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Les actualités dans l'imagerie du pied de la polyarthrite rhumatoïde (PR) concernent essentiellement l'échographie et l'imagerie par résonance magnétique (IRM). En complément des synovites et des ténosynovites déjà largement étudiées, des lésions inflammatoires juxta-articulaires, comme les bursites inter-capito-métatarsiennes (BIM), ont été décrites plus récemment. Devant des arthralgies cliniquement suspectes d'évolution vers une PR, une synovite échographique avec Doppler d'une articulation métatarso-phalangienne (MTP) et une BIM en IRM sont prédictives de la survenue d'une arthrite clinique. En cas d'arthrite indifférenciée, la présence d'une ténosynovite des fléchisseurs ou des extenseurs des orteils sur une IRM des pieds pourrait augmenter le risque d'évolution vers une PR. Dans la PR débutante, les lésions tendineuses inflammatoires (tibial postérieur, fibulaires) semblent plus fréquentes que les synovites articulaires. Aux avant-pieds, la douleur et le gonflement sont associés à la synovite d'une MTP et à la BIM, mais ces « synovites » sont également souvent rencontrées chez les sujets sains, avec une fréquence décroissante de la MTP 1 à la MTP 5. L'inflammation péri-articulaire aux pieds (ténosynovite, BIM) est associée au diagnostic de PR et pourrait être une caractéristique de l'arthrite débutante. Les érosions échographiques et IRM aux avant-pieds ne sont pas spécifiques de la PR, sauf sur la MTP5. Recent advances in foot imaging in rheumatoid arthritis (RA) essentially concern ultrasound and magnetic resonance imaging (MRI). In addition to synovitis and tenosynovitis, which have already been extensively studied, inflammatory juxta-articular lesions such as intermetatarsophalangeal bursitis (IMB) have been more recently described. In patients presenting with clinically suspect arthralgia evolving towards rheumatoid arthritis, Doppler ultrasound synovitis in metatarsophalangeal (MTP) joint and MRI IMB are predictive of the onset of clinical arthritis. In undifferentiated arthritis patients, the presence of flexor or extensor tenosynovitis on foot MRI could increase the risk of progression to RA. In early RA, inflammatory tendon lesions (tibialis posterior, peroneal tenosynovitis) appear to be more common than joint synovitis. In the forefeet, pain and swelling are associated with MTP synovitis and IMB, but these "synovitis" are also often encountered in healthy subjects, with a decreasing frequency from the first to the fifth metatarsophalangeal joint. Peri-articular inflammation in the feet (tenosynovitis, IMB) is associated with the diagnosis of RA and could be a characteristic of early arthritis. Ultrasound and MRI erosions in the forefeet are not specific to RA, except on the MTP5. [ABSTRACT FROM AUTHOR]

Chronic joint instability is one of the most common symptoms of ankle sprains in performance handball. The aim of our research was to demonstrate the efficiency of proprioceptive exercises on static and dynamic joint stability in handball players, who suffered at least one ankle sprain, during the last year. The present paper is an experimental research, carried out over a period of four months, on Junior II handball players (n = 22). The static and dynamic joint stability as well as the degree of joint instability were established by using the IsoShift stabilometric platform and the identification of functional ankle instability questionnaire. The proprioceptive exercise programme had a positive effect on the assessed functional parameters, the results obtained having statistical significance on the number of ankle sprains (P < 0.002), dynamic balance (P < 0.001), open-eyed static balance (P < 0.001), closed-eyed static balance (P < 0.001) and degree of joint instability (P < 0.001). The use of proprioceptive exercises with open and closed eyes in treating joint instability has led to improved average values of the dynamic and static bipodal balance, which has highlighted their efficiency in improving joint stability in handball athletes with ankle sprains. [ABSTRACT FROM AUTHOR]

Copyright of Foot Medicine & Surgery / Medecine et Chirurgie du Pied is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Movement & Sport Sciences / Science & Motricité is the property of EDP Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose of this study was to investigate the effects of Kinesio Taping (KT) in healthy semi-professional soccer players in both static and dynamic balances thorough a single blinded randomized placebo controlled crossover study. Equipment and methods Fifteen healthy male soccer players from the same team (A.C. Fucecchio) were recruited on a voluntary basis and evaluated in mid-season. A force platform was used to record forces and centre of pressure (CoP) data. Twenty seconds one-legged stance test was used to analyse static balance. For dynamic balancing test, subjects performed maximal vertical jump with both legs, landing on dominant limb, trying to balance as quickly as possible. Tasks were evaluated using CoP derived data as sway area, displacements in anterior-posterior and medio-lateral directions, total path length. In addition, time-to-stabilisation and jump height were evaluated only for dynamic task. Participants completed proposed tasks in three different conditions: tape, no-tape and placebo conditions, whose sequence was selected using computer-generated randomization. No significant differences between testing conditions were founded for all parameters investigated (P > 0.05). KT was not effective in improving both static and dynamic balances, otherwise showing no significant difference when compared to no-tape and placebo conditions. This may suggest that KT should not be used when the aim is to improve balance in healthy players focusing on ankle injury prevention. [ABSTRACT FROM AUTHOR]

