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MEDICAL ANIMATION TRANSCRIPT: Arthroscopic ankle fusion is a minimally invasive surgical procedure that fuses, or joins, the ankle bones together. The ankle is the joint that connects the leg and the foot. The ankle joint includes the two lower leg bones called the tibia and the fibula, and the ankle bone called the talus. Together, the ends of the tibia and fibula create a mortise, or slot, for the talus, which forms the bottom of the ankle joint. Tissues, called ligaments and tendons, support the ankle bones. Ligaments attach bones to bones, and tendons attach muscles to bones. The ankle joint allows the foot to move up and down. Articular cartilage on the ends of bones is a smooth, gliding covering that allows fluid joint movement. Ankle fusion, also known as arthrodesis, is a surgical procedure that joins the ankle bones together so they no longer move or rub against each other. Doctors may recommend this procedure for conditions that lead to severe ankle joint damage and pain. The most common condition is osteoarthritis, also known as degenerative joint disease. In the late stage of osteoarthritis, cartilage covering the ends of the bones has worn away, exposing bare bone. This, along with the growth of bony projections called bone spurs, causes swelling, pain, and limited movement of the joints. Another condition that may require ankle fusion is rheumatoid arthritis, where the patient's own immune system attacks the joints. Any condition that destroys the joint surface, such as a severe bone infection or death of bone tissue called osteonecrosis, may also require fusion of the ankle joint. To begin the procedure, the surgeon will hold the foot down with straps to be able to see inside the joint space better. Next, two tiny keyhole incisions will be made on the ankle. A small tube called a cannula, with a camera inside it, will be inserted through one incision. Surgical instruments will be inserted through the other incision. The surgeon will use the surgical instruments to remove cartilage and damaged bone from the bottom surface of the tibia. This will also be done to the top surface of the talus. After this, the surgeon will remove the arthroscopic tools and foot straps. Then, two or three metal guide pins will be placed through the bones of the ankle joint. The surgeon will use the guide pins to place hollow screws, which hold the bones in place. Finally, the incisions will be closed with sutures. After ankle fusion, the patient will no longer be able to move the ankle joint. However, fusion removes the pain caused by arthritic surfaces rubbing together, and other joints in the foot continue to allow limited movement.
"Our firm was able to settle our case at an all day mediation yesterday and
I am confident that the detail and overall appearance of the medical
illustrations significantly contributed to the settlement. When we require
medical illustrations in the future, I will be sure to contact [MLA]."
Noel Turner, III
Burts, Turner, Rhodes & Thompson
Spartanburg, SC
"I wanted to take some time out to let you know what a wonderful job you did
with the 'collapsed lung/fractured rib' illustrations. They were both
detailed and accurate. My medical expert was comfortable working with them
and he spent at least an hour explaining to the jury the anatomy of the
lungs, the ribs and the injuries depicted in the illustrations. Needless to
say, the jury was riveted to the doctor during his testimony.
The jury returned a verdict for $800,000.00 and I'm sure we would not have
done so well if not for the visualizations we were able to put forth with
your assistance. Lastly, my special thanks to Alice [Senior Medical
Illustrator] who stayed late on Friday night and patiently dealt with my
last minute revisions."
Daniel J. Costello
Proner & Proner
New York, NY
"Thank you for the splendid medical-legal art work you did for us in the
case of a young girl who was blinded by a bb pellet. As a result of your
graphic illustrations of this tragic injury, we were able to persuade the
insurance company to increase their initial offer of $75,000.00 to
$475,000.00, just short of their policy limits.
We simply wanted you to know how pleased we were with your work which, to
repeat, was of superlative character, and to let you know that we would be
more than willing to serve as a reference in case you ever need one. Many
thanks for an extraordinary and dramatic depiction of a very serious injury
which clearly "catapulted" the insurance company's offer to a "full and
fair" amount to settle this case."
Philip C. Coulter Coulter &Coulter Roanoke, VA
"Medical illustrations are essential during trial for any medical malpractice case. The people at MLA have the uncanny ability of creating medical illustrations that simplify the most complex of medical concepts and human anatomy to a lay audience. The exhibits of MLA allow experts to easily describe complex concepts and human anatomy in a manner that could
not be done otherwise.
In addition, their custom illustrations show in great detail the extent of
injuries suffered and the devastating effects they have had on the client's
anatomy. These custom illustration can show, side by side, the body before
and after a catastrophic injury. The effect of this juxtaposition is
unmatched by any testimony that can be adduced at the time of trial.
Even jurors after trial have commented on the ease with which they grasp
medical concepts and anatomy once the MLA exhibits were introduced and
used by my experts. Even judges who have "seen it all" are thoroughly
impressed by the detail and sophistication of the illustrations.
Medical Legal Art creates medical demonstrative evidence (medical
illustrations, drawings, pictures, graphics, charts, medical animations,
anatomical models, and interactive presentations) for use during legal
proceedings, including research, demand letters, client conferences,
depositions, arbitrations, mediations, settlement conferences, mock jury
trials and for use in the courtroom. We do not provide legal or medical
advice. If you have legal questions, you should find a lawyer with whom you
can discuss your case issues. If you have medical questions, you should seek the advice of a healthcare provider.