![]() Between the anterior and posterior margins of the tibia there is a triangular concave notch, named incisura tibialis, where the convex medial margin of the distal fibula rests. Posterior tubercle functions as a fulcrum during external rotation injury, and the fibula spins around its longitudinal axis. These tubercles represent the tibial attachment sites respective of the anterior and posterior syndesmotic ligaments. The lateral ridge of the distal tibia bifurcates into an anterior and posterior margin, forming a larger anterior (Chaput’s tubercle) and a smaller posterior tubercle (Volkman’s tubercle). The bony anatomy of the distal tibia and fibula is important for the osseous stability of the tibiofibular joint, which is a syndesmosis formed by the medial rough convex surface of the distal fibula which articulates with the lateral triangular fibular notch of the distal tibia. The aim of this study is to review anatomical and biomechanical characteristics of DTS, the mechanism of its acute injury associated to fractures, radiological and arthroscopic diagnosis and surgical treatment. However, there is no unique consensus on whether DF methods are superior to the static ones in terms of functional outcomes, change in range of motion, complication rates and incidence of reoperation. Recently, this technique has become increasingly popular because it allows a more physiological articular movement, early rehabilitation, satisfactory functional outcomes and no requirement for implant removal. An alternative dynamic method of fixation (DF) uses an implanted suture-button device it consists of a nonabsorbable synthetic suture between two metallic buttons implanted across the DTS. Screw loosening, breakage, discomfort, pain related to overcompression, the need for a reoperation for screw removal and the risk of late diastasis after early removal are potential drawbacks of this type of fixation. However, some significant issues should be considered. Static fixation (SF) with one or more cortical screws is the reference standard fixation method. Various fixation techniques have been introduced over recent decades (metallic and bioabsorbable screws, staples, polyester bands, syndesmosis hooks, Kirschner wires and suture-button fixation). Patients with unstable injuries require surgical stabilization. Persistent ankle pain, function disability and early osteoarthritis are potential problems related to misdiagnosed or inadequate treatment, and for this reason it is necessary to acquire an accurate diagnosis and maintain syndesmotic reduction when treating ankle fractures with concomitant syndesmotic disruption. Therefore, it is crucial that surgeons adequately diagnose these lesions, which are present in up to 40% of all type B injuries according to Danis-Weber classification and up to 80% of all type C. About 10% of all are associated to syndesmotic injury, and this percentage is twice as high in patients who require internal fixation. Ankle fractures occur with an incidence of 107-100 in the adult population. They are consequent to an external rotation force applied to the foot that leads to eversion of the talus within the ankle mortise. DTS injuries of sufficient severity can disrupt the normal stability of the ankle and they may occur in many forms, commonly classified into isolated or, more frequently, with an associated malleolar fracture. The distal tibiofibular syndesmosis (DTS) complex is critical for maintaining the congruency of the ankle mortise and is the most important supporter of this joint. This paper reviews anatomical and biomechanical characteristics of this syndesmosis, the mechanism of its acute injury associated to fractures, radiological and arthroscopic diagnosis and surgical treatment. In such an injury, including inadequately treated, misdiagnosed and correctly diagnosed cases, a chronic pattern characterized by persistent ankle pain, function disability and early osteoarthritis can result. Anatomical restoration and stabilization of the disrupted tibiofibular syndesmosis is essential to improve functional outcomes. The diagnosis is not simple, and ideal management of the various presentations of syndesmotic injury remains controversial to this day. The disruption of this joint is frequently accompanied by rotational ankle fracture, such as pronation-external rotation, and rarely occurs without ankle fracture. A stable and precise articulation of the distal tibiofibular syndesmosis maintains the tibiofibular relationship, and it is essential for normal motion of the ankle joint.