We aimed to study ankle and foot injuries profile among amateur soccer players and to identify eventual risk factors. We carried out a cross-sectional study using a simple self-administered questionnaire based on the (UEFA) Injury Study Questionnaire, The (OSICS) system and the F-MARC consensus statement. The study concerned five amateur male soccer teams from the region of Monastir. Fifty replies were received, giving a response rate of 79%. Half of the players suffered from ankle injuries and 8% presented foot injuries. Among ankle/foot injuries, 68% were acute injuries and 48% were direct injuries. The combinations of injuries that worth attention were acute indirect injuries of the lateral compartment of the ankle as they are the most frequent injuries (14%), and the injuries of ankle posterior compartment as they required the longest absence period (12%). Defenders were the most players suffering from acute indirect injuries. Goalkeepers and midfielders were the most players exposed to acute direct injuries. Only 24% of injured players followed physiotherapy for their injuries. More than half of injured players (56%) reported keeping sequelae. We found that players who suffer from other-body-sites injuries were significantly prone to suffer from ankle/foot injuries (P < 0.05). However, those reporting wearing insoles (12% of all players) were significantly at lower risk to suffer from ankle/foot injuries (P < 0.05). We noticed that players using Turf shoes (4% of all players) were at lower risk to suffer from direct injuries (P < 0.05) and that players who wear ankle/foot supports were significantly at lower risk of facing acute injuries (P < 0.05). After performing multivariate analysis, the occurrence of other-body- sites injuries was the only independent factor that significantly influenced ankle and foot injuries. Our results can lead to pragmatic guidance for the prevention of injuries by tailoring a suitable training or rehabilitation programs, prescription of ankle brace and adapted insoles, according the physical demand and position of the player. The prevention should focus on the whole body, since suffering other-body-sites injuries increases the risk of ankle/foot injuries. [ABSTRACT FROM AUTHOR]

Tibial pilon fractures are polymorphic fractures posing therapeutic and prognostic challenges. The purpose of this study is to examine the epidemiological profile of these fractures and to assess our findings from an anatomical and functional point of view. We collected data fom 50 medical records of patients treated for tibial pilon fractures and monitored over the period 2004-2013 at the Orthopedic-Trauma Department of the Habib Bourguiba University Hospital in Sfax. Functional outcomes were assessed using the Ankle-Hindfoot score. Radiological findings were used to determine fracture healing. Treatment was based on internal osteosynthesis in 30 cases, external fixation in 11 cases and on a combination of both techniques in 9 cases. At the end of this study, functional outcomes were good and very good in 36 cases. Thirty cases of fracture healing were reported, with 18 cases of vicious callus and two cases of pseudosteoarthritis. Therapeutic management of tibial pilon fractures is difficult in some cases. Solid osteosynthesis with anatomical reduction is the only therapeutic option to secure a satisfactory functional outcome. [ABSTRACT FROM AUTHOR]

Malunion at the level of the ankle inevitably progresses to osteoarthritis. The aim of this study was to describe the epidemiological aspects as well as the outcome of the surgical treatment at the Cotonou Hubert Koutoukou MAGA National University Hospital (CNHU-HKM).This was an observational retrospective study over 12 years, carried out at the Traumatology, Orthopedics and Corrective Surgery University Clinic (CUTO-CR) of the Cotonou CNHU-HKM, from January 2003 to December 2015. The study involved 11 patients presenting a malunion at the level of the ankle, who underwent surgery and were followed up during a minimal period of 6 months. The diagnosis of ankle malunion was evocked based on clinical examination and confirmed by an X-ray of ankle with frontal and lateral views. The treatment was surgical. The functional outcome were evaluated by the Kitaoka score. Eleven patients including 8 males and 3 females with a mean age of 41 years, ranging between 16 and 63 years had a malunion at the level of the ankle. The initial lesions were: 6 bimalleolar fracture (n=6), 2 trimalleolar fracture (n=2), tibial pestle fracture (n=2) and talus fracture (n=1). The surgical treatment consisted of arthrodesis in 4 cases and corrective osteotomy in 7 cases. The functional outcome was evaluated to be good in 4 cases, average in 6 cases and poor in 1 case. Ankle malunion is an uncommon, polymorphous and severe lesion. It is frequent in young male patients. Arthrodesis or corrective osteotomy provided satisfactory functional results in our patients. [ABSTRACT FROM AUTHOR]

