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ankle syndesmosis

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https://www.readbyqxmd.com/read/29320936/role-of-the-deltoid-ligament-in-syndesmotic-instability
#1
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
https://www.readbyqxmd.com/read/29298255/randomized-trial-comparing-suture-button-with-single-syndesmotic-screw-for-syndesmosis-injury
#2
Mette Renate Andersen, Frede Frihagen, Johan Castberg Hellund, Jan Erik Madsen, Wender Figved
BACKGROUND: This study compared clinical and radiographic results between patients who underwent stabilization of an acutely injured syndesmosis with a suture button (SB) and those treated with 1 quadricortical syndesmotic screw (SS). METHODS: Ninety-seven patients, 18 to 70 years old, with an ankle injury that included the syndesmosis were randomized to 2 groups: SB (48 patients) and SS (49). The main outcome measure was the score on the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scale...
January 3, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29287221/ankle-fractures-getting-it-right-first-time
#3
Anna S Walsh, Victoria Sinclair, Patrick Watmough, Alistair A Henderson
INTRODUCTION: Ankle fractures are common injuries presenting to trauma departments and ankle open reduction and internal fixation (ORIF2) is one of the first procedures targeted in early orthopaedic training. Failure to address the fracture pattern with the appropriate surgical technique and hardware may lead to early failure, resulting in revision procedures or premature degenerative change. Patients undergoing revision ORIF are known to be at much greater risk of complications and many of these secondary procedures may be preventable...
November 28, 2017: Foot
https://www.readbyqxmd.com/read/29278930/radiographic-change-of-the-distal-tibiofibular-joint-following-removal-of-transfixing-screw-fixation
#4
Jong Hun Baek, Tae Yong Kim, Yoo Beom Kwon, Bi O Jeong
BACKGROUND: Syndesmosis disruptions in the ankle joint are typically treated with anatomic reduction followed by transfixing screw and/or suture button fixation. The purpose of our study was to analyze the effects of the removal of transfixing screws on syndesmosis integrity using plain radiographs and computed tomography (CT) scans. METHODS: Twenty-nine cases (29 patients) who had been treated with transfixing screw fixation for syndesmosis disruptions were studied prospectively...
December 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/29244680/irreducible-ankle-fracture-from-an-interposed-chaput-fragment-a-case-report
#5
Chihua Lee, Thomas J Douglas
CASE: A 23-year-old active-duty military service member sustained an unusual irreducible fracture-dislocation of the ankle joint. Preoperative computed tomography showed an anterolateral tibial (Chaput) fragment entrapped within the distal syndesmosis, preventing adequate reduction. An open reduction of the fragment was performed in the operating room, which allowed near-anatomic reduction and internal fixation of the tibiotalar joint. At the 21-month follow-up visit, the patient remained on active duty in the Navy without limitations...
April 2017: JBJS Case Connector
https://www.readbyqxmd.com/read/29234648/supination-external-rotation-ankle-fractures-analysis-of-clinical-results-after-syndesmotic-screw-removal
#6
João Mendonça de Lima Heck, Rosalino Guareschi Junior, Luiz Carlos Almeida da Silva, Marcelo Teodoro Ezequiel Guerra
Objective: To evaluate the postoperative results of patients with supination-external rotation ankle fractures who underwent syndesmotic screw (SS) removal. Methods: Retrospective cohort study assessing the late postoperative results of 35 patients operated from January 2013 to June 2015. Patients undergoing treatment of rupture of the distal tibiofibular syndesmosis with SS fixation and who did not have any concomitant surgical injuries in sites other than the ankle were included...
November 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/29224059/lower-complication-rate-and-faster-return-to-sports-in-patients-with-acute-syndesmotic-rupture-treated-with-a-new-knotless-suture-button-device
#7
Christian Colcuc, Marc Blank, Thomas Stein, Florian Raimann, Sanjay Weber-Spickschen, Sebastian Fischer, Reinhard Hoffmann
PURPOSE: Suture button devices for tibiofibular syndesmosis injuries provide semirigid dynamic stabilization, but complications including knot irritation have been reported. No randomized trials of the new knotless suture button devices have been performed. We hypothesized that knotless suture button devices eliminate knot irritation and facilitate quicker return to sports. This study was performed to compare the clinical outcomes, complication rates, and time to return to sports between a new knotless suture button device and syndesmotic screw fixation...
