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Syndesmosis

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https://www.readbyqxmd.com/read/28027655/removal-of-hardware-after-syndesmotic-screw-fixation
#1
Kempland C Walley, Kurt J Hofmann, Brian T Velasco, John Y Kwon
BACKGROUND: While trans-syndesmotic fixation with metal screws is considered the gold standard in treating syndesmotic injuries, controversy exists regarding the need and timing of postoperative screw removal. Formal recommendations have not been well established in the literature and clinical practice is highly variable in this regard. The purpose of this systematic review is to critically examine the most recent literature regarding syndesmotic screw removal in order to provide surgeons an evidence-based approach to management of these injuries...
December 1, 2016: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28027384/an-anatomical-study-on-the-safe-placement-of-orthopedic-hardware-for-syndesmosis-fixation
#2
Franklin D Shuler, Daniel Woods, Zach Tankersley, Clint McDaniel, Jacob Hamm, Justin Jones, James Denvir, Brian Czarkowski
Articular cartilage and bony contact at the distal tibiofibular cartilage contact zone (TFCCZ) is variable. The appropriate placement of syndesmotic hardware would benefit from a more accurate characterization of the proximal extent of the TFCCZ allowing surgeons to place hardware that simultaneously improves biomechanical stability and decreases the risk of iatrogenic cartilage damage. In addition, Ilizarov wire fixation through the distal fibula and tibia can pass through the syndesmosis recess. Anatomically defining the proximal extent of this recess can help decrease the risk of inadvertent capsular penetration...
December 27, 2016: Orthopedics
https://www.readbyqxmd.com/read/28005114/an-update-on-management-of-syndesmosis-injury-a-national-us-database-study
#3
James C Carr, Brian C Werner, Seth R Yarboro
We conducted a study to determine the incidence of syndesmotic injury and stabilization within various ankle fracture patterns along with the rate of syndesmotic implant removal. All data were obtained from a publicly available for-fee healthcare database, the PearlDiver Patient Records Database. Current Procedural Terminology (CPT) codes were used to search the database for cases of fixation of lateral malleolus, bimalleolar, and trimalleolar fractures in addition to syndesmotic fixation and implant removal...
November 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28002322/the-effect-of-polydeoxyribonucleotide-prolotherapy-on-posterior-tibial-tendon-dysfunction-after-ankle-syndesmotic-surgery-a-case-report
#4
Tae-Ha Lim, Hyung Rae Cho, Keum Nae Kang, Chang Joon Rhyu, Sung Won Chon, Young Su Lim, Jee In Yoo, Jung-Won Kim, Young Uk Kim
RATIONALE: Ankle syndesmotic injuries occasionally require long-term therapy for recovery and can result in tendon injury. Posterior tibial tendon dysfunction (PTTD) is an acquired deformity that can cause flatfoot deformity. The current nonoperative management of PTTD includes nonsteroidal antiinflammatory drugs (NSAIDs), orthopedic devices. Although various treatment options have been attempted, optimal treatments for each stage of the condition are debated. Polydeoxyribonucleotide (PDRN) is effective in healing of chronic wounds associated with tissue damage by attracting tissue growth factors...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27942736/the-doubled-suture-nice-knot
#5
Pascal Boileau, Ghassan Alami, Adam Rumian, Daniel G Schwartz, Christophe Trojani, Adam J Seidl
The authors describe a novel suture fixation technique that combines a doubled suture with a sliding knot. The knot can be tied in both open and arthroscopic surgery to fix torn tendons/ligaments and fractured/osteotomized bones. The advantages of the doubled-suture Nice knot include strength, adjustability, simplicity, and versatility. This technique, which has proven useful in the authors' practice for the past 10 years, has replaced metallic wires and cables for bone fixation. The doubled-suture Nice knot can also be tied over a double-button and has been used for ankle syndesmosis, acromioclavicular joint separation repair, and coracoid bone block fixation...
December 8, 2016: Orthopedics
https://www.readbyqxmd.com/read/27920331/3d-model-analysis-of-ankle-flexion-on-anatomic-reduction-of-a-syndesmotic-injury
#6
Jason M Schon, Jacob D Mikula, Jonathon D Backus, Melanie B Venderley, Grant J Dornan, Robert F LaPrade, Thomas O Clanton
BACKGROUND: The effect of ankle positioning during suture-button fixation for syndesmosis repair on range of motion (ROM) and anatomic reduction has yet to be investigated. The purpose of this cadaveric study was to compare the effects of 3 different ankle positions during suture-button repair on volumetric reduction of the syndesmosis, fibular displacement, and ROM of the ankle using 3-dimensional computed tomography (CT) analysis. The null hypothesis was that ankle position during fixation would not affect syndesmotic volume restoration, fibular displacement, or ROM...
