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Fulltext Recurrent glomangiomas of the ankle: a case report

Saini SM, Hamid SA, Abdul Rashid SN, Bahari N, Fakhrizzaki AA, Abu Hassan H, et al.

Med J Malaysia, 2013 Aug;68(4):356-7.
PMID: 24145267 MyJurnal
Matched MeSH terms: Ankle*
Fulltext Ankle injuries in sports: anatomical considerations and clinical implications

Syarifah Aisyah, S.A.H., Elvy Suhana, M.R., Srijit, D., Norzana, A.G.

Medicine & Health, 2016;11(2):117-130.
MyJurnal

Ankle injuries are commonly seen in various sports. The main aim of the present
review was to highlight the normal anatomy of the ankle, mechanism of injuries
related to sports, congenital abnormalities or anatomical variations related to
ankle injury and discuss its effective management. A review of literature was done
to determine the ankle injuries which occur as a result of various sports related
activities. We documented all sports which involved injury to the ankle joint. The
anatomy of various structures in the sole of foot and their involvement in injuries
were discussed at length. The anatomical knowledge of ankle injury may be
beneficial for future diagnosis and treatment purpose.

Matched MeSH terms: Ankle; Ankle Joint; Ankle Injuries
Fulltext Isolated tuberculosis of talus without ankle and subtalar joint involvement

Anand A, Sood LK

Med J Malaysia, 2002 Sep;57(3):371-3.
PMID: 12440280

This case has been reported because of its rarity and atypical clinical presentation. An 8-year-old boy presented with a gradually increasing swelling localised on the antero-medial aspect of the foot haemogram, erythrocyte sedimentation rate (ESR), Mantoux and X-ray chest were normal. An irregular lytic lesion of the talus was seen on the x-ray of the affected part. Ziehl Nelson staining of the aspirated fluid revealed acid-fast bacilli. Material obtained after curettage and bone grafting was sent for histopathological examination which confirmed the diagnosis of tuberculosis. Post operatively a below knee cast was given for 12 weeks and anti tubercular treatment was given for 20 months. At the end of the treatment patient had full and painless motion at the ankle and subtalar joint. The lytic lesion had healed on X-ray.

Matched MeSH terms: Ankle/microbiology*; Ankle/radiography*; Ankle Joint/microbiology*; Ankle Joint/radiography*
Postural Control and Adaptation Strategy of Young Adults on Unstable Surface

Lai QQ, Gouwanda D, Gopalai AA

Motor Control, 2023 Apr 01;27(2):179-193.
PMID: 36216337 DOI: 10.1123/mc.2021-0138

Balance control is essential for postural adjustment in physical activities. This study investigates the behavior of human postural control and the coordination and adaptation strategy of hip, knee, and ankle when standing on an unstable surface. Twenty participants were recruited. Four different conditions were investigated: a quiet bipedal stance with eyes open and eyes closed, and standing on an unstable surface with eyes open and eyes closed. Other than the joint angle, the standard body sway measures, such as sway area and sway velocity, were computed. A nonlinear time series measure, that is, sample entropy, was used to determine the regularity of the time series and body adaptability to change and perturbation. The results show that the body sway increases as the difficulty increases. This study also confirms the coordination of the hip, knee, and ankle to maintain body balance on the unstable surface by decreasing the joint angle and adopting a lower posture. Even though the individual joint has lower sample entropy value and is deemed to be rigid and less adaptive to perturbation, the postural control exhibits higher sample entropy value, particularly in the anterior-posterior direction, and has the ability to stabilize the body by manipulating the joints simultaneously. These outcomes suggest that an unstable surface not only challenges the human postural control, but also reduces the hip, knee, and ankle adaptability to perturbation, thus making it a great tool to train body balance.