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Harris Computer Corporation, a wholly owned subsidiary of Constellation Software Inc. On November 4, 2010, Copernic entered into an arrangement agreement with N. The company proceeded to this sale in order to focus the company on new product offers. Transaction took place as planned by the two companies and will allow Copernic to reflect the details in their Q2 report. On June 30, 2009, Copernic completed the sale of and its third party Ad Net to Empresario, a privately owned digital media network based in Chicago Illinois. It was alleged that he directed his broker to sell his entire 600,000 shares of stock in the company to avoid losses in excess of $750,000 based on insider information. Securities and Exchange Commission announced that it had charged Mark Cuban with insider trading. changed its name to Copernic Inc., received a new stock symbol CNIC, (effective June 14, 2007), and launched its new corporate website. In the preceding fiscal year Copernic had a revenue of about $5.9 million and an EBITDA of about $1.8 million paid $15.9 million and issued 2,380,000 common shares. On December 22, 2005, completed its acquisition of Copernic Technologies Inc., a search technology company founded in July 1996 in Quebec City and maker of the desktop search utility Copernic Desktop Search. was incorporated In July, 1996, under the name Agents Technology, Inc. It was one of the web's first tier 2 metasearch engines.Ĭopernic Technologies Inc. was launched in July 1996 by Herman Tumurcuoglu in Montreal, Canada. ![]() ![]() There is a free edition and paid editions with free trial. is a company based in Ottawa, Ontario, Canada, producer of Copernic Desktop Search and Copernic Server Search, desktop search software for home and business, running on Microsoft Windows. Copernic Desktop Search, Copernic Server SearchĬopernic Inc. China’s “seam”, for example, is suspiciously thin throughout the length of the timeline. ![]() Certainly, the creator’s biases and blind spots become more apparent in the information-abundant 21st century. Lastly, Histomap refers to various cultural and racial groups using terms that may seem rather dated to today’s viewers. John Spark’s creation is an admirable attempt at making history more approachable and entertaining. ![]() Today, we have seemingly limitless access to information, but in the 1930s an all encompassing timeline of history would have been incredibly useful and groundbreaking. Indeed, the map’s publisher characterized the piece as a useful tool for examining the correlation between different empires during points in history.Ĭritiques aside, work like this paved the way for the production of modern data visualizations and charts that help people better understand the world around them today. Without a map who would attempt to study geography? –John B. We have since updated it, adding in new content for 2021. ℹ️ In sub-orbital spaceflight, a spacecraft reaches outer space, but it doesn’t complete an orbital revolution or reach escape velocity. In orbital spaceflight, a spacecraft remains in space for at least one orbit. Though the graphic above is a detailed list of many types of rocket launch sites, we’ll focus on major sites that are sending satellites and passengers into sub-orbit, orbit, and beyond. Thumba Equatorial Rocket Launching StationĮditor’s note: The above table includes all sites that are operational, as well as under construction, as of publishing date. The list above covers fixed locations, and does not include SpaceX’s autonomous spaceport drone ships. There are currently three active drone ships-one based near Los Angeles, and the other two based at Port Canaveral, Florida. Two of the most famous launch sites on the list are the Baikonur Cosmodrome (Kazakhstan) and Cape Canaveral (United States). The former was constructed as the base of operations for the Soviet space program and was the launch point for Earth’s first artificial satellite, Sputnik 1. The latter was NASA’s primary base of operations and the first lunar-landing flight was launched from there in 1969. ![]() The global roster of spaceports has grown immensely since Baikonur and Cape Canaveral were the only game in town. Now numerous countries have the ability to launch satellites, and many more are getting in on the action. Wenchang Space Launch Site, on the island of Hainan, is China’s newest launch location. The site recorded its first successful launch in 2016. One interesting quirk of the map above is the lack of spaceports in Europe. If you're 25 years old or older, you will be eligible for a provisional driver's license once you: See our Applying for a New License (Teen Drivers) in Maryland page. If you're under 25 years old, you will have different requirements to fulfill before moving on to your provisional driver's license. If you're under 25 years old, see our Applying for a New License (Teen Drivers) in Maryland page for learner's permit requirements.
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