L'ostéoblastome est une tumeur osseuse bénigne rare, qui survient chez l'adulte jeune avant 30 ans avec une nette prédominance masculine. Il se localise surtout au niveau du rachis et la diaphyse des os longs. La localisation au niveau de la cheville est exceptionnelle. Nous rapportons le cas d'un ostéoblastome de la cheville gauche chez un adulte révélé par des douleurs localisées et une impotence fonctionnelle partielle. La radiographie standard faite a été jugée strictement normale et devant la persistance des plaintes une TDM a été réalisée mais qui était trompeuse évoquant une ostéochondrite. C'est l'examen anatomopathologique effectué sur pièce opératoire qui a permis de redresser le diagnostic. Les suites chez ce patient ont été simples, le résultat fonctionnel était très satisfaisant. Notre observation est particulière par l'âge de survenue au-delà de 30 ans et par la localisation inhabituelle au niveau de la cheville. Même si des formes agressives ont été rapportées dans la littérature, le pronostic de l'ostéoblastome est bon, et les récidives peuvent être évitées par un traitement chirurgical adéquat.

Résumé Objectif Il est classique de considérer que la bi-arthrite de cheville est un critère diagnostique du syndrome de Löfgren. L'objectif de cette étude est de caractériser, à l'aide de l'échographie, l'atteinte articulaire et périarticulaire des chevilles au cours du syndrome de Löfgren. Méthodes Étude multicentrique descriptive sur une cohorte de patients atteints d'un syndrome de Löfgren ayant bénéficié d'une échographie de cheville. Les données cliniques, d'imagerie, de biologie, à la fois sanguine et du liquide synovial lorsqu'une ponction était réalisée, étaient recueillies. Résultats Les résultats d'échographie des chevilles de 40 patients ont été analysés. En mode B, un œdème sous-cutané était l'anomalie échographique la plus fréquente (26 patients), suivi par la ténosynovite (22/40), sans prédominance de compartiment. L'atteinte articulaire était retrouvée sous forme d'une synovite chez 7 patients et d'un épanchement chez 10 patients. Trois patients sur 40 avaient une synovite hyperhémique en mode Doppler. Nous n'avons retrouvé aucune association statistique significative entre la présence d'une synovite ou ténosynovite et les caractéristiques cliniques (âge, sexe) et paracliniques (biologie, imagerie thoracique) des cas de syndrome de Löfgren. Conclusion Contrairement à ce qui est classiquement admis, ces résultats suggèrent que l'atteinte abarticulaire des chevilles est plus fréquente que l'atteinte articulaire au cours du syndrome de Löfgren. Ceci doit faire discuter les critères diagnostiques du syndrome de Löfgren qui font référence à une « bi-arthrite » de chevilles. [ABSTRACT FROM AUTHOR]

Copyright of Physiotherapy Canada is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Foot Medicine & Surgery / Medecine et Chirurgie du Pied is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Foot Medicine & Surgery / Medecine et Chirurgie du Pied is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Pan African Medical Journal is the property of Pan African Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A modified inclinometer was designed for measuring total ankle range of motion (ROM) in the standing position for a large future study. The purpose of this pilot study was to assess the intra-examiner reliability of this new device in order to see if the examiner would be able to produce equally reliable measurements with this instrument as with a routinely used goniometer. Nineteen young healthy individuals took part in the pilot. The same examiner took the ROM measurements using both devices twice on the same day and one further time 2 or 3 days later. Test-retest reliability was measured using the intraclass correlation coefficient (ICC). The ICC values were 0.86 (95% CI=[0.67; 0.94]) and 0.83 (95% CI=[0.61; 0.93]) for the measurements taken with the goniometer on the same day and for those on two different days. The corresponding values for the modified inclinometer were 0.88 (95% CI=[0.72;0.95]) and 0.81 (95% CI=[0.57; 0.92]). Both instruments were found to have very good test-retest reliability. [ABSTRACT FROM AUTHOR]

