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https://www.readbyqxmd.com/read/29092978/posterior-malleolus-fractures-worth-fixing
#1
M C Solan, A Sakellariou
The posterior malleolus component of a fracture of the ankle is important, yet often overlooked. Pre-operative CT scans to identify and classify the pattern of the fracture are not used enough. Posterior malleolus fractures are not difficult to fix. After reduction and fixation of the posterior malleolus, the articular surface of the tibia is restored; the fibula is out to length; the syndesmosis is more stable and the patient can rehabilitate faster. There is therefore considerable merit in fixing most posterior malleolus fractures...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29081864/distal-tibiofibular-syndesmosis-anatomy-biomechanics-injury-and-management
#2
REVIEW
Chi Pan Yuen, Tun Hing Lui
A stable and precise articulation of the distal tibiofibular syndesmosis is essential for normal motion of the ankle joint. Injury to the syndesmosis occurs through rupture or bony avulsion of the syndesmotic ligament complex. External rotation of the talus has been identified as the major mechanism of syndesmotic injury. None of the syndesmotic stress tests was sensitive or specific; therefore the diagnosis of syndesmotic injury should not be made based on the medical history and physical examination alone...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/29078816/open-versus-minimally-invasive-fixation-of-a-simulated-syndesmotic-injury-in-a-cadaver-model
#3
Adam C Shaner, Norachart Sirisreetreerux, Babar Shafiq, Lynne C Jones, Erik A Hasenboehler
BACKGROUND: Malreduction of unstable syndesmotic ankle fractures is common. This study compared the reduction quality of an anterolateral open technique (OT) versus a conventional minimally invasive technique (MIT). METHODS: Fourteen fresh-frozen lower torso specimens with 28 matched lower extremities underwent computed tomography (CT) to measure syndesmosis position before dissection. Reduction was performed using direct visualization and fluoroscopy for the OT group (right-sided specimens) and fluoroscopy only for the MIT group (left-sided specimens)...
October 27, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29071125/management-of-syndesmotic-injuries-of-the-ankle
#4
Jorge de-Las-Heras Romero, Ana María Lledó Alvarez, Fernando Moreno Sanchez, Alejandro Perez Garcia, Pedro Antonio Garcia Porcel, Raul Valverde Sarabia, Marina Hernandez Torralba
Injuries to the tibioperoneal syndesmosis are more frequent than previously thought and their treatment is essential for the stability of the ankle mortise.Recognition of these lesions is essential to avoid long-term morbidity.Diagnosis often requires complete history, physical examination, weight-bearing radiographs and MRI.Treatment-oriented classification is mandatory.It is recommended that acute stable injuries are treated conservatively and unstable injuries surgically by syndesmotic screw fixation, suture-button dynamic fixation or direct repair of the anterior inferior tibiofibular ligament...
September 2017: EFORT open reviews
https://www.readbyqxmd.com/read/29058951/stability-of-the-syndesmosis-after-posterior-malleolar-fracture-fixation
#5
Matthew A Miller, Tyler C McDonald, Matthew L Graves, Clay A Spitler, George V Russell, LaRita C Jones, William Replogle, Jeremy A Wise, Josie Hydrick, Patrick F Bergin
BACKGROUND: We sought to define the rate of syndesmotic instability after anatomic reduction of the posterior malleolus when posterior stabilization of a trimalleolar or trimalleolar equivalent ankle fracture was chosen vs when a supine position and initially conservative management of the posterior elements was chosen. METHODS: The types of syndesmotic and posterior malleolar fixation used to treat adult patients with ankle fractures involving the posterior malleolus at our level I trauma center were retrospectively assessed (N = 198)...
October 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/29037926/comparison-of-clamp-reduction-and-manual-reduction-of-syndesmosis-in-rotational-ankle-fractures-a-prospective-randomized-trial
#6
Young Hwan Park, Jeong Hwan Ahn, Gi Won Choi, Hak Jun Kim
An optimal outcome of surgical treatment for a syndesmotic injury depends on accurate reduction and adequate fixation. It has been suggested that the use of a reduction clamp for reduction of the syndesmosis results in better reduction and a lower rate of redisplacement than manual reduction. However, these concepts have never been scientifically evaluated. We compared these 2 methods in a prospective randomized trial. A total of 85 acute ankle rotational fractures combined with syndesmotic injury were randomized to syndesmosis reduction with either a reduction clamp or manual manipulation...
October 13, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28985486/the-effect-of-ankle-distraction-on-arthroscopic-evaluation-of-syndesmotic-instability-a-cadaveric-study
#7
Bart Lubberts, Daniel Guss, Bryan G Vopat, Jonathon C Wolf, Daniel K Moon, Christopher W DiGiovanni
BACKGROUND: To assist with visualization, orthopaedic surgeons often apply ankle distraction during arthroscopic procedures. The study aimed to investigate whether ankle distraction suppresses fibular motion in cadaveric specimens with an unstable syndesmotic injury. METHODS: Fourteen fresh-frozen above knee specimens underwent arthroscopic assessment with 1) intact ligaments, 2) after sectioning of the anterior inferior tibiofibular ligament, the interosseous ligament, and the posterior inferior tibiofibular ligament, and 3) after sectioning of the deep and superficial deltoid ligament...
