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https://www.readbyqxmd.com/read/29162365/ankle-fracture-controversies-do-the-foot-and-ankle-specialists-have-a-different-vision
#1
G González-Lucena, D Pérez-Prieto, A López-Alcover, A Ginés-Cespedosa
OBJECTIVE: To analyse the differences in the management of ankle fractures between orthopaedic/trauma surgeons and foot and ankle specialists. MATERIAL AND METHOD: An e-mail survey was performed asking some of the country's orthopaedic surgeons controversial questions regarding the analysis of 5 clinical cases of different ankle fractures. RESULTS: Seventy-two surgeons responded to the questionnaire (response rate of 24.2%): 37 foot and ankle specialists and 35 non-specialist orthopaedic surgeons...
November 18, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/29162248/predicting-syndesmotic-injuries-in-ankle-fractures-a-new-system-based-on-the-medial-malleolar-focus
#2
Enrique Sánchez-Morata, José Carlos Martínez-Ávila, Elena Vacas Sánchez, Verónica Jiménez Díaz, Jaime Zorrilla Sánchez de Neyra, Jesús Vilá Y Rico
The early establishment of the diagnosis of a syndesmotic injury is essential for treatment selection. However, such injuries may not be apparent radiographically. Previous studies have attempted to describe correlations between medial malleolar fracture geometry and syndesmotic disruption. The main objective of this study was to create predictive models for assessing syndesmotic injuries based on an originally described angle, i.e., the medial crural-focal angle (MCFA). This study included 138 ankle fractures involving the medial malleolus...
November 2017: Injury
https://www.readbyqxmd.com/read/29149741/the-isolated-posterior-malleolar-fracture-and-syndesmotic-instability-a-case-report-and-review-of-the-literature
#3
Diederik P J Smeeing, Roderick M Houwert, Moyo C Kruyt, Falco Hietbrink
INTRODUCTION: Ankle fractures are among the most common type of fractures in the lower extremity. A posterior malleolar fracture is frequently part of a more complex ankle fracture and only in rare cases it occurs as isolated injury. Posterior malleolar fractures often occur with associated injuries, such as a Maisonneuve fracture or with bi- or trimalleolar ligamentous injuries. Knowledge about these associated injuries is essential to prevent missed diagnoses. The aim of this article is to describe the isolated posterior malleolar fracture, the possible associated injuries, the diagnostic work-up and therapeutic consequences...
November 13, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29081864/distal-tibiofibular-syndesmosis-anatomy-biomechanics-injury-and-management
#4
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
#5
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/29078057/short-term-results-of-a-ruptured-deltoid-ligament-repair-during-an-acute-ankle-fracture-fixation
#6
Seung Hun Woo, Su-Young Bae, Hyung-Jin Chung
BACKGROUND: There is no consensus on the optimal treatment or preferred method of operation for the management of acute deltoid ligament injuries during an ankle fracture fixation. This study aimed to analyze the outcomes of repairing the deltoid ligament during the fixation of an ankle fracture compared to conservative management. METHODS: We retrospectively evaluated 78 consecutive cases of a ruptured deltoid ligament with an associated ankle fracture between 2001 and 2016...
October 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/29071125/management-of-syndesmotic-injuries-of-the-ankle
#7
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
#8
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/29058759/implant-failure-rates-and-cost-analysis-of-contoured-locking-versus-conventional-plate-fixation-of-distal-fibula-fractures
#9
Lewis K Moss, Michael H Kim-Orden, Robert Ravinsky, Christopher M Hoshino, Daniel M Zinar, Stuart M Gold
The authors analyzed 330 consecutive Weber B distal fibula fractures that occurred during a 3-year period and were treated with either a contoured locking plate or a conventional one-third tubular plate to compare the cost and failure rates of the 2 constructs. The primary outcomes were failure of the distal fibular implant and loss of reduction. Secondary outcomes were surgical wound infection requiring surgical debridement and/or removal of the fibular implant, and removal of the fibular plate for persistent implant-related symptoms...
October 20, 2017: Orthopedics
https://www.readbyqxmd.com/read/29037926/comparison-of-clamp-reduction-and-manual-reduction-of-syndesmosis-in-rotational-ankle-fractures-a-prospective-randomized-trial
#10
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/29025279/fixation-techniques-in-lower-extremity-syndesmotic-injuries
#11
Pieter D'Hooghe, Philip J York, Jean Francois Kaux, Kenneth J Hunt
No abstract text is available yet for this article.
November 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28985486/the-effect-of-ankle-distraction-on-arthroscopic-evaluation-of-syndesmotic-instability-a-cadaveric-study
#12
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
#13
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/28901782/a-radiographic-dye-method-for-intraoperative-evaluation-of-syndesmotic-injuries
#14
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
#15
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
#16
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/28888229/changes-in-ankle-joint-motion-after-supramalleolar-osteotomy-a-cadaveric-model
#17
Hak Jun Kim, Eui Dong Yeo, Im Joo Rhyu, Soon-Hyuck Lee, Yeon Soo Lee, Young Koo Lee
BACKGROUND: Malalignment of the ankle joint has been found after trauma, by neurological disorders, genetic predisposition and other unidentified factors, and results in asymmetrical joint loading. For a medial open wedge supramalleolar osteotomy(SMO), there are some debates as to whether concurrent fibular osteotomy should be performed. We assessed the changes in motion of ankle joint and plantar pressure after supramalleolar osteotomy without fibular osteotomy. METHODS: Ten lower leg specimens below the knee were prepared from fresh-frozen human cadavers...
September 9, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28884593/effect-of-sequential-sectioning-of-ligaments-on-syndesmotic-instability-in-the-coronal-plane-evaluated-arthroscopically
#18
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/28865579/acute-syndesmotic-instability-in-ankle-fractures-a-review
#19
REVIEW
W J van Zuuren, T Schepers, A Beumer, I Sierevelt, A van Noort, M P J van den Bekerom
Ankle fractures are among the most common fracture types, and 10% of all ankle fractures lead to accessory syndesmotic injury. An injury that is challenging in every respect is syndesmotic instability. Since the range of diagnostic techniques and the therapeutic options is extensive, it still is a controversial subject, despite the abundance of literature. This review aimed to summarize the current knowledge on syndesmotic instability in ankle fractures and to formulate some recommendations for clinical practice...
September 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28761696/ankle-syndesmosis-repair-and-rehabilitation-in-professional-rugby-league-players-a-case-series-report
#20
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
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