Intraoperative three-dimensional imaging in the treatment of acute unstable syndesmotic injuries

Complications in ankle fracture surgery

“…However, recent studies with computed tomography (CT) have revealed, that the rate of syndesmotic malreduction is higher than previously thought , Vasarhelyi et al 2006, Mukhopadhyay et al 2011, Franke et al 2012, Davidovitch et al 2013. There is substantial anatomic variability in the tibiofibular incisure (Elgafy et al 2010, Mukhopadhyay et al 2011, Lepojärvi et al 2013, and the risk for syndesmotic malreduction is especially high in patients with flatter tibiofibular articulations (Elgafy et al 2010).…”

“…Fracture comminution, poor bone quality, and technical errors may predispose a patient to residual displacement following ankle fracture surgery , Lübbeke et al 2012. Recent studies with CT scan have revealed that proper reduction of a syndesmotic injury is especially demanding , Vasarhelyi et al 2006, Miller et al 2009, Mukhopadhyay et al 2011, Franke et al 2012, Sagi et al 2012, Davidovitch et al 2013. In a large population based study with 57,183 patients, the rate of revision ORIF following ankle fracture surgery was 0.8% within the first three postoperative months (Soohoo et al 2009).…”

“…It has recently been demonstrated that proper reduction of syndesmosis is technically more demanding than previously thought (Miller et al 2009, Mukhopadhyay et al 2011, Franke et al 2012, Sagi et al 2012. Direct visualization and open reduction of the syndesmosis has been recommended (Miller et al 2009), since lateral translation and rotational malalignment of the fibula at the level of the syndesmosis may go underdetected (Marmor et al 2011).…”

Complications in ankle fracture surgery

“…This is reflected in our findings, since the majority of reoperated cases were due to syndesmotic malreduction (III). Studies have revealed a large variation in syndesmosis anatomy regarding the degree of incisura concavity and the position of the fibula within it (Elgafy et al 2010, Mukhopadhyay et al 2011, Franke et al 2012, Sagi et al 2012. Additionally, recent studies have shown that syndesmotic transfixation may not be necessary in type B ankle fractures despite intraoperatively confirmed syndesmotic disruption (Pakarinen et al 2011c, Kortekangas et al 2014).…”

Current trends in the diagnosis and management of syndesmotic injury

“…This is especially troublesome when considering that this injury is most prevalent between the ages of 18 and 34 [1]. Non-isolated injury to the syndesmosis has been reported to be associated with 8.5% of all ankle injuries [8], although studies have documented up to 25% of operatively treated ankle fractures being identified with unstable syndesmosis injuries, most commonly occurring in Weber type C injuries [9][10][11].…”