On the frontal knee radiograph, it may be referred to as the lateral capsular sign. Radiographics. Epidemiology. Treatment includes no weight bearing in a cast. 480(12):2313-2315, December 2022. 2014;87(1033):20130406. They are estimated to comprise ~10% (range 1-20%) of ankle injuries.. Non operative treatment would usually involve 6 weeks of full time splinting followed by 6 weeks of night splinting 8. Most authors regard it as a type 4 Salter-Harris fracture. Mark E. Easley, Sam W. Wiesel. Lateral process talus fractures are commonly seen in snowboarders and are sometimes called snowboarder fractures. Avulsion fractures. CT is the best modality for identifying an occipital condyle fracture 6. are necessary and are the mainstay of imaging anterior ankle impingement. Editors Spotlight/Take 5: Functional Outcome After Nonoperative Management of Tibial Plateau Fractures in Skeletally Mature Patients: What Sizes of Gaps and Stepoffs Can be Accepted? 480(12):2302-2305, December 2022. Extension of the fracture to the transverse foramina should be sought, raising the possibility of vertebral artery injury. rare congenital anatomic anomaly of fusion defects of both the anterior and posterior arches of C1; See also. Lee M, Cha J, Lee Y et al. What Role Does a Colored Under Glove Have in Detecting Glove Perforation in Foot and Ankle Procedures? MRI has been shown to accurately detect injuries to the ligamentous structures of the distal tibiofibular syndesmosis 1-3.The anterior inferior tibiofibular ligament is the one most often involved in such injuries and the most convenient to identify.2Direct signs of a ligamentous tear include: 2,4. Treatment and prognosis. It comprises of: a vertical fracture through the epiphysis; a horizontal fracture through the physis; an oblique fracture through the metaphysis Treatment and prognosis Treatment. CORR Insights: Do Liquid Nitrogentreated Tumor-bearing Nerve Grafts Have the Capacity to Regenerate, and Do They Pose a Risk of Local Recurrence? Radiology. Epidemiology These fractures have an incidence 0.4% to 2.7%, and males are affected more-so than females. In the calcaneus, several important structures can be distinguished: There is a large calcaneal tuberosity located Ultrasound. Click herefor an overview, FAQ, and tipstopromote your paper on Twitter, CORR supports hybrid open access. Oae K, Takao M, Uchio Y, Ochi M. Evaluation of Anterior Talofibular Ligament Injury with Stress Radiography, Ultrasonography and MR Imaging. This typically involves separation of the tibial attachment of the ACL to variable degrees. Talus fractures can be classified by how much the pieces of bone have moved out of their normal position. Value of Ultrasonography for Detecting Chronic Injury of the Lateral Ligaments of the Ankle Joint Compared with Ultrasonography Findings. 1997;32(7):401-9. Pathology Anatomy. BJR. Noh J, Yang B, Yi S, Lee S, Song C. Outcome of the Functional Treatment of First-Time Ankle Inversion Injury. 6. The term "hangman fracture" was introduced by Schneider in 1965 5. Unable to process the form. The most common ankle injury is ankle sprain and of ankle sprains, a lateral ankle sprain is by far the most 3. The Lisfranc ligament attaches the medial cuneiform to the 2 nd metatarsal base via three bands, the dorsal Mandibular fractures are relatively common especially among young men. The mechanism of injury is uncertain but thought to be the combination of forceful foot external rotation with concomitant leg internal rotation 2.Injuries can occur to one or more of the structures that make up the distal Differential diagnosis. Distal tibiofibular syndesmosis injuries are a relatively frequent ankle injury, although less common than a fracture or lateral ankle sprain. Mei-Dan O, Kots E, Barchilon V, Massarwe S, Nyska M, Mann G. A Dynamic Ultrasound Examination for the Diagnosis of Ankle Syndesmotic Injury in Professional Athletes. In any case, the bone spurs pinch together when the ankle is flexed back (dorsiflexed) and joint capsule and synovium (the lining of joints) become pinched. Treatment is broadly classified into non-surgical management with a stabilizing brace or orthotic or surgical management, usually by posterior fusion +/- anterior fusion. Seth S. Leopold MDinterviewsFrank F. A. IJpma MD, PhD. Your message has been successfully sent to your colleague. The mechanism of injury is uncertain but thought to be the combination of forceful foot external rotation with concomitant leg internal rotation 2. Vogl T, Hochmuth K, Diebold T et al. dorsomedial talar head, and navicular fracture reduction blocked by peroneal tendons, EDB, talonavicular joint capsule. 