Matched MeSH terms: Ankle*; Ankle Joint*
The effects of additional hollow cylinder coated to external fixator screws for treating pilon fracture: A biomechanical perspective

Ramlee MH, Seng GH, Ros Felip A, Abdul Kadir MR

Injury, 2021 Aug;52(8):2131-2141.
PMID: 33745700 DOI: 10.1016/j.injury.2021.03.017

An external fixator is a promising medical device that could provide optimum stability and reduce the rate of complications in treating bone fracture during intervention period. It is noted that the biomechanics behaviour of device can be altered by introducing more features such as material suitability and additional components. Therefore, this study was conducted via finite element method to investigate the effects of additional hollow cylinder coated with external fixator screws in treating Type III pilon fracture. Finite element models which have been validated with experimental data were used to simulate stresses at the pin-bone interface and relative micromovement at interfragmentary fractures during swing (70 N load) and stance phases (350 N load). All bones and external fixators were assigned with isotropic material properties while the cartilages were simulated with hyper-elastic. For the hollow cylinder, polyethylene was assigned due to its properties which are equivalent to the bone. From the results, it is found that stresses at the pin-bone interface for the coated screws were reduced to 54% as compared to the conventional fixator. For the micromovement, there was no difference between both models, whereby the value was 0.03 mm. The results supported previously published literature, in which high stresses are unavoidable at the interface, fortunately, those stresses did not exceed the ultimate strength of bone, which is safe for treating patients. In conclusion, if patients are allowed to bear weight bearing, the external fixator with coated screws is a more favourable option to be fixed into the bone to avoid complications at the interface.

Matched MeSH terms: Ankle Fractures*
Stress Distributions and Micromovement of Fragment Bone of Pilon Fracture Treated With External Fixator: A Finite Element Analysis

Ramlee MH, Gan HS, Daud SA, Abdul Wahab A, Abdul Kadir MR

J Foot Ankle Surg, 2020 7 1;59(4):664-672.
PMID: 32600559 DOI: 10.1053/j.jfas.2019.09.006

Osteoporosis and osteoarthritis are common pathological problems of the human bone tissue. There are some cases of pilon fractures associated with these 2 pathological conditions. In terms of treatment, for a normal and healthy bone with pilon fracture, the use of the Delta external fixator is a favorable option because it can allow early mobilization for patients and provide stability for the healing process. However, the stability of the external fixator differs when there is low bone stiffness, which has not been previously investigated. Therefore, this study was conducted to determine the stability of the external fixator to treat pilon fracture associated with osteoporosis and osteoarthritis, particularly to differentiate the stress distribution and micromovement of fracture fragment. Three-dimensional finite element models of the ankle and foot bones were reconstructed based on the computed tomography datasets. The bones consisted of 5 metatarsal, 3 cuneiform, and 1 each of cuboid, navicular, calcaneus, talus, fibula, and tibia bones. They were assigned with linear isotropic behavior. The ankle joint consisted of ligament and cartilage, and they were assigned with the use of linear links and the Mooney-Rivlin model, respectively. During simulation of the gait cycle, 70 N and 350 N were applied axially to the tibia bone to represent the swing and stance phases, respectively. The metatarsal and calcaneus bones were fixed to prevent any movement of the rigid body. The study found that the greatest von Mises stress value was observed at the pin-bone interface for the osteoporosis (108 MPa) model, followed by the osteoarthritis (87 MPa) and normal (44 MPa) models, during the stance phase. For micromovement, the osteoporosis model had the largest value at 0.26 mm, followed by the osteoarthritis (0.09 mm) and normal (0.03 mm) models. In conclusion, the greatest magnitudes of stress and micromovement were observed for the osteoporosis bone and extra care should be taken to treat pilon fracture associated with this pathological condition.

Matched MeSH terms: Ankle Fractures*
Physiotherapy in the management of sports injuries

Teow G

Med J Malaysia, 1979 Mar;33(3):277-8.
PMID: 118323
Matched MeSH terms: Ankle Injuries*
Letter to the editor: Cardiovascular risk prediction with cardio-ankle vascular index in the Malaysian cohort study

Burki AUH, Khan AA, Ashraf DA, Rizvi A, Hassan S

Curr Probl Cardiol, 2024 Apr;49(4):102462.
PMID: 38346612 DOI: 10.1016/j.cpcardiol.2024.102462
Matched MeSH terms: Ankle*
Letter to the Editor: Cardiovascular risk prediction with cardio-ankle vascular index in the Malaysian cohort study

Sawlani A, Kumar J

Curr Probl Cardiol, 2024 Mar;49(3):102386.
PMID: 38184136 DOI: 10.1016/j.cpcardiol.2024.102386
Matched MeSH terms: Ankle/blood supply
A review on the mechanical design elements of ankle rehabilitation robot

