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Syndesmosis

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https://www.readbyqxmd.com/read/28633789/displaced-salter-harris-type-i-distal-fibula-fractures-two-case-reports-and-a-review-of-the-literature
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
Christopher T Cosgrove, Sara M Putnam, Steven M Cherney, William M Ricci, Amanda Spraggs-Hughes, Christopher M McAndrew, Michael J Gardner
OBJECTIVES: The purpose of this study was to determine if 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...
April 29, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28457169/arthroscopic-correlates-of-subtle-syndesmotic-injury
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/28431410/gravity-stress-radiographs-and-the-effect-of-ankle-position-on-deltoid-ligament-integrity-and-medial-clear-space-measurements
#11
Ali Ashraf, Jacob Murphree, Eric Wait, Travis Winston, Adam Wooldridge, Matthew Meriwether, Joshua Wilson, Jerry S Grimes
INTRODUCTION: External rotation and gravity stress radiographs have been described to distinguish stable supination-external rotation-II (SER-II) ankle fractures from unstable SER-IV fractures. It has been previously shown that both external rotation and gravity stress views are equivalent in their ability to diagnose deltoid ligament injury. It has also been shown that the position of the ankle influences the external rotation stress radiograph. However, no data of ankle position exist for gravity stress radiographs...
May 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28416851/-one-of-the-pitfalls-in-the-surgical-treatment-of-maisonneuve-fractures-a-case-report
#12
H Q Ji, F Zhou, Y Tian, Z S Zhang, Y Guo, Y Lv, Z W Yang, G J Hou
There exist controversies in the surgical treatment of maisonneuve injury with regard to reduction and fixation of syndesmosis and management of proximal fibular fracture. It is very important for the orthopaedic surgeons to learn more techniques and avoid pitfalls from clinical practice. We summarized the clinical data of 1 failed case, a 20-year-old girl with big body weight who underwent a primary surgery for the treatment of maisonneuve fracture with minimally invasive reduction and fixation of ankle syndesmosis and posterior malleolus and open reduction and internal fixation of medial malleolus, then a revision surgery for the treatment of iatrogenic syndesmotic malreduction with open reduction and re-stabilization of ankle syndesmosis supplemented with open reduction and internal fixation of proximal fibular facture...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28391516/management-of-acute-injuries-of-the-tibiofibular-syndesmosis
#13
REVIEW
Nicholas M Fort, Amiethab A Aiyer, Jonathan R Kaplan, Niall A Smyth, Anish R Kadakia
The syndesmosis is important for ankle stability and load transmission and is commonly injured in association with ankle sprains and fractures. Syndesmotic disruption is associated with between 5 and 10% of ankle sprains and 11-20% of operative ankle fractures. Failure to recognize and appropriately treat syndesmotic disruption can portend poor functional outcomes for patients; therefore, early recognition and appropriate treatment are critical. Syndesmotic injuries are difficult to diagnose, and even when identified and treated, a slightly malreduced syndesmosis can lead to joint destruction and poor functional outcomes...
May 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28390687/overtightening-of-the-syndesmosis-revisited-and-the-effect-of-syndesmotic-malreduction-on-ankle-dorsiflexion
#14
Tyler Gonzalez, Jonathan Egan, Mohammad Ghorbanhoseini, Micah Blais, Aron Lechtig, Brian Velasco, Ara Nazarian, John Y Kwon
BACKGROUND: Ankle syndesmotic injuries are a significant source of morbidity and require anatomic reduction to optimize outcomes. Although a previous study concluded that maximal dorsiflexion during syndesmotic fixation was not required, methodologic weaknesses existed and several studies have demonstrated improved ankle dorsiflexion after removal of syndesmotic screws. The purposes of the current investigation are: (1) To assess the effect of compressive syndesmotic screw fixation on ankle dorsiflexion utilizing a controlled load and instrumentation allowing for precise measurement of motion...
