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https://www.readbyqxmd.com/read/29738403/a-novel-indirect-reduction-technique-in-ankle-syndesmotic-injuries-a-cadaveric-study
#1
Christopher T Cosgrove, Amanda G Spraggs-Hughes, Sara M Putnam, William M Ricci, Anna N Miller, Christopher M McAndrew, Michael J Gardner
OBJECTIVE: To describe a novel technique using preoperative computed tomography (CT) to plan clamp tine placement along the trans-syndesmotic axis (TSA). We hypothesized that preoperative CT imaging provides a reliable template on which to plan optimal clamp tine positioning along the TSA, reducing malreduction rates compared with other described techniques. METHODS: CT images of 48 cadaveric through-knee specimens were obtained and the TSA was measured as well as the optimal position of the medial clamp tine...
May 4, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29706250/incidence-and-severity-of-malreduction-of-the-tibiofibular-syndesmosis-following-surgical-treatement-of-displaced-ankle-fractures-and-impact-on-the-function-clinical-study-and-mri-evaluation
#2
D Ntalos, M Rupprecht, L G Grossterlinden, A Hamurcu, M Regier, T O Klatte, J M Rueger, A S Spiro
PURPOSE: To compare tibiofibular reduction quality in different types of operatively treated ankle fractures and the impact on clinical and functional outcome at mid-term follow-up. PATIENTS AND METHODS: One hundred patients with an acute ankle fracture who had undergone open reduction and internal fixation were included. Eighty-eight patients who suffered from ligamentous ankle injury with neither fracture nor syndesmotic lesions served as a control group. Tibiofibular alignment was measured on MR images in all 188 patients...
April 23, 2018: Injury
https://www.readbyqxmd.com/read/29681436/compatibility-of-lauge-hansen-classification-between-plain-radiographs-and-magnetic-resonance-imaging-in-ankle-fractures
#3
Haluk Çabuk, Filiz Çelebi, Yunus İmren, Süleyman Semih Dedeoğlu, Mustafa Çağlar Kır, Abdullah Faruk Uyanık, Hakan Gürbüz
We evaluated the accuracy of the predictive injury sequences of the Lauge-Hansen (L-H) classification using magnetic resonance imaging (MRI) in patients with ankle fractures and determined the possible causes of mismatch. Sixty-five patients with ankle fractures who had a complete series of anteroposterior, lateral, and oblique radiographs and ankle MRI studies available were included. The fracture pattern was assigned by 2 senior orthopedic surgeons according to the L-H classification system. The syndesmotic ligaments, lateral collateral ligaments, and medial deltoid complex ligaments were evaluated on the preoperative MRI scans...
April 19, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29661674/evaluation-of-transsyndesmotic-fixation-and-primary-deltoid-ligament-repair-in-ankle-fractures-with-suspected-combined-deltoid-ligament-injury
#4
Kai Wu, Jian Lin, Jianhua Huang, Qiugen Wang
The present prospective study examined the utility of the intraoperative tap test/technique for distal tibiofibular syndesmosis in the diagnosis of deltoid ligament rupture and compared the outcomes of transsyndesmotic fixation to deltoid ligament repair with suture anchor. This diagnostic technique was performed in 59 ankle fractures with suspected deltoid ligament injury. The width of the medial clear space of 59 cases was evaluated to assess the sensitivity and specificity. Those with deltoid ligament rupture were randomly assigned to 2 groups and treated with deltoid ligament repair with a suture anchor or with syndesmosis screw fixation...
April 13, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29657842/repair-of-syndesmosis-injury-in-ankle-fractures-current-state-of-the-art
#5
May Fong Mak, Richard Stern, Mathieu Assal
Conventional treatment of syndesmosis injuries in rotationally unstable ankle fractures is associated with an unacceptably high rate of malreduction, and this has led to a paradigm shift in the approach to a newer concept of anatomical repair.In the anatomical approach, the principle is to 'directly fix what is broken and repair what is torn'. The approach is effective in reducing the rate of syndesmosis malreduction, increasing the biomechanical strength of syndesmosis fixation and avoiding the need for trans-syndesmotic fixation and its secondary removal...
January 2018: EFORT open reviews
https://www.readbyqxmd.com/read/29607668/weight-bearing-radiographic-analysis-of-the-tibiofibular-syndesmosis
#6
Arsalan Amin, Cory Janney, Christopher Sheu, Daniel C Jupiter, Vinod K Panchbhavi
BACKGROUND: Diagnosis of distal tibiofibular syndesmotic injuries includes assessment of radiographs; however, there exist no agreed on standard diagnostic criteria. Previous studies lack consistency with radiographic evaluation methods. The dynamic nature of the ankle joint supports analyzing anatomical parameters using weight-bearing films to assess for tibiofibular syndesmotic integrity. METHODS: Weight-bearing tibiofibular syndesmosis radiographs of 39 male and 40 female patients were retrospectively analyzed by 3 investigators, at different levels of orthopaedic training...