Khalid YM, Gouwanda D, Parasuraman S

Proc Inst Mech Eng H, 2015 Jun;229(6):452-63.
PMID: 25979442 DOI: 10.1177/0954411915585597

Ankle rehabilitation robots are developed to enhance ankle strength, flexibility and proprioception after injury and to promote motor learning and ankle plasticity in patients with drop foot. This article reviews the design elements that have been incorporated into the existing robots, for example, backdrivability, safety measures and type of actuation. It also discusses numerous challenges faced by engineers in designing this robot, including robot stability and its dynamic characteristics, universal evaluation criteria to assess end-user comfort, safety and training performance and the scientific basis on the optimal rehabilitation strategies to improve ankle condition. This article can serve as a reference to design robot with better stability and dynamic characteristics and good safety measures against internal and external events. It can also serve as a guideline for the engineers to report their designs and findings.

Matched MeSH terms: Ankle Joint/physiology; Ankle Injuries/physiopathology; Ankle Injuries/rehabilitation*
Fulltext Concomitant Traumatic Peroneal Tendon Dislocation and Medial Malleolus Fracture: A Case Report

Vosoughi AR, Erfani MA

Malays Orthop J, 2018 Mar;12(1):57-59.
PMID: 29725517 DOI: 10.5704/MOJ.1803.014

Peroneal tendon dislocation in association with medial malleolus fracture is a very rare traumatic injury to the ankle. A 19-year old male patient was referred after injury sustained in a motorcycle accident with car, with concomitant traumatic peroneal tendon dislocation and medial malleolus fracture. The possible mechanism of this unusual injury could have been sudden external rotation force to the pronated foot in full dorsiflexed position of the ankle. Diagnosis of peroneal tendon subluxation or dislocation should be carefully evaluated in patients with single medial malleolus fracture.

Matched MeSH terms: Ankle; Ankle Joint; Ankle Fractures
Fulltext Successful ankle replantation in two cases with different presentations

Wen APY, Jusoh MH, Saad AZM, Halim AS, Faisham NWIW, Azman WSW

Arch Plast Surg, 2020 Mar;47(2):182-186.
PMID: 31462030 DOI: 10.5999/aps.2018.00514

We report our experience of treating two patients with ankle amputation with different presentations. The first case was a clean-cut sharp amputation. The second case was an avulsion injury following a motor vehicle accident in a patient who arrived 8 hours after the injury. Replantation was successful in both cases. In avulsion injuries, a secondary operation for wound coverage is required at a later stage. With good strategy and a support team, encouraging limb survival outcomes are possible post-replantation.

Matched MeSH terms: Ankle; Ankle Joint
Fulltext Amplitude analysis of lower leg muscle in car pedal operation in specific driving posture and duration

Khamis, N.K., Deros, B.M

Journal of Engineering and Science Research, 2018;2(3):14-19.
MyJurnal

Driving posture is important to determine the comfortability of the driver. The purpose of this study is to investigate the muscle response in car pedal operation. To evaluate this response, 11 volunteers involved in simulated driving experiment using an electrical impedance myography to detect the muscle contraction of the lower leg, particularly at Gastrocnemius medial (GM). The driver requires to perform different pedal actions. The results depict that GM muscle shows different reaction according to pedal actions. According to these results, different degree of ankle angle lead to different muscle response. These findings help us to understand the effect of physical attribute related to muscle response and joint angle on driver during monotonous driving task.

Matched MeSH terms: Ankle; Ankle Joint
Systemic review of global case reports on ankle pseudo aneurysm: Analysis of epidemiology, clinical presentation, diagnosis and treatment

