: A dispatcher can improve a fleet's productivity by knowing where each vehicle in the fleet is located. This productivity gain is independent of whether reduced fleet costs, increased tonnage capacity, safe delivery of secure cargo or less down time due to distracted drivers is management's goal. This paper describes the portion of an automatic vehicle location system which has been designed to enhance fleet management depending on a variety of efficiency concerns. This subsystem, referred to as the Fixed End, is where the dispatcher manipulates the collected location information to make the decisions required to improve the fleet's performance. The Fixed End subsystem has three fundamental tasks it must perform: it must accept commands from the dispatcher then display and update the requested information, it must allow the dispatcher to control the communication rate between the Fixed End and the mobiles and it must allow the dispatcher to customize certain internal data structures to the desired use.Vehicular Technology Conference, 1986. 36th IEEE; 06/1986
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ABSTRACT: An examination is made of the spectral content of time-varying signals using a modified version of the instantaneous power spectrum (IPS). The pseudo-Wigner-Ville distribution (PWD) has been used extensively to display the time-varying spectral information. Potential problem associated with PWD are spectral cross terms and endpoint resolution. A modified IPS is shown to be less sensitive to these types of problems. In addition, IPS can operate with real signals sampled at the Nyquist rate. Representative test cases are providedAcoustics, Speech, and Signal Processing, 1989. ICASSP-89., 1989 International Conference on; 06/1989