Dynamische Ganganalyse bei blockiertem distalem Tibiofibulargelenk nach Syndesmosenkomplexverletzungen

Abstract

The temporary blockage of the TFJ results into an altered pattern of dynamic plantar pressure distribution. A constant foot progression angle in relative internal rotation is registered. After removal of the positioning screw the recovered ligamentous structures allow retraction to the anatomic position. But, concerning fibular torsional differences > 15 degrees osseous fixation leads to alterated fpa presented as diminished external rotation of the foot of the formerly fractured ankle with consecutive dysfunction of the physiologic kinematic of movement and eventual provocation of posttraumatic arthritis.

Accuracy of Corrective Osteotomies in Fibular Malunion: A Cadaver Model

“…after malleolar fractures. 1,5,6,7,8,9,11 Accordingly, the operative correction of malposition or malunion is essential. 4,10 Computerized tomography (CT) scanning is recommended for the detection of residual malalignment and preoperative planning of the correction.…”

“…4,10 Computerized tomography (CT) scanning is recommended for the detection of residual malalignment and preoperative planning of the correction. 7,9,12 While different methods are described for measuring this displacement, the physiologic range of fibular rotation is unknown. 9,12 Nonetheless, measurement using CT is accepted as the most precise method.…”

“…7,9,12 While different methods are described for measuring this displacement, the physiologic range of fibular rotation is unknown. 9,12 Nonetheless, measurement using CT is accepted as the most precise method. 9,12 Recommendations for acceptable residual displacement vary widely.…”

“…9,12 Nonetheless, measurement using CT is accepted as the most precise method. 9,12 Recommendations for acceptable residual displacement vary widely. Vasarelyi et al 9 conclude from their clinical trial that malrotation of more than 15 degrees should be corrected, while Thordarson et al 8 concluded from biomechanical experiments that malrotations of more than 5 degrees may need correction.…”

“…9,12 Recommendations for acceptable residual displacement vary widely. Vasarelyi et al 9 conclude from their clinical trial that malrotation of more than 15 degrees should be corrected, while Thordarson et al 8 concluded from biomechanical experiments that malrotations of more than 5 degrees may need correction. It is generally recommended, that shortening or lateral displacement of the fibula of 2 mm or more should be corrected.…”