Bruno C R Olory, Theodorakys Marín Fermín, Emmanouil Papakostas, Khalid Al-Khelaifi, Bashir A Zikria, Pieter D'Hooghe
{"title":"Simultaneous Single-Graft Tibiofibular Syndesmosis and Deltoid Ligament Reconstruction in Chronic Instability: Technical Tip.","authors":"Bruno C R Olory, Theodorakys Marín Fermín, Emmanouil Papakostas, Khalid Al-Khelaifi, Bashir A Zikria, Pieter D'Hooghe","doi":"10.1177/10711007231169999","DOIUrl":null,"url":null,"abstract":"Syndesmosis injury has been reported in up to 18% of sprains and 23% of ankle fractures.8 Failing to diagnose its involvement leads to neglected and malreduced ankle syndesmosis, resulting in pain, impairment, and poor clinical outcomes.5 The orthopaedic surgeon confronts a challenge when managing chronic injuries (>6 months) as standard repair techniques are no longer ideal. Recent studies have shown that restoring syndesmosis congruency and stability leads to improved outcomes and reduced posttraumatic arthritis.5 Among the available surgical options for chronic injuries, tibiofibular stabilization and arthrodesis yield improved American Orthopaedic Foot & Ankle Society (AOFAS) scores.5,8 Arthrodesis has been recommended for lesions with significant displacement, but the subsequently limited range of motion narrows its indication to nonactive patients.5 In contrast, anteroinferior tibiofibular (AITFL) and interosseous ligament (IOL) reconstruction techniques with autografts can yield better functional results by preserving its physiologic joint micromotion.8 The evidence on reconstruction techniques with tendon grafts is limited to case series, and no technique has been deemed superior5—even more so when associated with deltoid ligament (DL) injuries, as this injury pattern represents a critical syndesmosis instability. The aim of this study is to describe a modified Morris et al7 surgical technique to simultaneously reconstruct the tibiofibular syndesmosis and DL with a single autograft.","PeriodicalId":12446,"journal":{"name":"Foot & Ankle International","volume":"44 8","pages":"790-795"},"PeriodicalIF":2.4000,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Foot & Ankle International","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/10711007231169999","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Syndesmosis injury has been reported in up to 18% of sprains and 23% of ankle fractures.8 Failing to diagnose its involvement leads to neglected and malreduced ankle syndesmosis, resulting in pain, impairment, and poor clinical outcomes.5 The orthopaedic surgeon confronts a challenge when managing chronic injuries (>6 months) as standard repair techniques are no longer ideal. Recent studies have shown that restoring syndesmosis congruency and stability leads to improved outcomes and reduced posttraumatic arthritis.5 Among the available surgical options for chronic injuries, tibiofibular stabilization and arthrodesis yield improved American Orthopaedic Foot & Ankle Society (AOFAS) scores.5,8 Arthrodesis has been recommended for lesions with significant displacement, but the subsequently limited range of motion narrows its indication to nonactive patients.5 In contrast, anteroinferior tibiofibular (AITFL) and interosseous ligament (IOL) reconstruction techniques with autografts can yield better functional results by preserving its physiologic joint micromotion.8 The evidence on reconstruction techniques with tendon grafts is limited to case series, and no technique has been deemed superior5—even more so when associated with deltoid ligament (DL) injuries, as this injury pattern represents a critical syndesmosis instability. The aim of this study is to describe a modified Morris et al7 surgical technique to simultaneously reconstruct the tibiofibular syndesmosis and DL with a single autograft.
期刊介绍:
Foot & Ankle International (FAI), in publication since 1980, is the official journal of the American Orthopaedic Foot & Ankle Society (AOFAS). This monthly medical journal emphasizes surgical and medical management as it relates to the foot and ankle with a specific focus on reconstructive, trauma, and sports-related conditions utilizing the latest technological advances. FAI offers original, clinically oriented, peer-reviewed research articles presenting new approaches to foot and ankle pathology and treatment, current case reviews, and technique tips addressing the management of complex problems. This journal is an ideal resource for highly-trained orthopaedic foot and ankle specialists and allied health care providers.
The journal’s Founding Editor, Melvin H. Jahss, MD (deceased), served from 1980-1988. He was followed by Kenneth A. Johnson, MD (deceased) from 1988-1993; Lowell D. Lutter, MD (deceased) from 1993-2004; and E. Greer Richardson, MD from 2005-2007. David B. Thordarson, MD, assumed the role of Editor-in-Chief in 2008.
The journal focuses on the following areas of interest:
• Surgery
• Wound care
• Bone healing
• Pain management
• In-office orthotic systems
• Diabetes
• Sports medicine