For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
21
views
Article has an altmetric score of 21
37
references
 Top references
cited by
12
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      757
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Management of syndesmotic injuries of the ankle

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          • Injuries to the tibioperoneal syndesmosis are more frequent than previously thought and their treatment is essential for the stability of the ankle mortise.

          • Recognition of these lesions is essential to avoid long-term morbidity.

          • Diagnosis often requires complete history, physical examination, weight-bearing radiographs and MRI.

          • Treatment-oriented classification is mandatory.

          • It is recommended that acute stable injuries are treated conservatively and unstable injuries surgically by syndesmotic screw fixation, suture-button dynamic fixation or direct repair of the anterior inferior tibiofibular ligament.

          • Subacute injuries may require ligamentoplasty and chronic lesions are best treated by syndesmotic fusion.

          • However, knowledge about syndesmotic injuries is still limited as recommendations for surgical treatment are only based on level IV and V evidence.

          Cite this article: EFORT Open Rev 2017;2:403–409. DOI: 10.1302/2058-5241.2.160084

          Related collections

          Most cited references37

          • Record: found
          • Abstract: found
          • Article: not found

          Ankle syndesmosis injuries: anatomy, biomechanics, mechanism of injury, and clinical guidelines for diagnosis and intervention.

          Amanda Gross, Feng-Ying C Lin, Paul S Weinhold (2006)
          Syndesmosis injuries are rare, but very debilitating and frequently misdiagnosed. The purpose of this clinical commentary is to review the mechanisms of syndesmotic injuries, clinical examination methods, diagnosis, and management of the injuries. Cadaveric studies of the syndesmosis and deltoid ligaments are also reviewed for further understanding of stress transmission and the roles of different structures in stabilizing the distal syndesmosis. External rotation and excessive dorsiflexion of the foot on the leg have been reported as the most common mechanisms of injury. The injury is most often incurred by individuals who participate in skiing, football, soccer, and other sport activities played on turf. The external rotation and squeeze tests are reliable tests to detect this injury. The ability of imaging studies to assist in an accurate diagnosis may depend on the severity of the injury. The results of cadaveric studies indicate the importance of the deltoid ligament in maintaining stability of the distal tibiofibular syndesmosis and the congruency of the ankle mortise. Intervention programs with early rigid immobilization and pain relief strategies, followed by strengthening and balance training are recommended. Heel lift and posterior splint intervention can be used to avoid separation of the distal syndesmosis induced by excessive dorsiflexion of the ankle joint. Application of a rigid external device should be used with caution to prevent medial-lateral compression of the leg superior to the ankle mortise, thereby inducing separation of the distal syndesmosis articulation. Surgical intervention is an option when a complete tear of the syndesmotic ligaments is present or when fractures are observed.
          Article 0 comments Cited 48 times – based on 0 reviews     Review now
          Article has an altmetric score of 15
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Injury of the tibiofibular syndesmosis: value of MR imaging for diagnosis.

            Mitsuo Ochi, K. Naito, Kazunori Oae … (2003)
            To compare the use of magnetic resonance (MR) imaging with the use of arthroscopy for the diagnosis of tibiofibular syndesmotic injury. This study involved 58 patients who had ankle sprains or distal fibular fractures and underwent surgery. All patients were examined with MR imaging for diagnosis of tibiofibular syndesmotic injury. When MR imaging revealed ligament discontinuity (criterion 1) or either a wavy or curved ligament contour or nonvisualization of the ligament (criterion 2), the injury was considered to be a ligament disruption. After MR imaging, ankle arthroscopy was performed in all patients for a definitive diagnosis of ligament disruption. Arthroscopic findings showed anteroinferior tibiofibular ligament (AITFL) disruption in 28 patients and posteroinferior tibiofibular ligament (PITFL) disruption in five patients. When an MR imaging diagnosis was based on criterion 1 only, the diagnosis of AITFL disruption was made with a sensitivity of 100%, a specificity of 70%, and an accuracy of 84%, and the diagnosis of PITFL disruption was made with a sensitivity of 100%, a specificity of 94%, and an accuracy of 95%. When an MR imaging diagnosis was based on criteria 1 and 2, the diagnosis of AITFL disruption was made with a sensitivity of 100%, a specificity of 93%, and an accuracy of 97%, whereas the diagnosis of PITFL disruption was made with a sensitivity of 100%, a specificity of 100%, and an accuracy of 100%. MR imaging with use of both criteria is highly accurate for the diagnosis of tibiofibular syndesmotic disruption.
            Article 0 comments Cited 41 times – based on 0 reviews     Review now
            Article has an altmetric score of 3
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Syndesmotic ankle sprains.