December 9, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29196821/the-predictive-value-of-mri-in-the-syndesmotic-instability-of-ankle-fracture
#8
Young Hwan Park, Min A Yoon, Won Seok Choi, Gi Won Choi, Suk Joo Hong, Hak Jun Kim
OBJECTIVE: Although many types of ankle fracture can be combined with syndesmosis injury, preoperative imaging studies rarely reveal instability of the syndesmosis. This study assessed the use of magnetic resonance imaging (MRI) for syndesmotic instability in patients with unstable ankle fracture. METHODS: A total of 74 patients who were treated for Lauge-Hansen supination external rotation/Weber B type fracture or pronation external rotation/Weber C type fracture and who underwent MRI for preoperative assessment were enrolled...
December 1, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/29188345/imaging-in-syndesmotic-injury-a-systematic-literature-review
#9
Nicola Krähenbühl, Maxwell W Weinberg, Nathan P Davidson, Megan K Mills, Beat Hintermann, Charles L Saltzman, Alexej Barg
OBJECTIVES: To give a systematic overview of current diagnostic imaging options for assessment of the distal tibio-fibular syndesmosis. MATERIALS AND METHODS: A systematic literature search across the following sources was performed: PubMed, ScienceDirect, Google Scholar, and SpringerLink. Forty-two articles were included and subdivided into three groups: group one consists of studies using conventional radiographs (22 articles), group two includes studies using computed tomography (CT) scans (15 articles), and group three comprises studies using magnet resonance imaging (MRI, 9 articles)...
November 30, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/29178310/a-new-intraoperative-syndesmosis-instability-classification-system-utility-and-medium-term-results-in-closed-displaced-ankle-fractures
#10
Hai-Bin Qiu, Jun Jiang, Daniel Porter
OBJECTIVE: To investigate the utility and medium-term results of a new intra-operative classification system for distal tibiofibular syndesmosis injury in ankle fractures. METHODS: Between January 2010 and January 2015, 116 patients diagnosed with displaced closed Weber B and C ankle fractures were treated in our department. The etiology of injury was 56 cases of fall-sprain, 36 of traffic injury, 14 of fall from a height, and 10 of multiple injuries. After fixation of the fibular fracture, we classify syndesmosis stability as either normal or one of three grades of instability using the fibular hook traction test...
November 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/29158644/injury-mechanism-fracture-characteristics-and-clinical-treatment-of-pilon-fracture-with-intact-fibula-a-retrospective-study-of-23-pilon-fractures
#11
Jiang Liangjun, Zheng Qiang, Li Hang, Pan Zhijun
Objective: The effect of intact fibula on pilon fracture is not completely elucidated. We retrospectively analysed pilon fractures with intact fibula at our hospital over a 4 year period to understand the injury mechanism, fracture characteristics, treatment strategy and prognosis of this fracture. Methods: Pilon fracture patients with intact fibula treated in our hospital from January 2010 to December 2014 were observed. OA/ATO fracture type, Ruedi-Allgower classification and fracture characteristics were summarised...
November 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29092978/posterior-malleolus-fractures-worth-fixing
#12
M C Solan, A Sakellariou
The posterior malleolus component of a fracture of the ankle is important, yet often overlooked. Pre-operative CT scans to identify and classify the pattern of the fracture are not used enough. Posterior malleolus fractures are not difficult to fix. After reduction and fixation of the posterior malleolus, the articular surface of the tibia is restored; the fibula is out to length; the syndesmosis is more stable and the patient can rehabilitate faster. There is therefore considerable merit in fixing most posterior malleolus fractures...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29081864/distal-tibiofibular-syndesmosis-anatomy-biomechanics-injury-and-management
#13
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
#14
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/29071125/management-of-syndesmotic-injuries-of-the-ankle
#15
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
#16
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/29037926/comparison-of-clamp-reduction-and-manual-reduction-of-syndesmosis-in-rotational-ankle-fractures-a-prospective-randomized-trial
#17
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/28985486/the-effect-of-ankle-distraction-on-arthroscopic-evaluation-of-syndesmotic-instability-a-cadaveric-study
#18
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/28913369/changes-in-the-width-of-the-tibiofibular-syndesmosis-related-to-lower-extremity-joint-dynamics-and-neuromuscular-coordination-on-drop-landing-during-the-menstrual-cycle
#19
Michie Okazaki, Masaaki Kaneko, Yukisato Ishida, Norio Murase, Toshihito Katsumura
BACKGROUND: Many injuries of the lower extremities, especially the knee and ankle, occur during sports activity, and the incidence rate is higher in women than in men. HYPOTHESIS: The hypothesis was that phases of the menstrual cycle affect the width of the tibiofibular syndesmosis during drop landing in healthy young women and that such changes at the tibiofibular joint also affect the dynamics and neuromuscular coordination of the lower extremities. STUDY DESIGN: Descriptive laboratory study...
September 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28901782/a-radiographic-dye-method-for-intraoperative-evaluation-of-syndesmotic-injuries
#20
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
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