A Radiographic Dye Method for Intraoperative Evaluation of Syndesmotic Injuries

Pepe, Murad; Kocadal, Onur; Gunes, Zafer; Calisal, Emre; Ceritoğlu, Kubilay Uğurcan; Aktekin, Cem Nuri

doi:10.1177/1071100717730328

Cited by 4 publications

(3 citation statements)

References 29 publications

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“…In a study, preoperative CT in the diagnosis of the syndesmosis was compared with the Chertsey test (a radiographic dye method for intraoperative evaluation of syndesmotic injuries), which is one of the intraoperative tests for diagnosing syndesmotic injuries [ 24 ]. The Chertsey test was found positive in 13 (33.3%) of 39 patients diagnosed syndesmotic injury in preoperative CT, which was found valuable in diagnosing syndesmosis.…”

Section: Discussionmentioning

confidence: 99%

Reliability of preoperative CT and intraoperative manual tests in syndesmosis injury

Kaya

2024

North Clin Istanbul

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OBJECTIVE We always confirm the diagnosis of syndesmotic injury with a Hook test for all ankle fractures and fixed if necessary. Then, we noticed a discrepancy between preoperative radiology and the Hook test. Moreover, we want to report the reliability of syndesmotic fixation decisions with Hook test and preoperative radiology. METHODS A total of 37 surgically treated patients with isolated Weber type C ankle fractures were included in the study. In all patients, the syndesmosis joint was injured in preoperative computed tomography and X-ray imaging. However, only patients with (+) Hook tests had undergone a syndesmosis fixation. Patients were divided into two groups: Group A: Hook tests (+) and Group B: Hook test (–). Also, the groups were compared according to clinical outcomes with the Visual Analog Scale (VAS), American Orthopedic Foot and Ankle Society (AOFAS), and foot and ankle disability index (FADI) scores. RESULTS The mean participant age was 39 (19–80) years, and the mean follow-up period was 47.27 (22–68) months. Groups A and B consisted of 17 (45.9%) and 20 (54.1%) patients, respectively. The mean VAS, AOFAS, and FADI scores were 17.7±14.3, 90.32±8.06, and 92.9±6.88, respectively. “Excellent” and “good” results were found in 34 (%91.8) patients according to AOFAS nad FADI. The malreduction rate was 8.1% in all patients, 5% in group A, and 11.8% in group B. No statistically significant differences in final functional scores were found between groups A and B. CONCLUSION Hook test is reliable and adequate for evaluating the stability and quality of syndesmosis reduction. Weber type C lateral malleolar fractures in the decision of syndesmosis fixation; although syndesmosis injury is diagnosed in preoperative radiology, we recommend that the diagnosis be confirmed with the Hook test.

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Section: Discussionmentioning

confidence: 99%

Reliability of preoperative CT and intraoperative manual tests in syndesmosis injury

Kaya

2024

North Clin Istanbul

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“…[ 13 ] Pepe et al . [ 27 ] in a study comparing the diagnostic value of preoperative CT scan and intraoperative Chertsey test stated that the dye injection test was positive in 13 out of 39 cases (33.3%) of ankle fractures. In their study, patients categorized as Chertsey positive demonstrated a noteworthy increment in the width and volume of the syndesmosis in comparison to the control group which is consistent with the present study results.…”

Section: Discussionmentioning

confidence: 99%

“…They generally concluded that the Chertsey test is a decisive and advantageous test that can easily be performed during surgery to diagnose syndesmosis injuries. [ 27 ] Yeung et al . in a study of ankle fractures revealed that the mean ATFD, MTFD, PTFD, and MAXTFD in Chertsey positive group were 4.9 ± 3.7 mm, 5.3 ± 2.4 mm, 5.3 ± 1.8 mm, and 7.2 ± 2.96 mm, respectively, and in the Chertsey negative group were 4.2 ± 4.2 mm, 5.1 ± 3.1 mm, 5.0 ± 1.7 mm, and 6.3 ± 3.7 mm, respectively.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative Chertsey Test, is it a Reliable Alternative to Computed Tomography Scan for Diagnosing Syndesmotic Injuries of the Ankle?

Rasi

Sayyadi

Omidian

et al. 2022

Advanced Biomedical Research

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Background: The present study aims to evaluate the diagnostic exactitude of the intraoperative Chertsey test in tibiofibular syndesmotic injuries in patients with malleolar fractures, in comparison with a computed tomography (CT) scan. Materials and Methods: In this study, patients with malleolar fractures operated between 2018 and 2020 were examined. Thirty-nine patients were enrolled in the study. A three-dimensional preoperative CT scan was obtained. The opposite unfractured ankle was also scanned and considered as the control group. The Chertsey test was performed during the operation to assess the syndesmosis injury. Then, patients were partitioned into two distinct groups, considering the condition of their ankle, namely the Chertsey positive (unstable syndesmosis) group and the Chertsey negative (stable syndesmosis) group. Results: The outcomes of the present survey illustrated that the Chertsey test was positive in 16 patients (41.03%) and negative in 23 patients (59.07%). The median of all CT scan parameters (anterior tibiofibular distances (TFD), middle TFD, posterior TFD, and maximal TFD and volume) before surgery in the group of patients with a positive Chertsey test was significantly higher, measured against the unfractured control group ( P < 0.001 for all parameters). Furthermore, a comparison of CT scan parameters and syndesmosis space volume before surgery between the two groups of patients with positive and negative Chertsey test results showed that the measurement of parameters in Chertsey-positive patients was significantly higher than the Chertsey-negative patients ( P < 0.001). Conclusion: Chertsey test could be used to diagnose syndesmosis injuries in patients with malleolar fractures due to its high importance in the outcome of patients.

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Diagnosis and treatment of ankle syndesmosis injuries with associated interosseous membrane injury: a current concept review

Lin

Xiong

et al. 2019

International Orthopaedics (SICOT)

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A Radiographic Dye Method for Intraoperative Evaluation of Syndesmotic Injuries

Abstract: III, comparative series.

Cited by 4 publications

References 29 publications

Reliability of preoperative CT and intraoperative manual tests in syndesmosis injury

Reliability of preoperative CT and intraoperative manual tests in syndesmosis injury

Intraoperative Chertsey Test, is it a Reliable Alternative to Computed Tomography Scan for Diagnosing Syndesmotic Injuries of the Ankle?

Diagnosis and treatment of ankle syndesmosis injuries with associated interosseous membrane injury: a current concept review

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