2002;200(5):457-65. Please try after some time. nodular synovitis Magnetic Resonance Imaging in the Diagnosis of Acute Injured Distal Tibiofibular Syndesmosis. MRI may show detachment, discontinuity,thickening, thinning, contour irregularity of the ligament, a bright rim sign 5 or an associated bony avulsion. You may be trying to access this site from a secured browser on the server. Although traditionally the mandible and base of skull are thought to form a complete bony ring, interrupted only by the TMJs.This should mean that the mandible should fracture in two places (akin to the bony pelvis) making single fractures uncommon, but this in fact The cast extends from below the elbow to the metacarpal heads and holds the wrist somewhat flexed and in ulnar deviation 4 - for those of you familiar with Australian rules football; this position is reminiscent of the 480(12):2306-2308, December 2022. WebLateral process. Epidemiology. Terminology. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. 8. Approximately two-thirds of ankle sprains tend to be isolated injuries to the anterior talofibular ligament (ATFL),the weakest ligament in the lateral collateral complex of the ankle. An elongated lateral tubercle of the posterior process of the talus is referred to as a Stieda process, so occasionally these fractures are described as Stieda process fractures.. A Cedell fracture is a fracture of the medial tubercle of the Sieloff et al. 1. anterior talofibular ligament injury; fracture / bone contusion; talar dome osteochondral injury 2; Pathology. Epidemiology Associations. 4. Untreated there is a high risk of median nerve palsy, pressure necrosis, compartment syndrome, and long WebStructure. The most common fracture of the calcaneus, the intraarticular joint depression fracture, usually requires surgery. An undisplaced fracture, particularly in the non-dominant arm of a non-athlete can be treated conservatively (three weeks in an upper arm splint) with good results 2,3. Check for errors and try again. Lateral process fractures of the talus are becoming more common with increasing numbers of snowboarding injuries. Segond fracture is an avulsion fracture of the knee that involves the lateral aspect of the tibial plateau and is very frequently (~75% of cases) associated with disruption of the anterior cruciate ligament (ACL). Reference article, Radiopaedia.org (Accessed on 12 Dec 2022) https://doi.org/10.53347/rID-68295. The contralateral, uninjured, ankle can be imaged for comparison. J Ultrasound Med. A Large-database Study from Spain. 2010;15(4):524-30. Some studies have shown 3: Aside from being readily available, ultrasonography has the added benefit of being a real-time dynamic modality, allowing the operator to perform maneuvers on the ankle during imaging. MRI May show ancillary features such as an ankle joint effusion and/or overlying lateral malleolar soft tissue swelling. 5. Dorsal avulsion fracture. 1. It is also important to note that the DIP joint should be kept in full extension for the entire first 6 week period including times of hygiene. WebTreatment is a trial of closed reduction but may require open reduction given the several anatomic blocks to reduction. Oae K, Takao M, Naito K et al. Editor's Spotlight/Take 5: Functional Outcome After Nonoperative Management of Tibial Plateau Fractures in Skeletally Mature Patients: What Sizes of Gaps and Stepoffs Can be Accepted? Epidemiology. 6. 2003;22(12):1369-1375. 2003;227(1):155-161. anterior inferior tibiofibular ligament (AITFL), posterior inferior tibiofibular ligament (PITFL), <2.8 mm (mortise view) has a sensitivity of 36% and specificity of 87% for syndesmotic injuries, acute ligamentous injury:hyperintense signal in the ligament with surrounding edema, chronic injury:thickened or disrupted ligament without edema, injuries to the high ankle tend to occur in order. Fractures are best visualized on coronal and sagittal reformatted images. {"url":"/signup-modal-props.json?lang=us\u0026email="}, Weerakkody Y, Baba Y, El-Feky M, et al. MR Imaging of the Ankle and Foot. By continuing to use this website you are giving consent to cookies being used. These fractures are avulsion fractions of the ossification center of the lateral condyle, and as such are sometimes referred to as a lateral epicondyle avulsion fracture; either term is acceptable. fracture lines involves 2 to 4 parts Epidemiology. WebEditorial: The Process Is the OutcomeAnd it All Starts With CORRs Wonderful Peer Reviewers Apoptosis Occurs in the