Disruption of the ankle syndesmosis: Diagnosis and treatment by arthroscopic surgery

Ogilvie-Harris, D.J.; Reed, Stephen C.

doi:10.1016/s0749-8063(05)80015-5

Cited by 210 publications

(149 citation statements)

References 12 publications

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“…Normal widening of the diastasis should be approximately 1 mm. An arthroscopic study by Ogilvie-Harris et al 38 consistently found scarring around the PITFL, disruption of the interosseous ligament, and chondral damage to the posterolateral portion of the tibial plafond in patients with syndesmotic injuries. Takao et al 48 reported 100% accuracy in identifying patients with syndesmotic injury using arthroscopy, when compared to AP radiography (48%) and mortise radiography (64%), which provides further support for arthroscopy as an accurate diagnostic tool.…”

Section: Imaging Studiesmentioning

confidence: 97%

“…14,15,38,48,58 Ebraheim et al 14,15 have demonstrated that a CT scan is a more accurate and sensitive method for detecting syndesmotic injuries when compared to plain film radiography. A CT scan is particularly sensitive for minor or partial ruptures and to assess diastasis.…”

Section: Imaging Studiesmentioning

confidence: 99%

“…38,48 Movements between the tibia and fibula can be measured using a probe that is introduced from a medial portal. Normal widening of the diastasis should be approximately 1 mm.…”

Section: Imaging Studiesmentioning

confidence: 99%

“…They also suggest that radiography should be acquired following surgical reduction to insure a complete reduction of the ankle mortise. OgilvieHarris et al 38 have described the benefits of using arthroscopic surgery to resect the torn portions of the interosseous ligament and chondral fractures. These arthroscopic procedures significantly improved pain, swelling, stiffness, stability, gait, and activity levels in their patient series.…”

Section: Clinical Interventionmentioning

confidence: 99%

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Ankle Syndesmosis Injuries: Anatomy, Biomechanics, Mechanism of Injury, and Clinical Guidelines for Diagnosis and Intervention

Lin

Gross

Weinhold

2006

J Orthop Sports Phys Ther

178

149

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Syndesmosis injuries are rare, but very debilitating and frequently misdiagnosed. The purpose of this clinical commentary is to review the mechanisms of syndesmotic injuries, clinical examination methods, diagnosis, and management of the injuries. Cadaveric studies of the syndesmosis and deltoid ligaments are also reviewed for further understanding of stress transmission and the roles of different structures in stabilizing the distal syndesmosis. External rotation and excessive dorsiflexion of the foot on the leg have been reported as the most common mechanisms of injury. The injury is most often incurred by individuals who participate in skiing, football, soccer, and other sport activities played on turf. The external rotation and squeeze tests are reliable tests to detect this injury. The ability of imaging studies to assist in an accurate diagnosis may depend on the severity of the injury. The results of cadaveric studies indicate the importance of the deltoid ligament in maintaining stability of the distal tibiofibular syndesmosis and the congruency of the ankle mortise. Intervention programs with early rigid immobilization and pain relief strategies, followed by strengthening and balance training are recommended. Heel lift and posterior splint intervention can be used to avoid separation of the distal syndesmosis induced by excessive dorsiflexion of the ankle joint. Application of a rigid external device should be used with caution to prevent medial-lateral compression of the leg superior to the ankle mortise, thereby inducing separation of the distal syndesmosis articulation. Surgical intervention is an option when a complete tear of the syndesmotic ligaments is present or when fractures are observed.

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Section: Imaging Studiesmentioning

confidence: 97%

Section: Imaging Studiesmentioning

confidence: 99%

“…38,48 Movements between the tibia and fibula can be measured using a probe that is introduced from a medial portal. Normal widening of the diastasis should be approximately 1 mm.…”

Section: Imaging Studiesmentioning

confidence: 99%

Section: Clinical Interventionmentioning

confidence: 99%

See 2 more Smart Citations

Ankle Syndesmosis Injuries: Anatomy, Biomechanics, Mechanism of Injury, and Clinical Guidelines for Diagnosis and Intervention

Lin

Gross

Weinhold

2006

J Orthop Sports Phys Ther

178

149

View full text Add to dashboard Cite

show abstract

“…This is the reason for the susceptibility to injury of the syndesmosis. From a cadaveric study, it emerged that the AITFL confers 35 %, the TTFL 33 %, the IOL 22 %, and the PITFL 9 % of the overall tibiofibular stability, with evidence of severe instability when two of the ligaments are disrupted [12]. When the AITFL is transected, the combined lateral translation (2 mm), shortening (2 mm), and external rotation (5°) of the fibula will significantly decrease the contact area between the tibia and talus, it will increase the contact pressures, and the mortise will be deformed.…”

Section: Biomechanics and Mechanism Of Injurymentioning

confidence: 99%