Aimanan K, Lim SY, Mohd Nor MR, Wahi AM, Chew LG

Med J Malaysia, 2020 01;75(1):88-93.
PMID: 32008030

INTRODUCTION: Pseudo aneurysm of the ankle is a rare presentation and the management is complex due to the complex anatomy. The aim of this review is to examine the epidemiology, etiology, diagnostic modalities used and management. This is the first systematic review of this topic in literature.
METHODS: We performed a systematic review in multiple databases (including PubMed, MEDLINE, EMBASE, and Scopus) from 1966 to May 18, 2019, to identify all case reports and case series describing patients with ankle pseudo aneurysm. This systematic review was performed in accordance with the Preferred Reporting Items for a Systematic Review and Meta-analysis (PRISMA). Our inclusion criteria included patients with ankle pseudo aneurysm of any age. We excluded reports in which the individual level data is not available. Patients demographic (gender, age), clinical characteristics (precipitating event, duration), diagnostic modality and treatment were recorded.
RESULT: There were in total 23 case reports identified on ankle pseudo aneurysm from 1966 until 2018. Among these twenty-three reports, 16 (70%) were male and seven (30%) patients were female. Age distribution showed higher number of reports among young adults, 15 patients (65%). Based on our systematic review trauma (48%), arthroscope (48%) and arthrodesis (4%) were the etiologies described in all these case reports. Ultrasound duplex and CT Angiogram has been used as a single modality in three reports each. In fifteen patients (65%) combination of imaging has been used for diagnosis. Anterior tibial artery is the most commonly injured vessel among the reported cases, comprised of 14 (61%) patients. Among these arthroscopes were the highest reported precipitating events, 9 (64%), followed by trauma in four patients (29%) and arthrodesis in one patient (7%). Treatment modalities described in all previous reports were excision and ligation, 10 (42%); excision of sac and primary repair, 4 (17%); excision of sac followed by reversed saphenous venous graft repair, 2 (8%); US guided compression, 2 (8%); US guided thrombin injection, 4 (17%); stenting, 1 (4%) and coiling, 1 (4%).
CONCLUSION: Ankle pseudoaneurysm is mostly preventable by detailed initial assessment following trauma or careful approach during arthroscope. Evolving diagnostic modality and treatment has shed some light into noninvasive management of pseudo aneurysm of ankle.

Matched MeSH terms: Ankle/blood supply*
Proximal Tibia Bone Graft: An alternative Donor Source especially for Foot and Ankle Procedures

Jia TY, Gurmeet S, Asni A, Ramanathan R

Malays Orthop J, 2015 Mar;9(1):14-17.
PMID: 28435589 MyJurnal DOI: 10.5704/MOJ.1503.016

Bone graft is essential in various orthopaedic procedures. Among the many donor sites for harvesting autologous bone graft, the iliac crest has been the most commonly used. However, for foot and ankle procedures the proximal tibia has gained popularity as an alternative donor site due to its anatomic proximity to the primary surgical site. In this article we evaluated the possible complications associated with harvesting proximal tibia bone graft. Our study showed the low incidence of morbidity in harvesting proximal tibia bone graft, thereby providing a good alternative donor for foot and ankle procedures.

Matched MeSH terms: Ankle; Ankle Joint
Fulltext Healing of venous ulcers secondary to an ankle arteriovenous fistula

Liew NC, Lee L, Gee T, Jabar MF

J Vasc Surg Cases, 2015 Dec;1(4):229-231.
PMID: 31724592 DOI: 10.1016/j.jvsc.2015.07.007

Venous ulcer as a complication of ankle arteriovenous fistula for hemodialysis is rarely reported. It poses a challenge between ulcer healing and fistula preservation. We report our experience in the management of venous ulcers secondary to an ankle arteriovenous fistula in a hemodialysis patient.

Matched MeSH terms: Ankle; Ankle Joint
A triple compound pendulum model to analyse the effect of an ankle-foot orthosis on swing phase kinematics

Marconi G, Gopalai AA, Chauhan S

Med Eng Phys, 2023 Feb;112:103951.
PMID: 36842774 DOI: 10.1016/j.medengphy.2023.103951

Powered ankle-foot orthoses can be utilised to overcome gait abnormalities such as foot drop; however, normal gait is rarely restored with compensatory gait patterns arising and prevalence of gait asymmetry. Therefore, this study aims to determine the effect of orthosis mass and mass distribution on the swing phase of gait, to understand residual gait asymmetry with orthosis use. Using a triple compound pendulum model, which accounts for mass distribution of the limb and orthosis, the swing phase of gait is simulated in terms of natural dynamics and the effect of an orthosis on kinematic parameters is quantitatively determined. It was found that additional mass causes faster and shorter steps on the affected side due to rapid knee extension and reduced hip flexion, with particular actuator positions and natural cadence causing varying severity of these effects. Our study suggests that this model could be used as a preliminary design tool to identify subject specific optimum orthosis mass distribution of a powered ankle-foot orthosis, without the need for motion data or experimental trials. This optimisation intends to more accurately mimic natural swing phase kinematics, consequently allowing for the reduction in severity of gait asymmetry and the potential to improve rehabilitative outcomes.

