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https://www.readbyqxmd.com/read/29738403/a-novel-indirect-reduction-technique-in-ankle-syndesmotic-injuries-a-cadaveric-study
#1
Christopher T Cosgrove, Amanda G Spraggs-Hughes, Sara M Putnam, William M Ricci, Anna N Miller, Christopher M McAndrew, Michael J Gardner
OBJECTIVE: To describe a novel technique using preoperative computed tomography (CT) to plan clamp tine placement along the trans-syndesmotic axis (TSA). We hypothesized that preoperative CT imaging provides a reliable template on which to plan optimal clamp tine positioning along the TSA, reducing malreduction rates compared with other described techniques. METHODS: CT images of 48 cadaveric through-knee specimens were obtained and the TSA was measured as well as the optimal position of the medial clamp tine...
May 4, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29706250/incidence-and-severity-of-malreduction-of-the-tibiofibular-syndesmosis-following-surgical-treatement-of-displaced-ankle-fractures-and-impact-on-the-function-clinical-study-and-mri-evaluation
#2
D Ntalos, M Rupprecht, L G Grossterlinden, A Hamurcu, M Regier, T O Klatte, J M Rueger, A S Spiro
PURPOSE: To compare tibiofibular reduction quality in different types of operatively treated ankle fractures and the impact on clinical and functional outcome at mid-term follow-up. PATIENTS AND METHODS: One hundred patients with an acute ankle fracture who had undergone open reduction and internal fixation were included. Eighty-eight patients who suffered from ligamentous ankle injury with neither fracture nor syndesmotic lesions served as a control group. Tibiofibular alignment was measured on MR images in all 188 patients...
April 23, 2018: Injury
https://www.readbyqxmd.com/read/29705234/syndesmosis-fixation-in-unstable-ankle-fractures-using-a-partially-threaded-5-0-mm-cannulated-screw
#3
Seung Yeol Lee, Sang Young Moon, Moon Seok Park, Byung Chae Jo, Hyunseok Jeong, Kyoung Min Lee
The present study evaluated the radiographic outcomes of syndesmosis injuries treated with a partially threaded 5.0-mm cannulated screw. The present study included 58 consecutive patients with syndesmosis injuries concurrent with ankle fractures who had undergone operative fixation with a partially threaded 5.0-mm cannulated screw to repair the syndesmosis injury. Radiographic indexes, including the medial clear space, tibiofibular overlap, tibiofibular clear space, and fibular position on the lateral radiograph, were measured on the preoperative, immediate postoperative, and final follow-up radiographs...
April 25, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29678138/an-anthropometric-study-of-distal-tibiofibular-syndesmosis-dts-in-a-chinese-population
#4
Mingyang Yu, Yao Zhang, Yun Su, Feng Wang, Dewei Zhao
BACKGROUND: To improve the diagnostic accuracy of distal tibiofibular syndesmoses (DTS), this study quantified the range in variations of the normal DTS in a Chinese population, based on CT scan images. METHODS: The study population comprised 92 patients with unilateral ankle injury. CT scans included the non-injured contralateral DTS. The position of the fibula relative to the fibular notch (incisure) of the tibia was quantified by inclusion or separation indices, based on whether the fibula was within or outside the fibular incisure, respectively...
April 20, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29661674/evaluation-of-transsyndesmotic-fixation-and-primary-deltoid-ligament-repair-in-ankle-fractures-with-suspected-combined-deltoid-ligament-injury
#5
Kai Wu, Jian Lin, Jianhua Huang, Qiugen Wang
The present prospective study examined the utility of the intraoperative tap test/technique for distal tibiofibular syndesmosis in the diagnosis of deltoid ligament rupture and compared the outcomes of transsyndesmotic fixation to deltoid ligament repair with suture anchor. This diagnostic technique was performed in 59 ankle fractures with suspected deltoid ligament injury. The width of the medial clear space of 59 cases was evaluated to assess the sensitivity and specificity. Those with deltoid ligament rupture were randomly assigned to 2 groups and treated with deltoid ligament repair with a suture anchor or with syndesmosis screw fixation...
April 13, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29657842/repair-of-syndesmosis-injury-in-ankle-fractures-current-state-of-the-art
#6
May Fong Mak, Richard Stern, Mathieu Assal
Conventional treatment of syndesmosis injuries in rotationally unstable ankle fractures is associated with an unacceptably high rate of malreduction, and this has led to a paradigm shift in the approach to a newer concept of anatomical repair.In the anatomical approach, the principle is to 'directly fix what is broken and repair what is torn'. The approach is effective in reducing the rate of syndesmosis malreduction, increasing the biomechanical strength of syndesmosis fixation and avoiding the need for trans-syndesmotic fixation and its secondary removal...
