Syndesmosenverletzungen – Anatomie, Verletzungsmuster und Diagnostik

Viele Verletzungen der Außenbänder des Sprunggelenks heilen ohne langfristige Folgen. Ist aber die Syndesmose mit verletzt, drohen spätere Komplikationen. Eine gründliche Diagnose ist daher unabdingbar.

Publikationsverlauf

Artikel online veröffentlicht:
03. Mai 2022

• Literatur

• 1 Beumer A, Valstar ER, Garling EH. et al. Effects of ligament sectioning on the kinematics of the distal tibiofibular syndesmosis: A radiostereometric study of 10 cadaveric specimens based on presumed trauma mechanisms with suggestions for treatment. Acta Orthop 2006; 77: 531-540 DOI: 10.1080/17453670610012557.
• 2 Clanton TO, Ho CP, Williams BT. et al. Magnetic resonance imaging characterization of individual ankle syndesmosis structures in asymptomatic and surgically treated cohorts. Knee Surg Sports Traumatol Arthrosc 2016; 24: 2089-2102 DOI: 10.1007/s00167-014-3399-1.
• 3 Clanton TO, Williams BT, Backus JD. et al. Biomechanical analysis of the individual ligament contributions to syndesmotic stability. Foot Ankle Int 2017; 38: 66-75 DOI: 10.1177/1071100716666277.
• 4 Cosgrove CT, Putnam SM, Cherney SM. et al. Medial clamp tine positioning affects ankle syndesmosis malreduction. J Orthop Trauma 2017; 31: 440-446 DOI: 10.1097/BOT.0000000000000882.
• 5 Del Rio A, Bewsher SM, Roshan-Zamir S. et al. Weightbearing cone-beam computed tomography of acute ankle syndesmosis injuries. J Foot Ankle Surg 2020; 59: 258-263 DOI: 10.1053/j.jfas.2019.02.005.
• 6 Dikos GD, Heisler J, Choplin RH. et al. Normal tibiofibular relationships at the syndesmosis on axial CT imaging. J Orthop Trauma 2012; 26: 433-438 DOI: 10.1097/BOT.0b013e3182535f30.
• 7 Ebraheim NA, Lu J, Yang H. et al. Radiographic and CT evaluation of tibiofibular syndesmotic diastasis: A cadaver study. Foot Ankle Int 1997; 18: 693-698 DOI: 10.1177/107110079701801103.
• 8 Elgafy H, Semaan HB, Blessinger B. et al. Computed tomography of normal distal tibiofibular syndesmosis. Skeletal Radiol 2010; 39: 559-564 DOI: 10.1007/s00256-009-0809-4.
• 9 Fort NM, Aiyer AA, Kaplan JR. et al. Management of acute injuries of the tibiofibular syndesmosis. Eur J Orthop Surg Traumatol 2017; 27: 449-459 DOI: 10.1007/s00590-017-1956-2.
• 10 Grossterlinden LG, Hartel M, Yamamura J. et al. Isolated syndesmotic injuries in acute ankle sprains: Diagnostic significance of clinical examination and MRI. Knee Surg Sports Traumatol Arthrosc 2016; 24: 1180-1186 DOI: 10.1007/s00167-015-3604-x.
• 11 Hamard M, Neroladaki A, Bagetakos I. et al. Accuracy of cone-beam computed tomography for syndesmosis injury diagnosis compared to conventional computed tomography. Foot Ankle Surg 2020; 26: 265-272 DOI: 10.1016/j.fas.2019.03.006.
• 12 Han SH, Lee JW, Kim S. et al. Chronic tibiofibular syndesmosis injury: The diagnostic efficiency of magnetic resonance imaging and comparative analysis of operative treatment. Foot Ankle Int 2007; 28: 336-342 DOI: 10.3113/FAI.2007.0336.
• 13 Harper MC. An anatomic and radiographic investigation of the tibiofibular clear space. Foot Ankle 1993; 14: 455-458 DOI: 10.1177/107110079301400805.
• 14 Harper MC, Keller TS. A radiographic evaluation of the tibiofibular syndesmosis. Foot Ankle 1989; 10: 156-160 DOI: 10.1177/107110078901000308.
• 15 Hermans JJ, Beumer A, de Jong TA. et al. Anatomy of the distal tibiofibular syndesmosis in adults: A pictorial essay with a multimodality approach. J Anat 2010; 217: 633-645 DOI: 10.1111/j.1469-7580.2010.01302.x.
• 16 Hunt KJ, George E, Harris AH. et al. Epidemiology of syndesmosis injuries in intercollegiate football: Incidence and risk factors from National Collegiate Athletic Association injury surveillance system data from 2004–2005 to 2008–2009. Clin J Sport Med 2013; 23: 278-282 DOI: 10.1097/JSM.0b013e31827ee829.
• 17 Hunt KJ, Phisitkul P, Pirolo J. et al. High ankle sprains and syndesmotic injuries in athletes. J Am Acad Orthop Surg 2015; 23: 661-673 DOI: 10.5435/JAAOS-D-13-00135.
• 18 Kaplan LD, Jost PW, Honkamp N. et al. Incidence and variance of foot and ankle injuries in elite college football players. Am J Orthop (Belle Mead NJ) 2011; 40: 40-44
• 19 Kellett JJ, Lovell GA, Eriksen DA. et al. Diagnostic imaging of ankle syndesmosis injuries: A general review. J Med Imaging Radiat Oncol 2018; 62: 159-168 DOI: 10.1111/1754-9485.12708.
