Background: Ankle syndesmosis injury is difficult to diagnose accurately at the initial visit. Missed diagnosis or improper treatment can lead to chronic complications. Complete syndesmosis injury with a concomitant rupture of the interosseous membrane (IOM) is more unstable and severe. The relationship between this type of injury and Maisonneuve injury, in which the syndesmosis is also injured, has not been discussed in the literature previously.
Case Summary: A 16-year-old patient sustained left medial malleolar fracture, and the associated inferior tibiofibular syndesmotic instability was overlooked. After open reduction and internal fixation of the medial malleolar fracture, inferior tibiofibular syndesmosis diastasis with IOM rupture was detected by auxiliary imaging. Secondary surgical intervention was performed to reduce anatomically and fix with two trans-syndesmosis screws. Twelve weeks later, the screws were removed. At the 6-mo follow-up, the patient gained full range of motion of the ankle.
Conclusion: Complete syndesmosis injury with IOM rupture should be considered Maisonneuve-type injury. Open reduction and internal fixation could obtain good outcomes.
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http://dx.doi.org/10.12998/wjcc.v9.i15.3733 | DOI Listing |
Foot Ankle Orthop
January 2025
University Medical Center, University of Geneva, Geneva, Switzerland.
Background: Syndesmotic instability is a significant concern in the management of unstable ankle fractures, occurring in approximately 10% to 13% of these cases. Early recognition and stabilization of syndesmotic injuries are essential to ensure optimal long-term outcomes. Several techniques are currently in use, often involving complex procedure and/or costly devices.
View Article and Find Full Text PDFJ Orthop Surg Res
January 2025
Department of Orthopedics and Rheumoorthopedics, Centre of Postgraduate Medical Education, Prof. Adam Gruca Orthopedic and Trauma Teaching Hospital, Konarskiego 13, Otwock, 05-400, Poland.
Background: Posterior malleolus fractures may be fixed to restore syndesmosis stability. However, these fractures are often accompanied by ruptures of other ligaments that stabilize the syndesmosis. This study investigates the frequency of anterior syndesmosis injury in posterior malleolus fractures and its effect on rotational stability.
View Article and Find Full Text PDFActa Ortop Bras
January 2025
Hospital Getulio Vargas, Departamento de Ortopedia e Traumatologia, do Hospital Getúlio Vargas, Recife, Pernambuco, PE, Brazil.
Introduction: The three-dimensional evaluation of patients in the gait laboratory is a diagnostic method that is gaining ground in various orthopedic pathologies and, in the case of ankle fractures, can more accurately detail the degree of joint limitation.
Objective: To present the importance of laboratory gait studies in the postoperative period of ankle fractures associated with syndesmosis ligament injuries, increasing the arsenal for assessing whether the surgical approach and outcome were satisfactory.
Methods: Case series of 13 patients who underwent surgical treatment for ankle fractures associated with syndesmosis injuries, evaluated postoperatively in the gait clinic using the BTS GAITLAB hardware program.
J Foot Ankle Surg
January 2025
Trauma Unit, Department of Surgery, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands. Electronic address:
Ankle fractures are often accompanied by syndesmotic injuries, contributing to instability and potential long term complications. Syndesmotic injuries are traditionally fixed with either small fragment (3.5-mm diameter) or large fragment (4.
View Article and Find Full Text PDFEur J Orthop Surg Traumatol
January 2025
Department of Orthopaedic Surgery, University of California San Diego, 200 West Arbor Drive MC 8894, San Diego, CA, 92103, USA.
Purpose: While treatment modalities for Maisonneuve fractures involving the proximal third of the fibula are established, no studies to date have reported outcomes associated with syndesmotic-only fixation of middle third fibular shaft fractures. The purpose of this study was to evaluate outcomes associated with syndesmotic-only fixation in the treatment of Maisonneuve fractures involving the middle third of the fibula.
Methods: A retrospective review was conducted on 257 cases of syndesmotic ankle instability with associated fibular fractures at a level 1 trauma center between 2013 and 2023.
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