Probably one of the most controversial subjects in the orthopedic field is the distal tibiofibular articulation. Even though its most primary knowledge can be a matter of enormous debate, it is in the diagnosis and treatment most of the disagreements reign. Distinguishing between injury and instability remains challenging as well as an optimal clinical decision regarding surgical intervention. The last years presented technology and that was able to bring body to an already well-developed scientifical rationale. In this review article, we aim to demonstrate the current data behind syndesmotic instability in the ligament scenario, whereas using few fracture concepts.
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| http://dx.doi.org/10.1016/j.fcl.2023.01.006 | DOI Listing |
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Deltoid ligament injuries: When and how to repair.
Knee Surg Sports Traumatol Arthrosc
December 2024
Hospital Particular do Algarve, Gambelas, Portugal.
Purpose: This study aims to illustrate the assessment and treatment strategies of acute and chronic deltoid ligament injuries, providing a treatment algorithm for each scenario.
Methods: A retrospective review was conducted on 39 patients, who had either an acute deltoid ligament injury or suffered chronic deltoid ligament insufficiency. All patients were operated on between January 2016 and December 2022.
Cadaveric Diagnostic Study of Subtle Syndesmotic Instability Using a 3-Dimensional Weight-Bearing CT Distance Mapping Algorithm.
J Bone Joint Surg Am
December 2024
Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa.
Background: The diagnosis of syndesmotic instability is challenging, and chronically unstable injuries can potentially lead to ankle arthritic degeneration. The objective of this cadaveric study was to utilize a 3-dimensional (3D) weight-bearing computed tomography (WBCT) distance mapping algorithm for the detection of subtle syndesmotic instability, induced by complete syndesmotic ligament sectioning and stressed by isolated axial load. We hypothesized that this algorithm would accurately detect subtle syndesmotic instability.
View Article and Find Full Text PDFRisk Factors for Chronic Syndesmotic Instability After the First Episode of Acute Ankle Sprain: A Cross-Sectional Study of 356 Cases.
Foot Ankle Int
January 2025
Department of Foot and Ankle Surgery, Wuhan Fourth Hospital, Wuhan, China.
Article Synopsis
- Chronic syndesmotic instability (CSI) can lead to significant long-term pain and disability, and this study explored factors contributing to its development in patients with unresolved acute ankle sprains.
- Researchers analyzed data from 356 patients who underwent ankle arthroscopy and identified 5 main clinical risk factors linked to CSI: deltoid ligament injuries, a positive bandage-binding test, moderate to severe injury of the posterior inferior tibiofibular ligament, a positive squeeze test, and higher body mass index (BMI).
- The findings suggest that recognizing these risk factors can help in managing and possibly preventing CSI after initial ankle sprain treatments.
Comparison of the outcomes of syndesmotic ankle fractures treated with dynamic fixation versus static fixation versus fibular nail: a meta-analysis and systematic review.
Ann Jt
September 2024
Department of Orthopedic Surgery, University of Toledo Medical Center, Toledo, OH, USA.
Article Synopsis
- Syndesmotic ankle fractures cause significant pain and instability, and this review compares the effectiveness of various surgical treatments, including static fixation, dynamic fixation, and fibular nailing.
- A total of nineteen studies with 1,182 patients were analyzed, revealing that dynamic fixation resulted in better functional outcomes and lower reoperation rates compared to static fixation and fibular nails at 1 and 2 years post-surgery.
- The findings suggest that dynamic fixation is superior for improving ankle function, but it comes with a higher reoperation rate compared to fibular nailing, which also presents lower infection rates.
No difference in early outcomes comparing intramedullary versus extramedullary fibular fixation in operative ankle fractures.
Injury
December 2024
Division of Orthopaedic Trauma & Adult Reconstruction, Department of Orthopaedic Surgery, Cooperman Barnabas Medical Center/Jersey City Medical Center -RWJBarnabas Health Livingston/Jersey City, NJ, United States. Electronic address:
Introduction: The purpose of this study was to compare postoperative complications and outcomes of minimally invasive intramedullary fixation (IMF) versus plate fixation (PF) in the treatment of distal fibular fractures.
Materials And Methods: A retrospective review was performed from identifying all consecutive ankle fracture patients aged ≥18-years-old surgically managed between August 2017 to September 2022 at a tertiary care center with minimum 6 months clinical follow-up. Patients were grouped into those receiving intramedullary versus extramedullary fibular fixation.
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