Résumé But de l’étude Les pertes de substance distales des membres inférieurs sont encore un défi pour le chirurgien plasticien. Il faut apporter une couverture efficace et fonctionnelle avec un minimum de séquelle pour le site donneur. Le lambeau libre antérolatéral de cuisse présente dans ces domaines de nombreux avantages par rapport aux lambeaux locaux pédiculés et aux lambeaux musculaires libres classiquement utilisés. Nous essayons de définir sa place à travers notre expérience par une étude rétrospective bicentrique. Patients et méthodes Une analyse rétrospective exhaustive des cas de reconstruction des pertes de substance distales des membres inférieurs par lambeau libre antérolatéral de cuisse a été effectuée dans 2 centres de chirurgie réparatrice. Les caractéristiques des pertes de substance et des reconstructions ont été collectées. Le taux de succès et le taux de complications ont été rapportés, ainsi que les résultats esthétiques et fonctionnels à distance. Résultats Quarante et un patients ont été reconstruits entre 2008 et 2013 pour une prise en charge post-traumatique dans 58,5 % des cas. La taille moyenne des pertes de substance était de 191,4 cm 2 , leur localisation était principalement sur le pied et la cheville (61 %) et une exposition osseuse était le plus souvent retrouvée (82,9 %). Le taux de succès était de 92,8 %. Les résultats fonctionnels étaient jugés comme très bons et bons dans 75,5 % des cas et les résultats esthétiques comme très bons et bons pour 63,6 % des cas. Trois patients « perdus de vue » soit 7,3 % et 3 échecs soit 7,3 % n’ont pas pu être évalués sur le résultat final. Conclusion Montrant des résultats fonctionnels au moins similaires aux autres lambeaux, l’antérolatéral de cuisse fait la preuve de sa fiabilité et limite les séquelles au site donneur à une simple cicatrice ou greffe de peau mince. Sa polyvalence permet de s’adapter à la grande majorité des cas de reconstruction des pertes de substance des membres inférieurs. Summary Context Soft tissue defects of lower leg are still a challenge for the plastic surgeon. It should provide an effective and functional coverage with a minimal morbidity on the donor site. Free anterolateral thigh flap present in these areas many advantages over the pedicled local flaps and free muscle flaps used conventionally. We try to define its place through our experience with a bicentric retrospective study. Materials and methods A retrospective analysis of all cases of reconstruction of the lower leg using the free ALT flap was performed in two centers of reconstructive surgery. The characteristics of the defect and reconstructions were collected. The rate of success and complication has been reported as well as long term aesthetic and functional outcomes. Results Forty-one patients were reconstructed between 2008 and 2013 for post-traumatic care in 58.5% of cases. The average size of the defect was 191.4 cm 2 , their location was mainly on the foot and ankle (61%) and bone exposure was most frequently found (82.9%). Success rate was 92.8%. Functional results were judged as very good and good in 75.5% of cases and aesthetic results as very good and good for 63.6% of cases. Three “lost sight” 7.3% and 3 fails (7.3%) patients were not included in the result analysis. Conclusion Showing functional results at least similar to other flaps, ALT flap demonstrated its reliability and its low morbidity on the donor site. Its versatility allows adaptation to the vast majority of defects of the lower leg. [ABSTRACT FROM AUTHOR]

Copyright of Foot Medicine & Surgery / Medecine et Chirurgie du Pied is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Les principales pathologies de la cheville sont l’entorse, les tendinopathies achilléennes et la laxité chronique de la cheville. Des orthèses et des attelles sont disponibles à l’officine pour pallier ces différents problèmes. [ABSTRACT FROM AUTHOR]

Objective: To detail the presentation of calcium pyrophosphate deposition disease (CPPD) in the ankle joint. The aim of this case report is to inform health-care practitioners about the presentation of this condition in an uncommon location and discuss the diagnosis, potential treatment, and management strategies for a patient with CPPD. Clinical Features: A 36-year-old male patient presented to a chiropractic clinic with an acute, painful, and swollen ankle, which was later diagnosed by plain film radiograph as CPPD. A rheumatology follow-up was recommended and at-home treatment was prescribed to treat acute symptoms and monitor progress. Outcome: No chiropractic treatment was provided and the patient has been referred to a rheumatologist simifor further assessment. The diagnosis of CPPD was confirmed and he was advised to take an antiinflammatory if symptoms recurred and booked for further follow-up in six months. Summary: Although the presentation is less common, CPPD can present in the ankle joint and mimic other inflammatory disorders. Conservative treatment can be applied to treat acute symptoms and referral to a rheumatologist is suggested to monitor progress of this condition. [ABSTRACT FROM AUTHOR]