March 1, 2018: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/29605554/ankle-arthritis-combined-with-chronic-instability-of-the-syndesmosis-after-ankle-fracture-with-syndesmotic-injury-a-case-report
#7
Bi O Jeong, Jong Hun Baek, Wook Jae Song
Syndesmotic injuries associated with ankle fractures are commonly treated with reduction and fixation using a transfixing screw. On rare occasions, however, progression to chronic instability of the syndesmosis is observed. Several surgical techniques have been applied in such cases but usually without a report on the results. We report a case of chronic syndesmotic instability and ankle joint osteoarthritis after ankle fracture-dislocation in a 21-year-old male patient who underwent distal tibiofibular arthrodesis...
March 28, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29600720/effect-of-ankle-position-on-tibiotalar-motion-with-screw-fixation-of-the-distal-tibiofibular-syndesmosis-in-a-fracture-model
#8
Mark P Pallis, David N Pressman, Kenneth Heida, Tyler Nicholson, Susan Ishikawa
BACKGROUND: Anatomic reduction and fixation of the syndesmosis in traumatic injuries is paramount in restoring function of the tibiotalar joint. While overcompression is a potential error, recent work has called into question whether ankle position during fixation really matters in this regard. Our study aimed to corroborate more recent findings using a fracture model that, to our knowledge, has not been previously tested. METHODS: Twenty cadaver leg specimens were obtained and prepared...
March 1, 2018: Foot & Ankle International
https://www.readbyqxmd.com/read/29580095/minimal-invasive-fixation-can-decrease-infection-rates-in-diabetic-and-obese-patients-with-severe-ankle-fracture-and-syndesmotic-injury
#9
Nabil A Ebraheim, Matthew Dailey, Scott Huff, Yihuai Qu, Erik White, Jiayong Liu
BACKGROUND: Ankle fractures involving syndesmosis disruption cause severely unstable joint conditions. Traditional invasive operations put certain patient groups at an increased risk of infection. There is limited literature discussing the outcomes of minimally invasive fixation of severe ankle fractures including syndesmotic injury, as clinicians may be tempted to treat these difficult cases with open reduction internal fixation (ORIF). METHODS: A retrospective case-control study was conducted on patients treated at a level one trauma center...
March 1, 2018: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/29536695/-classification-and-treatment-of-syndesmotic-injury
#10
REVIEW
Zhi-Peng Wu, Peng-Tao Chen, Jin-Shan He, Jing-Cheng Wang
The distal tibiofibular syndesmosis is a critical structure in maintaining the ankle stability. Syndesmotic injuries are usually associated with ankle fractures and high fibula fractures. Non-isolated and partially isolated syndesmotic injuries are involved in unstable injuries, which need to operative treatment. Partially isolated syndesmotic injuries belong to stable injuries, which should be treated with non-operative management. It is becoming clear that early fixation and stabilization for unstable injuries are probably better than non-treatment or delayed treatment...
February 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29533732/strain-distribution-in-the-anterior-inferior-tibiofibular-ligament-posterior-inferior-tibiofibular-ligament-and-interosseous-membrane-using-digital-image-correlation
#11
Daorong Xu, Yibei Wang, Chunyu Jiang, Maoqing Fu, Shiqi Li, Lei Qian, Peidong Sun, Jun Ouyang
BACKGROUND: Ligament repair and augmentation techniques can stabilize syndesmosis injuries. However, little is known about the mechanical behavior of syndesmotic ligaments. The aim of this study was to analyze full-field strain, strain trend under foot rotation, and subregional strain differences of the anterior inferior tibiofibular ligament (AITFL), posterior inferior tibiofibular ligament (PITFL), and interosseous membrane (IOM). METHODS: Eleven fresh-frozen lower limbs were dissected to expose the AITFL, PITFL, and IOM...
May 2018: Foot & Ankle International
https://www.readbyqxmd.com/read/29523956/a-novel-method-of-using-elastic-bionic-fixation-device-for-distal-tibiofibular-syndesmosis-injury
#12
Lin Wang, Yingze Zhang, Zhaohui Song, Hengrui Chang, Ye Tian, Fei Zhang
PURPOSE: To describe and evaluate the novel method of using elastic bionic fixation device in treating the distal tibiofibular syndesmosis (DTS) injury. METHODS: From June 2013 to January 2014, 17 subjects with ankle fractures combined with DTS separation were treated by the elastic bionic fixation device. The syndesmotic parameters, healing, functional scores, and possible complications were recorded. RESULTS: All patients had a mean follow-up of 23...
March 9, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29521685/cost-effectiveness-analysis-of-syndesmotic-screw-versus-suture-button-fixation-in-tibiofibular-syndesmotic-injuries
#13
Duncan C Ramsey, Darin M Friess
OBJECTIVES: To evaluate the cost effectiveness of suture buttons compared with syndesmotic screws for repair of tibiofibular syndesmotic injuries. METHODS: A decision tree model was constructed to describe outcomes after syndesmosis repair using suture buttons and syndesmotic screws from the perspective of a capitated health care system. Outcomes were uneventful healing, removal of symptomatic implants, deep infection, and persistent diastasis requiring revision...
