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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
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...
March 1, 2018: Foot & Ankle International
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
Duncan C Ramsey, Darin M Friess
OBJECTIVES: To evaluate the cost-effectiveness of suture buttons compared to 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 healthcare system. Outcomes were uneventful healing, removal of symptomatic implants, deep infection, and persistent diastasis requiring revision. Weighted literature averages were used to estimate variables for a baseline model...
February 20, 2018: Journal of Orthopaedic Trauma
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
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...
February 26, 2018: Injury
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
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
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
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
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
Sudhakar Rao Challagundla, Sandeep Shewale, Calum Cree, Amanda Hawkins
BACKGROUND: Operative management of ever increasing ankle fractures in the elderly need a reliable system of internal fixation. We present results of one such fixation, Fibula Rod System. METHODS: Patients who underwent Fibula Rod System were included. Fracture union rate, complications, time to weight bearing and patient satisfaction using FAAM score were studied. RESULTS: The mean age of the fifteen patients included was 74 years. Satisfactory reduction was achieved and maintained in all...
April 27, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Elizabeth Fitzpatrick, Jessica E Goetz, Tinnart Sittapairoj, Vinay Hosuru Siddappa, John E Femino, Phinit Phisitkul
BACKGROUND: Syndesmotic malreduction and fractures of the posterior malleolus negatively influence outcomes of rotational ankle fractures. Recent data have shown that posterior malleolus fixation contributes to the stability of the syndesmosis. The purpose of this study was to analyze syndesmotic reduction within the context of different sizes of posterior malleolus fracture fragments and different qualities of reduction. METHODS: A model of stage-IV supination-external rotation injury was created in 9 through-the-knee cadaveric specimens...
February 7, 2018: Journal of Bone and Joint Surgery. American Volume
John J Kellett, Gregory A Lovell, David A Eriksen, Matthew J Sampson
Literature on the various techniques for imaging injuries to the ankle syndesmosis to determine the most appropriate imaging modality for diagnosing syndesmosis ligament disruption and instability was reviewed using the following data sources: Pubmed, Google scholar, SportsDiscus, E-journals and PLOSone. Search terms used were: syndesmosis paired with injury, imaging, radiology, X-ray, stress X-ray, arthrography, ultrasound, nuclear medicine scan, CT scan, MRI and arthroscopy. Articles were selected by reading abstracts and the full article if indicated...
February 5, 2018: Journal of Medical Imaging and Radiation Oncology
Rachael J Da Cunha, Sydney C Karnovsky, William Schairer, Mark C Drakos
PURPOSE: To delineate the prevalence of chondral lesions, in particular full-thickness talar dome lesions, with concurrent arthroscopy in acute ankle fracture open reduction-internal fixation (ORIF) and evaluate the impact on clinical outcomes. METHODS: We conducted a retrospective chart review of prospectively collected registry data at our institution from 2012 to 2016. Consecutive patients who underwent acute ankle fracture ORIF with concurrent arthroscopy were identified...
February 2, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
S A Dingemans, M F N Birnie, F R K Sanders, M P J van den Bekerom, M Backes, E van Beeck, F W Bloemers, B van Dijkman, E Flikweert, D Haverkamp, H R Holtslag, J M Hoogendoorn, P Joosse, M Parkkinen, G Roukema, N Sosef, B A Twigt, R N van Veen, A H van der Veen, J Vermeulen, J Winkelhagen, B C van der Zwaard, S van Dieren, J C Goslings, T Schepers
BACKGROUND: Syndesmotic injuries are common and their incidence is rising. In case of surgical fixation of the syndesmosis a metal syndesmotic screw is used most often. It is however unclear whether this screw needs to be removed routinely after the syndesmosis has healed. Traditionally the screw is removed after six to 12 weeks as it is thought to hamper ankle functional and to be a source of pain. Some studies however suggest this is only the case in a minority of patients. We therefore aim to investigate the effect of retaining the syndesmotic screw on functional outcome...
January 31, 2018: BMC Musculoskeletal Disorders
Daniel Yiang Wu, Eddy Kwok Fai Lam
One of the main objectives of hallux valgus surgery is correction of the metatarsus primus varus deformity by osteotomy, arthrodesis, or soft tissue correction. The syndesmosis procedure uses intermetatarsal cerclage sutures to realign the first metatarsal and also induces a syndesmotic bonding between the first and second metatarsals to prevent metatarsus primus varus deformity recurrence. The purpose of the present study was to demonstrate radiologic evidence of the effectiveness of the syndesmosis concept and to identify the incidence and nature of deformity recurrence...
January 12, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Mas'uud Ibnu Samsudin, Ming Quan Wayne Yap, Ang Wei Luong, Ernest Beng Kee Kwek
BACKGROUND: Tightrope fixation is an emerging technique for syndesmotic fixation with promising results. However, our case series highlights the slippage of Tightrope buttons as a complication of suture button syndesmotic fixation of Weber C malleolar fractures using limited contact dynamic compression (LCDCP) plates. METHODS: We report a series of cases from our database in which slippage of the Tightrope button through the LCDCP holes in Weber C malleolar fractures was noted...
January 1, 2018: Foot & Ankle International
Jafet Massri-Pugin, Bart Lubberts, Bryan G Vopat, Jonathon C Wolf, Christopher W DiGiovanni, Daniel Guss
BACKGROUND: The deltoid ligament (DL) is the principal ligamentous stabilizer of the medial ankle joint. Little is known, however, about the contribution of the DL toward stabilizing the syndesmosis. The aim of this study was to arthroscopically evaluate whether the DL contributes to syndesmotic stability in the coronal plane. METHODS: Eight above-knee cadaveric specimens were used in this study. A lateral hook test was performed by applying 100 N of lateral force to the fibula in the intact state and after sequential transection of the DL, anterior-inferior tibiofibular ligament (AITFL), interosseous ligament (IOL), and posterior-inferior tibiofibular ligament (PITFL)...
January 1, 2018: Foot & Ankle International
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