Periosteal stripping in high ankle sprains: An association with osteonecrosis

Baldassarre, Randall L.; Pathria, Mini N.; Huang, Brady K.; Dwek, Jerry R.; Fliszar, Evelyne

doi:10.1016/j.clinimag.2020.07.032

Cited by 5 publications

(7 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There are several limitations in our study. (1) We chose to measure FN related parameters at 10 mm above tibial plafond, which is consistent with previous studies and convenient to compare with similar studies. But some studies also believed that the best measurement site was 5 mm above.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 91%

“…A nkle sprain is one of the most common sports injuries, and about 20% of them involve syndesmosis, 1 known as high ankle sprain (HAS). It is nearly three to four times more severe than lateral ankle sprain and medial ankle sprain, [1][2][3] and requires a longer recovery time, averaging 13.9 days, compared with 8.1 days for lateral ankle sprain and 10.7 days for medial ankle sprain.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

In Different Gender Groups, What Is the Impact of the Fibular Notch on the Severity of High Ankle Sprain: A Retrospective Study of 360 Cases

Chen

Peng

Yang

et al. 2023

Orthopaedic Surgery

View full text Add to dashboard Cite

ObjectivesThe role of the distal tibiofibular ligament in the occurrence of high ankle sprain (HAS) has been widely studied. But previous studies have overlooked the physiological and anatomical differences between males and females and have not further refined gender. Therefore, the impact of the anatomical morphology of fibular notch (FN) on HAS in different genders is still unclear. This study aimed to explore the impact of different types of FN on the severity of HAS and to estimate the prognosis of patients with HAS while excluding anatomical differences caused by gender.MethodsOne hundred and eighty patients with HAS were included in this study as the experimental group (i.e., HAS group). They were further divided into four groups according to gender and FN depth, with deep concave FN ≥ 4 mm and shallow flat FN < 4 mm. Another 180 normal individuals were set as the control group. The FN morphological indicators, tibiofibular distance (TFD), and ankle mortise indexes were measured and compared with those in HAS group. The independent t‐test was used to compare continuous variables between groups, the intraclass correlation coefficient (ICC) was used to analyze the reliability of intra‐observer measurement, and the Pearson correlation coefficient was used to verify the correlation between FN and the severity of HAS.ResultsIn males with shallow flat type, the measurements of anterior tibiofibular distance (aTFD), middle tibiofibular distance (mTFD), posterior tibiofibular distance (pTFD), front ankle mortise width (fAMW), middle ankle mortise width (mAMW), posterior ankle mortise width (pAMW), and depth of ankle mortise (DOAM) in HAS group were significantly larger than those in normal group (p < 0.05). In male patients with deep concave type, the measurements of aTFD, mTFD, fAMW, mAMW, and DOAM were significantly larger than those in normal group (p < 0.05). Among female patients with shallow flat type, the measurements of aTFD, mTFD, pTFD, fAMW, mAMW, pAMW, and DOAM were found to be significantly larger than those in normal group (p < 0.05). Among female patients with deep concave type, the measurements of mTFD, pTFD, fAMW, mAMW, and DOAM were found to be significantly larger than those of the normal group (p < 0.05). The depth of FN was negatively correlated with TFD, and the AOFAS score of patients with shallow flat type was significantly lower than that of patients with deep concave type after treatment (p < 0.05).ConclusionsIn different gender groups, compared with the normal controls, the TFD and partial ankle mortise indices were significantly different in HAS patients. Moreover, FN depth was negatively correlated with TFD, and the AOFAS score of shallow flat patients was significantly lower than that of deep concave patients. These suggested that shallow flat FN may be associated with more severe distal tibiofibular ligament injury and ankle mortise widening, leading to poorer prognosis. This should be taken seriously in clinical practice.

show abstract

Section: Strengths and Limitations Of This Studymentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

In Different Gender Groups, What Is the Impact of the Fibular Notch on the Severity of High Ankle Sprain: A Retrospective Study of 360 Cases

Chen

Peng

Yang

et al. 2023

Orthopaedic Surgery

View full text Add to dashboard Cite

show abstract

“…Four ligaments comprise the syndesmotic ankle ligament complex (Figure 1): the anterior inferior tibiofibular ligament (AITFL), commonly injured first; the posterior inferior tibiofibular ligament (PITFL); the transverse ligament; and the interosseus ligament (IOL). 6,7 The AITFL provides 35%, the IOL provides 22%, and the combined PITFL and transverse ligament provides 42% of the strength of the syndesmosis. 8 Grade I, II, and III injuries include combinations of damage to the AITFL, IOL, and PITFL.…”

Section: Pertinent Anatomymentioning

confidence: 99%

“…24,26,27,29 Greater tensile strength in ligaments of children may favor fractures, periosteal stripping, osteochondral injuries, and avulsions over sprains. 7,35 Therefore, when ligamentous injuries occur in the younger populations, these are more easily missed and can result in poorer outcomes with persistent disability. 4,7,34,36…”

Section: Mechanism Of Injurymentioning

confidence: 99%

See 1 more Smart Citation

Pediatric Ankle Syndesmosis Injuries

Alexanian¹,

Loveland²,

Friebele³

2022

Journal of the Pediatric Orthopaedic Society of North America

View full text Add to dashboard Cite

Ankle syndesmosis injuries occur in 1% of pediatric ankle trauma. In the younger populations, an open physis has been thought to be a protective factor against syndesmotic injury and therefore favors more Salter-Harris type injuries. Clinical methods used to diagnose syndesmotic injuries may not be effective in the pediatric population. Radiographic findings are mostly based on the study of adolescent and adult populations. Therefore, syndesmotic injuries may be overlooked in the younger pediatric patient with ankle trauma and open physes. Here we present a review of the literature of ankle syndesmotic injuries and demonstrate how isolated injury can be missed in the younger pediatric patient. Further research is needed to fully characterize clinical exam and radiographic findings of syndesmotic injury in the younger pediatric patient and how these may change with time and growth. Key Concepts• Diagnosis of ankle syndesmotic injuries, including isolated injuries, in children is difficult and has different criteria for diagnosis than in adults.• Syndesmotic anatomy changes with growth and false positives or negatives in diagnosis are possible using plain radiographs alone.• Stress radiographs, bilateral radiographs, and MRI imaging should be considered when clinical suspicion is high.• Consider tightrope fixation in lieu of syndesmotic screws as recent literature in adolescents supports it as equivalent or superior regarding patient outcomes.

show abstract

Use of Musculoskeletal Ultrasound and Regenerative Therapies in Sports

Castro

2022

Musculoskeletal Ultrasound-Guided Regenerative Medicine

View full text Add to dashboard Cite

Periosteal stripping in high ankle sprains: An association with osteonecrosis

Cited by 5 publications

References 20 publications

In Different Gender Groups, What Is the Impact of the Fibular Notch on the Severity of High Ankle Sprain: A Retrospective Study of 360 Cases

In Different Gender Groups, What Is the Impact of the Fibular Notch on the Severity of High Ankle Sprain: A Retrospective Study of 360 Cases

Pediatric Ankle Syndesmosis Injuries

Use of Musculoskeletal Ultrasound and Regenerative Therapies in Sports

Contact Info

Product

Resources

About