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

Yu, Guang-Shu; Lin, Yu‐Liang; Xiong, Guosheng; Xu, Hongbin; Liu, Youying

doi:10.1007/s00264-019-04396-w

Cited by 24 publications

(18 citation statements)

References 74 publications

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“…The ankle joint fracture and dislocation is often combined with the distal tibiofibular syndesmosis separation. Whereas bony and ligamentous disruption of the distal tibiofibular relationship are difficult to diagnose (5). A middle-term follow-up indicated that distal tibiofibular syndesmosis injury without fixation would seriously affect the ankle function and advocated that the injured syndesmosis requires anatomical reduction (17).…”

Section: Anatomical and Physiological Characteristics Of Distal Tibiofibular Syndesmosismentioning

confidence: 99%

“…We found that there was no statistically significant difference in middle-term OM scores between suture button fixation group and screw fixation group. Some studies show that the average full weightbearing time is 4.93 (2)(3)(4)(5)(6)(7)(8) weeks in the suture button fixation group while 10.52 (8)(9)(10)(11)(12)(13)(14) weeks in the screw fixation group (23). Other studies show that suture button fixation can achieve the same fixation effect as screw fixation for the distal tibiofibular syndesmosis injury, and the application of such fixation allows the fibula fracture to heal physiologically because its movement fits greater to the biological environment (24).…”

Section: Current Fixation Strategy For the Distal Tibiofibular Syndesmosis Injurymentioning

confidence: 99%

“…The syndesmosis screw fixation remains the most common fixation method. However, due to the physiological slight movements of the distal tibiofibular syndesmosis, the complications of syndesmotic screws fixation include malreduction, heterotopic ossification, implant irritation, screw breakage and limitation of ankle dorsiflexion (4,5). Hence there have been numerous Level 1 RCTs over the past 5 years demonstrated that the middle-term results favor the use of suture button when treating an acute syndesmotic injury (6)(7)(8).…”

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confidence: 99%

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The Clinical Efficacy of Suture-Button Fixation and Trans-Syndesmotic Screw Fixation in the Treatment of Ankle Fracture Combined With Distal Tibiofibular Syndesmosis Injury: A Retrospective Study

Kang²,

et al. 2022

The Journal of Foot and Ankle Surgery

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Twenty percent of ankle fractures present with concomitant syndesmosis injury which results in poor clinical outcomes. Surgical stabilization of the syndesmosis can be achieved with either trans-syndesmotic screws or a suture button device. The aim of this study is to investigate the clinical efficacy of suture button fixation and trans-syndesmotic screw fixation in the treatment of ankle fracture combined with distal tibiofibular syndesmosis injury. A retrospective analysis was conducted by enrolling 76 patients with ankle fractures combined with distal tibiofibular syndesmosis injury who were admitted in our trauma center from January 2018 to January 2019, including 34 cases of suture button group and 42 cases of the syndesmotic screw group with a mean follow-up period of 16 § 7 (range 12-21) months. The demographic data included gender, age, injury mechanism, AO classification and the operation duration were recorded, the radiographic and clinical outcomes were determined by tibiofibular clear space, tibiofibular overlap distance, complications, and the Olerud-Molander Ankle Score at the last follow-up. All the indexes were compared between the 2 groups to discover the related statistical differences. With the numbers available, no significant difference could be detected in the surgical duration, tibiofibular clear space, tibiofibular overlap distance, total complication rate, and middle-term Olerud-Molander Ankle scores between the 2 groups. However, the suture button fixation group showed higher early stage Olerud-Molander Ankle scores (p = .027) and shorter full weightbearing time (p = .018) than that of syndesmotic screw fixation group. Considering the outcomes, we conclude that the suture button fixation not only shows equivalent efficacy to the traditional syndesmotic screw, but also has advantages of allowing early weightbearing, low requirements for routine removal.

