Radiographic and CT Evaluation of Tibiofibular Syndesmotic Diastasis: A Cadaver Study

Ebraheim, Nabil A.; Lu, Jian; Yang, Hua; Mekhail, Anis O.; Yeasting, Richard A.

doi:10.1177/107110079701801103

Cited by 247 publications

(157 citation statements)

References 23 publications

Supporting

Mentioning

137

Contrasting

Unclassified

Order By: Relevance

“…First, we evaluated the syndesmosis reduction only with radiographs. Several studies suggest radiographic evaluations are insensitive when evaluating the syndesmosis [3,7,27]. Gardner et al reported a 52% malreduction seen on CT as compared with apparently well-reduced fractures on plain radiographs [11].…”

Section: Discussionmentioning

confidence: 99%

Posterior Malleolar Stabilization of Syndesmotic Injuries is Equivalent to Screw Fixation

Miller¹,

Carroll²,

Parker³

et al. 2010

Clinical Orthopaedics &Amp; Related Research

215

150

View full text Add to dashboard Cite

Background Fixation of unstable ankle fractures, including fixation of posterior malleolus fracture fragments with the attached, intact posteroinferior tibiofibular ligament (PITFL), reportedly provides more stable fixation than transsyndesmotic screws. Questions/Purposes To confirm this observation we compared the Foot and Ankle Outcome Score (FAOS) and radiographic maintenance of fixation for fractures treated through direct posterior malleolar fixation versus syndesmotic screw fixation. Methods We prospectively followed 31 one patients with unstable ankle fractures treated with (1) open posterior malleolus fixation whenever the posterior malleolus was fractured, regardless of fragment size (PM group; n = 9); (2) locked syndesmotic screws in the absence of a posterior malleolar fracture (S group; n = 14); or (3) combined fixation in fracture-dislocations and more severe soft tissue injury (C group; n = 8). All patients had preoperative MRI confirming syndesmotic injury and an intact PITFL; postoperative and followup radiographs were evaluated for syndesmotic congruence. The minimum followup was 12 months (mean, 15 months; range, 12-31 months).

show abstract

Section: Discussionmentioning

confidence: 99%

Posterior Malleolar Stabilization of Syndesmotic Injuries is Equivalent to Screw Fixation

Miller¹,

Carroll²,

Parker³

et al. 2010

Clinical Orthopaedics &Amp; Related Research

215

150

View full text Add to dashboard Cite

show abstract

“…Importantly, the deltoid ligament can be associated with syndesmotic sprain as they share similar external rotation and eversion mechanisms of injury [ 108 ]. Increased swelling, pain with palpation, ecchymosis over the medial ankle, and greater than 4 mm widening of the syndesmosis on plain fi lms may be indicative of deltoid ligament involvement [ 110 ]. Special clinical tests used for diagnosis of syndesmotic injury include the external rotation test, the squeeze test, the crossedleg test, the cotton test, the point test, the dorsifl exion maneuver, and one-legged hop test [ 108 ].…”

Section: Syndesmosis Instabilitymentioning

confidence: 98%

Epidemiology and Mechanisms of Ankle Pathology in Football

Anderson

Engebretsen

Kennedy³

et al. 2014

Sports and Traumatology

View full text Add to dashboard Cite

The ankle is one of the most commonly injured joints in football and represents a signifi cant cost to the healthcare system due to time lost from play. The ligaments that stabilize the ankle joint determine its biomechanics, and alterations of those normal biomechanics result from various football-related injuries. Acute sprains are generally treated conservatively, with emphasis placed on secondary prevention to reduce the risk of future sprains and progression to chronic ankle stability. Repetitive ankle injuries in footballers may cause chronic ankle instability, which include both mechanical ligamentous laxity and functional changes. Chronic ankle pathology often requires surgery to repair ligamentous damage and remove

show abstract

“…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%

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

View full text Add to dashboard Cite

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.

show abstract

Radiographic and CT Evaluation of Tibiofibular Syndesmotic Diastasis: A Cadaver Study

Cited by 247 publications

References 23 publications

Posterior Malleolar Stabilization of Syndesmotic Injuries is Equivalent to Screw Fixation

Posterior Malleolar Stabilization of Syndesmotic Injuries is Equivalent to Screw Fixation

Epidemiology and Mechanisms of Ankle Pathology in Football

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

Contact Info

Product

Resources

About