June 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29518294/-functional-comparison-in-the-treatment-of-weber-type-b-ankle-fractures-with-suture-device-versus-screw
#14
M M Rius-Zavala, F I Gil-Orbezo, C A Trueba-Davalillo, C Trueba-Vasavilbaso, M Acuña-Tovar
BACKGROUND: Ten percent of all ankle fractures, 20% of the fractures treated surgically, and 1-18% of all sprains involve a syndesmosis injury. The methods used for reduction are metal or bioabsorbable syndesmotic set screws, direct repair, and sutures with or without buttons. The purpose of this study was to compare the clinical function of patients who sustained Weber B ankle fractures and were treated with the TightRope system or a syndesmotic set screw. MATERIAL AND METHODS: An observational, comparative, cross-sectional study was conducted between March 2012 and March 2015...
September 2017: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/29496318/technical-tip-removal-of-a-broken-tri-cortical-syndesmotic-screw-using-a-perfect-circle-technique
#15
Matthew D Riedel, Jorge Briceno, Christopher P Miller, John Y Kwon
While broken or loose syndesmotic screws are typically of no clinical consequence, occasionally breakage can result in pain, metal fretting, or bony erosion. Despite quad-cortical syndesmotic screws being relatively easy to remove due to the prominent screw tip penetrating the medial tibial cortex, removal of a broken tri-cortical screw can be technically challenging. The purpose of this manuscript is to describe a safe technique for removing the buried, broken tri-cortical screw fragment via a minimally invasive medial tibial approach by verifying the screw location using intra-operative fluoroscopy...
April 2018: Injury
https://www.readbyqxmd.com/read/29409299/distal-fibular-malrotation-and-lateral-ankle-contact-characteristics
#16
D Alex Stroh, Kenneth DeFontes, Adrian Paez, Brent Parks, Gregory P Guyton
BACKGROUND: Any amount of malreduction of the syndesmotic joint compared with the uninjured syndesmosis has been associated with an adverse effect on functional outcome. The amount of malrotation that may lead to clinically relevant pressure change in this joint has not been reported. Our purpose was to determine whether small degrees of external and internal malrotation would be associated with statistically significant changes in contact pressure in the tibiofibular and talofibular articulations...
September 20, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29409288/ankle-fractures-with-syndesmotic-stabilisation-are-associated-with-a-high-rate-of-secondary-osteoarthritis
#17
Robbie Ray, Nina Koohnejad, Nick D Clement, Gary F Keenan
BACKGROUND: The primary aim of this study was to present the incidence of clinically significant end stage osteoarthritis (cOA) after syndesmotic fixation of ankle fractures. The secondary aim was to and identify independent predictors of cOA. METHODS: A retrospective review of consecutive patients presenting to a single University affiliated institution between March 2008 and May 2010 was undertaken. Inclusion criteria were ankle fractures with syndesmotic stabilisation...
October 28, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29409259/to-compare-the-efficacy-between-fixation-with-tightrope-and-screw-in-the-treatment-of-syndesmotic-injuries-a-meta-analysis
#18
BaiHang Chen, Chao Chen, ZeTian Yang, PeiZhen Huang, Hang Dong, ZhanPeng Zeng
BACKGROUND: To compare the efficacy between fixation with suture-button and screw in the treatment of syndesmotic injuries: a meta-analysis. METHODS: We comprehensively searched PubMed, Embase, and the Cochrane Library and performed a meta-analysis of randomized controlled trials (RCTs) and retrospective comparative studies (RTCs). We performed using Review Manager 5.2. RESULTS: Three RCTs and six retrospective studies were conducted, including a total of 397 patients...
August 18, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29409257/anatomy-of-the-tibial-incisura-as-a-risk-factor-for-syndesmotic-injury
#19
Andrzej Boszczyk, Sławomir Kwapisz, Martin Krümmel, Rene Grass, Stefan Rammelt
BACKGROUND: The study aims at comparing the bony anatomy of the syndesmosis in patients who sustained a high fibular fracture with syndesmosis disruption and that of the non-injured population. We hypothesised that there are certain anatomical features making the syndesmosis susceptible to injury. METHODS: The CT examinations of 75 patients who sustained a high fibular fracture with syndesmosis disruption and control group of 75 patients with unrelated foot problems were compared...
August 16, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29409215/syndesmotic-stability-is-there-a-radiological-normal-a-systematic-review
#20
REVIEW
Dr Akilesh Anand Prakash
BACKGROUND: Syndesmotic injury and instability poses a diagnostic challenge with unreliable clinical tests and inconsistent radiologic measures. Thus, used widely in clinical practice, there is huge debate pertaining to the reliability and validity of the radiologic parameters used for syndesmotic instability. OBJECTIVE: Hence the purpose of the review was to explore the normal radiologic measures and morphometrics of distal tibiofibular syndesmosis and its relationships, which can aid in diagnosing syndesmotic instability...
February 16, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
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