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Tibiotalar dislocation without concomitant fracture in the surrounding bones is a rare injury. We report one of them presenting unreduced after a 10 month interval. A 23 y/o female presented to our clinic 10 months after Bam earthquake, during which she had sustained an anterior tibiotalar dislocation without any associated fracture. Open reduction was tried two times, but both attempts were unsuccessful because of the very poor quality of bone. Although ankle dislocation has been reported to be associated with good prognosis, it was not the case with our late presenting patient.

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Background & Objective: Pulse pressure is a marker of arterial stiffness. In old age the pressure wave reflection also contribute to disparity of pulse pressure between upper and lower limbs. This study was done to determine the relation between ageing and increased pulse pressure of upper and lower limbs. Materials & Methods: In this discriptive study blood pressure measured in 40 nonsmoker men, all free from medication and disease history, insubjects divided in two groups: 18-25 and 50-70 years old with mean age of 22±1.3 and 59±2 years respectively. Using a mercury-column sphygmomanometer (ERKA) with appropriate cuff size and after five minutes of quiet rest, the blood pressure was determined in supine posture at three separate times. The lower limb pressure was measured with placing the cuff on calf muscle and the stethoscope on posterior surface of internal malleolus. The mean of the second and third records rounded and were used for analysis. Results: The right and left brachial and ankles pulse pressure in two groups were: 44.50±2.03, 44.50±1.71, 37.90±2.24, 37.25±2.30 mmHg in 18-25 years old group and 47.10±2.74, 46.90±2.65, 56.05±3.18, 55.90±4.48 mmHg in 50-70 years old group, respectively. Significant differences were found between brachial and ankle pulse pressure in both sides in first group, (P<0.05). In the second group this difference was only significant at right, (P<0.05). The ratio of brachial pulse pressure to ankle pulse pressure in 18-25 years old group was greater than 1 and in 50-70 years old group it was less than .15 In both side the ankles pulse pressure was significantly greater in 50-70 years old group (P<0.05). Conclusion: This study showed that in subjects of more than 55 years of age, the increasing of pulse pressure was more prominent in lower limb. The ankle pulse pressure may be a proper index of central pulse pressure changes and atherosclerosis of elastic arteries with ageing.

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Background and Objective: Reducion of efficiency of the muscles after long duration training increases the probability of injury after the occurrence of fatigue. Sprain lateral ankle is one of the most common injuries occurs during sport activities. This study was done to compare the effect of two types of hopping and combined balance - strength training on the balance of static and dynamic balance and strength of selected muscles in soccer men with unilateral chronic ankle instability.
Methods: In this quasi-experimental study 36 soccer men with unilateral chronic ankle instability non-randomly divided into the three groups including: control, hopping and combined balance - strength training groups. Check list was used to collect demographic information, for the measurement the balance of the static, dynamic balance and strength respectively of the tests bass stick and Y balance and manual muscle test were used.
Results: There was significant increasd of the balance of the static and the total result of dynamic balance in the two training groups in compare to controls (P<0.05). The subjects of the group trianing balance - strength in the all directions of the test Y performance were better than training hopping group (P<0.05). After training, the strength of abduction, adduction and inversion of ankle significantly increased in the two training groups in compare to controls (P<0.05). According to invertion test the ankle of subjects in balance - strength training group had beter function in compare to training hopping group (P<0.05). However, other factors such as strength, extension and flexion of the knee and dorsi and plantar flexion of the ankle were not significant between the two intervention groups.
Conclusion: Both the balance - strength and hopping training can be effective in improving the balance and strength soccer men with chronic ankle instability unilateral. However, it seems the training selected balance - strength training due to the comprehensive nature of it and the reason as to strengthen each of these factors for conduit and have a greater effect on athletes with chronic ankle instability to have faster recovery.

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Osteoid osteoma is benign bone tumor, in which talus bone involvement is rare. This case was a 17 year old man with a right ankle pain and reduced range of motion since one year ago. Following clinical evaluation and radiological studies (X-ray, CT scan, and MRI), a bone tumor was detected in the talus with a possible diagnosis of Osteoid osteoma. The patient was operated with ankle anterior approach and the tumor was resected from the site. The patient was discharged after two days. The patient's pain was eliminated after surgery. Ankle movements are back after two months. Due to the rare nature of the disease and clinical diagnostic problems and its unusual radiographic manifestations, osteoid osteoma in chronic ankle pain in young patients, is included in the list of differential diagnosis.

