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ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2019, Number 5

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Acta Ortop Mex 2019; 33 (5)

Residual ankle instability in patients with syndesmosis lesions without fracture treated with situational screws

Castro-Guerrero DE, Rosas-Medina JA

Language: Spanish
References: 11
Page: 292-296
PDF size: 142.09 Kb.


ABSTRACT

Introduction: The lesion of the distal tibiofibular syndesmosis is commonly accompanied by the fracture of the maleollus either medial or lateral, rarely, the syndesmosis can be injured without there being a fracture of any of the bone structures that make up the ankle, accounting for about 1% of all injuries. Being very rare, they are not diagnosed at the acute event, and are usually treated as a simple sprained ankle. Material and methods: Series of cases with ankle fractureless syndesmosis lesion, treated with situational double screw placement, deferred support and implant removal at two months. After six months of initial surgery, the Cumberland ankle instability (CAIT) test is applied which measures the degree of ankle instability. Results: For one year, 4 cases of fractureless synosmosis lesions were found out of a total of 349 surgical cases treated in the hospital, exclusively in male patients, all under the age of 40. Six months after surgery, CAIT was applied, encountering residual instability in 100% of treated cases. Discussion: This result is unencouraging and makes us reconsider the treatment established to improve the final stability of the ankle.


REFERENCES

  1. Attarian DE, McCrackin HJ, DeVito DP, McElhaney JH, Garrett WE. Biomechanical characteristics of human ankle ligaments. Foot Ankle. 1985; 6: 54-8.

  2. Leardini A, O’Connor JJ, Catani F, Giannini S. The role of passive structures in the mobility and stability of the human ankle joint: a literature review. Foot Ankle Int. 2000; 21(7): 602-15.

  3. Bonnel F, Toullec E, Mabit C, Tourne Y, Sofcot. Chronic ankle instability: biomechanics and pathomechanics of ligaments injury and associated lesions. Orthop Tramatol Surg Res. 2010; 96(4): 424-32.

  4. Brostrom L: Sprained ankles. Part 1: Anatomic lesions in recent sprains. Acta Chir Scand. 1964; 128: 483-95.

  5. Boden SD, Labropoulos PA, McCowin P, Lestini WF, Hurwitz MSR. Mechanical considerations for the syndesmosis screw. A cadaver study. J Bone Joint Surg Am. 1989; 71: 1548-55.

  6. Eyring EJ, Guthrie WD. A surgical approach to the problem of severe lateral instability at the ankle. Clin Orthop. 1986; 206: 185-91.

  7. Edwards GS Jr., DeLee JC. Ankle diastasis without fracture. Foot Ankle. 1984; 4(6): 305-12.

  8. Álvarez LA, Rodríguez RE, García LY, Muñoz IA. Lesiones de la sindesmosis tibioperonea distal: review article. Rev Cubana Ortop Traumatol. 2008; 22(1).

  9. Willmott HJ, Singh B, David LA. Outcome and complications of treatment of ankle diastasis with tightrope fixation. Injury. 2009; 40(11): 1204-6.

  10. Ogilvie-Harris DJ, Reed SC. Disruption of the ankle syndesmosis: diagnosis and treatment by arthroscopic surgery. Arthroscopy. 1994; 10(5): 561-8.

  11. Hiller CE, Refshauge KM, Bundy AC, et al. The Cumberland ankle instability tool: a report of validity and reliability testing. Arch Phys Med Rehabil. 2006; 87: 1235-41.




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