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ankle syndesmosis

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https://www.readbyqxmd.com/read/28431410/gravity-stress-radiographs-and-the-effect-of-ankle-position-on-deltoid-ligament-integrity-and-medial-clear-space-measurements
#1
Ali Ashraf, Jacob Murphree, Eric Wait, Travis Winston, Adam Wooldridge, Matthew Meriwether, Joshua Wilson, Jerry S Grimes
INTRODUCTION: External rotation and gravity stress radiographs have been described to distinguish stable supination-external rotation-II (SER-II) ankle fractures from unstable SER-IV fractures. It has been previously shown that both external rotation and gravity stress views are equivalent in their ability to diagnose deltoid ligament injury. It has also been shown that the position of the ankle influences the external rotation stress radiograph. However, no data of ankle position exist for gravity stress radiographs...
May 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28416851/-one-of-the-pitfalls-in-the-surgical-treatment-of-maisonneuve-fractures-a-case-report
#2
H Q Ji, F Zhou, Y Tian, Z S Zhang, Y Guo, Y Lv, Z W Yang, G J Hou
There exist controversies in the surgical treatment of maisonneuve injury with regard to reduction and fixation of syndesmosis and management of proximal fibular fracture. It is very important for the orthopaedic surgeons to learn more techniques and avoid pitfalls from clinical practice. We summarized the clinical data of 1 failed case, a 20-year-old girl with big body weight who underwent a primary surgery for the treatment of maisonneuve fracture with minimally invasive reduction and fixation of ankle syndesmosis and posterior malleolus and open reduction and internal fixation of medial malleolus, then a revision surgery for the treatment of iatrogenic syndesmotic malreduction with open reduction and re-stabilization of ankle syndesmosis supplemented with open reduction and internal fixation of proximal fibular facture...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28391516/management-of-acute-injuries-of-the-tibiofibular-syndesmosis
#3
REVIEW
Nicholas M Fort, Amiethab A Aiyer, Jonathan R Kaplan, Niall A Smyth, Anish R Kadakia
The syndesmosis is important for ankle stability and load transmission and is commonly injured in association with ankle sprains and fractures. Syndesmotic disruption is associated with between 5 and 10% of ankle sprains and 11-20% of operative ankle fractures. Failure to recognize and appropriately treat syndesmotic disruption can portend poor functional outcomes for patients; therefore, early recognition and appropriate treatment are critical. Syndesmotic injuries are difficult to diagnose, and even when identified and treated, a slightly malreduced syndesmosis can lead to joint destruction and poor functional outcomes...
April 8, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28390687/overtightening-of-the-syndesmosis-revisited-and-the-effect-of-syndesmotic-malreduction-on-ankle-dorsiflexion
#4
Tyler Gonzalez, Jonathan Egan, Mohammad Ghorbanhoseini, Micah Blais, Aron Lechtig, Brian Velasco, Ara Nazarian, John Y Kwon
BACKGROUND: Ankle syndesmotic injuries are a significant source of morbidity and require anatomic reduction to optimize outcomes. Although a previous study concluded that maximal dorsiflexion during syndesmotic fixation was not required, methodologic weaknesses existed and several studies have demonstrated improved ankle dorsiflexion after removal of syndesmotic screws. The purposes of the current investigation are: (1) To assess the effect of compressive syndesmotic screw fixation on ankle dorsiflexion utilizing a controlled load and instrumentation allowing for precise measurement of motion...
March 25, 2017: Injury
https://www.readbyqxmd.com/read/28386571/the-broken-ring-of-fire-a-new-radiological-sign-as-predictor-of-syndesmosis-injury
#5
James Calder, Adam Mitchell, Adam Lomax, Moez S Ballal, John Grice, Niek van Dijk, Justin Lee
BACKGROUND: Subcircumferential periosteal edema above the ankle joint is frequently present on magnetic resonance imaging (MRI) with syndesmosis injuries but has not been previously reported. Fluid height within the interosseous membrane also has not previously been shown to be associated with syndesmosis injury severity. PURPOSE: To investigate whether a new sign on MRI and measurement of the length of fluid within the interosseous membrane above the ankle may be used to enable identification of a syndesmosis injury and allow differentiation from lateral ligament injury...
