医学
联合韧带
矢状面
冠状面
脚踝
模式
固定(群体遗传学)
外科
口腔正畸科
放射科
腓骨
胫骨
社会科学
环境卫生
社会学
人口
作者
Lorena Bejarano-Pineda,Christopher W. DiGiovanni,Gregory R. Waryasz,Daniel Guss
出处
期刊:Journal of the American Academy of Orthopaedic Surgeons
[American Academy of Orthopaedic Surgeons]
日期:2021-09-01
卷期号:29 (23): 985-997
被引量:4
标识
DOI:10.5435/jaaos-d-20-01350
摘要
Up to 10% of ankle sprains are considered “high ankle” sprains with associated syndesmotic injury. Initial diagnosis of syndesmotic injury is based on physical examination, but further evaluation of the distal tibiofibular joint in the sagittal, coronal, and rotational planes is necessary to determine instability. Imaging modalities including weight-bearing CT and ultrasonography allow a physiologic and dynamic assessment of the syndesmosis. These modalities in turn provide the clinician useful information in two and three dimensions to identify and consequently treat syndesmotic instability, especially when subtle. Because there is notable variability in the shape of the incisura between individuals, contralateral comparison with the uninjured ankle as an optimal internal control is advised. Once syndesmotic instability is identified, surgical treatment is recommended. Several fixation methods have been described, but the foremost aspect is to achieve an anatomic reduction. Identifying any associated injuries and characteristics of the syndesmotic instability will lead to the appropriate treatment that restores the anatomy and stability of the distal tibiofibular joint.
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