September 28, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28927702/morphology-of-the-incisura-fibularis-at-the-distal-tibiofibular-syndesmosis-in-the-japanese-population
#8
Ichiro Tonogai, Daisuke Hamada, Koichi Sairyo
The morphology of the distal tibiofibular syndesmosis can determine the pathology and mechanism of syndesmotic injury. The present study assessed measurements obtained from computed tomography (CT) images of the normal distal tibiofibular syndesmosis in Japanese subjects. CT scans of 120 right feet with a normal distal tibiofibular syndesmosis obtained from January 2009 to December 2016 were retrospectively assessed at the level 10 mm proximal to the tibial plafond. The incisura fibularis was considered concave when its depth was ≥4 mm and shallow when its depth was <4 mm...
November 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28913369/changes-in-the-width-of-the-tibiofibular-syndesmosis-related-to-lower-extremity-joint-dynamics-and-neuromuscular-coordination-on-drop-landing-during-the-menstrual-cycle
#9
Michie Okazaki, Masaaki Kaneko, Yukisato Ishida, Norio Murase, Toshihito Katsumura
BACKGROUND: Many injuries of the lower extremities, especially the knee and ankle, occur during sports activity, and the incidence rate is higher in women than in men. HYPOTHESIS: The hypothesis was that phases of the menstrual cycle affect the width of the tibiofibular syndesmosis during drop landing in healthy young women and that such changes at the tibiofibular joint also affect the dynamics and neuromuscular coordination of the lower extremities. STUDY DESIGN: Descriptive laboratory study...
September 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28901782/a-radiographic-dye-method-for-intraoperative-evaluation-of-syndesmotic-injuries
#10
Murad Pepe, Onur Kocadal, Zafer Gunes, Emre Calisal, Kubilay Ceritoglu, Cem Nuri Aktekin
BACKGROUND: The Chertsey test has been recently defined as an intraoperative test for the detection of the syndesmotic injuries by the application of intra-articular contrast. However, no study has investigated the reliability and comparative analysis of the Chertsey test. The purpose of this study was to explore the diagnostic accuracy of the Chertsey test in predicting syndesmosis instability of the injured ankle, with correlation to preoperative computed tomography (CT) findings. METHODS: A total of 39 patients who were operated on due to the unilateral ankle fracture and had no complaint on the contralateral ankle joint were included in the study...
September 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28899558/arthroscopically-measured-syndesmotic-stability-after-screw-vs-suture-button-fixation-in-a-cadaveric-model
#11
Bart Lubberts, Bryan G Vopat, Jonathon C Wolf, Umile Giuseppe Longo, Christopher W DiGiovanni, Daniel Guss
BACKGROUND: Appropriate management of ankle syndesmotic instability is needed to prevent the development of complications. Previous biomechanical studies have evaluated movement of the fibula after screw or suture button fixations with different results, most likely being caused by variations in experimental setups that did not mirror the in vivo clinical setting. This study aimed to arthroscopically compare in a cadaveric model the stability of syndesmotic fixation with either a suture button or syndesmotic screw...
August 31, 2017: Injury
https://www.readbyqxmd.com/read/28888716/ideal-angle-of-syndesmotic-screw-fixation-a-ct-based-cross-sectional-image-analysis-study
#12
Young Hwan Park, Won Seok Choi, Gi Won Choi, Hak Jun Kim
Without clear reference, the precision of syndesmotic screw placement cannot be guaranteed and malposition of these screws leads to poor results. Therefore, to prevent malpositioning of syndesmotic screws, an improved understanding of the orientation of tibiofibular syndesmosis is essential. We analyzed cross-sectional computed tomography (CT) scans of the foot and ankle to identify precise screw positions for the treatment of syndesmotic injuries. A total of 134 calcaneal fractures with intact tibiofibular syndesmosis were enrolled in this retrospective study...
September 6, 2017: Injury
https://www.readbyqxmd.com/read/28884593/effect-of-sequential-sectioning-of-ligaments-on-syndesmotic-instability-in-the-coronal-plane-evaluated-arthroscopically
#13
Jafet Massri-Pugin, Bart Lubberts, Bryan G Vopat, Daniel Guss, Ali Hosseini, Christopher W DiGiovanni
BACKGROUND: Arthroscopic evaluation of the syndesmosis allows direct visualization of syndesmotic instability. The purpose of this study was to determine the minimum degree of ligamentous injury necessary to destabilize the syndesmosis in the coronal plane when assessed arthroscopically and pinpoint where such instability should be measured within the incisura. METHODS: Fourteen cadaveric specimens were divided into 2 groups and arthroscopically assessed first with the syndesmosis intact and then following serial differential ligamentous transection...
