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https://www.readbyqxmd.com/read/28927702/morphology-of-the-incisura-fibularis-at-the-distal-tibiofibular-syndesmosis-in-the-japanese-population
#1
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...
September 16, 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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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/28708780/syndesmotic-ankle-fractures-a-systematic-review
#11
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
#12
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
#13
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
#14
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
#15
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/28663388/when-is-a-simple-fracture-of-the-lateral-malleolus-not-so-simple-how-to-assess-stability-which-ones-to-fix-and-the-role-of-the-deltoid-ligament
#16
REVIEW
N Gougoulias, A Sakellariou
Stable fractures of the ankle can be safely treated non-operatively. It is also gradually being recognised that the integrity of the 'medial column' is essential for the stability of the fracture. It is generally thought that bi- and tri-malleolar fractures are unstable, as are pronation external rotation injuries resulting in an isolated high fibular fracture (Weber type-C), where the deltoid ligament is damaged or the medial malleolus fractured. However, how best to identify unstable, isolated, trans-syndesmotic Weber type-B supination external rotation (SER) fractures of the lateral malleolus remains controversial...
July 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28645547/an-alternative-strategy-for-treatment-of-distal-tibiofibular-syndesmotic-disruption-a-technical-note
#17
Jin-Tao Qu, Guo-Hua Shi, Yang-Cai Wang, Jian Li, Ji-Wu Dong, Yue Hu
Metal screws are the most widely used in treating syndesmotic injuries; however, failure and the rigidity of the screws can threaten the success of the treatment and increase the cost of care. We performed open reduction and internal fixation of a fibula fracture followed by fixation of the tibiofibular joint with an olive wire and one half of an external fixator. We present a review of 1 patient treated with this material. We believe this method to be a physiologic fixation system with the advantage of being safe, inexpensive, adjustable, and effective; however, further clinical investigation and comparison to other methods is needed in order to better understand it clinical utility...
June 20, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28634682/searching-for-the-sweet-spot-the-foot-rotation-and-parallel-engagement-of-ankle-ligaments-in-maximizing-injury-tolerance
#18
Bingbing Nie, Jason L Forman, Alexander R Mait, John-Paul Donlon, Matthew B Panzer, Richard W Kent
Ligament sprains, defined as tearing of bands of fibrous tissues within ligaments, account for a majority of injuries to the foot and ankle complex in field-based sports. External rotation of the foot is considered the primary injury mechanism of syndesmotic ankle sprains with concomitant flexion and inversion/eversion associated with particular patterns of ligament trauma. However, the influence of the magnitude and direction of loading vectors to the ankle on the in situ stress state of the ligaments has not been quantified in the literature...
June 20, 2017: Biomechanics and Modeling in Mechanobiology
https://www.readbyqxmd.com/read/28633789/displaced-salter-harris-type-i-distal-fibula-fractures-two-case-reports-and-a-review-of-the-literature
#19
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/28633770/a-24-month-follow-up-of-a-custom-made-suture-button-assembly-for-syndesmotic-injuries-of-the-ankle
#20
Mohamed A Imam, Ahmed Matthana, Ji Wan Kim, Mohamed Nabil
In the present retrospective analysis, we introduce a custom suture-button fixation device for acute ankle syndesmotic injuries that allows for early weightbearing without another planned operation for hardware removal. We evaluated 87 consecutive ankles in 87 patients (49 males [56.32%] and 38 females [43.68%]). Of the 87 patients, 15 (17.24%) withdrew or were lost to follow-up, leaving 72 patients (82.76%) in the present study. Their mean age was 35.2 (range 17 to 67) years. Nineteen patients (26.39%) presented with a pure syndesmotic disruption, and 53 (73...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
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