March 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28321479/novel-anatomical-reconstruction-of-distal-tibiofibular-ligaments-restores-syndesmotic-biomechanics
#6
Jian Che, Chunbao Li, Zhipeng Gao, Wei Qi, Binping Ji, Yujie Liu, Ming Han Lincoln Liow
PURPOSE: To date, there is a paucity of literature on syndesmotic reconstruction techniques that restore both anatomic stability and physiologic syndesmotic biomechanics. In this cadaveric study, (1) a novel syndesmotic reconstruction surgical technique using autogenous peroneus brevis tendon was described and (2) the biomechanical properties of the reconstruction was investigated. METHODS: Ten fresh-frozen lower extremities were used in this study. Reconstruction of the anterior and posterior, as well as the interosseous tibiofibular ligaments was performed with a halved peroneus brevis tendon...
March 20, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28237080/isolated-syndesmosis-diastasis-computed-tomography-scan-assessment-with-arthroscopic-correlation
#7
Tae-Keun Ahn, Seung-Myung Choi, Jae-Young Kim, Woo-Chun Lee
PURPOSE: To investigate which method can predict tibiofibular diastasis more accurately among the tibiofibular interval at the ankle joint level or previous parameters taken 1 cm above the joint line. METHODS: An arthroscopic examination was performed in 78 consecutive patients with anterolateral ankle pain. Four different methods were performed to take measurements of the tibiofibular interval using an axial computed tomography (CT) scan under existing arthroscopic diagnosis...
February 22, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28219637/malreduction-of-syndesmosis-injury-associated-with-malleolar-ankle-fracture-can-be-avoided-using-weber-s-three-indexes-in-the-mortise-view
#8
Kentaro Futamura, Tomonori Baba, Atsuhiko Mogami, Itaru Morohashi, Akio Kanda, Osamu Obayashi, Kazuo Sato, Yasuhisa Ueda, Yoshiaki Kurata, Hideki Tsuji, Kazuo Kaneko
PURPOSE: Malalignment of syndesmosis is generally associated with a poor outcome, yet occurs at a high rate in malleolar ankle fractures. In this study, we examine whether malreduction of syndesmosis injury associated with malleolar ankle fracture can be avoided using Weber's three indexes in the mortise view. MATERIALS AND METHODS: Of 156 patients with malleolar ankle fracture who underwent surgery from December 2012 to March 2016 at two medical facilities, 24 patients who received syndesmotic screw fixation were included in the study...
February 14, 2017: Injury
https://www.readbyqxmd.com/read/28207979/a-comparison-of-injuries-in-elite-male-and-female-football-players-a-five-season-prospective-study
#9
J Larruskain, J A Lekue, N Diaz, A Odriozola, S M Gil
The aim was to compare the epidemiology of injuries between elite male and female football players from the same club. Injuries and individual exposure time in a male team and a female team, both playing in the Spanish first division, were prospectively recorded by the club's medical staff for five seasons (2010-2015) following the FIFA consensus statement. Total, training, and match exposure hours per player-season were 20% higher for men compared to women (P<.01). Total, training, and match injury incidence were 30%-40% higher in men (P≤...
February 16, 2017: Scandinavian Journal of Medicine & Science in Sports
https://www.readbyqxmd.com/read/28177647/comprehensive-assessment-of-ankle-syndesmosis-injury-using-3d-isotropic-turbo-spin-echo-sequences-diagnostic-performance-compared-with-that-of-conventional-and-oblique-3-t-mri
#10
COMPARATIVE STUDY
Minchul Kim, Yun Sun Choi, Min Sun Jeong, Mira Park, Tong Jin Chun, Jin Su Kim, Ki Won Young
OBJECTIVE: The objective of this study is to evaluate the diagnostic performance of 3D sampling perfection with application-optimized contrasts using different flip angle evolution (SPACE) sequences in the evaluation of ankle syndesmosis injuries, compared with that of conventional orthogonal MRI and oblique proton density-weighted turbo spin-echo (TSE) sequences performed with 3-T MRI. MATERIALS AND METHODS: This retrospective study included 98 patients with suspected ankle syndesmosis injuries who underwent both MRI and surgery...
