Management of syndesmotic injuries:What is the evidence?  

作　　者：Marc Schnetzke Sven Y Vetter Nils Beisemann Benedict Swartman Paul A Grützner Jochen Franke 

机构地区：[1]Department for Trauma and Orthopaedic Surgery,MINTOS-Medical Imaging and Navigation in Trauma and Orthopaedic Surgery,BG Trauma Center Ludwigshafen at Heidelberg University Hospital

出　　处：《World Journal of Orthopedics》2016年第11期718-725,共8页世界骨科杂志（英文版）

摘　　要：Ankle fractures are accompanied by a syndesmotic injury in about 10% of operatively treated ankle fractures. Usually, the total rupture of the syndesmotic ligaments with an external rotation force is associated with a Weber type B or C fracture or a Maisonneuve fracture. The clinical assessment should consist of a comprehensive history including mechanism of injury followed by a specific physical examination. Radiographs, and if in doubt magnetic resonance imaging, are needed to ascertain the syndesmotic injury. In the case of operative treatment the method of fixation, the height and number of screws and the need for hardware removal are still under discussion. Furthermore, intraoperative assessment of the accuracy of reduction of the fibula in the incisura using fluoroscopy is difficult. A possible solution might be the assessment with intraoperative three-dimensional imaging. The aim of this article is to provide a current concepts review of the clinical presentation, diagnosis and treatment of syndesmotic injuries.Ankle fractures are accompanied by a syndesmotic injury in about 10% of operatively treated ankle fractures. Usually, the total rupture of the syndesmotic ligaments with an external rotation force is associated with a Weber type B or C fracture or a Maisonneuve fracture. The clinical assessment should consist of a comprehensive history including mechanism of injury followed by a specific physical examination. Radiographs, and if in doubt magnetic resonance imaging, are needed to ascertain the syndesmotic injury. In the case of operative treatment the method of fixation, the height and number of screws and the need for hardware removal are still under discussion. Furthermore, intraoperative assessment of the accuracy of reduction of the fibula in the incisura using fluoroscopy is difficult. A possible solution might be the assessment with intraoperative three-dimensional imaging. The aim of this article is to provide a current concepts review of the clinical presentation, diagnosis and treatment of syndesmotic injuries.

关 键 词：ANKLE SPRAIN Syndesmotic INJURY Syndesmotic SCREW ANKLE TIGHTROPE Three-dimensional 

分 类 号：R687.4[医药卫生—骨科学]