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Syndesmosis

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https://www.readbyqxmd.com/read/28761696/ankle-syndesmosis-repair-and-rehabilitation-in-professional-rugby-league-players-a-case-series-report
#1
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
#2
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
#3
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)...
July 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28740251/shapes-of-distal-tibiofibular-syndesmosis-are-associated-with-risk-of-recurrent-lateral-ankle-sprains
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/28676078/a-systematic-review-of-suture-button-versus-syndesmotic-screw-in-the-treatment-of-distal-tibiofibular-syndesmosis-injury
#7
Pei Zhang, Yuan Liang, Jinshan He, Yongchao Fang, Pengtao Chen, Jingcheng Wang
BACKGROUND: Now, using a suture-button device to treat distal tibiofibular syndesmotic injuries is overwhelming due to its advantages over screw fixation. Current systematic review was conducted to make a comparison between suture-button fixation and traditionally screw fixation in the treatment of syndesmotic injuries. The outcomes included functional outcomes, implant removal, implant failure, malreduction, post-operative complications (except implant failure and malreduction), and cost-effectiveness aspects...
July 4, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28675813/radiological-assessment-of-ankle-syndesmotic-reduction
#8
Constantinos Louis Loizou, Alexis Sudlow, Ruaraidh Collins, David Loveday, George Smith
INTRODUCTION: The intraoperative assessment of adequacy of syndesmotic reduction is challenging. The aim of this study was to develop a radiographic measure based on the lateral ankle view to assess both the normal and abnormal relationship between the tibia and fibula after simulated syndesmotic malreduction and to evaluate the effect on commonly used mortise measurements. METHODS: Mortise and talar dome lateral radiographs were obtained in eight fresh-frozen cadaveric specimens before and following syndesmosis division and posterior fibular displacement of 2mm increments...
May 3, 2017: Foot
https://www.readbyqxmd.com/read/28665565/-isolated-lesions-of-the-distal-tibiofibular-syndesmosis
#9
Morad Mohamad, Victor Dubois-Ferrière
A tibiofibular syndesmotic injury is rare, accounting 6 % of ankle sprain. The diagnosis can be difficult and is often likened to a lateral ankle sprain. Clinical signs are more subtle and pains are located above the joint line tibiotalar. These lesions should be considered in athletes with pain or trauma to the ankle. Late diagnosis is associated with significant morbidity up to osteoarthritis of the ankle. The management of these lesions is paramount and surgery may be necessary. The purpose of our article is to highlight this condition to increase the diagnosis rate and get our patients optimum recovery...
July 13, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28642663/weber-c-ankle-fractures-with-tibiofibular-diastasis-syndesmosis-only-fixation
#10
Serkan Sipahioglu, Sinan Zehir, Erdem Isikan
OBJECTIVES: To evaluate syndesmosis-only fixation in Weber C ankle fractures with tibiofibular diastasis and to assess the need for additional fibular fixation. METHODS: Twenty-one patients with Weber C ankle fractures and tibiofibular diastasis were followed for at least 24 months after treatment. In treatment of the Weber C fractures, only a syndesmosis screw was used through a mini open lateral incision if the syndesmosis could be anatomically reduced and fibular length and rotation could be restored...
May 2017: Acta Ortopedica Brasileira
https://www.readbyqxmd.com/read/28633789/displaced-salter-harris-type-i-distal-fibula-fractures-two-case-reports-and-a-review-of-the-literature
#11
Jeremy Korsh, Stephen Adolfsen
Salter-Harris type I (SH-I) fractures of the distal fibula are commonly encountered in pediatric orthopedics. We describe 2 unique cases of adolescents with completely displaced SH-I distal fibula fractures that were treated operatively. In the first case, a closed reduction attempt failed and the patient required open reduction and internal fixation of the distal fibula and syndesmosis. The syndesmotic ligaments were avulsed from the distal fibular metaphysis. In the second case, closed reduction of the distal fibula fracture was partially successful, but anatomic reduction could not be achieved without open reduction...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28633768/comparing-different-surgical-techniques-for-addressing-the-posterior-malleolus-in-supination-external-rotation-ankle-fractures-and-the-need-for-syndesmotic-screw-fixation
#12
Mengnai Li, Rachel C Collier, Brian W Hill, Nathaniel Slinkard, Thuan V Ly
Trimalleolar ankle fractures are unstable injuries with possible syndesmotic disruption. Recent data have described inherent morbidity associated with screw fixation of the syndesmosis, including the potential for malreduction, hardware irritation, and post-traumatic arthritis. The posterior malleolus is an important soft tissue attachment for the posterior inferior syndesmosis ligament. We hypothesized that fixation of a sizable posterior malleolar (PM) fracture in supination external rotation type IV (SER IV) ankle fractures would act to stabilize the syndesmosis and minimize or eliminate the need for trans-syndesmotic fixation...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28608862/vascular-density-of-inferior-tibiofibular-joint-cadaveric-experimental-study
#13
Łukasz Warchoł, Izabela Mróz, Ewa Mizia, Jarosław Zawiliński, Paweł Depukat, Wojciech Kurzydło, Krzystof A Tomaszewski
The study was carried out on 50 human lower legs obtained during autopsies (KBET: 122.6120.315.2016). The anatomy of the joint was studied using classical anatomical description methods. Based also on literature we have reviewed the current knowledge on the inferior tibiofibular joint blood supply considering the important clinically aspect - vascular density. Authors of this paper postulate relatively low vascular density of the region described and potential worse condition for healing in case of injury or after surgical procedures performed...
