Arthrographic differential diagnosis between ruptures of the anterior talofibular ligament, the joint capsule and the anterior tibiofibular ligament

Moppes, F. I. van; Meijer, Frederick J. A.; Hoogenband, C. R. van den

doi:10.1055/s-2008-1056783

Cited by 7 publications

(2 citation statements)

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“…injury mostly to the ATIFL, the syndesmotic recess can tear. In the acute setting, arthrography of the tibiotalar joint would demonstrate leakage of contrast fluid into the incisura tibialis or, depending on the extent of injury, into the interosseous ligament between the tibia and fibula, or even outside the borders of the ATIFL and PTIFL (van Moppes et al. 1980; Wrazidlo et al.…”

Section: Syndesmotic Recess (Recessus Tibiofibularis)mentioning

confidence: 99%

Anatomy of the distal tibiofibular syndesmosis in adults: a pictorial essay with a multimodality approach

et al. 2010

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A syndesmosis is defined as a fibrous joint in which two adjacent bones are linked by a strong membrane or ligaments. This definition also applies for the distal tibiofibular syndesmosis, which is a syndesmotic joint formed by two bones and four ligaments. The distal tibia and fibula form the osseous part of the syndesmosis and are linked by the distal anterior tibiofibular ligament, the distal posterior tibiofibular ligament, the transverse ligament and the interosseous ligament. Although the syndesmosis is a joint, in the literature the term syndesmotic injury is used to describe injury of the syndesmotic ligaments. In an estimated 1-11% of all ankle sprains, injury of the distal tibiofibular syndesmosis occurs. Forty percent of patients still have complaints of ankle instability 6 months after an ankle sprain. This could be due to widening of the ankle mortise as a result of increased length of the syndesmotic ligaments after acute ankle sprain. As widening of the ankle mortise by 1 mm decreases the contact area of the tibiotalar joint by 42%, this could lead to instability and hence early osteoarthritis of the tibiotalar joint. In fractures of the ankle, syndesmotic injury occurs in about 50% of type Weber B and in all of type Weber C fractures. However, in discussing syndesmotic injury, it seems the exact proximal and distal boundaries of the distal tibiofibular syndesmosis are not well defined. There is no clear statement in the Ashhurst and Bromer etiological, the LaugeHansen genetic or the Danis-Weber topographical fracture classification about the exact extent of the syndesmosis. This joint is also not clearly defined in anatomical textbooks, such as Lanz and Wachsmuth. Kelikian and Kelikian postulate that the distal tibiofibular joint begins at the level of origin of the tibiofibular ligaments from the tibia and ends where these ligaments insert into the fibular malleolus. As the syndesmosis of the ankle plays an important role in the stability of the talocrural joint, understanding of the exact anatomy of both the osseous and ligamentous structures is essential in interpreting plain radiographs, CT and MR images, in ankle arthroscopy and in therapeutic management. With this pictorial essay we try to fill the hiatus in anatomic knowledge and provide a detailed anatomic description of the syndesmotic bones with the incisura fibularis, the syndesmotic recess, synovial fold and tibiofibular contact zone and the four syndesmotic ligaments. Each section describes a separate syndesmotic structure, followed by its clinical relevance and discussion of remaining questions.

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Section: Syndesmotic Recess (Recessus Tibiofibularis)mentioning

confidence: 99%

Anatomy of the distal tibiofibular syndesmosis in adults: a pictorial essay with a multimodality approach

et al. 2010

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“…It attached to the distal tibia medially and the distal fibula laterally with an interposing fat-containing synovial fold [3, 5]. In acute syndesmotic injury, this recess can tear causing leakage of contrast into the incisura tibialis [6]. In chronic syndesmotic injury, the synovial lining may become irregular due to inflammation [7].…”

Section: Anatomymentioning

confidence: 99%

Distal Tibiofibular Syndesmosis: Anatomy, Biomechanics, Injury and Management

Yuen¹,

Lui²

2017

TOORTHJ

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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. With the improvement in ankle arthroscopic technique, it can be used as a diagnostic and therapeutic tool in the management of distal tibiofibular syndesmosis injury.

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The Unstable Syndesmosis

Hintermann

Ruiz

2021

Foot and Ankle Instability

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Arthrographic differential diagnosis between ruptures of the anterior talofibular ligament, the joint capsule and the anterior tibiofibular ligament

Cited by 7 publications

References 0 publications

Anatomy of the distal tibiofibular syndesmosis in adults: a pictorial essay with a multimodality approach

Anatomy of the distal tibiofibular syndesmosis in adults: a pictorial essay with a multimodality approach

Distal Tibiofibular Syndesmosis: Anatomy, Biomechanics, Injury and Management

The Unstable Syndesmosis

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