Overtightening of the Ankle Syndesmosis: Is It Really Possible?

Tornetta, P.; Spoo, Jeffrey E.; Reynolds, Fletcher A.; Lee, Cassandra

doi:10.2106/00004623-200104000-00002

Cited by 147 publications

(104 citation statements)

References 5 publications

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“…The distal tibiofibular articulation stability was assessed by direct observation and fluoroscopically. The tibiofibular articulation had less than 1 mm of diastasis and the superior clear space was not more than 1 mm different than the medial clear space under stress in all cases; this was our determinant of adequate stabilization [3,28].…”

Section: Methodsmentioning

confidence: 75%

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Posterior Malleolar Stabilization of Syndesmotic Injuries is Equivalent to Screw Fixation

Miller¹,

Carroll²,

Parker³

et al. 2010

Clinical Orthopaedics &Amp; Related Research

212

150

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Background Fixation of unstable ankle fractures, including fixation of posterior malleolus fracture fragments with the attached, intact posteroinferior tibiofibular ligament (PITFL), reportedly provides more stable fixation than transsyndesmotic screws. Questions/Purposes To confirm this observation we compared the Foot and Ankle Outcome Score (FAOS) and radiographic maintenance of fixation for fractures treated through direct posterior malleolar fixation versus syndesmotic screw fixation. Methods We prospectively followed 31 one patients with unstable ankle fractures treated with (1) open posterior malleolus fixation whenever the posterior malleolus was fractured, regardless of fragment size (PM group; n = 9); (2) locked syndesmotic screws in the absence of a posterior malleolar fracture (S group; n = 14); or (3) combined fixation in fracture-dislocations and more severe soft tissue injury (C group; n = 8). All patients had preoperative MRI confirming syndesmotic injury and an intact PITFL; postoperative and followup radiographs were evaluated for syndesmotic congruence. The minimum followup was 12 months (mean, 15 months; range, 12-31 months).

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Section: Methodsmentioning

confidence: 75%

“…Displaced fractures typically are treated operatively to restore anatomic alignment of joint surfaces, reduce tibiotalar contact stresses, and minimize posttraumatic arthritis [1,2,14,24,25,28,29,32]. Treatment of these fractures must include intraoperative examination of the syndesmosis to ensure its integrity.…”

Section: Introductionmentioning

confidence: 99%

Posterior Malleolar Stabilization of Syndesmotic Injuries is Equivalent to Screw Fixation

Miller¹,

Carroll²,

Parker³

et al. 2010

Clinical Orthopaedics &Amp; Related Research

212

150

View full text Add to dashboard Cite

show abstract

“…151 However, more recent literature does not support this. 152,153 Thus, it is the surgeon's choice in determining the position of the ankle during fixation. However, in the setting of a posterior malleolar fracture, the authors do not recommend dorsiflexion to minimize iatrogenic posterior translation of the fibula.…”

Section: Implant Placementmentioning

confidence: 99%

Acute and Chronic Injuries to the Syndesmosis

Switaj

Mendoza

Kadakia

2015

Clinics in Sports Medicine

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“…Two syndesmotic screws provide superior stability, as compared with one [45], but biomechanical stability and outcomes are no different when three-cortical is compared with four-cortical screw placement [48,57,59,60]. The position of the foot during insertion of the syndesmotic screw does not impact final ankle range-of-motion or clinical outcome [61,62].…”

Section: Trans-syndesmotic Screwsmentioning

confidence: 99%

Syndesmosis injuries

Hunt

2013

Curr Rev Musculoskelet Med

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Traumatic injuries to the distal tibiofibular syndesmosis commonly result from high-energy ankle injuries. They can occur as isolated ligamentous injuries and can be associated with ankle fractures. Syndesmotic injuries can create a diagnostic and therapeutic challenge for musculoskeletal physicians. Recent literature has added considerably to the body of knowledge pertaining to injury mechanics and treatment outcomes, but there remain a number of controversies regarding diagnostic tests, implants, techniques, and postoperative protocols. Use of the novel suture button device has increased in recent years and shows some promise in clinical and cadaveric studies. This article contains a review of syndesmosis injuries, including anatomy and biomechanics, diagnosis, classification, and treatment options.

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Overtightening of the Ankle Syndesmosis: Is It Really Possible?

Cited by 147 publications

References 5 publications

Posterior Malleolar Stabilization of Syndesmotic Injuries is Equivalent to Screw Fixation

Posterior Malleolar Stabilization of Syndesmotic Injuries is Equivalent to Screw Fixation

Acute and Chronic Injuries to the Syndesmosis

Syndesmosis injuries

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