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European Journal of Trauma and Emergency Surgery
Erschienen in: European Journal of Trauma and Emergency Surgery 6/2015

01.12.2015 | Review Article

An update on the evaluation and treatment of syndesmotic injuries

verfasst von: S. Rammelt, P. Obruba

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 6/2015

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Abstract

Introduction

Injuries to the distal tibiofibular syndesmosis are frequent and continue to generate controversy.

Methods

The majority of purely ligamentous injuries (“high ankle sprains”) is not sassociated with a latent or frank tibiofibular diastasis and may be treated with an extended protocol of physical therapy. Relevant instability of the syndesmosis with diastasis results from rupture of two or more ligaments that require surgical stabilization. Syndesmosis disruptions are commonly associated with bony avulsions or malleolar fractures. Treatment consists in anatomic reduction of the distal fibula into the corresponding incisura of the distal tibia and stable fixation. Proposed means of fixation are refixation of bony syndesmotic avulsions, one or two tibiofibular screws and suture button. There is no consensus on how long to maintain fixation. Both syndesmotic screws and suture buttons need to be removed if symptomatic.

Results/Complications

The most frequent complication is syndesmotic malreduction and may be minimized with open reduction and intraoperative 3D scanning. Other complications include hardware failure, heterotopic ossification, tibiofibular synostosis, chronic instability and posttraumatic arthritis.

Conclusion

The single most important prognostic factor is anatomic reduction of the distal fibula into the tibial incisura.
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Metadaten
Titel
An update on the evaluation and treatment of syndesmotic injuries
verfasst von
S. Rammelt
P. Obruba
Publikationsdatum
01.12.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Trauma and Emergency Surgery / Ausgabe 6/2015
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-014-0466-8

Weitere Artikel der Ausgabe 6/2015

European Journal of Trauma and Emergency Surgery 6/2015 Zur Ausgabe

Original Article

The accuracy of physical examination in identifying significant pathologies in penetrating thoracic trauma

Original Article

The impact of body mass index on severity, patterns and outcomes after traumatic brain injuries caused by low level falls

Review Article

Osteoligamentous injuries of the medial ankle joint

Original Article

Child drowning deaths in Aydin province, western Turkey, 2002–2012

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Posterior malleolar fractures of the ankle

Review Article

Assessment of elevated compartment pressures by pressure-related ultrasound: a cadaveric model

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