Nous rapportons le cas d'un sportif de 20 ans victime d'un accident de hand-ball occasionnant une luxation pure de la cheville (A). La réduction a été pratiquée en urgence sous anesthésie générale, la radiographie et le scanner de contrôle après réduction avaient objectivés une bonne congruence articulaire (B, C). Une contention par une botte plâtrée fut assurée pendant six semaines. L'examen de la cheville réalisé après l'ablation du plâtre n'a pas retrouvé une laxité de la cheville et l'IRM de la cheville réalisée à la recherche d'une lésion ligamentaire avait objectivée une intégrité des ligaments péri-articulaire (D). Après un recul de neuf mois, les résultats fonctionnels étaient excellents, sans signes d'instabilité ni d'arthrose.La luxation tibio-talienne sans fracture malléolaire associée est une lésion très rare, souvent causée par un traumatisme de haute vélocité, jusqu'à l'heure actuelle, peu de cas ont été rapportés dans la littérature.La rareté de cette lésion peut être expliquée par la durabilité des ligaments par rapport aux malléoles et donc lors d'un traumatisme de la cheville une fracture se produise plutôt qu'une luxation.

Nous rapportons le cas d'une rupture post-traumatique du tendon tibial postérieur survenue lors d'une fracture bimalléolaire de la cheville. Le diagnostic a été posé lors de l'intervention chirurgicale. La réparation du tendon, non dégénératif, a été réalisée en même temps que l'ostéosynthèse. Bien que rare, cette possibilité de lésion tendineuse lors des fractures de la cheville ne doit pas êtreoubliée. Des douleurs résiduelles, un déficit de l'inversion active du pied, une modification de l'arche médiane du pied et à terme une évolution vers un pied plat valgus doivent faire évoquer rétrospectivement le diagnostic.

Une patiente âgée de 28 ans sans antécédents pathologiques et sans notion de contage tuberculeux, a été hospitalisée pour prise en charge rééducative d'une paraparésie post-spondylodiscite tuberculeuse multi-étagée découverte devant des dorsalgies de type mixte à irradiation intercostale avec fièvre, paresthésies, lourdeurs des deux membres inférieurs, fuites urinaires, le tout évoluant depuis 8 mois. La TDM et l'IRM rachidienne ont montré: une collection épidurale en regard de D3D4D5D6, une destruction vertébrale de D4 avec recul du mur postérieur responsable d'une déformation dorsale avec compression médullaire( A, B, C), une atteinte D8D9D10D11D12 avec présence d'une collection intra-osseuse (D), une atteinte de L5 avec une petite collection vertébrale, une opacité alvéolaire de l'hémi-champs pulmonaire gauche. L'examen a trouvé un syndrome pyramidal prédominant à droite (E), une paraparésie et une douleur à la mobilisation de la cheville droite avec limitation articulaire. Les radiographies standards étaient sans anomalies. Devant ce contexte, une ostéo-arthrite tuberculeuse de la cheville a été suspectée (F). La patiente a eu une arthrotomie montrant une hypertrophie synoviale pour laquelle elle a eu un lavage articulaire avec une synovectomie partielle. L'origine tuberculeuse a été confirmée par l'examen anatomo-pathologique. Concernant le rachis, la patiente a eu une immobilisation par un corset cervico-dorso-lombaire pendant 6 mois. L'évolution était marquée par la disparition des rachialgies, la récupération du déficit musculaire des deux membres inférieurs, la disparition des troubles vésico-sphinctériens, la disparition des douleurs et l'amélioration des amplitudes articulaires de la cheville droite.

Copyright of Foot Medicine & Surgery / Medecine et Chirurgie du Pied is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To describe the pain and functional improvements of a patient with posterior ankle impingement following a treatment plan incorporating soft tissue therapy, chiropractic adjustment and a progressive rehabilitation program. Clinical Features: A 37-year- old male presented with posterolateral ankle pain exacerbated by plantar flexion two weeks after sustaining an inversion ankle sprain. Oedema was present and the patient was describing a sensation of instability while walking. The initial diagnosis of lateral ankle sprain was found to be complicated by a posterior ankle impingement caused by a tenosynovitis of the flexor hallucis longus sheath suspected during the physical examination and confirmed by MRI. Intervention and Outcome: The patient was treated over a 14-week period. Soft tissue therapy, a rehabilitation program and cortisone injection were used to treat this condition. A precise description of the rehabilitation program that contains open kinetic chain, closed kinetic chain, proprioception, and conditioning exercises prescribed to the patient is given. After the treatment plan, the patient returned to play pain free and had no daily living restrictions. Summary: A protocol including rest, soft tissue therapy, open and closed kinetic chain exercises, sport-specific exercises and cortisone injection appeared to facilitate complete recovery of this patient's posterior ankle impingement. [ABSTRACT FROM AUTHOR]