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Background and Objective: Using lumbar orthoses changes the running mechanics. An essential biomechanical factor in rehabilitation and injury prevention is the co-contraction of the knee and ankle joints. Therefore, this study aimed to investigate the effect of 2 types of thoracolumbosacral braces on ankle and knee joint co-contraction in people with kyphosis during running.
Methods: This quasi-experimental study was conducted on 15 men aged 18-25 years suffering from kyphosis greater than 40 degrees in the Biomechanics Laboratory of the University of Mohaghegh Ardabili Health Center during the summer of 2020. Each participant randomly performed 3 running tests in each condition: without a brace, with a sensor brace, and with a simple brace. The test consisted of electromyographic data of the selected lower limb muscles, which also recorded the contraction of the knee and ankle muscles in the right leg when running at a constant speed.
Results: The results showed a reduction of the general knee co-contraction while using a sensory brace compared to without the brace by 6% during the loading phase (P<0.05). Additionally, using a simple brace compared to the condition without a brace, the ankle-directed contraction during the push-off phase decreased by 38% (P<0.05). Directed vastus medialis and lateralis co-contraction while using a sensory brace increased by about 49% compared to without the brace at the loading phase and increased by about 47% at the mid-stance phase without a brace condition compared to the simple brace condition (P<0.05).
Conclusion: General knee co-contraction after using a sensory brace was lower than when a simple brace was used.

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Background and Objective: Ankle instability is one of the most prevalent injuries among athletes. Biomechanical changes, sensory-motor impairments, and neuromuscular disorders have been reported in individuals with chronic ankle instability. The present study was conducted to compare the electrical activity of selected leg and thigh muscles during performing functional movements in female athletes with and without chronic ankle instability.
Methods: This case-control research was conducted on 40 female athletes in the age range of 18-30 years in two groups, including the case (with ankle instability, n=20) and healthy control (without ankle instability, n=20) groups. The electrical activity of selected leg and thigh muscles was recorded during three functional patterns, i.e., the overhead squat, overhead squat with heel lift, and single-legged squat, by electromyography apparatus. The investigated muscles consisted of the gastrocnemius medialis (GM) muscle, the gastrocnemius lateralis (GL) muscle, the tibialis anterior (TA) muscle, the fibularis longus (FL) muscle, the soleus (SO) muscle, the vastus lateralis (VL) muscle, the vastus mediali (VM) muscle, and the biceps femoris (BF) muscle.
Results: The activity of the VM, VL, BF, and TA muscles in the single-legged squat and the activity of the VM, VL, BF, SO, and TA muscles in the overhead squat showed a statistically significant increase in the case group compared to the control group (P<0.05). The highest difference in the muscle activity of the two groups was observed in the overhead squat with heel lift movement, which in this movement, except for the GL muscle, there was a statistically significant increase among all other muscles (P<0.05).
Conclusion: Functional movements culminate in increasing the electrical activity level of leg and thigh muscles in female athletes with ankle instability.

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Studies indicate a significant impact of rehabilitation exercises on improving complications related to ankle injuries. This review aimed to evaluate the effects of various exercise protocols with and without the use of taping and kinesio taping, in individuals with ankle injuries. Article were searched in both Persian and English from 2007 to 2023 in the specialized databases of PubMed, Scopus, Science Direct, Web of Science (WoS), Google Scholar, Islamic World Sciences Citation (ISC), Civilica, State Inpatient Database (SID), and Magiran. The keywords used for article extraction included "Ankle ligament," "Ankle injury," "Ankle sprain," "Corrective exercises," and "Taping." Ultimately, 16 articles related to the effects of various exercise protocols with and without the use of taping following ankle injury were reviewed and analyzed. A review of 6 articles revealed that exercise protocols with the use of taping have reduced the likelihood of lower extremity injuries by increasing ankle muscle strength and improving selected kinetic variables, proprioception, and ankle function. Additionally, an examination of 3 articles on exercise protocols with the use of taping demonstrated that the application of taping had no significant effect on function. Furthermore, a review of 7 articles on exercise protocols without the use of taping demonstrated that performing such exercises culminated in the restoration of muscle strength and improved proprioception and static balance. The results revealed that various exercise protocols with and without the use of taping are significantly effective in preventing recurrent ankle ligament injuries; however, the application of taping may have a superior effect on ankle injury recovery.