The management of acute distal tibio-fibular syndesmotic injuries: Results of a nationwide survey

Schepers, Tim; Zuuren, Wouter J. van; Bekerom, Michel P.J. van den; Vogels, L.M.M.; Lieshout, Esther M.M. Van

doi:10.1016/j.injury.2012.06.015

Cited by 61 publications

(47 citation statements)

References 45 publications

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“…Syndesmotic fixation was supposed to be necessary in cases of syndesmotic instability [37,38]. Currently, transsyndesmotic screw is still the predominant treatment [39].…”

Section: Discussionmentioning

confidence: 99%

Internal fixation of distal tibiofibular syndesmotic injuries: a systematic review with meta-analysis

Wang

et al. 2013

International Orthopaedics (SICOT)

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No consensus had been reached about the optimal method for syndesmotic fixation. The present study analysed syndesmotic fixation based on the highest level of clinical evidence in order to obtain more reliable results. Medline, Embase and Cochrane database were searched through the OVID retrieval engine. Manual searching was undertaken afterward to identify additional studies. Only randomized controlled trials (RCT) and prospective comparative studies were selected for final inclusion. Study screening and data extraction were completed independently by two reviewers. All study characteristics were summarized into a table. The extracted data were used for data analysis. Twelve studies were finally included: six of them were RCTs, two were quasi-randomized studies and four were prospective comparative studies. Four comparisons with traditional metallic screw were identified in terms of bioabsorbable screws, tricortical fixation method, suture-button device as well as non-fixation choice in low syndesmotic injuries. Both absorbable screws and the tricortical fixation method showed almost no better results than traditional quadricortical metallic screw (p>0.05). Additionally, existing studies could not illustrate their efficiency of reducing hardware removal rate. The suture button technique had significantly better functional score (p=0.003), ankle motion (p=0.02), time to full weightbearing (p<0.0001) and much less complications (p=0.0008) based on short and intermediate term follow-up data. Transfixation in low syndesmotic injuries showed poorer results than the non fixed group in all outcome measurements, but didn't reach a significant level (p>0.05). The present evidence still couldn't find superior performance of the bioabsorbable screw and tricortical fixation method. Their true effects in decreasing second operation rate need further specific studies. Better results of the suturebutton made it a promising technique, but it still needs long-term testing and cost-efficiency studies. The patients with low syndemotic injuries should be well assessed before fixation determination and the indication of screw placement in such conditions needs to be further defined.

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“…Syndesmotic fixation was supposed to be necessary in cases of syndesmotic instability [37,38]. Currently, transsyndesmotic screw is still the predominant treatment [39].…”

Section: Discussionmentioning

confidence: 99%

Internal fixation of distal tibiofibular syndesmotic injuries: a systematic review with meta-analysis

Wang

et al. 2013

International Orthopaedics (SICOT)

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“…The authors consider this injury pattern to have an entirely different natural history and spectrum of implications compared to those syndesmotic injuries which occur without fracture. Regardless, most surgeons advocating the above technique place one or two screws starting between 2.1 and 4.0 cm above the tibial plafond [41]. McBryde et al performed a cadaveric study that found that less syndesmotic widening was found at 2.0 cm when compared with 3.5 cm proximal to the tibotalar joint [42].…”

Section: Operative Treatment For Isolated Syndesmotic Injuriesmentioning

confidence: 99%

“…Recently, Schepers et al found that 87% of surgeons routinely remove the syndesmotic screw [41]. There has been disagreement in the literature, however, as to whether or not these screws should be retained as well as timing of removal 2 If comparative CT scanning is normal but there is still a high suspicion, further analysis can be performed by arthroscopic stress evaluation of the syndesmosis (a) in both the sagittal and coronal planes.…”

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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“…[81] Ortopedistler arasında yapılan bir anket çalışmasında, sindesmoz tespiti sonrasında çoğunluğun erken yük vermediği ortaya çıkmıştır. [75] …”

Section: Cerrahiunclassified

“…[70][71][72][73][74] Erken ya da geç dönem-de redüksiyon kaybı bildirilmemiştir. [75] Düğme dikiş-lere has bir komplikasyon, mediyaldeki düğmeye bağlı olarak tendon tuzaklanmasıdır. [76] Vidalarda da görü-lebilen düğme dikişlerin nadir bir komplikasyonu distal tibia kırığıdır.…”

Section: Kroni̇k Si̇ndesmoz Yaralanmalariunclassified

Akut ve kronik sindesmoz yaralanmaları

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2018

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The management of acute distal tibio-fibular syndesmotic injuries: Results of a nationwide survey

Cited by 61 publications

References 45 publications

Internal fixation of distal tibiofibular syndesmotic injuries: a systematic review with meta-analysis

Internal fixation of distal tibiofibular syndesmotic injuries: a systematic review with meta-analysis

Current trends in the diagnosis and management of syndesmotic injury

Akut ve kronik sindesmoz yaralanmaları

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