December 5, 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/27900312/posterior-tibial-tendon-displacement-behind-the-tibia-and-its-interposition-in-an-irreducible-isolated-ankle-dislocation-a-case-report-and-literature-review
#7
Alessandro Ortolani, Roberto Bevoni, Alessandro Russo, Maurilio Marcacci, Mauro Girolami
Isolated posteromedial ankle dislocation is a rare condition thanks to the highly congruent anatomical configuration of the ankle mortise, in which the medial and lateral malleoli greatly reduce the rotational movement of the talus, and the strength of the ligaments higher than the malleoli affords protection against fractures. However, other factors, like medial malleolus hypoplasia, laxity of the ligaments, peroneal muscle weakness and previous ankle sprains, could predispose to pure dislocation. In the absence of such factors, only a complex high-energy trauma, with a rotational component, can lead to this event...
July 2016: Joints
https://www.readbyqxmd.com/read/27824010/surgical-treatment-of-ankle-syndesmosis-injuries-with-syndesmosis-elastic-hook
#8
Jian-Yun Miao, Qing-Jun Liu, Bin Lin, Lin-Xin Guo
No abstract text is available yet for this article.
2016: Chinese Medical Journal
https://www.readbyqxmd.com/read/27816101/role-of-ankle-arthroscopy-in-management-of-acute-ankle-fracture
#9
Kwok Bill Chan, Tun Hing Lui
PURPOSE: To report the operative findings of ankle arthroscopy during open reduction and internal fixation of acute ankle fractures. METHODS: This was a retrospective review of 254 consecutive patients with acute ankle fractures who were treated with open reduction and internal fixation of the fractures, and ankle arthroscopy was performed at the same time. The accuracy of fracture reduction, the presence of syndesmosis disruption and its reduction, and the presence of ligamentous injuries and osteochondral lesions were documented...
November 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/27810152/syndesmosis-reduction-by-computer-assisted-orthopaedic-surgery-with-navigation-feasibility-and-accuracy-in-a-cadaveric-study
#10
Victor Dubois-Ferrière, Axel Gamulin, Ashwin Chowdhary, Jean Fasel, Richard Stern, Mathieu Assal
INTRODUCTION: Syndesmotic disruption may be difficult to reduce and fix, and malreduction is associated with inferior outcomes. Intraoperative computed tomography (CT) can provide accurate assessment of syndesmotic reduction. We hypothesized that three-dimensional (3-D) computer-assisted orthopaedic surgery (CAOS) with navigation of syndesmotic reduction could avoid malreduction. Our goal was to assess feasibility and accuracy of such a technic in a cadaveric study. METHOD: Eleven through-the-knee cadaveric specimens were used...
December 2016: Injury
https://www.readbyqxmd.com/read/27803225/should-syndesmotic-screws-be-removed-after-surgical-fixation-of-unstable-ankle-fractures-a-systematic-review
#11
S A Dingemans, S Rammelt, T O White, J C Goslings, T Schepers
AIMS: In approximately 20% of patients with ankle fractures, there is an concomitant injury to the syndesmosis which requires stabilisation, usually with one or more syndesmotic screws. The aim of this review is to evaluate whether removal of the syndesmotic screw is required in order for the patient to obtain optimal functional recovery. MATERIALS AND METHODS: A literature search was conducted in Medline, Embase and the Cochrane Library for articles in which the syndesmotic screw was retained...
November 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27788927/a-systematic-review-on-dynamic-versus-static-distal-tibiofibular-fixation
#12
REVIEW
S Y Inge, A F Pull Ter Gunne, C A M Aarts, M Bemelman
BLACKGROUND: In the last couple of years dynamic fixation for syndesmosis injuries, using a suture-button technique, raised more interest due to its advantages over the static fixation. In the current systematic review suture-button fixation is compared to the traditionally applied static fixation in unstable ankle fractures accompanied with distal tibiofibular syndesmosis injury, including the functional outcome, post-operative complications, reoperation rate, recurrent diastasis and financial aspects...
December 2016: Injury
https://www.readbyqxmd.com/read/27755331/the-effect-of-varying-tension-of-a-suture-button-construct-in-fixation-of-the-tibiofibular-syndesmosis-evaluation-using-stress-computed-tomography
#13
John Morellato, Hakim Louati, Andrew Bodrogi, Andrew Stewart, Steven Papp, Allan Liew, Wade Gofton
BACKGROUND/PURPOSE: There have been no studies assessing the optimal biomechanical tension of suture button constructs. The purpose of this study was to assess optimal tensioning of suture button fixation and its ability to maintain reduction under loaded conditions using a stress computed tomography (CT) model. METHODS: Ten cadaveric lower limbs disarticulated at the knee were used. The limbs were placed in a modified ankle load frame that allowed for the application of sustained torsional axial, or combined torsional/axial loads...
October 13, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27733557/mri-quantification-of-the-impact-of-ankle-position-on-syndesmosis-anatomy
#14
Marie-Lyne Nault, Melissa Marien, Jonah Hébert-Davies, G Yves Laflamme, Vincent Pelsser, Dominique M Rouleau, Nayla Gosselin-Papadopoulos, Stéphane Leduc
BACKGROUND: Despite the common occurrence of syndesmotic injuries in ankle trauma, the distal tibiofibular relationship remains poorly understood. The aim of this study was to evaluate the anatomical impact of ankle sagittal positioning on the tibiofibular relationship in intact ankles by using a validated magnetic resonance imaging (MRI)-based measurement system. METHODS: In this radiologic study, 34 healthy volunteers underwent a series of ankle MRIs with the ankle stabilized in 3 positions: neutral position (NP), dorsiflexion (DF), and plantarflexion (PF)...
