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5. Correlation of Incisura Anatomy With Syndesmotic Malreduction

Author

Boszczyk, Andrzej, Kwapisz, Sławomir, Krümmel, Martin, Grass, Rene, Rammelt, Stefan, Boszczyk, Andrzej, Kwapisz, Sławomir, Krümmel, Martin, Grass, Rene, and Rammelt, Stefan

Abstract

Background: The anatomy of the syndesmosis is variable, yet little is known on the correlation between differences in anatomy and syndesmosis reduction results. The aim of this study was to analyze the correlation between syndesmotic anatomy and the modes of syndesmotic malreduction. Methods: Bilateral postreduction ankle computed tomography (CT) scans of 72 patients treated for fractures with syndesmotic disruption were analyzed. Incisura depth, fibular engagement into the incisura, and incisura rotation were correlated with degree of syndesmotic malreduction in coronal and sagittal planes as well as rotational malreduction. Results: Clinically relevant malreduction in the coronal plane, sagittal plane, and rotation affected 8.3%, 27.8%, and 19.4% of syndesmoses, respectively. The syndesmoses with a deep incisura and the fibula not engaged into the tibial incisura were at risk of overcompression, anteverted incisuras at risk of anterior fibular translation, and retroverted incisuras at risk of posterior fibular translation. Conclusions: Certain morphologic configurations of the tibial incisura increased the risk of specific syndesmotic malreduction patterns. Level of Evidence: Level III, comparative study.

Published
2018

9. Correlation of Incisura Anatomy With Syndesmotic Malreduction.

Author

Boszczyk A, Kwapisz S, Krümmel M, Grass R, and Rammelt S

Subjects
Adult, Ankle Injuries surgery, Ankle Joint growth & development, Cohort Studies, Female, Fracture Fixation, Internal instrumentation, Fracture Healing physiology, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Range of Motion, Articular physiology, Risk Assessment, Treatment Outcome, Young Adult, Ankle Injuries diagnostic imaging, Ankle Joint anatomy & histology, Bone Screws, Fracture Fixation, Internal methods, Joint Instability prevention & control, Tomography, X-Ray Computed methods
Abstract

Background: The anatomy of the syndesmosis is variable, yet little is known on the correlation between differences in anatomy and syndesmosis reduction results. The aim of this study was to analyze the correlation between syndesmotic anatomy and the modes of syndesmotic malreduction., Methods: Bilateral postreduction ankle computed tomography (CT) scans of 72 patients treated for fractures with syndesmotic disruption were analyzed. Incisura depth, fibular engagement into the incisura, and incisura rotation were correlated with degree of syndesmotic malreduction in coronal and sagittal planes as well as rotational malreduction., Results: Clinically relevant malreduction in the coronal plane, sagittal plane, and rotation affected 8.3%, 27.8%, and 19.4% of syndesmoses, respectively. The syndesmoses with a deep incisura and the fibula not engaged into the tibial incisura were at risk of overcompression, anteverted incisuras at risk of anterior fibular translation, and retroverted incisuras at risk of posterior fibular translation., Conclusions: Certain morphologic configurations of the tibial incisura increased the risk of specific syndesmotic malreduction patterns., Level of Evidence: Level III, comparative study.

Published
2018
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