2017: Folia Medica Cracoviensia
https://www.readbyqxmd.com/read/28552927/fixation-of-distal-fibular-fractures-a-biomechanical-study-of-plate-fixation-techniques
#14
Jiri Marvan, Zdenek Horak, Miloslav Vilimek, Lukas Horny, David Kachlik, Vaclav Baca
Ankle fractures are complex injuries with variable prognoses that depend upon many factors. The aim of the treatment is to restore the ankle joint biomechanical stability with maximum range of motion. Most ankle fractures are fibular fractures, which have a typical oblique fracture line in the distal fibula located in the area of the tibiofibular syndesmosis. The aim of this study was to simulate numerically several fixation techniques of the distal fibular fractures, evaluate their stability, determine their impact on surrounding tissue load, and correlate the results to clinical treatment experience...
2017: Acta of Bioengineering and Biomechanics
https://www.readbyqxmd.com/read/28508007/five-year-outcomes-after-treatment-for-acute-instability-of-the-tibiofibular-syndesmosis-using-a-suture-button-fixation-system
#15
Paul F Förschner, Knut Beitzel, Andreas B Imhoff, Stefan Buchmann, Georg Feuerriegel, Felix Hofmann, Dimitrios C Karampinos, Pia Jungmann, Jonas Pogorzelski
BACKGROUND: Suture-button repair is a widely accepted surgical treatment for acute and isolated ankle syndesmosis injuries. To our knowledge, midterm results have not previously been reported. PURPOSE: To evaluate the clinical, qualitative, and quantitative radiological midterm outcomes of suture-button repair after acute isolated ankle syndesmosis injuries. STUDY DESIGN: Retrospective case series; Level of evidence, 4. METHODS: Clinical outcomes were measured using the Foot and Ankle Disability Index (FADI) and the American Orthopaedic Foot and Ankle Society (AOFAS) score...
April 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28473957/syndesmotic-internalbrace-tm-for-anatomic-distal-tibiofibular-ligament-augmentation
#16
Markus Regauer, Gordon Mackay, Mirjam Lange, Christian Kammerlander, Wolfgang Böcker
Reconstruction of unstable syndesmotic injuries is not trivial, and there is no generally accepted treatment guidelines. Thus, there still remain considerable controversies regarding diagnosis, classification and treatment of syndesmotic injuries. Syndesmotic malreduction is the most common indication for early re-operation after ankle fracture surgery, and widening of the ankle mortise by only 1 mm decreases the contact area of the tibiotalar joint by 42%. Outcome of ankle fractures with syndesmosis injury is worse than without, even after surgical syndesmotic stabilization...
April 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28471914/medial-clamp-tine-positioning-affects-ankle-syndesmosis-malreduction
#17
Christopher T Cosgrove, Sara M Putnam, Steven M Cherney, William M Ricci, Amanda Spraggs-Hughes, Christopher M McAndrew, Michael J Gardner
OBJECTIVES: To determine whether the position of the medial clamp tine during syndesmotic reduction affected reduction accuracy. DESIGN: Prospective cohort. SETTING: Urban Level 1 trauma center. PATIENTS: Seventy-two patients with operatively treated syndesmotic injuries. INTERVENTION: Patients underwent operative fixation of their ankle syndesmotic injuries using reduction forceps. The position of the medial clamp tine was then recorded with intraoperative fluoroscopy...
August 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28457169/arthroscopic-correlates-of-subtle-syndesmotic-injury
#18
Gregory P Guyton, Kenneth DeFontes, Cameron R Barr, Brent G Parks, Lyn M Camire
BACKGROUND: Arthroscopic criteria for identifying syndesmotic disruption have been variable and subjective. We aimed to quantify syndesmotic disruption arthroscopically using a standardized measurement device. METHODS: Ten cadaveric lower extremity specimens were tested in intact state and after serial sectioning of the syndesmotic structures (anterior inferior tibiofibular ligament [AiTFL], interosseous ligament [IOL], posterior inferior tibiofibular ligament [PiTFL], deltoid)...
May 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28448709/-ankle-arthroscopy-in-treatment-of-bosworth-fracture
#19
D Saraiva, R Pereira, A Sarmento, R Lemos, X M Oliva
The Bosworth fracture is a pattern of fracture-dislocation of the ankle joint with fixed dislocation of the proximal part of the fibula behind the posterior malleolus. It is a rare injury, which requires high index of suspicion for diagnosis. Fixed dislocation of the fibula does not allow for closed reduction, so open reduction and fixation of fibula or tibia is required. We present a case report of a patient who suffered a Bosworth fracture, with associated medial malleolus fracture. She underwent surgical treatment with open reduction and internal fixation of the fibula and tibia...
September 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28439310/syndesmosis-injuries-in-the-pediatric-and-adolescent-athlete-an-analysis-of-risk-factors-related-to-operative-intervention
#20
D E Kramer, M X Cleary, P E Miller, Y-M Yen, B J Shore
PURPOSE: To review all paediatric ankle syndesmotic injuries occurring at our institution and identify risk factors associated with operative intervention. METHODS: Among 22 873 evaluations for ankle trauma, we found 220 children suffering from syndesmotic injuries (incidence: 0.96%). We recorded demographic data, details of the injury, features on examination and treatment variables. Univariable and multivariable logistic regression modelling was performed to identify risk factors associated with operative intervention...
2017: Journal of Children's Orthopaedics
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