January 2018: EFORT open reviews
https://www.readbyqxmd.com/read/29607668/weight-bearing-radiographic-analysis-of-the-tibiofibular-syndesmosis
#7
Arsalan Amin, Cory Janney, Christopher Sheu, Daniel C Jupiter, Vinod K Panchbhavi
BACKGROUND: Diagnosis of distal tibiofibular syndesmotic injuries includes assessment of radiographs; however, there exist no agreed on standard diagnostic criteria. Previous studies lack consistency with radiographic evaluation methods. The dynamic nature of the ankle joint supports analyzing anatomical parameters using weight-bearing films to assess for tibiofibular syndesmotic integrity. METHODS: Weight-bearing tibiofibular syndesmosis radiographs of 39 male and 40 female patients were retrospectively analyzed by 3 investigators, at different levels of orthopaedic training...
March 1, 2018: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/29605554/ankle-arthritis-combined-with-chronic-instability-of-the-syndesmosis-after-ankle-fracture-with-syndesmotic-injury-a-case-report
#8
Bi O Jeong, Jong Hun Baek, Wook Jae Song
Syndesmotic injuries associated with ankle fractures are commonly treated with reduction and fixation using a transfixing screw. On rare occasions, however, progression to chronic instability of the syndesmosis is observed. Several surgical techniques have been applied in such cases but usually without a report on the results. We report a case of chronic syndesmotic instability and ankle joint osteoarthritis after ankle fracture-dislocation in a 21-year-old male patient who underwent distal tibiofibular arthrodesis...
March 28, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29602887/proximal-tibiofibular-joint-dislocation-treated-using-flexible-and-permanent-syndesmosis-fixation
#9
Antonio Carlos Moscon, Ana Luiza Cabrera Martimbianco, Aires Duarte Junior, Guilherme Conforto Gracitelli
We present the case of a 40-year-old man who suffered an isolated proximal tibiofibular dislocation of the left knee after a trauma during a soccer game. Physical examination and radiographic imaging revealed an anterolateral dislocation of the proximal fibula. The diagnosis was confirmed by MRI. The treatment choice was open reduction and internal fixation under direct visualisation using flexible and permanent internal fixation. Postoperative treatment includes knee immobilisation during the first week, and partial weight was allowed for 2 weeks progressing to full weight bearing over 4 weeks...
March 30, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29601967/tarsal-coalition-in-paediatric-patients
#10
REVIEW
P-L Docquier, P Maldaque, M Bouchard
Tarsal coalition is due to failure of segmentation between two or more foot bones during embryological development at a site where the joint cleft fails to develop. Depending on the nature of the tissue connecting the bones, the abnormality is a syndesmosis, synchondrosis, or synostosis. Although the coalition exists at birth, synostosis usually develops only late during growth. Talo-calcaneal and calcaneo-navicular coalitions account for over 90% of all cases of tarsal coalition. The joint at the site of the coalition is stiff...
March 27, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29600720/effect-of-ankle-position-on-tibiotalar-motion-with-screw-fixation-of-the-distal-tibiofibular-syndesmosis-in-a-fracture-model
#11
Mark P Pallis, David N Pressman, Kenneth Heida, Tyler Nicholson, Susan Ishikawa
BACKGROUND: Anatomic reduction and fixation of the syndesmosis in traumatic injuries is paramount in restoring function of the tibiotalar joint. While overcompression is a potential error, recent work has called into question whether ankle position during fixation really matters in this regard. Our study aimed to corroborate more recent findings using a fracture model that, to our knowledge, has not been previously tested. METHODS: Twenty cadaver leg specimens were obtained and prepared...
March 1, 2018: Foot & Ankle International
https://www.readbyqxmd.com/read/29599074/radiographic-evaluation-of-the-normal-ankle-joint-in-children-and-adolescent
#12
Ki Hyuk Sung, Soon-Sun Kwon, Seung Jun Moon, Seung Yeol Lee
BACKGROUND: The purpose of this study was to determine the reliability of numerous radiographic measurements of the skeletally immature ankle joint, timing of ossification of medial malleolus and appearance of tibial incisura and differences in the values of radiographic measurements based on age and sex. METHODS: This study included 590 subjects (0-15 years), who underwent ankle AP, lateral and mortise radiographs. Presence of the medial malleolus and incisura fibularis were recorded...
March 26, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/29580095/minimal-invasive-fixation-can-decrease-infection-rates-in-diabetic-and-obese-patients-with-severe-ankle-fracture-and-syndesmotic-injury
#13
Nabil A Ebraheim, Matthew Dailey, Scott Huff, Yihuai Qu, Erik White, Jiayong Liu
BACKGROUND: Ankle fractures involving syndesmosis disruption cause severely unstable joint conditions. Traditional invasive operations put certain patient groups at an increased risk of infection. There is limited literature discussing the outcomes of minimally invasive fixation of severe ankle fractures including syndesmotic injury, as clinicians may be tempted to treat these difficult cases with open reduction internal fixation (ORIF). METHODS: A retrospective case-control study was conducted on patients treated at a level one trauma center...