April 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28167065/late-treatment-of-syndesmotic-injuries
#11
REVIEW
Michael P Swords, Andrew Sands, John R Shank
Normal syndesmosis anatomy and alignment are essential to ankle function. Although injuries to the syndesmosis are common with ankle injuries, accurate diagnosis and reduction continue to be a challenge. Late reconstruction for syndesmosis is reviewed. A surgical technique for late reconstruction is outlined in detail.
March 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28167064/syndesmosis-stabilisation-screws-versus-flexible-fixation
#12
REVIEW
Matthew C Solan, Mark S Davies, Anthony Sakellariou
Orthopedic surgery is not short of situations where there is controversy regarding optimum management. Treating ankle syndesmosis injuries is an example where practice varies widely and there are many questions that remain unsatisfactorily answered. When addressing the type of syndesmosis stabilization that is required it is essential to ascertain the extent of instability. Only then can a logical approach to restoring the ankle mortise be achieved. Fixation of fibula shaft fractures and posterior malleolus fractures can restore sufficient stability to render syndesmosis stabilization unnecessary...
March 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28167058/posterior-malleolar-fractures-changing-concepts-and-recent-developments
#13
REVIEW
Jan Bartoníček, Stefan Rammelt, Michal Tuček
Injuries to the posterior malleolus are of prognostic relevance in ankle fracture-dislocations. The three-dimensional outline of the fragments as reflected by computed tomography classification, involvement of the fibular notch, and the presence of intercalary fragments seem to be of greater therapeutic relevance than the size of the fragment and amount of the articular surface involved. Operative treatment aims at reconstruction of the posterior tibial plafond, the fibular notch, and the integrity of the posterior inferior tibiofibular syndesmosis...
March 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28160934/arthroscopic-quantification-of-syndesmotic-instability-in-a-cadaveric-model
#14
Ross Feller, Todd Borenstein, Amanda J Fantry, Roy Bradley Kellum, Jason T Machan, Florian Nickisch, Brad Blankenhorn
PURPOSE: To investigate whether arthroscopy or stress radiography can identify instability resulting from single-ligament injury of the ankle syndesmosis and to determine whether either modality is capable of differentiating between various levels of ligament injury. METHODS: Syndesmotic/deltoid ligament sectioning was performed in 10 cadaver legs. Arthroscopic evaluation and fluoroscopic stress testing were completed after each sectioning. In group 1 (n = 5), sectioning began with anteroinferior tibiofibular ligament (AITFL), then interosseous membrane (IOM), posteroinferior tibiofibular ligament (PITFL), and deltoid...
February 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28131483/simulating-clamp-placement-across-the-trans-syndesmotic-angle-of-the-ankle-to-minimize-malreduction-a-radiological-study
#15
Sara M Putnam, Michael S Linn, Amanda Spraggs-Hughes, Christopher M McAndrew, William M Ricci, Michael J Gardner
BACKGROUND: Ankle fractures associated with syndesmotic injury have a poorer prognosis than those without such an injury. Anatomic reduction of the distal tibiofibular joint restores joint congruency and minimizes contact pressures, yet operative fixation of syndesmotic ankle injuries is frequently complicated by malreduction of the syndesmosis. Current methods of assessing reduction have been shown to be inadequate. As such, additional methods to judge the accuracy of syndesmotic reduction are required...
