The ALL was consistently found in all knees. Segond fractures appear to occur primarily from the avulsion of the ALL.

The reduced early elongation of open repairs suggests that patients treated with this technique may be able to progress through an earlier and/or more aggressive postoperative rehabilitation protocol with a lower risk of early irrevocable repair elongation or gapping about the repair site. However, in cases where cosmesis or wound-healing complications are of significant concern, minimally invasive percutaneous techniques provide a biomechanically reasonable alternative based on their repair strengths (cycles to failure). These repairs may need to be protected longer postoperatively to allow for biological healing and avoid early repair elongation and potential gapping between the healing tendon ends.

This study defined normal motion of the syndesmosis and the biomechanical consequences of injury. The degree of instability was increased with each additional injured structure; however, isolated injuries to the AITFL alone may lead to significant external rotary instability.

Residual internal rotation and a positive pivot shift after ACL reconstruction may be attributed to ALL injury. For these patients, surgical treatment of an ALL tear may be considered.

Background: Citation rate and journal impact factor have traditionally been used to assess research impact; however, these may fail to represent impact beyond the sphere of academics. Given that social media is now used to disseminate research, alternative web-based metrics (altmetrics) were recently developed to better understand research impact on social media. However, the relationship between altmetrics and traditional bibliometrics in orthopaedic literature is poorly understood. Purpose: To (1) assess the extent that altmetrics correlate with traditional bibliometrics and (2) identify publication characteristics that predict greater altmetrics scores. Study Design: Cross-sectional study. Methods: Articles published in The American Journal of Sports Medicine ( AJSM), The Journal of Bone and Joint Surgery, Clinical Orthopaedics and Related Research, Acta Orthopaedica, and Knee Surgery, Sports Traumatology, Arthroscopy between January 2016 and December 2016 were analyzed. Among the extracted publication characteristics were journal, number of authors, geographic region of origin, highest degree of first author, study subject and design, sample size, conflicts of interest, and level of evidence; number of references, institutions, citations, tweets, Facebook mentions, and news mentions; and Altmetric Attention Score (AAS). Multivariate regressions were used to determine (1) publication characteristics predictive of AAS and social media attention (mentions on Twitter, Facebook, and the news) and (2) the relationship between AAS and citation rate. Results: A total of 496 published articles were included, with a mean AAS of 8.6 (SD, 31.7; range, 0-501) and a mean citation rate of 15.0 (SD, 16.1; range, 0-178). Articles in AJSM (β = 19.9; P < .001), publications from North America (β = 8.5; P = .033), and studies concerning measure validation/reliability (β = 25.5; P = .004) were independently associated with higher AAS. Greater AAS score significantly predicted a greater citation rate (β = 0.16; P < .0001). The citation rate was an independent predictor of greater social media attention on Twitter, Facebook, and the news (odds ratio range, 1.02-1.03; P < .05 all). Conclusion: AAS had a significant positive association with citation rates of articles in 5 high-impact orthopaedic journals. Articles in AJSM, studies concerning measure validation and reliability, and publications from North America were positively associated with greater AAS. A greater number of citations was consistently associated with publication attention received on social media platforms.

Constructs were comparable across most conditions; however, when repairing injuries with a suture-button construct, a single suture-button construct may not provide sufficient resistance to sagittal translation of the fibula.

Background Stress radiography is a widely used diagnostic tool to assess injury to the anterior and posterior cruciate ligaments and the medial and lateral structures of the knee. However, to date, numerous techniques have been reported in the literature with no clear consensus as to which methodology is best for assessing ligament stability.

Significant increases in residual internal rotation and laxity during the pivot-shift test may exist in both acute and chronic settings of an ACL deficiency and in patients treated with isolated ACLR for a combined ACL and ALL deficiency. For this subset of patients, surgical treatment of the ALL, in addition to ACLR, should be considered to restore knee stability.