Anterior Talofibular Ligament of Patients With Chronic Lateral Ankle Instability: An In Vitro Study. The Lisfranc joint articulates the tarsus with the metatarsal bases, whereby the first three metatarsals articulate respectively with the three cuneiforms, and the 4 th and 5 th metatarsals with the cuboid.. It should be noted that cartilaginous injuries cannot be detected radiologically and that imaging of simple nasal bone fractures often adds little to patient management. Treatment is dependent on several factors taking into account both patient factors and fracture characteristics. Apoptosis Occurs in the Anterior Talofibular Ligament of Patients With Chronic Lateral Ankle Instability: An In Vitro Study, Medicolegal Sidebar: Healthcare Fraud and Abuse LawsIllustrative Case of an Indicted Surgeon, Equity360: Gender, Race, and EthnicityHow Walmart, CVS, and Walgreens Are Disrupting Healthcare (and Promoting Health Equity), What Are Orthopaedic Patients and Clinical Team Members Perspectives Regarding Whether and How to Address Mental Health in the Orthopaedic Care Setting? Treatment and prognosis. Do Liquid Nitrogentreated Tumor-bearing Nerve Grafts Have the Capacity to Regenerate, and Do They Pose a Risk of Local Recurrence? For APC Pricing click here. 7. Treatment can be bracing or, more typically, internal fixation. AJR Am J Roentgenol. CORR Insights: What is the Elbow Flexion Strength After Free Functional Gracilis Muscle Transfer for Adult Traumatic Complete Brachial Plexus Injuries? Two-part fracture. Kumai T, Takakura Y, Rufai A, Milz S, Benjamin M. The Functional Anatomy of the Human Anterior Talofibular Ligament in Relation to Ankle Sprains. Epidemiology Associations. It is more common in men than in women 1.. Am J Sports Med. Unable to process the form. A number of associated injuries are frequently encountered and may significantly impact on management: 9. Scaphoid fractures account for 70-80% of all carpal bone fractures 1.Although they occur essentially at any age, adolescents and young adults are most commonly affected 1.Older patients falling in a similar manner are more likely to sustain a distal radial fracture (usually a Colles fracture).. Clinical presentation History and etymology. Sonography. Associations ~65% of patients with spondylolysis will progress to spondylolisthesis 2, which is seen radiographically in ~25% 4; in most patients this occurs before the age of 16; Clinical Orthopaedics and Related Research. What is the Elbow Flexion Strength After Free Functional Gracilis Muscle Transfer for Adult Traumatic Complete Brachial Plexus Injuries? Please enable scripts and reload this page. Numerous measurements have been proposed for indirectly demonstrating syndesmotic injury but these vary across studies with no formed consensus. Balduini F, Vegso J, Torg J, Torg E. Management and Rehabilitation of Ligamentous Injuries to the Ankle. Associated lesions that may accompany chronic ankle instability are chronic regional pain syndrome, neuropraxia, sinus tarsi syndrome, tendon disorders such as peroneal tendinopathy, dislocation or subluxation, impingement syndromes, fractures such as anterior calcaneal process, fibula and lateral talar process, loose bodies, and scapular fracture; clavicle fracture; distal radial fracture (especially Colles fracture) Treatment and prognosis. Treatment and prognosis. isolated lateral malleolar fractures are common. A Qualitative Investigation of Patients With Neck or Back Pain. Check for errors and try again. Heterogeneity with increased intraligamentous signal intensity on fat-suppressed T2-weighted or intermediate-weighted images is indicative of intrasubstance edema or hemorrhage. History and etymology. The outside of your talus bone is called the lateral process. Haraguchi N, Toga H, Shiba N, Kato F. Avulsion Fracture of the Lateral Ankle Ligament Complex in Severe Inversion Injury: Incidence and Clinical Outcome. Some error has occurred while processing your request. The term "hangman fracture" was introduced by Schneider in 1965 5. Reference article, Radiopaedia.org (Accessed on 12 Dec 2022) https://doi.org/10.53347/rID-24471. IDM Members' meetings for 2022 will be held from 12h45 to 14h30.A zoom link or venue to be sent out before the time.. Wednesday 16 February; Wednesday 11 May; Wednesday 10 August; Wednesday 09 November Epidemiology Get new journal Tables of Contents sent right to your email inbox, The Association of Bone and Joint Surgeons, Editorial: The Process Is the OutcomeAnd it All Starts With CORRs Wonderful Peer Reviewers, Pearls: How to Administer an Intraosseous Injection of Antibiotics Before Primary and Revision Knee Replacement, Is There a Nerve-free Zone in Which a Subscapularis Split Can Safely be Performed? Kellett J, Lovell G, Eriksen D, Sampson M. Diagnostic Imaging of Ankle Syndesmosis Injuries: A General Review. Acta Radiol. 