September 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28826651/what-s-new-in-ankle-fractures
#14
REVIEW
Matthew J Toth, Richard S Yoon, Frank A Liporace, Kenneth J Koval
The diagnosis and treatment of ankle fractures has evolved considerably over the past two decades. Recent topics of interest have included indications for operative treatment of isolated lateral malleolus fractures, need for fixation of the posterior malleolus, utilization of the posterolateral approach, treatment of the syndesmosis, and the potential role of fibular nailing. In this update, we concisely review these topics and what to expect in the future literature.
October 2017: Injury
https://www.readbyqxmd.com/read/28761696/ankle-syndesmosis-repair-and-rehabilitation-in-professional-rugby-league-players-a-case-series-report
#15
Alex James Latham, Peter Charles Goodwin, Ben Stirling, Adam Budgen
BACKGROUND/AIM: The distal tibiofibular joint is described as a syndesmosis. Traditionally, severe syndesmotic injuries with diastasis have been treated surgically with screw fixation. This case series details an ankle syndesmosis tightrope repair and an accelerated rehabilitation protocol that reduces the amount of time to return to professional rugby league in the UK. The aim of this study was to describe players' journey from injury, through diagnosis to surgery, rehabilitation and return to participation, detailing time scales and methods used at each stage to highlight the change in current practice...
2017: BMJ Open Sport & Exercise Medicine
https://www.readbyqxmd.com/read/28759316/conservative-management-for-stable-high-ankle-injuries-in-professional-football-players
#16
Derrick M Knapik, Anthony Trem, Joseph Sheehan, Michael J Salata, James E Voos
CONTEXT: High ankle "syndesmosis" injuries are common in American football players relative to the general population. At the professional level, syndesmotic sprains represent a challenging and unique injury lacking a standardized rehabilitation protocol during conservative management. EVIDENCE ACQUISITION: PubMed, Biosis Preview, SPORTDiscus, PEDro, and EMBASE databases were searched using the terms syndesmotic injuries, American football, conservative management, and rehabilitation...
July 1, 2017: Sports Health
https://www.readbyqxmd.com/read/28758439/pathoanatomy-and-associated-injuries-of-posterior-malleolus-fracture-of-the-ankle
#17
Lyndon W Mason, William J Marlow, James Widnall, Andrew P Molloy
BACKGROUND: We present a classification system that progresses in severity, indicates the pathomechanics that cause the fracture and therefore guides the surgeon to what fixation will be necessary by which approach. METHODS: The primary posterior malleolar fracture fragments were characterized into 3 groups. A type 1 fracture was described as a small extra-articular posterior malleolar primary fragment. Type 2 fractures consisted of a primary fragment of the posterolateral triangle of the tibia (Volkmann area)...
November 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28740251/shapes-of-distal-tibiofibular-syndesmosis-are-associated-with-risk-of-recurrent-lateral-ankle-sprains
#18
Qingjun Liu, Bin Lin, Zhimin Guo, Zhenqi Ding, Kejian Lian, Dasheng Lin
Distal tibiofibular syndesmosis (DTS) has wide anatomic variability in depth of incisura fibularis and shape of tibial tubercles. We designed a 3-year prospective cohort study of 300 young physical training soldiers in an Army Physical Fitness School. Ankle computed tomography (CT) scans showed that 56% of the incisura fibularis were a "C" shape, 25% were a "1" shape, and 19% were a "Г" shape. Furthermore, we invited a randomly selected subcohort of 6 participants in each shape of DTS to undergo a three-dimensional (3D) laser scanning...
July 24, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28708780/syndesmotic-ankle-fractures-a-systematic-review
#19
James D Michelson, Michael Wright, Michael Blankstein
OBJECTIVES: The diagnosis and treatment of syndesmotic ankle fractures is controversial. This systematic review was performed to clarify the current understanding addressing several clinical questions that arise in the treatment of such injuries DATA SOURCES:: The English language literature was searched using PubMed, EMBASE, and Web of Science. The search terms were "syndesmosis" or "syndesmotic" in combination with the terms "ankle fracture" or "fracture". The included dates were between 1967 and July 2015...
June 22, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28697074/repair-of-bimalleolar-ankle-fracture
#20
Nina Fisher, Abiola Atanda, Stephanie Swensen, Kenneth A Egol
PURPOSE: The incidence of ankle fractures is rapidly increasing in geriatric populations. Of the 4 fracture patterns described by the Lauge-Hansen classification system, supination-external rotation (SER) accounts for most ankle fractures. This video demonstrates surgical repair of a SER type 4 ankle fracture in a geriatric patient. METHODS: SER type 4 ankle fractures are considered unstable and are generally treated with surgical fixation. After placement of plate and screws, intraoperative stress tests can be used to assess for syndesmotic widening...
August 2017: Journal of Orthopaedic Trauma
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