March 1, 2018: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/29552482/anatomical-arthroscopic-graft-reconstruction-of-the-anterior-tibiofibular-ligament-for-chronic-disruption-of-the-distal-syndesmosis
#14
Jesús Vilá-Rico, Enrique Sánchez-Morata, Elena Vacas-Sánchez, Cristina Ojeda-Thies
Injuries of the distal tibiofibular syndesmosis are commonly overlooked or mismanaged, and chronic instability is a debilitating condition leading to premature joint degeneration. Several methods of treatment have been described, mainly screw fixation, arthrodesis, or ligament reconstruction. Most clinical evidence is limited to case series, mainly screw fixation, and there is a general paucity of evidence regarding ligament reconstruction, which is considered to be more anatomic and to restore joint biomechanics...
February 2018: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29548633/is-it-possible-to-overcompress-the-syndesmosis
#15
Piyush Mahapatra, Ben Rudge, Paul Whittingham-Jones
The case we present suggests that it might be possible to overcompress the syndesmosis, causing subluxation of the talus within the ankle mortise. A 26-year-old female patient had had a Weber Type C ankle fracture internally fixed with a lateral plate and syndesmosis screws. Despite the fibula appearing well reduced and computed tomography imaging showing a well-aligned fibula within the fibular notch, anteromedial subluxation of the talus was present in the ankle mortise. Examination with the patient under anesthesia revealed a stable syndesmosis fixation; however, talar malpositioning was not affected by the foot position...
March 13, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29536695/-classification-and-treatment-of-syndesmotic-injury
#16
REVIEW
Zhi-Peng Wu, Peng-Tao Chen, Jin-Shan He, Jing-Cheng Wang
The distal tibiofibular syndesmosis is a critical structure in maintaining the ankle stability. Syndesmotic injuries are usually associated with ankle fractures and high fibula fractures. Non-isolated and partially isolated syndesmotic injuries are involved in unstable injuries, which need to operative treatment. Partially isolated syndesmotic injuries belong to stable injuries, which should be treated with non-operative management. It is becoming clear that early fixation and stabilization for unstable injuries are probably better than non-treatment or delayed treatment...
February 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29533732/strain-distribution-in-the-anterior-inferior-tibiofibular-ligament-posterior-inferior-tibiofibular-ligament-and-interosseous-membrane-using-digital-image-correlation
#17
Daorong Xu, Yibei Wang, Chunyu Jiang, Maoqing Fu, Shiqi Li, Lei Qian, Peidong Sun, Jun Ouyang
BACKGROUND: Ligament repair and augmentation techniques can stabilize syndesmosis injuries. However, little is known about the mechanical behavior of syndesmotic ligaments. The aim of this study was to analyze full-field strain, strain trend under foot rotation, and subregional strain differences of the anterior inferior tibiofibular ligament (AITFL), posterior inferior tibiofibular ligament (PITFL), and interosseous membrane (IOM). METHODS: Eleven fresh-frozen lower limbs were dissected to expose the AITFL, PITFL, and IOM...
May 2018: Foot & Ankle International
https://www.readbyqxmd.com/read/29523956/a-novel-method-of-using-elastic-bionic-fixation-device-for-distal-tibiofibular-syndesmosis-injury
#18
Lin Wang, Yingze Zhang, Zhaohui Song, Hengrui Chang, Ye Tian, Fei Zhang
PURPOSE: To describe and evaluate the novel method of using elastic bionic fixation device in treating the distal tibiofibular syndesmosis (DTS) injury. METHODS: From June 2013 to January 2014, 17 subjects with ankle fractures combined with DTS separation were treated by the elastic bionic fixation device. The syndesmotic parameters, healing, functional scores, and possible complications were recorded. RESULTS: All patients had a mean follow-up of 23...
March 9, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29521685/cost-effectiveness-analysis-of-syndesmotic-screw-versus-suture-button-fixation-in-tibiofibular-syndesmotic-injuries
#19
Duncan C Ramsey, Darin M Friess
OBJECTIVES: To evaluate the cost effectiveness of suture buttons compared with syndesmotic screws for repair of tibiofibular syndesmotic injuries. METHODS: A decision tree model was constructed to describe outcomes after syndesmosis repair using suture buttons and syndesmotic screws from the perspective of a capitated health care system. Outcomes were uneventful healing, removal of symptomatic implants, deep infection, and persistent diastasis requiring revision...
June 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29518294/-functional-comparison-in-the-treatment-of-weber-type-b-ankle-fractures-with-suture-device-versus-screw
#20
M M Rius-Zavala, F I Gil-Orbezo, C A Trueba-Davalillo, C Trueba-Vasavilbaso, M Acuña-Tovar
BACKGROUND: Ten percent of all ankle fractures, 20% of the fractures treated surgically, and 1-18% of all sprains involve a syndesmosis injury. The methods used for reduction are metal or bioabsorbable syndesmotic set screws, direct repair, and sutures with or without buttons. The purpose of this study was to compare the clinical function of patients who sustained Weber B ankle fractures and were treated with the TightRope system or a syndesmotic set screw. MATERIAL AND METHODS: An observational, comparative, cross-sectional study was conducted between March 2012 and March 2015...
September 2017: Acta Ortopédica Mexicana
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