La luxation tibiotalienne pure est une lésion extrêmement rare, causée par un traumatisme toujours de haute vélocité. Les auteurs rapportent l'observation d'une luxation tibiotalienne pure fermée chez un jeune de 19 ans, survenue à la suite d'un accident du sport (football) à déplacement postéro-médiale. La réduction a été pratiquée en urgence sous anesthésie générale. Une contention par une botte plâtrée fut assurée pendant six semaines, suivie de rééducation. Après un recul de seize mois, les résultats fonctionnels étaient excellents, sans signes d'instabilité ni d'arthrose.

L'instabilité chronique de la cheville est l'une des évolutions possibles dans l'histoire naturelle de l'entorse aigüe de cheville. Elle représente 10% à 30% des séquelles d'entorses. Le traitement chirurgical est réservé aux patients ayant une instabilité de cheville persistante après rééducation à l'origine d'une gêne invalidante. L'a technique de ligamentoplastie utilisant le court fibulaire selon Castaing est la plus répondue en France. La simplicité du geste et ses bons résultats nous ont incités à poursuivre cette voie. Il s'agit dune étude rétrospective à propos de 52 patients ayant bénéficié d'une ligamentoplastie au court fibulaire selon Castaing entre Janvier 2000 et Décembre 2010. Le recul minimum était d'un an. L'évaluation des patients reposait sur le score de Karlson et le "Ankle score" Molander et Olerud. Les patients sont satisfaits ou très satisfaits de l'intervention dans 80% des cas revus. Les résultats fonctionnels de nos patients sont comparables à ceux publiés dans la littérature. Le prélèvement du transplant du court fibulaire ne semble pas avoir de retentissement sur la stabilité de la cheville. Les patients conservent une éversion du pied satisfaisante avec une force comparable au côté opposé. L'évolution arthrosique de la cheville ne semble pas significative après cette chirurgie. Le point faible de notre étude est le nombre des patients perdus de vue, cela est lié à la jeunesse de la population opérée et au recrutement du service d'envergure nationale.

Copyright of Movement & Sport Sciences / Science & Motricité is the property of EDP Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

L 'arthrodèse de la cheville est le traitement de choix dans les atteintes articulaires importantes de la cheville afin de lui restituer une indolence parfaite et une bonne stabilité. L'objectif de notre travail est d'évaluer les résultats à moyen terme de l'arthrodèse de la cheville pour arthrose post-traumatique à travers l 'étude d 'une série de dix patients. Nous avons menu une étude rétrospective étalée entre janvier 2009 et juin 2013, portant sur dix cas d 'arthrose post-traumatique de la cheville traités par arthrodèse. Selon la technique de Méary, utilisant une voie d 'abord antérolatérale de la cheville avec une fixation par deux vis. L 'âge moyen au moment du traitement est de 45 ans. La consolidation a été obtenue dans un délai moyen de 10 semaines. Au recul moyen de 30 mois, sur les dix patients 7 se sont estimés satisfaits, 2 moyennement satisfait et un patient non satisfait vu la persistance de douleurs. Le score moyen de l 'AOFAS postopératoire est de 69,6. L 'étude de notre série, nous a permis de confirmer l'intérêt l'arthrodèse dans le traitement de l'arthrose post-traumatique de la cheville en assurant à la fois indolence et stabilité.

Copyright of Foot Medicine & Surgery / Medecine et Chirurgie du Pied is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Pan African Medical Journal is the property of Pan African Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé: Les tendinopathies de la cheville sont fréquentes. Elles surviennent dans un contexte sportif, ou de surmenage, soit de pathologies plus générales. Les quatre compartiments de la cheville (postérieur, médial, latéral et antérieur) peuvent être concernés. Les atteintes du tendon d’Achille (TA) sont les plus fréquentes et les mieux connues. [Copyright &y& Elsevier]

