Isolated syndesmotic injuries in acute ankle sprains: diagnostic significance of clinical examination and MRI

Großterlinden, Lars; Hartel, Maximilian; Yamamura, Jin; Schoennagel, Bjoern P.; Burger, N.D.L.; Krause, Matthias; Spiro, A. G.; Hoffmann, Michael; Lehmann, Wolfgang; Rueger, Johannes M.; Rupprecht, Martin

doi:10.1007/s00167-015-3604-x

Cited by 36 publications

(52 citation statements)

References 37 publications

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“…Se analizaron un total de 16 artículos, todos ellos de los 10 últimos años. Según la escala USPSTF 21 , los niveles de evidencia en 2 de ellos fue I 5,22 , en 6 fue II-1 [23][24][25][26][27][28] y el resto II-2 [29][30][31][32][33][34][35][36] . Un total de 1337 pacientes fueron analizados (Tabla II).…”

Section: Resultsunclassified

“…En la mayoría de los artículos no se especifican los síntomas principales de la lesión 5,[26][27][28][29][30][31][34][35][36] exceptuando algunos de ellos que sí que manifiestan los síntomas principales que padece el paciente [22][23][24][25]29,32,33 (Tabla III).…”

Section: Resultsunclassified

“…De las principales pruebas analizadas en cada artículo, las más utilizadas coincidiendo según los diferentes autores son la prueba de Cajón Anterior 5,22,24,29,31,35 , prueba de Rotación Externa 5,22,31,32,35 , Star Excursion Balance Test 24,26,28,30,33 y Squeeze Test 5,22,31,32,35 (Tabla III).…”

Section: Resultsunclassified

“…32 , Lars y cols. 31 , Cailbhe y cols. 29 , donde dicen que las maniobras clínicas utilizadas son insuficientes y limitadas para un correcto diagnóstico, teniendo que complementarlas con otras pruebas más específicas y sensibles para confirmar la lesión de entorsis de tobillo.…”

Section: Discussionunclassified

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Maniobras clínicas en el diagnóstico de la entorsis de tobillo: una revisión de la literatura

Tor¹,

Pérez-Morcillo²,

Alfaro-Santafé³

et al. 2019

Rev. Esp. Pod.

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Section: Resultsunclassified

Section: Discussionunclassified

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Maniobras clínicas en el diagnóstico de la entorsis de tobillo: una revisión de la literatura

Tor¹,

Pérez-Morcillo²,

Alfaro-Santafé³

et al. 2019

Rev. Esp. Pod.

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“…The syndesmotic ligaments, including the anterior inferior tibiofibular ligament (AITFL), the posterior inferior tibiofibular ligament (PITFL), and the interosseous tibiofibular ligament (ITFL) were graded as follows: unaffected (grade 0), hyperintense signal alterations on T2-weighted images (grade 1), partial tear (grade 2, partial discontinuity but preserved remnant fibers), and complete tear (grade 3, complete discontinuity of the ligament). 10 Widening of the syndesmosis was measured separately for the anterior width of syndesmosis and the posterior width of syndesmosis on transverse T2-weighted images. 4 Malreduction of the syndesmosis was defined as a 2-mm difference in the width of the syndesmosis, separately for anterior and posterior syndesmosis, compared with the untreated contralateral ankle.…”

Section: Methodsmentioning

confidence: 99%

Five-Year Outcomes After Treatment for Acute Instability of the Tibiofibular Syndesmosis Using a Suture-Button Fixation System

Förschner

Beitzel

Imhoff

et al. 2017

Orthopaedic Journal of Sports Medicine

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Background:Suture-button repair is a widely accepted surgical treatment for acute and isolated ankle syndesmosis injuries. To our knowledge, midterm results have not previously been reported.Purpose:To evaluate the clinical, qualitative, and quantitative radiological midterm outcomes of suture-button repair after acute isolated ankle syndesmosis injuries.Study Design:Retrospective case series; Level of evidence, 4.Methods:Clinical outcomes were measured using the Foot and Ankle Disability Index (FADI) and the American Orthopaedic Foot and Ankle Society (AOFAS) score. Three-tesla magnetic resonance imaging (MRI) was performed bilaterally at the ankle. Besides morphological sequences for evaluation of the syndesmosis and degenerative changes of the ankle using the Ankle Osteoarthritis Scoring System (AOSS), the MR protocol included a coronal 2-dimensional multislice multiecho sequence for quantitative cartilage T2-weighted mapping. Spearman correlations and paired t tests were used for statistical analysis.Results:This retrospective study included 19 consecutive patients (mean age, 29.7 ± 11.5 years) with acute isolated syndesmosis injuries treated with a suture-button system between January 2006 and June 2014, with a mean follow-up of 5.1 ± 2.6 years. Postoperatively, the median FADI score was 136 (range, 78-136), and the median AOFAS score was 100 (range, 87-100). Seventeen (89.5%) patients reported to have reached their preinjury level of sports activities. MRIs of 16 patients were obtained and all showed intact anterior and posterior syndesmotic ligaments; however, in most patients, the previously injured syndesmotic ligament was thickened compared with the uninjured ankle. Average width of the anterior (P = .81) and posterior (P = .60) syndesmosis was not significantly different between the ipsilateral (3.2 ± 1.2 and 4.4 ± 0.9 mm) and contralateral ankles (3.0 ± 0.6 and 4.2 ± 0.7 mm). The median AOSS score was 1.5 (range, 0-11) for the ipsilateral ankle and 0 (range, 0-6) for the contralateral ankle. T2 values of articular cartilage did not significantly differ between the involved and the uninjured ankle (P = .68). Five patients needed hardware removal due to persistent skin irritation, and 1 patient suffered from reinstability of the ankle resulting in revision surgery 2 years after the index surgery.Conclusion:Suture-button fixation is an excellent treatment for acute and isolated syndesmosis injuries, resulting in stable ankles without early or advanced osteoarthritic changes at midterm follow-up.

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Syndesmotic Injuries

Lintz

Fernando

Bernasconi

et al. 2022

Tendon and Ligament Injuries of the Foot and Ankle

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Isolated syndesmotic injuries in acute ankle sprains: diagnostic significance of clinical examination and MRI

Abstract: I.

Cited by 36 publications

References 37 publications

Maniobras clínicas en el diagnóstico de la entorsis de tobillo: una revisión de la literatura

Maniobras clínicas en el diagnóstico de la entorsis de tobillo: una revisión de la literatura

Five-Year Outcomes After Treatment for Acute Instability of the Tibiofibular Syndesmosis Using a Suture-Button Fixation System

Syndesmotic Injuries

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