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MEDICAL ANIMATION TRANSCRIPT: An ankle scope procedure, also known as ankle arthroscopy, can be used to treat conditions that cause pain or decreased flexibility of the ankle joint. 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. 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. A variety of conditions can cause pain or decreased flexibility of the ankle joint. Abnormal bone growths called bone spurs may have formed, impinging on the ankle joint as it moves. Ligaments may be damaged either from overuse or from ankle injuries such as sprains. Old ankle injuries may stretch the ligaments, allowing abnormal movement of the ankle joint. This can lead to more rapid degenerative changes in the joint. Cartilage may be damaged or worn thin due to prior ankle injury or osteoarthritis. Small pieces of cartilage may have detached from the underlying bone and may be floating in the joint. The joint space may be infected, usually from bacteria. To treat these and other conditions, a surgeon may perform an ankle scope. The surgeon will begin by making several tiny incisions or portals in the ankle. A small tube called a cannula will be placed into one of the incisions. A scope will be passed through the cannula to allow the surgeon to see inside the joint area. The scope contains a tiny camera that will project the image of the ankle joint onto a TV monitor for the surgeon to watch. A sterile saline solution will be pumped through the scope cannula to expand the area so the surgeon can see better and have more area in which to work. The surgeon will insert surgical instruments through the other incision to do one or more of the following treatments. A bone spur will be removed or burred down. Excess tissue will be removed from a thick scarred ligament. Loose pieces of cartilage floating in the joint will be removed. Infection in the ankle joint will be cleaned out by washing the joint with fluid. If a person has damaged cartilage or bone from arthritis, ankle fusion will be performed. During an ankle fusion, damaged cartilage and bone will be removed. The bones will be attached to each other with screws. This will lock the ankle joint in one position, while other joints in the foot will continue to allow limited movement. Once the treatment is finished, the sterile saline will be drained out of the joint. The instruments will be removed and the incisions will be closed with stitches.
"Thank you for the wonderful illustrations. The case resulted in a defense verdict last Friday. I know [our medical expert witness] presented some challenges for you and I appreciate how you were able to work with him."
Robert F. Donnelly
Goodman Allen & Filetti, PLLC
Richmond, VA
"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
"It is my experience that it's much more effective to show a jury what
happened than simply to tell a jury what happened. In this day and age where
people are used to getting information visually, through television and
other visual media, I would be at a disadvantage using only words.
I teach a Litigation Process class at the University of Baltimore Law Schooland use [Medical Legal Art's] animation in my class. Students always saythat they never really understood what happened to [to my client] until theysaw the animation.
Animations are powerful communication tools that should be used wheneverpossible to persuade juries."
Andrew G. Slutkin Snyder Slutkin & Kopec Baltimore, MD
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illustrators for all my medical malpractice cases. … Please know
that I enthusiastically recommend you to all my colleagues.
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