High-energy trauma can cause transsyndesmotic ankle fracture dislocation. These fractures are quite rare. Here we present a clinical case of a male patient with this type of injury. A systematic review of PubMed, Ovid MEDLINE, and Embase electronic databases revealed only two prior publications on a similar topic. We discuss the typical clinical features of these injuries, the treatment of high-energy trauma which can cause transsyndesmotic ankle fracture dislocation, and its prognosis.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6230424PMC
http://dx.doi.org/10.1155/2018/7902641DOI Listing

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Article Synopsis
  • - The study focuses on evaluating the effectiveness of trans-syndesmotic fixation in patients with SER type 4 ankle fractures after assessing syndesmosis using intraoperative tests.
  • - Results show that patients treated with trans-syndesmotic fixation had better outcomes in terms of ankle range of motion and scores on the AOFAS and OMAS compared to those who did not receive this fixation.
  • - However, the lack of fixation for the posterior malleolus significantly increases the risk of developing arthritis, highlighting the need for careful detection and treatment of syndesmotic injuries.
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Background: Due to the variability in evidence supporting either trans-syndesmosis fixation or deltoid ligament repair in unstable ankle fractures with medical clear space (MCS) widening makes it unclear which surgical technique leads to the best patient outcomes. The goal of our systematic review and meta-analysis was to compare clinical outcomes of trans-syndesmotic fixation versus anatomic deltoid ligament repair in the management of unstable ankle fractures with MCS widening.

Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were utilized in this study.

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High-Energy Transsyndesmotic Ankle Fracture Dislocation-Does Deltoid Ligament Repair Influence the Progression of Posttraumatic Arthritis in Logsplitter Injuries?

J Orthop Trauma

November 2024

Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University; London Health Sciences Centre, Victoria Hospital, London, ON, Canada.

Article Synopsis
  • The study aimed to assess how deltoid ligament repair impacts the onset of posttraumatic arthritis (PTOA) in patients with logsplitter ankle injuries treated with surgical fixation from 2008 to 2021.
  • A total of 59 patients were evaluated, revealing that 44% developed PTOA post-surgery, with a notable difference in outcomes based on whether deltoid ligament repair was performed.
  • Patients who had the ligament repaired showed a significantly lower PTOA rate (15%) compared to those who didn't (52%), indicating that this repair may help reduce long-term complications after such injuries.
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Incisura tangent method to determine the transsyndesmotic axis for syndesmotic fixation.

Foot Ankle Surg

January 2025

Graduate School of Medical and Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8670, Japan.

Background: Clamping along the transsyndesmotic (TS) axis decreases the risk of malreduction when reducing syndesmotic diastasis. We aimed to measure the difference between the TS axis and the axis determined by the newly proposed fluoroscopic incisura tangent (IT) method. The measurements were compared to those between the TS axis and those based on the center-center (CC) and talar dome lateral (TL) methods.

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Introduction: Surgery is widely recognised as the treatment of choice for suprasyndesmotic ankle fractures, because of the assumption that these injuries yield instability of the ankle joint. Stability assessment of ankle fractures using weightbearing radiographs is now used regularly to guide the treatment of transsyndesmotic and infrasyndesmotic ankle fractures. Patients with a congruent ankle joint on weightbearing radiographs can be treated non-operatively with excellent results.

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