• 20 Kim S, Huh YM, Song HT. et al. Chronic tibiofibular syndesmosis injury of ankle: Evaluation with contrast-enhanced fat-suppressed 3 D fast spoiled gradient-recalled acquisition in the steady state MR imaging. Radiology 2007; 242: 225-235 DOI: 10.1148/radiol.2421051369.
• 21 Lamb SE, Marsh JL, Hutton JL. et al. Mechanical supports for acute, severe ankle sprain: A pragmatic, multicentre, randomised controlled trial. Lancet 2009; 373: 575-581 DOI: 10.1016/S0140-6736(09)60206-3.
• 22 Lepojarvi S, Pakarinen H, Savola O. et al. Posterior translation of the fibula may indicate malreduction: CT study of normal variation in uninjured ankles. J Orthop Trauma 2014; 28: 205-209 DOI: 10.1097/BOT.0b013e3182a59b3c.
• 23 Lilyquist M, Shaw A, Latz K. et al. Cadaveric analysis of the distal tibiofibular syndesmosis. Foot Ankle Int 2016; 37: 882-890 DOI: 10.1177/1071100716643083.
• 24 Mei-Dan O, Carmont M, Laver L. et al. Standardization of the functional syndesmosis widening by dynamic US examination. BMC Sports Sci Med Rehabil 2013; 5: 9 DOI: 10.1186/2052-1847-5-9.
• 25 Mei-Dan O, Kots E, Barchilon V. et al. A dynamic ultrasound examination for the diagnosis of ankle syndesmotic injury in professional athletes: A preliminary study. Am J Sports Med 2009; 37: 1009-1016 DOI: 10.1177/0363546508331202.
• 26 Milz P, Milz S, Putz R. et al. 13 MHz high-frequency sonography of the lateral ankle joint ligaments and the tibiofibular syndesmosis in anatomic specimens. J Ultrasound Med 1996; 15: 277-284 DOI: 10.7863/jum.1996.15.4.277.
• 27 Mousavian A, Shakoor D, Hafezi-Nejad N. et al. Tibiofibular syndesmosis in asymptomatic ankles: Initial kinematic analysis using four-dimensional CT. Clin Radiol 2019; 74: 571 e571-571 e8 DOI: 10.1016/j.crad.2019.03.015.
• 28 Nielson JH, Gardner MJ, Peterson MG. et al. Radiographic measurements do not predict syndesmotic injury in ankle fractures: An MRI study. Clin Orthop Relat Res 2005; 216-221
• 29 Nussbaum ED, Hosea TM, Sieler SD. et al. Prospective evaluation of syndesmotic ankle sprains without diastasis. Am J Sports Med 2001; 29: 31-35 DOI: 10.1177/03635465010290011001.
• 30 Ochmann S. Knochen- und Knorpelläsionen am oberen Sprunggelenk. In: Dohle J, Rammelt S. Expertise Orthopädie und Unfallchirurgie. Fuß und Sprunggelenk. Stuttgart: Thieme; 2021
• 31 Patel S, Malhotra K, Cullen NP. et al. Defining reference values for the normal tibiofibular syndesmosis in adults using weight-bearing CT. Bone Joint J 2019; 101-B: 348-352 DOI: 10.1302/0301–620X.101B3.BJJ-2018–0829.R1.
• 32 Schoennagel BP, Karul M, Avanesov M. et al. Isolated syndesmotic injury in acute ankle trauma: Comparison of plain film radiography with 3 T MRI. Eur J Radiol 2014; 83: 1856-1861 DOI: 10.1016/j.ejrad.2014.06.034.
• 33 Sclafani SJ. Ligamentous injury of the lower tibiofibular syndesmosis: Radiographic evidence. Radiology 1985; 156: 21-27 DOI: 10.1148/radiology.156.1.4001407.
• 34 Shakoor D, Osgood GM, Brehler M. et al. Cone-beam CT measurements of distal tibio-fibular syndesmosis in asymptomatic uninjured ankles: Does weight-bearing matter?. Skeletal Radiol 2019; 48: 583-594 DOI: 10.1007/s00256-018-3074-6.
• 35 Szeimies U, Staebler A, Walther M. Diagnostic imaging of the foot and ankle. Stuttgart: Thieme; 2015
• 36 Takao M, Ochi M, Naito K. et al. Arthroscopic diagnosis of tibiofibular syndesmosis disruption. Arthroscopy 2001; 17: 836-843 DOI: 10.1016/s0749-8063(01)90007-6.
• 37 Takao M, Ochi M, Oae K. et al. Diagnosis of a tear of the tibiofibular syndesmosis. The role of arthroscopy of the ankle. J Bone Joint Surg Br 2003; 85: 324-329 DOI: 10.1302/0301-620x.85b3.13174.
• 38 Uys HD, Rijke AM. Clinical association of acute lateral ankle sprain with syndesmotic involvement: A stress radiography and magnetic resonance imaging study. Am J Sports Med 2002; 30: 816-822 DOI: 10.1177/03635465020300061101.
• 39 van Zuuren WJ, Schepers T, Beumer A. et al. Acute syndesmotic instability in ankle fractures: A review. Foot Ankle Surg 2017; 23: 135-141 DOI: 10.1016/j.fas.2016.04.001.
• 40 Williams GN, Jones MH, Amendola A. Syndesmotic ankle sprains in athletes. Am J Sports Med 2007; 35: 1197-1207 DOI: 10.1177/0363546507302545.
• 41 Xenos JS, Hopkinson WJ, Mulligan ME. et al. The tibiofibular syndesmosis. Evaluation of the ligamentous structures, methods of fixation, and radiographic assessment. J Bone Joint Surg Am 1995; 77: 847-856