A new assessment for syndesmosis injury – The ‘Chertsey test’

Boyd, R; Nawaz, Syed Zuhair; Khaleel, A.

doi:10.1016/j.injury.2016.03.005

Cited by 8 publications

(10 citation statements)

References 10 publications

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“…The distal tibiofibular syndesmosis comprises 2 bones and 4 ligaments and is a delicate structure. It provides a dynamic relationship for the tibia and fibula during ankle motion (19,20). The main treatment of distal tibiofibular syndesmosis injury includes conservative care and surgery.…”

Section: Discussionmentioning

confidence: 99%

Novel Elastic Syndesmosis Hook Plate Fixation Versus Routine Screw Fixation for Syndesmosis Injury

Xian

Miao

Zhou

et al. 2018

The Journal of Foot and Ankle Surgery

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Unstable external-rotation type ankle fractures with concomitant syndesmosis injury commonly occur. Syndesmosis screw fixation has long been regarded as a reference standard treatment for syndesmosis injury. However, its complications and biomechanical disadvantages have become controversial; thus, we designed a novel elastic syndesmosis hook plate (ESHP) that combines the features of both rigidity and flexibility. The purpose of the present study was to introduce this new method and compare its clinical outcomes with those of routine screw fixation. We randomized 25 patients to the screw fixation group and ESHP group. The average follow-up period was 12 months. The clinical outcomes included malreduction or loss of reduction, overall complications, and function. During the follow-up period, 3 cases (25%) of malreduction were found in screw fixation group on postoperative computed tomography. In the ESHP group, only 1 patient (7.69%) had a narrowed anterior gap between the distal tibia and fibula. However, the difference in the malreduction rate between the 2 groups was not significant statistically (p = .32). The overall complication rate in the ESHP group was lower than that in the screw group, although no significant differences were found between the 2 groups. The mean visual analog scale scores in the ESHP and screw groups were 1.46 ± 1.33 and 2.42 ± 2.07, respectively. The average dorsiflexion range of motion in both groups was satisfactory (14.77° versus 12.83°; p = .16). However, a statistically significant difference was found in the plantarflexion range of motion between the 2 groups (p < .05). In addition, the ESHP group had an earlier time to return to work (p < .05). The ESHP fixation construct can stably fix syndesmosis, retain the physiologic micromotion function of the syndesmosis, and results in fewer complications compared with routine syndesmosis screw fixation for syndesmotic instability. In conclusion, our results have shown ESHP to be a viable method for treatment of syndesmosis instability.

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Section: Discussionmentioning

confidence: 99%

Novel Elastic Syndesmosis Hook Plate Fixation Versus Routine Screw Fixation for Syndesmosis Injury

Xian

Miao

Zhou

et al. 2018

The Journal of Foot and Ankle Surgery

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“…A 20-gauge needle was inserted into the lateral aspect of the ankle joint and 2 to 4 mL radio-opaque contrast injected. 1 Anteroposterior (AP) and lateral radiographs were obtained by the image intensifier. If the contrast dye was seen tracking up to the syndesmotic space, the test was determined positive and syndesmotic fixation was performed.…”

Section: Methodsmentioning

confidence: 99%

“…Some surgeons prefer ankle arthroscopy, but the technique is invasive and requires surgical experience. 7,12,20,23 Recently, Boyd et al 1 found a new intraoperative assessment for the syndesmosis injury called the Chertsey test. The test includes an ankle arthrogram by contrast dye injection, and if a syndesmotic injury occurs, the radio-opaque contrast collects in the syndesmotic area.…”

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confidence: 99%

A Radiographic Dye Method for Intraoperative Evaluation of Syndesmotic Injuries

et al. 2017

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“…4 Further fixation is required with syndesmotic disruption since the ankle mortise is highly unstable and severe joint complications may result if the fracture is not properly reduced. 4,5 Diabetes and obesity, body mass index (BMI) ≥30.0 kg/m 2 , are 2 notable comorbidities that have been previously studied for their impact on fracture recovery. Diabetes' detrimental effects on wound healing are well-known.…”

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confidence: 99%

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confidence: 99%