Matched MeSH terms: Ankle*
Fulltext Early functional outcome of a modified Brostrom-Gould surgery using bioabsorbable suture anchor for chronic lateral ankle instability

Shahrulazua A, Ariff Sukimin MS, Tengku Muzaffar TM, Yusof MI

Singapore Med J, 2010 Mar;51(3):235-41.
PMID: 20428746

The purpose of this study was to evaluate the early functional outcome following the use of a bioabsorbable suture anchor to simplify the repair of injured lateral ankle structures as a variation of an established technique known as the Brostrom-Gould procedure.

Matched MeSH terms: Ankle/surgery; Ankle Joint/surgery*; Ankle Injuries/rehabilitation; Ankle Injuries/surgery*
Fulltext Effects of the standard physiotherapy programme on pain and isokinetic ankle strength in individuals with grade I ankle sprain

Mohd Salim NS, Umar MA, Shaharudin S

J Taibah Univ Med Sci, 2018 Dec;13(6):576-581.
PMID: 31435381 DOI: 10.1016/j.jtumed.2018.10.007

Objectives: The isokinetic evaluation of the ankle joint is important in determining the effectiveness of the rehabilitation programme for the management of ankle sprains. This study aimed to determine the effects of physiotherapy programme on isokinetic variables in individuals with grade I ankle sprains.
Methods: Seven patients with acute grade 1 ankle sprain (15 days of ankle sprain) were recruited. They were provided with 7 days of protection, optimal loading, ice, compression, and elevation (POLICE) treatment, and the standard physiotherapy programme consisted of towel stretching and balancing exercises on one leg. Pain scale score was recorded daily during the physiotherapy programme. The isokinetic ankle strengths of the patient's injured and uninjured legs were compared before and after the physiotherapy programme. Isokinetic tests were conducted in painless range of motion for the injured leg.
Results: Pain was significantly reduced after the patients underwent the standard physiotherapy programme. No significant differences were observed in terms of the ankle peak torque, time to peak torque, and ankle plantar flexion-to-dorsiflexion ratio of the injured and uninjured legs. The injured leg showed significant improvement in terms of ankle eversion-to-inversion ratio (E:I) after 7 days of performing the standard physiotherapy programme.
Conclusion: Performing the standard physiotherapy programme for 1 week reduces pain and improves the ankle E:I in patients with grade 1 ankle sprain.

Matched MeSH terms: Ankle; Ankle Joint; Ankle Injuries
Fulltext Comparison of lower limb kinematics during early and late phases of 2km time trial on stationary rowing ergometer among male national rowers

Amirah Zahiran, Fara Liana Zainuddin, Shazlin Shaharudin

Malaysian Journal of Medicine and Health Sciences, 2020;16(3):3-7.
MyJurnal

Introduction: In this study, we evaluated the kinematics of lower limb during early and late phases of 2km time trial on stationary rowing ergometer among Malaysian male rowers. Methods: Seventeen national-level rowers voluntari- ly participated. Three dimensional lower limb kinematics data were collected to represent the first 400 m (i.e., early) and the last 400m (i.e., late) phases of 2km time trial on a stationary ergometer. The kinematics data at sagittal, frontal and transverse planes of dominant leg during catch and finish positions were compared across early and late phases of the time trial using paired T-test. Results: The kinematics of lower limb joints at three planes were not significantly different during early versus late phases of 2km time trial among male senior rowers except for hip flexion at finish (p=0.411), ankle rotation at catch (p=0.779) and ankle abduction at finish (p=0.677). Conclusion: Lower limb kine- matics particularly the hip flexion, ankle rotation and ankle abduction may change across early and late phases of 2km time trial due to fatigue. Coaches and rowers should monitor these motions during fatiguing rowing piece and develop necessary injury prevention measures.

Matched MeSH terms: Ankle; Ankle Joint

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