Aspects radiographiques des lésions ostéo-articulaires et ligamentaires des entorses de pied et de cheville

Journal de Radiologie (Impact Factor: 0.57). 04/2007; 88(4):541-547. DOI: 10.1016/S0221-0363(07)89853-2


Emergency departments frequently encounter pathology resulting from injury to the foot and ankle, with approximately 6000 case per day in France. In an ankle sprain, 85% of the lesions involve the lateral collateral ligament. Many other, much rarer, types of lesion with different therapeutic consequences can present, however. Interpretation of the initial conventional radiographs is vital to establishing the type lesion and to proposing adapted and rapid treatment. The objective of this article is to review the various osteoarticular and ligament injuries encountered in the foot and the ankle.

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    • "Table 1shows the clinical criteria used. The radiological criteria were[8]: -on incidence of face: the side edge of the first metatarsal aligned with the lateral edge of the medial cuneiform ; the medial edge of the second metatarsal aligned with the medial border of the intermediate cuneiform; existence of gap between the medial cuneiform and the second metatarsal and/or between the first two meta- tarsals. -on the incidence of three quarters: the side edge of the third metatarsal aligned with the lateral edge of the lateral cuneiform both dorsal surface at its plantar surface; the medial edge of the fourth metatarsal aligned with the medial edge of the cuboid bone; the side edge of the cuboid is the eighth note of the articular surface of the base of the fifth metatarsal. "

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    ABSTRACT: Careful diagnosis of ankle joints with suspected ligamentous trauma is necessary to decide on adequate therapy. Accurate 3D stress test techniques can assist in diagnosis. However, the devices used to stress the foot relative to the lower leg are inapt for clinical application as they are not ergonomical. The goal was to present and to evaluate a newly designed 3D foot plate intended to fulfill the requirements of its users. Criteria on functionality included position and fixation of the foot in extreme positions relative to the lower leg; and compatibility with imaging systems. Criteria on usability included: the operator having a sense of control, application for 95% of an adult human population, and operation within 100 s with low mental and physical effort. The design was based on a Stewart platform. Preliminary assessment of the 3D foot plate performed with CT-scans of 4 subjects showed that an extreme foot position could be reached repeatedly within 6°. The remainder of evaluation was focused was on ergonomic assessment. The prototype can reach all extreme foot positions for adults with varying anthropometric dimensions. A usability test was performed with 20 radiology technicians who were asked to perform four tasks with the prototype. All radiology technicians surveyed agreed that the device can be operated by one person with minor physical and mental effort (NASA XLT median 3.5–11%). The tasks were executed with a median time of 91 s (20–513 s) and a median error of 0 (0–6). The 3D foot plate fulfills the majority of criteria and is well-received by the intended users.
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