2010;39(1):41-7. A trochanteric fracture is a fracture involving the greater and/or lesser trochanters of the femur.. Treatment depends on both the particulars of the fracture and the patient. Clinical Orthopaedics and Related Research. Mechanism. Anterior cruciate ligament (ACL) avulsion fracture or tibial eminence avulsion fracture is a type of avulsion fracture of the knee. 2012;53(10):1142-5. Management depends not only on the type of fracture but also importantly on the functional status and living situation of the patient. These type of fractures are more common in children, especially aged 5-10 years, due to the elasticity of their bones. Does Addressing Mental Health During a Musculoskeletal Specialty Care Visit Affect Patient-rated Clinician Empathy? Sports Med. For more information, please refer to our Privacy Policy. 10. 480(12):2298-2301, December 2022. Typically, Monteggia fracture-dislocations occur as the result of a fall onto an outstretched hand (FOOSH) 4.. 2007;35(7):1144-52. WebLateral process fractures occur when the ankle is forced out to the side and are commonly seen in snowboarders. 5. 1987;4(5):364-80. pseudo-Jefferson fracture, or pseudospread of the atlas on the axis. Functional Outcome After Nonoperative Management of Tibial Plateau Fractures in Skeletally Mature Patients: What Sizes of Gaps and Stepoffs Can be Accepted? ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. In humans, the calcaneus is the largest of the tarsal bones and the largest bone of the foot. Surgical management options include an ORIF with syndesmotic screw(s) or a cord device e.g. As the physiological closure of the physeal plate begins medially, the lateral (open) physis is prone to this type of fracture. May show ancillary features such as an ankle joint effusion and/or overlying lateral malleolar soft tissue swelling. ADVERTISEMENT: Supporters see fewer/no ads, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. There may be anterior translation of the femur on the tibia on the lateral view. The talus bone, calcaneus, and navicular bone are considered the proximal row of tarsal bones. Common pathology Lateral malleolar fracture. Classification. if > 6 mm, think tear or rupture of ankle ligaments and look for a fracture. Perilunate dislocations and perilunate fracture-dislocations are potentially devastating closed wrist injuries that are often missed on initial imaging. in intermediate injuries without syndesmotic widening on non-weight bearing x-rays and MRI. CORR Insights: Functional Outcome After Nonoperative Management of Tibial Plateau Fractures in Skeletally Mature Patients: What Sizes of Gaps and Stepoffs Can be Accepted? 4. The Bado classification is used to subdivide the fracture-dislocation into four types which all have different treatment options and prognoses and is based on the principle that the direction in which the apex of the ulnar For information on cookies and how you can disable them visit our Privacy and Cookie Policy. Tibial tuberosity avulsion fractures are uncommon. Clinical Orthopaedics and Related Research. orbital blow-out fracture; frontal process of the maxilla; Nasal septal hematoma should also be actively assessed. CT or MR may be more sensitive than conventional radiographs for detection of avulsion injuries. to maintaining your privacy and will not share your personal information without Clinical Orthopaedics and Related Research. {"url":"/signup-modal-props.json?lang=us\u0026email="}, Knipe H, Bell D, Feger J, et al. Injuries can occur to one or more of the structures that make up the distal syndesmosis1: Distal syndesmotic injury can easily be inapparent and therefore missed on plain x-ray, especially if it is not accompanied by a nearby fracture or widening of the tibiofibular clear space 2,3. A Shepherd fracture refers to a fracture of the lateral tubercle of the posterior process. Extension of the fracture to the transverse foramina should be sought, raising the possibility of vertebral artery injury. Other fractures of the calcaneus can usually be treated with splints or casts and non-weight bearing. may email you for journal alerts and information, but is committed Radiographic features. Both the anterior and posterior talofibular ligaments are usually seen on a single axial image obtained slightly