RESUMO
INTRODUCTION: Results of operative fixation for ankle fractures had been suboptimal, with cases of posttraumatic osteoarthritis occurring following the surgeries. Intra-articular injuries have been suggested as the cause of this problem. This case report aims to present an ankle pilon fracture Ruedi Allgower type II case treated with percutaneous fixation and arthroscopy evaluation. PRESENTATION OF CASE: Female, 17 years old, complained of pain and swelling at the right ankle. The physical examination revealed swelling, deformity, tenderness, and limited range of motion at the right ankle. The radiological examination showed a Ruedi Allgower type II pilon fracture with right ankle dislocation. The patient underwent closed reduction, arthroscopy to evaluate her right ankle and percutaneous internal fixation. The post-surgery evaluation showed a stable ankle. DISCUSSION: Patients undergoing ankle fracture surgery may benefit from ankle arthroscopy because it may increase visualization of articular reductions, assess and repair cartilage and ligament damage, remove loose bodies, decrease soft tissue exposure, preservative vascularity, and evaluate syndesmosis. Moreover, rapid arthroscopic evaluation has a low complication rate. The ability of arthroscopy to improve syndesmotic instability diagnosis suggests that arthroscopy may play a significant role in managing ankle fractures. CONCLUSION: Arthroscopy-assisted internal fixation provides more benefits and information as a single case report, and more studies are warranted; regarding patients' intra-articular injuries, preventing future complications, such as posttraumatic osteoarthritis.
RESUMO
INTRODUCTION: Ankle arthrodesis is one of the managements for a significantly unstable Charcot ankle. Some of the methods of internal fixation for ankle arthrodesis include the use of intramedullary nails, screws, and plates. Ankle arthrodesis using intramedullary nails has become more popular. However, studies evaluating the use of plate fixation, particularly double posterior lateral plating, are limited. We report the clinical and radiological outcomes of double posterior lateral plating ankle arthrodesis in three diabetic Charcot ankle patients. PRESENTATION OF CASE: Three patients, aged 73, 67, and 65 years old, complained of ankle pain and with a history of type 2 diabetes mellitus. The physical examination revealed swelling and erythema without a sign of active infection. The radiological examination showed ankle deformity, and the American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot scores were 5, 10, and 0, respectively. All patients were diagnosed with a diabetic Charcot ankle and underwent ankle arthrodesis using double posterior lateral plating. Four months and six months follow up revealed talus union, improved ankle deformity, and improved AOFAS Ankle-Hindfoot scores to 70, 76, and 73, respectively. DISCUSSION: Various methods of ankle arthrodesis are retrograde intramedullary nails, screws, and plates. In this report, we opt for plate fixation because it allows for stable internal fixation, adequate compression, high angular stability, and a lower irreversible deformation in osteoporotic bone. CONCLUSION: Double posterior lateral plating ankle arthrodesis provided satisfactory clinical and radiological outcomes. This method can be an alternative for patients with Charcot ankle requiring ankle arthrodesis.
RESUMO
Background: The Knee injury and Osteoarthritis Outcome Score (KOOS) is a useful diagnostic tool to assess knee ligament injury and osteoarthritis, but no validated Indonesian version of the KOOS was available. Methods: We used the forward-backward translation protocol to develop the Indonesian version of the KOOS. The translated questionnaire was administered twice to 51 subjects diagnosed with a knee ligament injury and osteoarthritis. Validity of the questionnaire was assessed by analyzing the correlation between the score of each subscale and the overall score of the 36-Item Short Form Health Survey (SF-36) using the Pearson correlation coefficient. Reliability was measured by evaluating internal consistency (Cronbach α) and test-retest reliability (intraclass correlation coefficient). Results: For construct validity, moderate Pearson correlation coefficients were found between the KOOS subscales and the SF-36. Cronbach α was 0.84 to 0.97 for all subscales, indicating adequate internal consistency. The test-retest reliability was excellent, with intraclass correlation coefficients ranging from 0.91 to 0.99 for all subscales. No significant differences were found in the KOOS subscale responses between the first administration of the questionnaire and the second administration within 21 days. Conclusion: The Indonesian version of the KOOS was determined to be valid and reliable and is therefore an objective instrument for evaluating knee ligament injury and knee osteoarthritis in the Indonesian population.
