(1-3,5,6,11) With excessive external rotation of the forefoot, the talus is forced against the medial aspect of the fibula, resulting in separation of the distal tibia and fibula and injury to the syndesmotic
Using metal trans-syndesmosis screw was the most popular and mainstream approach to restore syndesmotic
stability, although there is a lot of published information about malreduction of the syndesmotic
screw and alternatives to syndesmotic
screw fixation.,,,,,, Intraoperative stress testing is recommended for diagnosing syndesmotic
disruption or instability.
complex is the most complicated ligament of the ankle .
medial malleolus fracture were successfully treated using TBW.
A dynamic ultrasound examination for the diagnosis of ankle syndesmotic
injury in professional athletes: A preliminary study.
For the Agility[TM] system, unique characteristics of the surgical technique include use of an external fixator to provide distraction and correction of alignment during implantation, as well as dependence upon syndesmotic
arthrodesis for tibial component fixation.
Where there is a suspicion of a syndesmotic
injury, the proximal fibula fracture should be fixed and the stability of the mortise tested.
The use of these screws appears to be a valid option in the fixation of syndesmotic
injuries after a Bosworth dislocation.
Syndesmosis injuries arise in 10–15% of all patients with ankle fractures.[sup] Several authors have demonstrated that restoration of the syndesmosis as well as anatomic reduction of any associated fracture of the fibula or the medial malleolus is equally important.[sup] The literature showed that widening and chronic instability of the distal tibiofibular syndesmosis have been correlated with poor functional outcomes and the development of osteoarthritis.[sup] Therefore, the surgical fixation is usually recommended for the treatment of syndesmotic
injury: Syndesmosis stability was checked by laterally displacing the distal fibula from the tibia while observing the relationship of the two bones under fluroscopic guidance.
(13) Previous MOT of the ankle in athletes has been reported as heterotopic ossification involving the interosseous membrane following a syndesmotic
sprain in football players.
(8) In this study, the investigators established radiographic criteria for evaluating the adequacy of lateral malleolar reduction and syndesmotic
disruption and then used these criteria to assess ankle fractures treated by medial malleolar fixation versus bimalleolar fixation.