Copyright of Pan African Medical Journal is the property of Pan African Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: The impressive power-law decay of the energy spectrum of cosmic rays over more than thirty orders of magnitude in intensity and for energies ranging over eleven decades between and is actually dotted with small irregularities. These irregularities are highly valuable for uncovering and understanding the modes of production and propagation of cosmic rays. They manifest themselves through changes in the spectral index characterising the observed power laws. One of these irregularities, known as the ankle, is subject to conflicting interpretations for many years. If contemporary observations characterising it have shed new lights, they are still far from being able to deliver all the story. The purpose of this contribution is to give an overview of the physics of cosmic rays in the energy range where the transition between Galactic and extragalactic cosmic rays is expected to occur, and to deliver several lines of thought about the origin of the ankle. [Copyright &y& Elsevier]

Abstract: The shape and composition of the primary spectrum as well as the large-scale anisotropy in the arrival direction of cosmic rays are key elements to understand the origin, acceleration and propagation of the Galactic radiation. Besides the well-known knee and ankle features, the measured energy spectrum exhibits also a less pronounced but still clear deviation from a single power law between the knee and the ankle, with a spectral hardening at and a steepening at . The average mass composition gets heavier after the knee till , where a bending of the heavy component is observed. An indication of a hardening of the light component just above has been measured as well. First indications of anisotropy of the arrival direction in the southern hemisphere have been reported at . [Copyright &y& Elsevier]

Résumé: Près de 40 % de la population adulte consulte pour une douleur au pied et leurs causes sont nombreuses et douleurs variées. Elles sont souvent débilitantes et affectent la vie professionnelle et psychologique des patients. L’examen clinique doit être précis et rigoureux pour émettre les principales hypothèses diagnostiques permettant de choisir l’examen d’imagerie le plus approprié au diagnostic positif. La radiographie reste la pierre angulaire du bilan d’imagerie initial. Le choix entre IRM et TDM dépendra ensuite de la pathologie suspectée. La collaboration clinicien–radiologue est primordiale pour envisager l’examen optimal permettant de progresser dans la démarche diagnostique afin de mettre en place rapidement le traitement adéquat et ainsi soulager le patient. [Copyright &y& Elsevier]

Résumé: Le pied est un ensemble anatomique et biomécanique complexe. La pathologie locale est riche et de nombreuses maladies, qu’elles soient rhumatologiques voire systémiques, métaboliques, neurologiques ou vasculaires trouvent un mode d’expression, dans une symptomatologie podologique. L’examen clinique du pied n’est de fait jamais restreint à la seule extrémité distale des membres inférieurs car non seulement il amène souvent à suspecter une pathologie plus générale, mais il impose toujours une étude stato-dynamique de l’ensemble du squelette. L’examen clinique, toujours guidé par un interrogatoire préalable obligatoire, se divise en quatre phases : l’examen pieds nus en décharge, pieds nus à la mise en charge, debout en position statique et à la marche ainsi que l’examen pieds chaussés. L’examen des chaussures ainsi que d’éventuelles orthèses plantaires déjà prescrites ne sera pas oublié. [Copyright &y& Elsevier]

La décision d'amputation pour traumatisme grave de membre n'est pas toujours facile à prendre. Les auteurs rapportent le cas d'un traumatisme ouvert de la cheville gauche avec luxation tibiotalienne complète, référé pour amputation. Il s'agit d'une passagère d'une moto-taxi percutée par une voiture. A l'admission, le pouls tibial postérieur était présent et le score dit MESS (Mangled Extremity Severity Score) côté à 5, ce qui a permis et d'éviter l'amputation. Après débridement et réduction, une broche transplantaire a permis d'immobiliser la cheville et de faire les pansements. L'amputation a été évitée. La cicatrisation dirigée de la peau a été suivie par la kinésithérapie. La mobilité de la cheville autorise une marche avec cannes au quatrième mois post-opératoire. Les auteurs recommandent l'utilisation du MESS dans la décision d'amputation après traumatisme grave de membre.

La tuberculose ostéoarticulaire représente 2 à 5% de l'ensemble des tuberculoses, la localisation au médio-pieds est rare. Nous en rapportons le cas d'une patiente âgée de 18 ans, qui présente depuis 2 ans des douleurs du médio-pied droit inflammatoires avec tuméfactio, La radiographie a montré des géodes et des érosions des os naviculaire et cunéiformes. L'IRM a orienté vers le dignostic de tuberculose confirm par biospie et étude anathomopathologique. C'est pourquoi devant tout tableau clinique traînant ou devant toute lésion osseuse suspecte ou de présentation atypique le diagnostic de tuberculose doit être évoqué afin d'éviter un retard diagnostique.

