Arthroscopic Evaluation of Syndesmotic Instability in a Cadaveric Model

Abstract

Arthroscopic evaluation of subtle displacement in multiple planes may assist the surgeon in understanding the extent of the syndesmotic injury. Further studies are necessary to determine to what extent instability requires fixation as well as the role for arthroscopy in assessing anatomic reduction of the syndesmosis after fixation is performed.

Arthroscopically Assisted Versus Standard Open Reduction and Internal Fixation Techniques for the Acute Ankle Fracture

“…5,13,14,32,41 Arthroscopy in patients undergoing ankle fracture surgery offers the proposed advantages of improved visualization of articular reductions, assessment and treatment of cartilage and ligamentous damage, removal of loose bodies, decreased soft tissue exposure, preservation of vascularity, and evaluation of the syndesmosis. 5,9,13,20 Indeed, a recent study by Watson et al demonstrated the effectiveness of arthroscopy in evaluating even partial disruptions of the syndesmosis, 44 and Takao et al have shown the superiority of arthroscopy in the evaluation of the syndesmosis as compared to plain radiographs. 40 The ability of arthroscopy to enhance the diagnosis of syndesmotic instability indicates that there may well be an important role for arthroscopy in the treatment of ankle fractures.…”

Role of the Deltoid Ligament in Syndesmotic Instability

“…4,11 Advances in ankle arthroscopy allow direct inspection of the syndesmosis, 5,15,24,25 affording the opportunity to directly visualize even subtle syndesmotic instability. 9,16,27 Variable anatomic locations within the distal tibiofibular joint have historically been used to diagnose syndesmotic instability, including the center, anterior, and posterior aspect of the incisura. 9,17,27 There is a paucity of literature, however, exploring the role of the DL in conferring stability to the injured syndesmosis.…”

“…9,16,27 Variable anatomic locations within the distal tibiofibular joint have historically been used to diagnose syndesmotic instability, including the center, anterior, and posterior aspect of the incisura. 9,17,27 There is a paucity of literature, however, exploring the role of the DL in conferring stability to the injured syndesmosis. 3,21 The purpose of this study was to arthroscopically evaluate the role of the DL in stabilizing the syndesmosis in the coronal plane by measuring both the anterior and posterior third diastasis of the distal tibiofibular articulation in a cadaveric model.…”

Use of Anatomical Landmarks in Ankle Arthroscopy to Determine Accuracy of Syndesmotic Reduction: A Cadaveric Study

“…Watson et al 22 utilized a cadaveric model (below-knee amputations) to determine syndesmotic instability with intact and progressively sectioned components of the syndesmotic and lateral ankle ligamentous complexes. They concluded that arthroscopic evaluation of subtle displacement in multiple planes may help the surgeon understand the extent of injury and assist in anatomical reduction.…”