              M J Boytim, D Fischer, L. Neumann (1991)
              In this study we reviewed ankle sprains in a professional football team over a 6 year period. Fifteen players who sustained syndesmotic ankle sprains were compared with 28 players who sustained significant lateral ankle sprains. Players with syndesmotic sprains missed significantly more games and practices and they received substantially more treatments than players with lateral ankle sprains. Physical examination findings, results of radiographic evaluations, and etiologic factors are discussed. The external rotation stress test, a clinical method for diagnosis of this type of sprain at the time of injury, is described. Results of this study clearly demonstrate a prolonged recovery time for syndesmotic ankle sprains. Physicians and trainers who are aware of this injury can differentially diagnose these two types of sprains in the early postinjury period by the method described.
              Article 0 comments Cited 40 times – based on 0 reviews     Review now
              Article has an altmetric score of 4
                Bookmark
                All references

                Author and article information

                Journal
                Journal ID (nlm-ta): EFORT Open Rev
                Journal ID (iso-abbrev): EFORT Open Rev
                Title: EFORT Open Reviews
                Publisher: British Editorial Society of Bone and Joint Surgery
                ISSN (Electronic): 2058-5241
                Publication date Collection: September 2017
                Publication date (Electronic): 21 September 2017
                Volume: 2
                Issue: 9
                Pages: 403-409
                Affiliations
                [1 ]Department of Orthopaedics and Traumatology, University General Hospital Reina Sofía, Avda Intendente Jorge Palacios 1, Murcia 30003, Spain
                [2 ]Regional Statistical Center, Treasury and public administration council, Murcia, Spain
                [3 ]Department of Orthopaedics and Traumatology, University General Hospital Reina Sofía, Murcia, Spain
                Author notes
                [*]Jorge de-las-Heras Romero, Department of Orthopaedics and Traumatology, University General Hospital Reina Sofía, Avda Intendente Jorge Palacios 1, Murcia 30003, Spain. E-mail: jorgeheras@ 123456gmail.com
                Article
                Publisher ID: 10.1302_2058-5241.2.160084
                DOI: 10.1302/2058-5241.2.160084
                PMC ID: 5644422
                PubMed ID: 29071125
                SO-VID: 034008ee-c5a4-4884-a442-af3c81a00819
                Copyright © © 2017 The author(s)
                License:

                This article is distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC BY-NC 4.0) licence ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed.

                History
                Categories
                Subject: Foot & Ankle
                Subject: 3
                Subject: Syndesmosis Injury
                Subject: Ankle
                Subject: Ligaments
                Subject: Diagnosis
                Subject: Imaging
                Subject: Management
                Subject: Operative Technique

                Keywords: syndesmosis injury,ankle,ligaments,diagnosis,imaging,management,operative technique
                Data availability:
                Keywords: syndesmosis injury, ankle, ligaments, diagnosis, imaging, management, operative technique

                Comments

                Comment on this article

                scite_
                0
                0
                0
                0
                Smart Citations
                0
                0
                0
                0
                Citing PublicationsSupportingMentioningContrasting
                View Citations

                See how this article has been cited at scite.ai

                scite shows how a scientific paper has been cited by providing the context of the citation, a classification describing whether it supports, mentions, or contrasts the cited claim, and a label indicating in which section the citation was made.

                Similar content757

                See all similar

                Cited by12

                See all cited by

                Most referenced authors285

                See all reference authors