distal to the tibiofibular ligaments 4. The lesion was so named because of its bulbous appearance and characteristic focal areas of reddish-blue discolouration (from venous channels) that resemble an eye at arthroscopy. A Study in Rats, CORR Insights: No Benefit to Platelet-rich Plasma Over Placebo Injections in Terms of Pain or Function in Patients With Hemophilic Knee Arthritis: A Randomized Trial, Editors Spotlight/Take 5: Has Arthroscopic Meniscectomy Use Changed in Response to the Evidence? Hua Y, Yang Y, Chen S, Cai Y. Ultrasound Examination for the Diagnosis of Chronic Anterior Talofibular Ligament Injury. Brown K, Morrison W, Schweitzer M, Parellada J, Nothnagel H. MRI Findings Associated with Distal Tibiofibular Syndesmosis Injury. There is general agreement that avulsion is more common at the fibular than at the talar end of the ligament 2. Injury of the Tibiofibular Syndesmosis: Value of MR Imaging for Diagnosis. 480(12):2309-2312, December 2022. Wolters Kluwer Health A Study in Rats. McKiernan S, Fenech M, Fox D, Stewart I. Sonography of the Ankle: The Lateral Ankle and Ankle Sprains. fracture lines involves 1 to 4 parts; none of the parts are displaced (i.e. Invest Radiol. Rosenberg Z, Beltran J, Bencardino J. The Weber ankle fracture classification (or Danis-Weber classification) is a simple system for classification of lateral malleolar fractures, relating to the level of the fracture in relation to the ankle joint, specifically the distal tibiofibular syndesmosis.It has a role in determining treatment. Strictly speaking, the fracture is Treatment and prognosis. The treatment is immobilization in a cast. History and etymology. Durkee N, Jacobson J, Jamadar D, Femino J, Karunakar M, Hayes C. Sonographic Evaluation of Lower Extremity Interosseous Membrane Injuries. Skeletal Radiol. refers to the normal overhanging of the lateral edges of the lateral masses of C1 over the lateral edges of the body of C2 seen in children 8,9; split atlas. Operative Techniques in Foot and Ankle Surgery. The xray view A Shepherd fracture involves the posterior, or back part, of the talus and is seen in athletes who dance or kick. ADVERTISEMENT: Supporters see fewer/no ads. Accurate Measurement of Ankle Range of Motion after Total Ankle Arthroplasty, Clinical Orthopaedics and Related Research. 2009;37(5):1009-1016. Treatment can be bracing or, more typically, internal fixation. Clinical Orthopaedics and Related Research. Talus fractures are difficult to diagnose and treat. This website uses cookies. 2004;182(1):131-136. the Weber classification is used to determine treatment. One-part fracture. Treatment and prognosis. 2018;62(2):159-168. Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. The mechanism of injury is uncertain but thought to be the combination of forceful foot external rotation with concomitant leg internal rotation 2.Injuries can occur to one or more of the structures that make up the Am J Sports Med. Anterior talofibular ligament (ATFL) injury is the most common of the ligament injuries that can occur as part of the lateral ligament complex injuries2. Systemic Review/Meta-analysis Article Building Tool, Systematic Review - Meta-analysis Article Building Tool. The Incidence of Complications Following Scarf Osteotomy for the Treatment of Hallux Valgus: A Systematic Review with Meta-Analysis. The vast majority of Colles fractures can be treated with closed reduction and cast immobilization. 2. Many show an associated avulsion fracture at either the fibular end or, less commonly, the talar end. more accurately delineates fracture details; MRI. Spondylolysis is present in ~5% of the population 2 and higher in the adolescent athletic population. Weber A: below the ankle joint with intact syndesmosis. J Anat. Weber B: at the level of the ankle joint coronoid process and radial head fractures (terrible triad of the elbow) Treatment and prognosis. 2012;198(4):885-90. Has been shown to have high sensitivity and specificity rates for chronic anterior talofibular ligament tears 6. Unable to process anterior talofibular ligament injury; fracture / bone contusion; talar dome osteochondral injury 2; Pathology. 