Copyright of Pan African Medical Journal is the property of Pan African Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Movement & Sport Sciences / Science & Motricité is the property of EDP Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Because the lower extremities are weight bearing, malalignment plays a key role in the development of degenerative disease of the joints. This is particularly true as degenerative arthropathy is of mechanical and not inflammatory cause. Deviation of the axis has been shown to alter the load and force distribution in the joint and thereby causing excessive wear. Whether or not a deformity is clinically relevant or not depends on the symptoms, the amount of the deformity and the location of the deformity. Relevant deformities can be treated with orthotics or corrective osteotomies in early stages. In late stages fusions or joint replacement is the mainstay of treatment. [ABSTRACT FROM AUTHOR]

Abstract: Objective: This study was designed to compare the effects of different ankle taping methods on lower leg EMG and subtalar kinematics. Methods: Twelve healthy volunteers were tested on an inversion platform in one of three taping conditions: non-elastic basketweave, elastic adhesive bandage wrap and non-taped control. Muscle activation and range of motion data were collected during an inversion of 35 degrees using a Biometrics® datalogger. Testing was done before and after 30minutes of treadmill running. Results: Significant differences were noted in total inversion, time to peak inversion and rate of inversion. While total inversion did not differ between tape conditions, the rate of inversion in the non-elastic condition was lower than the elastic adhesive condition, which was lower than the control. There was no effect of ankle taping style on latency of the peroneus longus. Conclusions: The choice of ankle taping style can have significant effects on ankle biomechanics and the use of non-elastic tape reduces the rate of inversion. While the rate increased after 30minutes of running, it was still lower than the other conditions. [Copyright &y& Elsevier]

The original colours of doors and windows in seventeenth- and eighteenth-century buildings can be discovered by carrying out probes on original samples that have survived. Observations were systematically recorded during restoration work and have produced very coherent results. In window casings, a fairly deep grey is the rule. Changes in intensity do not appear to follow a clear trend, however. Few elements of window joinery have been left ‘au naturel’. Research on portes-cochères (carriage gates) was more limited but confirms the use of very dark colours.

Purpose: To examine reliability and validity of the Lunge Test (LT) of dorsiflexion range of motion and determine the impact of different approaches to obtain a score on these parameters. Methods: Fifty-three patients with ankle injury/dysfunction provided initial assessment data for cross-sectional convergent and known-groups validity analysis with the Pearson coefficient (r) and paired t-test, respectively; data after 4-8 weeks of treatment for longitudinal validity analysis with coefficient r; and data 3 days later for test-retest reliability using the intra-class correlation coefficient (ICC) and minimal detectable change (MDC). LT scores were determined for the affected leg only (LTAff) and for the difference between the two limbs (LTDiff). Two strategies were used to calculate LT scores: a single series and the mean of three series of lunges. LTs were correlated with the Lower Extremity Functional Scale and Global Foot and Ankle Scale. Results: Reliability coefficients were high (ICC=0.93-0.99). The MDC=1.0/1.5 cm, LTAff/LTDiff, respectively. Cross-sectional validity was confirmed for LTDiff (r=-0.40 to -0.50). Between-limb differences (p<0.05) supported known-groups validity. Longitudinal validity was supported for both LT change scores (r=0.39-0.63). The number of series of lunges used did not impact results. Conclusions: A single series of lunges produces a reliable LT score. From a validity perspective, clinicians should use LTDiff on initial assessment and either LT to assess change. [ABSTRACT FROM AUTHOR]

Copyright of Foot Medicine & Surgery / Medecine et Chirurgie du Pied is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Foot Medicine & Surgery / Medecine et Chirurgie du Pied is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Foot Medicine & Surgery / Medecine et Chirurgie du Pied is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Annales Françaises de Médecine d'Urgence is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

La tuberculose ostéoarticulaire représente 2 à 5% de l'ensemble des tuberculoses, la localisation au médio-pieds est rare. Nous en rapportons le cas d'une patiente âgée de 18 ans, qui présente depuis 2 ans des douleurs du médio-pied droit inflammatoires avec tuméfactio, La radiographie a montré des géodes et des érosions des os naviculaire et cunéiformes. L'IRM a orienté vers le dignostic de tuberculose confirm par biospie et étude anathomopathologique. C'est pourquoi devant tout tableau clinique traînant ou devant toute lésion osseuse suspecte ou de présentation atypique le diagnostic de tuberculose doit être évoqué afin d'éviter un retard diagnostique. [ABSTRACT FROM AUTHOR]