October 12, 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/27733556/a-3-d-ct-analysis-of-screw-and-suture-button-fixation-of-the-syndesmosis
#15
Jason M Schon, Brady T Williams, Melanie B Venderley, Grant J Dornan, Jonathon D Backus, Travis Lee Turnbull, Robert F LaPrade, Thomas O Clanton
BACKGROUND: Historically, syndesmosis injuries have been repaired with screw fixation; however, some suggest that suture-button constructs may provide a more accurate anatomic and physiologic reduction. The purpose of this study was to compare changes in the volume of the syndesmotic space following screw or suture-button fixation using a preinjury and postoperative 3-D computed tomography (CT) model. The null hypothesis was that no difference would be observed among repair techniques...
October 12, 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/27723566/correlation-and-comparison-of-syndesmosis-dimension-on-ct-and-mri
#16
Fabian Wong, Rebecca Mills, Nadeem Mushtaq, Roland Walker, Samrendu K Singh, Ali Abbasian
INTRODUCTION: Various methods using CT scan have been described to diagnose distal tibiofibular syndesmotic injuries. However, CT scan does not take into account the amount of cartilage within the distal tibiofibular joint and could therefore lead to false positive results. We present the first study correlating the findings of the distal tibiofibular syndesmosis on CT and MRI scans. METHODS: CT and MRI scan of consecutive patients over a period of 18 months, and of a time lapsed less than 12 months between the two imaging modalities, were reviewed...
August 2016: Foot
https://www.readbyqxmd.com/read/27681857/biomechanical-analysis-of-the-individual-ligament-contributions-to-syndesmotic-stability
#17
Thomas O Clanton, Brady T Williams, Jonathon D Backus, Grant J Dornan, Daniel J Liechti, Scott R Whitlow, Adriana J Saroki, Travis Lee Turnbull, Robert F LaPrade
BACKGROUND: Biomechanical data and contributions to ankle joint stability have been previously reported for the individual distal tibiofibular ligaments. These results have not yet been validated based on recent anatomic descriptions or using current biomechanical testing devices. METHODS: Eight matched-pair, lower leg specimens were tested using a dynamic, biaxial testing machine. The proximal tibiofibular joint and the medial and lateral ankle ligaments were left intact...
January 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/27672016/biomechanical-comparison-of-3-current-ankle-syndesmosis-repair-techniques
#18
Thomas O Clanton, Scott R Whitlow, Brady T Williams, Daniel J Liechti, Jonathon D Backus, Grant J Dornan, Adriana J Saroki, Travis Lee Turnbull, Robert F LaPrade
BACKGROUND: Significant debate exists regarding optimal repair for unstable syndesmosis injuries. Techniques range from screw fixation, suture-button fixation, or a combination of the two. In this study, 3 common repairs were compared using a simulated weightbearing protocol with internal and external rotation of the foot. METHODS: Twenty-four lower leg specimens with mean age 54 years (range, 38-68 years) were used for testing. Following creation of a complete syndesmotic injury (AITFL, ITFL, PITFL, interosseous membrane), specimens were repaired using 1 of 3 randomly assigned techniques: (1) one 3...
September 25, 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/27645618/distal-tibiofibular-synostosis-after-surgically-resolved-ankle-fractures-an-epidemiological-clinical-and-morphological-evaluation-of-a-patient-sample
#19
Jiri Marvan, Valer Dzupa, Martin Krbec, Jiri Skala-Rosenbaum, Radek Bartoska, David Kachlik, Vaclav Baca
INTRODUCTION: Ankle fractures comprise a highly morphologically and etiologically diverse group of injuries, which includes various degrees of impairment of bone and ligamentous structures. The complete synostosis and incomplete bony bridging of tibiofibular syndesmosis are among the local late complications after surgically treated ankle fractures. PATIENTS AND METHOD: 269 patients were evaluated, including 203 patients with Weber type-B fractures, and 66 patients with Weber type-C fractures...
September 7, 2016: Injury
https://www.readbyqxmd.com/read/27642700/-conventional-x-rays-of-ankle-joint-fractures-in-older-patients-are-not-always-predictive
#20
A Jubel, C Faymonville, J Andermahr, S Boxberg, G Schiffer
Background: Ankle fractures are extremely common in the elderly, with an incidence of up to 39 fractures per 100,000 persons per year. We found a discrepancy between intraoperative findings and preoperative X-ray findings. It was suggested that many relevant lesions of the ankle joint in the elderly cannot be detected with plain X-rays. Methods: Complete data sets and preoperative X-rays of 84 patients aged above 60 years with ankle fractures were analysed retrospectively. There were 59 women and 25 men, with a mean age of 69...
September 19, 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
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