Evaluation of the Syndesmotic Screw in Low Weber C Ankle Fractures

Kennedy, John G.; Soffe, Karen; Vedova, Pietro Dalla; Stephens, Michael M.; O'Brien, Timothy; Walsh, M. G.; McManus, F.

doi:10.1097/00005131-200006000-00010

Cited by 120 publications

(83 citation statements)

References 24 publications

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“…Failure to reproduce the anatomic relationship of the distal tibia and fibula leads to altered loading of the tibiotalar joint (Ramsay and Hamilton 1976, Thordarson et al 1997, Harris and Fallat 2004, Lloyd et al 2006, Thordarsson 2012 with subsequent post-traumatic arthritis (Lindsjö 1981, Pettrone et al 1983, Leeds et al 1984, Lindsjö 1985, Rukavina 1998, Thordasson 2012 and poor functional outcomes (Joy et al 1974, Pettrone et al 1983, Mont et al 1992, Kennedy et al 2000, Weening et al 2005, Wikerøy et al 2009, Sagi et al 2012. The more structures showing residual displacement, the poorer the outcome (Pettrone et al 1983).…”

Section: Malreduction Loss Of Reduction and Post-traumatic Osteoarthmentioning

confidence: 99%

Complications in ankle fracture surgery

Ovaska¹

2015

Acta Orthop

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Section: Malreduction Loss Of Reduction and Post-traumatic Osteoarthmentioning

confidence: 99%

Complications in ankle fracture surgery

Ovaska¹

2015

Acta Orthop

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“…Normal tibiofibular overlap for the AP view is more than 6 mm or more than 42% of the fibular width. 23,27 Normal tibiofibular overlap for the mortise view ( Figure 9) should be more than 1 mm. 23,27 All measurements of tibiofibular clear space and tibiofibular overlap are made 1 cm above the tibia plafond.…”

Section: Imaging Studiesmentioning

confidence: 99%

“…The 2 groups did not demonstrate significant differences with regard to pain, stiffness, swelling, and the ability to return to work. Kennedy et al 27 concluded that there was no advantage to using syndesmotic screws in addition to their internal fixation method for these patients. Yamaguchi et al 60 treated a similar series of 21 patients and reported that syndesmotic screw fixation was necessary only if the fibular fracture was more than 4.5 cm proximal to the tibiotalar joint line and if deltoid ligament tears were present.…”

Section: Clinical Interventionmentioning

confidence: 99%

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

Lin

Gross

Weinhold

2006

J Orthop Sports Phys Ther

177

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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“…It should be remembered that there exists abundant literature over the past 50 years documenting relatively good outcomes after ORIF of rotational ankle fractures with fixation of concurrent syndesmotic instability using various combinations of traditional plate/screw/ washer constructs. In the face of syndesmotic injury with associated fractures requiring ORIF, this form of repair in the absence of any other management has proven reliable over time for myriad patients [57,[64][65][66][67].…”

Section: Operative Treatment For Isolated Syndesmotic Injuriesmentioning

confidence: 99%

Current trends in the diagnosis and management of syndesmotic injury

Vopat

Lubberts

et al. 2017

Curr Rev Musculoskelet Med

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Ideal management of the various presentations of syndesmotic injury remains controversial to this day. High quality evidentiary science on this topic is rare, and numerous existing studies continue to contradict one another. The primary reasons for these discrepancies are that previous studies have failed to (1) properly distinguish between isolated (nonfractured) and non-isolated injuries, (2) accurately define stable from unstable injuries, and (3) sufficiently differentiate between acute and chronic injuries. The purpose of this review is to summarize today's body of literature regarding diagnosis and management of syndesmotic injury and discuss current trends and important future directions to optimize care of this very heterogeneous population.

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Evaluation of the Syndesmotic Screw in Low Weber C Ankle Fractures

Abstract: Judicious fixation of Weber C type injuries within five centimeters of the ankle joint, with or without a syndesmotic screw, gives similar results. Obligatory fixation of these fractures with syndesmotic screws appears to have no benefit and creates the need for an additional procedure.

Cited by 120 publications

References 24 publications

Complications in ankle fracture surgery

Complications in ankle fracture surgery

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

Current trends in the diagnosis and management of syndesmotic injury

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