March 2017: Injury
https://www.readbyqxmd.com/read/28129269/the-effect-of-varying-tension-of-a-suture-button-construct-in-fixation-of-the-tibiofibular-syndesmosis-evaluation-using-stress-computed-tomography
#16
John Morellato, Hakim Louati, Andrew Bodrogi, Andrew Stewart, Steven Papp, Allan Liew, Wade Gofton
BACKGROUND/PURPOSE: There have been no studies assessing the optimal biomechanical tension of suture button constructs. The purpose of this study was to assess optimal tensioning of suture button fixation and its ability to maintain reduction under loaded conditions using a stress computed tomography (CT) model. METHODS: Ten cadaveric lower limbs disarticulated at the knee were used. The limbs were placed in a modified ankle load frame that allowed for the application of sustained torsional axial or combined torsional/axial loads...
February 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28005114/an-update-on-management-of-syndesmosis-injury-a-national-us-database-study
#17
James C Carr, Brian C Werner, Seth R Yarboro
We conducted a study to determine the incidence of syndesmotic injury and stabilization within various ankle fracture patterns along with the rate of syndesmotic implant removal. All data were obtained from a publicly available for-fee healthcare database, the PearlDiver Patient Records Database. Current Procedural Terminology (CPT) codes were used to search the database for cases of fixation of lateral malleolus, bimalleolar, and trimalleolar fractures in addition to syndesmotic fixation and implant removal...
November 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28002322/the-effect-of-polydeoxyribonucleotide-prolotherapy-on-posterior-tibial-tendon-dysfunction-after-ankle-syndesmotic-surgery-a-case-report
#18
Tae-Ha Lim, Hyung Rae Cho, Keum Nae Kang, Chang Joon Rhyu, Sung Won Chon, Young Su Lim, Jee In Yoo, Jung-Won Kim, Young Uk Kim
RATIONALE: Ankle syndesmotic injuries occasionally require long-term therapy for recovery and can result in tendon injury. Posterior tibial tendon dysfunction (PTTD) is an acquired deformity that can cause flatfoot deformity. The current nonoperative management of PTTD includes nonsteroidal antiinflammatory drugs (NSAIDs), orthopedic devices. Although various treatment options have been attempted, optimal treatments for each stage of the condition are debated. Polydeoxyribonucleotide (PDRN) is effective in healing of chronic wounds associated with tissue damage by attracting tissue growth factors...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27942736/the-doubled-suture-nice-knot
#19
Pascal Boileau, Ghassan Alami, Adam Rumian, Daniel G Schwartz, Christophe Trojani, Adam J Seidl
The authors describe a novel suture fixation technique that combines a doubled suture with a sliding knot. The knot can be tied in both open and arthroscopic surgery to fix torn tendons/ligaments and fractured/osteotomized bones. The advantages of the doubled-suture Nice knot include strength, adjustability, simplicity, and versatility. This technique, which has proven useful in the authors' practice for the past 10 years, has replaced metallic wires and cables for bone fixation. The doubled-suture Nice knot can also be tied over a double-button and has been used for ankle syndesmosis, acromioclavicular joint separation repair, and coracoid bone block fixation...
March 1, 2017: Orthopedics
https://www.readbyqxmd.com/read/27920331/3d-model-analysis-of-ankle-flexion-on-anatomic-reduction-of-a-syndesmotic-injury
#20
Jason M Schon, Jacob D Mikula, Jonathon D Backus, Melanie B Venderley, Grant J Dornan, Robert F LaPrade, Thomas O Clanton
BACKGROUND: The effect of ankle positioning during suture-button fixation for syndesmosis repair on range of motion (ROM) and anatomic reduction has yet to be investigated. The purpose of this cadaveric study was to compare the effects of 3 different ankle positions during suture-button repair on volumetric reduction of the syndesmosis, fibular displacement, and ROM of the ankle using 3-dimensional computed tomography (CT) analysis. The null hypothesis was that ankle position during fixation would not affect syndesmotic volume restoration, fibular displacement, or ROM...
April 2017: Foot & Ankle International
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