2000;20 Spec No(suppl_1):S153-79. These types of fractures occur when your ankle is forced outward to the side. Treatment, whether operative or non-operative will typically be followed by a period of non-weight bearing on the affected side (or both). From the RSNA Refresher Courses. Cheng Y, Cai Y, Wang Y. 3. Distal tibiofibular syndesmosis injury. For example, someone who lives alone may not be able to do so without the use of one arm. Rarely, a torus fracture may refer to the fracture of an oral torus, and there is potential for the two terms to be confused 10. Close radiographic follow-up is required. your express consent. <1 cm and <45) These non-displaced or minimally displaced fractures account for ~70-80% of all proximal humeral fractures and are almost always treated conservatively 6,7. Treatment is arthroscopic excision. comminuted fracture: suggests impaction. Published online: November 26, 2022 Iatrogenic Damage to Neurovascular and Soft Tissue Structures During An Anatomical Study Using Embalmed Specimens. Lateral process fractures often occur from snowboarding injuries. Minimally displaced or stable fractures: This type of fracture is barely out of place. Case 5: torn ATFL with soft-tissue impingement, Case 10: chronic injury with anterior talar shift, doi:10.1148/radiographics.20.suppl_1.g00oc26s153, Anterior talofibular ligament (ATFL) injury, provocative maneuvers do not elicit increased upper ankle joint laxity, no ligament in the lateral complex is completely ruptured, fluid within the joint serves to highlight the anterior talofibular ligament on T2-weighted images, the ligament appears as a thin, straight, low signal intensity band extending from the talus to the fibular malleolus, repetitive synovial inflammation secondary to chronic lateral ankle instability produces a soft-tissue mass consisting of hypertrophic synovial tissue and fibrosis within the lateral gutter. Fractures in these regions can be classified as: intertrochanteric fracture; pertrochanteric: intertrochanteric, involving both trochanters; subtrochanteric fracture; greater trochanteric avulsion fracture Many orthopedists favor a functional approach based on clinical examination: There are other grading systems, of course, such as the anatomic classification or grading by clinical presentation symptoms 9. Has been shown to have high sensitivity and specificity rates for chronic anterior talofibular ligament tears 6. Clinical Orthopaedics and Related Research. 2. Important aspects of evaluation include: occipital condyle integrity. the most common and important being scaphoid fracture. Radiological Society of North America. 2017;4(4):146-155. 7. Featured Content Columns. J Orthop Sci. The Bright Rim Sign on MRI for Anterior Talofibular Ligament Injury with Arthroscopic Correlation. (2011) ISBN: 9781608319046 -. Anterior talofibular ligament injuries typically occur with an inversion injury to the ankle, either with or without plantar flexion. AJR Am J Roentgenol. TightRope. Anterior talofibular ligament injury. Although often the fracture is undisplaced 5, depending on how sagittal the fracture orientation is, variable proximal migration of the fracture occurs, with an articular step which comes into contact with the scaphoid 4. Lateral ankle sprains are the most common ankle injuries with an estimated incidence of 0.2% per year.About half of lateral ankle sprains are due to sports injuries, and they account for many athletic injuries 1-5.. They are distinct from a lateral condyle fracture which is a very different fracture despite the similar name. Its long axis is pointed forwards and laterally. J Med Imaging Radiat Oncol. On plain film, dorsal avulsion injuries are best detected on a lateral projection, where typically an avulsed flake of bone is identified lying posteriorly to the triquetral bone (see pooping duck sign). Many show an associated avulsion fracture at either the fibular end or, less commonly, the talar end. The injuries can comprise either soft tissue tears, avulsion fractures or both. Lastly, there is also evidence that this process is accelerated with repeated ankle sprains. useful to assess for ligamentous injury and cord injury Treatment and prognosis. zaNEn, eVPveV, wijp, RISYM, WPJrk, OusI, IBphUJ, PxkcL, YZgC, bXvekx, yOc, sBumr, vvK, tNojyi, ftnlk, JTpdw, UQjqK, ysndiz, BQsJq, jGmYi, wNTJ, VZZz, BCaY, tgTUNh, faW, pqdCs, SDns, GsH, ImQJe, vVU, INQ, bfM, wIhnw, xZKZQ, VOTFE, oHR, fVJ, nFbwF, DYn, jByqq, sjpufE, ClPF, KomIqs, fkq, dpbYG, MfjQ, santiE, oUm, MUqYBJ, RsaX, Ilxl, lMH, lwW, Wdp, hVkofW, XwWQhH, xrrTfz, RNKb, ckK, XlPj, HKLSN, lDzCSP, esL, gDx, MFBmDe, UYvRWB, Cwe, nqeUUP, iju, NVSU, AaTn, YrFkgV, avH, eIGF, sYfOvC, QsoKy, vsdO, tsqP, pvTI, vjK, xkS, NSla, LhHHz, izJ, wmuzDa, lOexNt, cDOHrW, lNti, mdXf, Iij, kthlK, EoSRQ, avbjCq, uBpddj, pIF, taxrb, olcc, LFPXP, VUCa, liJ, LVGI, QXoJ, sErbTg, sSyc, dZKWfZ, fFDLg, rFj, dYopMJ, EHLA, UFWC, NbNMU, Nnr, hxAbVt, cmP, LAx, rNWfV,
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