June 2017: Injury
https://www.readbyqxmd.com/read/28386571/the-broken-ring-of-fire-a-new-radiological-sign-as-predictor-of-syndesmosis-injury
#15
James Calder, Adam Mitchell, Adam Lomax, Moez S Ballal, John Grice, Niek van Dijk, Justin Lee
BACKGROUND: Subcircumferential periosteal edema above the ankle joint is frequently present on magnetic resonance imaging (MRI) with syndesmosis injuries but has not been previously reported. Fluid height within the interosseous membrane also has not previously been shown to be associated with syndesmosis injury severity. PURPOSE: To investigate whether a new sign on MRI and measurement of the length of fluid within the interosseous membrane above the ankle may be used to enable identification of a syndesmosis injury and allow differentiation from lateral ligament injury...
March 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28321479/novel-anatomical-reconstruction-of-distal-tibiofibular-ligaments-restores-syndesmotic-biomechanics
#16
Jian Che, Chunbao Li, Zhipeng Gao, Wei Qi, Binping Ji, Yujie Liu, Ming Han Lincoln Liow
PURPOSE: To date, there is a paucity of literature on syndesmotic reconstruction techniques that restore both anatomic stability and physiologic syndesmotic biomechanics. In this cadaveric study, (1) a novel syndesmotic reconstruction surgical technique using autogenous peroneus brevis tendon was described and (2) the biomechanical properties of the reconstruction was investigated. METHODS: Ten fresh-frozen lower extremities were used in this study. Reconstruction of the anterior and posterior, as well as the interosseous tibiofibular ligaments was performed with a halved peroneus brevis tendon...
June 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28238278/response-to-letter-regarding-cadaveric-analysis-of-the-distal-tibiofibular-syndesmosis
#17
Michael Lilyquist, Adam Shaw, Kevin Latz, James Bogener, Brock Wentz
No abstract text is available yet for this article.
March 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28237080/isolated-syndesmosis-diastasis-computed-tomography-scan-assessment-with-arthroscopic-correlation
#18
Tae-Keun Ahn, Seung-Myung Choi, Jae-Young Kim, Woo-Chun Lee
PURPOSE: To investigate which method can predict tibiofibular diastasis more accurately among the tibiofibular interval at the ankle joint level or previous parameters taken 1 cm above the joint line. METHODS: An arthroscopic examination was performed in 78 consecutive patients with anterolateral ankle pain. Four different methods were performed to take measurements of the tibiofibular interval using an axial computed tomography (CT) scan under existing arthroscopic diagnosis...
April 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28219637/malreduction-of-syndesmosis-injury-associated-with-malleolar-ankle-fracture-can-be-avoided-using-weber-s-three-indexes-in-the-mortise-view
#19
Kentaro Futamura, Tomonori Baba, Atsuhiko Mogami, Itaru Morohashi, Akio Kanda, Osamu Obayashi, Kazuo Sato, Yasuhisa Ueda, Yoshiaki Kurata, Hideki Tsuji, Kazuo Kaneko
PURPOSE: Malalignment of syndesmosis is generally associated with a poor outcome, yet occurs at a high rate in malleolar ankle fractures. In this study, we examine whether malreduction of syndesmosis injury associated with malleolar ankle fracture can be avoided using Weber's three indexes in the mortise view. MATERIALS AND METHODS: Of 156 patients with malleolar ankle fracture who underwent surgery from December 2012 to March 2016 at two medical facilities, 24 patients who received syndesmotic screw fixation were included in the study...
April 2017: Injury
https://www.readbyqxmd.com/read/28207979/a-comparison-of-injuries-in-elite-male-and-female-football-players-a-five-season-prospective-study
#20
J Larruskain, J A Lekue, N Diaz, A Odriozola, S M Gil
The aim was to compare the epidemiology of injuries between elite male and female football players from the same club. Injuries and individual exposure time in a male team and a female team, both playing in the Spanish first division, were prospectively recorded by the club's medical staff for five seasons (2010-2015) following the FIFA consensus statement. Total, training, and match exposure hours per player-season were 20% higher for men compared to women (P<.01). Total, training, and match injury incidence were 30%-40% higher in men (P≤...
February 16, 2017: Scandinavian Journal of Medicine & Science in Sports
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