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Section: Anatomical and Physiological Characteristics Of Distal Tibiofibular Syndesmosismentioning

confidence: 99%

Section: Current Fixation Strategy For the Distal Tibiofibular Syndesmosis Injurymentioning

confidence: 99%

mentioning

confidence: 99%

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The Clinical Efficacy of Suture-Button Fixation and Trans-Syndesmotic Screw Fixation in the Treatment of Ankle Fracture Combined With Distal Tibiofibular Syndesmosis Injury: A Retrospective Study

Kang²,

et al. 2022

The Journal of Foot and Ankle Surgery

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“…Rupture of the AITFL first occurs, followed by rupture of the IOL and IOM when the force persists. If the force is strong enough and continues to transmit up to the upper fibula, it may result in a stress concentration at the upper fibula due to the limitation of the upper tibiofibular syndesmosis; subsequently, upper fibula fracture occurs[ 23 ]. The fracture site of the fibula acts as a breakthrough point to release the force.…”

Section: Discussionmentioning

confidence: 99%

Maisonneuve injury with no fibula fracture: A case report

Liu¹,

Li²,

Xiao³

et al. 2021

WJCC

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BACKGROUND Ankle syndesmosis injury is difficult to diagnose accurately at the initial visit. Missed diagnosis or improper treatment can lead to chronic complications. Complete syndesmosis injury with a concomitant rupture of the interosseous membrane (IOM) is more unstable and severe. The relationship between this type of injury and Maisonneuve injury, in which the syndesmosis is also injured, has not been discussed in the literature previously. CASE SUMMARY A 16-year-old patient sustained left medial malleolar fracture, and the associated inferior tibiofibular syndesmotic instability was overlooked. After open reduction and internal fixation of the medial malleolar fracture, inferior tibiofibular syndesmosis diastasis with IOM rupture was detected by auxiliary imaging. Secondary surgical intervention was performed to reduce anatomically and fix with two trans-syndesmosis screws. Twelve weeks later, the screws were removed. At the 6-mo follow-up, the patient gained full range of motion of the ankle. CONCLUSION Complete syndesmosis injury with IOM rupture should be considered Maisonneuve-type injury. Open reduction and internal fixation could obtain good outcomes.

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“…So, their treatment is troublesome. [1][2][3] The foot and ankle have thinner subcutaneous tissue than other regions and a relatively poor blood supply. Hence, foot and ankle trauma can easily lead to soft tissue defects while increasing the probability of deep tissue exposure.…”

Section: Introductionmentioning

confidence: 99%

Clinical application of retrograde sural neurofasciocutaneous flap repair combined with jingulian capsules to treat foot and ankle soft tissue defects

Hao

Tian²,

Hu³

et al. 2021

Pak J Med Sci

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Objectives: To observe and analyse the efficacy of retrograde sural neurofasciocutaneous flap repair combined with Jingulian capsules to treat foot and ankle soft tissue defects. Methods: One hundred and eighty patients with foot and ankle soft tissue defects were enrolled in the study from January 2016 to June 2019 in The Second Department of General Surgery,Baoding First Central Hospital. They were divided into a study group and a reference group with the same case number. The former group was provided combination treatment, i.e. retrograde sural neurofasciocutaneous flap repair combined with Jingulian capsules; the latter group was given vacuum sealing drainage. Then, the treatment outcomes of the two groups were compared. Results: The study group needed fewer dressing changes, less preoperative preparation time and antibiotic use than the reference group, p<0.05. The study group had a significantly lower incidence of wound infections and flap necrosis than the reference group, p<0.05. The study group was significantly superior to the reference group regarding ankle function scores and the pain visual analogue scores (VAS) p<0.05. Conclusions: Retrograde sural neurofasciocutaneous flap repair combined with Jingulian capsules is a protocol that improves efficacy for soft tissue defects in the foot and ankle, which are worthy of promotion and practice. doi: https://doi.org/10.12669/pjms.38.1.4546 How to cite this:Hao Z, Tian S, Hu C, Jia Y. Clinical application of retrograde sural neurofasciocutaneous flap repair combined with jingulian capsules to treat foot and ankle soft tissue defects. Pak J Med Sci. 2022;38(1):---------. doi: https://doi.org/10.12669/pjms.38.1.4546 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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

Cited by 24 publications

References 74 publications

The Clinical Efficacy of Suture-Button Fixation and Trans-Syndesmotic Screw Fixation in the Treatment of Ankle Fracture Combined With Distal Tibiofibular Syndesmosis Injury: A Retrospective Study

The Clinical Efficacy of Suture-Button Fixation and Trans-Syndesmotic Screw Fixation in the Treatment of Ankle Fracture Combined With Distal Tibiofibular Syndesmosis Injury: A Retrospective Study

Maisonneuve injury with no fibula fracture: A case report

Clinical application of retrograde sural neurofasciocutaneous flap repair combined with jingulian capsules to treat foot and ankle soft tissue defects

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