Ankle Joint Contact Loads and Displacement With Progressive Syndesmotic Injury

Hunt, Kenneth J.; Goeb, Yannick; Behn, Anthony W.; Criswell, Braden; Chou, Loretta B.

doi:10.1177/1071100715583456

Cited by 87 publications

(55 citation statements)

References 30 publications

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“…Compared to other studies, the proportion of syndesmotic injuries in the skeletally mature patients in this cohort (20%) is similar to existing data on ankle fractures in adults. [7,16,17] The absence of syndesmotic injury fixation in the 2 immature groups raises the following questions: either syndesmotic injuries are essentially nonexistent in skeletally immature patients or they cannot be diagnosed accurately with current techniques.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of syndesmotic fixations in a pediatric center

et al. 2019

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Syndesmosis injuries need to be accurately diagnosed and managed to avoid chronic pain, early arthritis, and instability. To this end, the present study aimed to analyze the epidemiology of syndesmotic injuries in a pediatric ankle fracture cohort and identify patient and surgery-related characteristics. A retrospective review of all the ankle fractures during a 12-year period at a single pediatric referral center was conducted. Inclusion criteria were: a fractured ankle that underwent a surgical fixation, at least 1 radiograph available for review before fixation, available information regarding surgery, including operative report and fluoroscopic images, and younger than 18 years at the time of surgery. Demographic information, trauma, radiographs, surgical details, clinical examination, follow up, outcomes, and physeal status (skeletally immature, transitional, or mature) were recorded. Finally, patients were divided in 2 groups: with or without syndesmotic fixation. Statistical analysis included descriptive statistics, Mann–Whitney test for nonparametric data to compare continuous parameters, and χ 2 test for categorical parameters. A total of 128 patients were included with a mean age of 14.1 years. There were 80 boys and 48 girls. There were 51 skeletally immature patients, 23 with transitional fractures, and 54 that were skeletally mature. The main finding of this study is that only 11 patients from the mature group underwent syndesmotic fixation. There were no cases of syndesmotic fixation in the skeletally immature and transitional groups. This is the first retrospective study to focus specifically on syndesmotic injuries in a pediatric population who underwent ankle fracture fixation. Only 11 skeletally mature patients underwent syndesmotic fixation out of 128 patients in this cohort. This result raises the question of whether there are accurate diagnostic tools to evaluate syndesmosis in children.

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Section: Discussionmentioning

confidence: 99%

Epidemiology of syndesmotic fixations in a pediatric center

et al. 2019

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“…Ankle ligaments provide mechanical stability, proprioceptive information, and directed motion for the joint. Much research has focused on injury to the lateral ankle ligaments and inversion ankle sprains 32–34 . Risk factors are those activities, such as basketball and jumping sports, in which an athlete can come down on and turn the ankle or step on an opponent’s foot.…”

Section: Discussionmentioning

confidence: 99%

Shapes of distal tibiofibular syndesmosis are associated with risk of recurrent lateral ankle sprains

Liu¹,

Lin²,

Guo³

et al. 2017

Sci Rep

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Distal tibiofibular syndesmosis (DTS) has wide anatomic variability in depth of incisura fibularis and shape of tibial tubercles. We designed a 3-year prospective cohort study of 300 young physical training soldiers in an Army Physical Fitness School. Ankle computed tomography (CT) scans showed that 56% of the incisura fibularis were a “C” shape, 25% were a “1” shape, and 19% were a “Г” shape. Furthermore, we invited a randomly selected subcohort of 6 participants in each shape of DTS to undergo a three-dimensional (3D) laser scanning. The “1” shape group showed widest displacement range of the DTS in the y-axis, along with the range of motion (ROM) on the position more than 20° of the ankle dorsiflexion, inversion and eversion. During the 3-year study period, 23 participants experienced recurrent lateral ankle sprains. 7 cases of the incisura fibularis were “C” shape, 13 cases were “1” shape, and 3 cases were “Г” shape. The “1” shape showed highest risk among the three shapes in incident recurrent lateral ankle sprains. We propose that it is possible to classify shapes of DTS according to the shapes of incisura fibularis, and people with “1” shape may have more risk of recurrent lateral ankle sprains.

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“…Por lo tanto, la lesión de los ligamentos de la sindesmosis aumenta los movimientos de rotación y traslación del peroné durante la carga y en rotación externa (5) . Este hecho influye en el aumento exponencial de las fuerzas de presión tibiotalar y en el pronóstico futuro de la articulación tras un traumatismo.…”

Section: Biomecánica De Los Ligamentosunclassified

Biomecánica de la sindesmosis

Martínez-de-Albornoz-Torrente¹,

Monteagudo-de-la-Rosa²

2019

MACT

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Este es un artículo Open Access bajo la licencia CC BY-NC-ND (www.creativecommons.org/licenses/by-nc-nd/4.0/). FS Introducción La sindesmosis es una articulación que proporciona estabilidad y flexibilidad a la mortaja del tobillo. Tiene la peculiaridad de funcionar como un estabilizador dinámico del complejo tibio-peroneo-astragalino. Este concepto de estabilizador dinámico es importante y el conocimiento global de las propiedades biomecánicas de la sindesmosis sana y patológica proporciona un fundamento objetivo para un mejor diagnóstico, tratamiento y rehabilitación. Se trata de un tema que todavía los cirujanos ortopédicos tenemos pendiente. De aquí el interés creciente en los últimos años, que se traduce con el aumento exponencial de publicaciones al respecto: 16 publicaciones de media anual entre los años 1998 y 2012, y 60 publicaciones de media anual entre los años 2013 y 2018 (https://www.ncbi.nlm.nih.gov/pubmed). Anatomía mecánica La estabilidad en carga de la articulación del tobillo y de la sindesmosis se atribuye en parte a: 1) La anatomía ósea distal de la tibia y el peroné: "incisura tibiofibular". 2) La estabilidad ligamentosa de los 3 principales ligamentos: ligamento tibiofibular anterior e inferior (LTFAI), ligamento interóseo tibiofibular (LTFI) y las fibras superficiales y profundas (también conocido como ligamento transverso) del ligamento tibiofibular posterior e inferior (LTFPI). Existe una transición anatómica gradual de la membrana interósea (MIO) al ligamento interóseo, e incluso del LTFI y los ligamentos inferiores anterior y posterior tibiofibulares (LTFAI y LTFPI).

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Ankle Joint Contact Loads and Displacement With Progressive Syndesmotic Injury

Abstract: Considerable changes in ankle joint kinematics and contact mechanics may explain why moderate syndesmosis injuries take longer to heal and are more likely to develop long-term dysfunction and, potentially, ankle arthritis.

Cited by 87 publications

References 30 publications

Epidemiology of syndesmotic fixations in a pediatric center

Epidemiology of syndesmotic fixations in a pediatric center

Shapes of distal tibiofibular syndesmosis are associated with risk of recurrent lateral ankle sprains

Biomecánica de la sindesmosis

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