Schnetzke M, Vetter SY, Beisemann N, Swartman B, Grützner PA, Franke J. Management of syndesmotic injuries: What is the evidence? World J Orthop 2016; 7(11): 718-725 [PMID: 27900268 DOI: 10.5312/wjo.v7.i11.718]
Corresponding Author of This Article
Jochen Franke, MD, Department for Trauma and Orthopaedic Surgery, MINTOS - Medical Imaging and Navigation in Trauma and Orthopaedic Surgery, BG Trauma Center Ludwigshafen at Heidelberg University Hospital, Ludwig-Guttmann-Strasse 13, 67071 Ludwigshafen am Rhein, Germany. jochen.franke@bgu-ludwigshafen.de
Research Domain of This Article
Surgery
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Nov 18, 2016; 7(11): 718-725 Published online Nov 18, 2016. doi: 10.5312/wjo.v7.i11.718
Management of syndesmotic injuries: What is the evidence?
Marc Schnetzke, Sven Y Vetter, Nils Beisemann, Benedict Swartman, Paul A Grützner, Jochen Franke
Marc Schnetzke, Sven Y Vetter, Nils Beisemann, Benedict Swartman, Paul A Grützner, Jochen Franke, Department for Trauma and Orthopaedic Surgery, MINTOS - Medical Imaging and Navigation in Trauma and Orthopaedic Surgery, BG Trauma Center Ludwigshafen at Heidelberg University Hospital, 67071 Ludwigshafen am Rhein, Germany
Author contributions: All authors contributed to this manuscript.
Conflict-of-interest statement: The following authors declared potential conflicts of interest: The MINTOS research group had grants/grants pending from Siemens (Erlangen, Germany); Jochen Franke, MD, is a paid lecturer for Siemens; Paul A Grützner, MD, is a paid lecturer for Siemens.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jochen Franke, MD, Department for Trauma and Orthopaedic Surgery, MINTOS - Medical Imaging and Navigation in Trauma and Orthopaedic Surgery, BG Trauma Center Ludwigshafen at Heidelberg University Hospital, Ludwig-Guttmann-Strasse 13, 67071 Ludwigshafen am Rhein, Germany. jochen.franke@bgu-ludwigshafen.de
Telephone: +49-621-68102290 Fax: +49-621-68102285
Received: May 18, 2016 Peer-review started: May 19, 2016 First decision: July 5, 2016 Revised: August 26, 2016 Accepted: September 7, 2016 Article in press: September 8, 2016 Published online: November 18, 2016
Abstract
Ankle fractures are accompanied by a syndesmotic injury in about 10% of operatively treated ankle fractures. Usually, the total rupture of the syndesmotic ligaments with an external rotation force is associated with a Weber type B or C fracture or a Maisonneuve fracture. The clinical assessment should consist of a comprehensive history including mechanism of injury followed by a specific physical examination. Radiographs, and if in doubt magnetic resonance imaging, are needed to ascertain the syndesmotic injury. In the case of operative treatment the method of fixation, the height and number of screws and the need for hardware removal are still under discussion. Furthermore, intraoperative assessment of the accuracy of reduction of the fibula in the incisura using fluoroscopy is difficult. A possible solution might be the assessment with intraoperative three-dimensional imaging. The aim of this article is to provide a current concepts review of the clinical presentation, diagnosis and treatment of syndesmotic injuries.
Core tip: The aim of this article is to provide a current concepts review of the clinical presentation, diagnosis and management of syndesmotic lesions. Even if syndesmotic injuries are common, the appropriate management is still under discussion. Current treatment options are discussed and future directions are provided.
