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The management of acute distal tibio-fibular syndesmotic injuries: results of a nationwide survey.
- Source :
-
Injury [Injury] 2012 Oct; Vol. 43 (10), pp. 1718-23. Date of Electronic Publication: 2012 Jul 15. - Publication Year :
- 2012
-
Abstract
- Introduction: Ankle fractures are one of the most frequently encountered musculoskeletal injuries, and 10% of patients have a concomitant distal tibiofibular syndesmotic disruption necessitating surgical repair. A national survey was conducted to gain more insight into the current approaches in the management of syndesmotic injuries in the Netherlands.<br />Materials and Methods: A postal survey was sent to one or two staff members of the trauma and orthopaedic surgery departments in each of the 86 hospitals in the Netherlands. Questions concerned the pre-, per- and postoperative strategies and the different ideas on the type, number and placement of the syndesmotic screw.<br />Results: A total of 85.2% of the trauma surgeons and 61.9% of the orthopaedic surgeons responded (representing 87% of all hospitals). Syndesmotic injury was judged mainly using the 'Hook test'. Syndesmotic injuries in a Weber-B ankle fracture were treated with one screw in 81.2% of cases and in Maisonneuve injuries mainly with two screws. The 3.5-mm screw was used most frequently over three cortices at 2.1-4.0cm above the tibial plafond. Removal of the syndesmotic screw was routinely done by 87.0% of surgeons, mostly between 6 and 8 weeks. Of all respondents, 62.3% showed interest in participating in a randomised controlled trial comparing standard removal with removal on indication.<br />Conclusion: Compared with previous surveys our survey is more complete, has the highest response rate and has almost national coverage. Most individual items reviewed compare well with current literature, except for the routine removal of the syndesmotic screw, which might not be encouraged from a literature point of view. For this reason, the results of the current survey will be used in the development of a multicentre randomised controlled trial comparing the functional outcome in routine removal of the syndesmotic screw compared with removal on indication.<br /> (Copyright © 2012 Elsevier Ltd. All rights reserved.)
- Subjects :
- Ankle Injuries complications
Ankle Injuries epidemiology
Ankle Injuries physiopathology
Bone Screws
Female
Fibula injuries
Fibula physiopathology
Fractures, Bone epidemiology
Fractures, Bone physiopathology
Health Care Surveys
Humans
Male
Netherlands epidemiology
Reproducibility of Results
Surveys and Questionnaires
Tibia injuries
Tibia physiopathology
Treatment Outcome
Weight-Bearing
Ankle Injuries surgery
Fibula surgery
Fracture Fixation, Internal methods
Fractures, Bone surgery
Tibia surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1879-0267
- Volume :
- 43
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Injury
- Publication Type :
- Academic Journal
- Accession number :
- 22795845
- Full Text :
- https://doi.org/10.1016/j.injury.2012.06.015