Subscribe to RSS
DOI: 10.1055/a-2214-1953
Syndesmosenverletzungen
Syndesmosis InjuriesSyndesmosenverletzungen entstehen bei Sprunggelenkfrakturen oder rein ligamentär. können stabil oder instabil sein. In den letzten Jahren konnten zunehmende Erkenntnisse über den Verletzungsmechanismus und die Therapie gewonnen werden, kontroverse Diskussionen werden über Diagnostik, neue operative Verfahren wie Suture-Button-Systeme und die Nachbehandlung geführt. Eine zunehmende Bedeutung erlangten die knöchernen Ausrisse der vorderen und hinteren Syndesmose, dessen Refixation großzügig erfolgen sollte. Bei chronischer Instabilität ist eine Ursachenanalyse entscheidend, operative Verfahren beinhalten dynamische Verfahren, Sehnenplastiken oder knöcherne Rekonstruktionen. Entscheidend für das Outcome ist bei allen Verfahren die anatomische Rekonstruktion der Sprunggelenkgabel.
Publication History
Article published online:
10 April 2024
© 2024. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
Literatur
- 1 Bartonicek J. Anatomy of the tibiofibular syndesmosis and its clinical relevance. Surg Radiol Anat 2003; 25: 379-386 DOI: 10.1007/s00276-003-0156-4. (PMID: 14504816)
- 2 Zwipp H. Chirurgie des Fußes. Wien: Springer; 1994
- 3 Ogilvie-Harris DJ, Reed SC. Disruption of the ankle syndesmosis: diagnosis and treatment by arthroscopic surgery. Arthroscopy 1994; 10: 561-568 DOI: 10.1016/s0749-8063(05)80015-5. (PMID: 7999168)
- 4 Falk SSI, Mittlmeier T. Biomechanik des Sprunggelenks. Orthopädie und Unfallchirurgie up2date 2017; 12: 491-518 DOI: 10.1055/s-0043-100293.
- 5 Peter RE, Harrington RM, Henley MB. et al. Biomechanical effects of internal fixation of the distal tibiofibular syndesmotic joint: comparison of two fixation techniques. J Orthop Trauma 1994; 8: 215-219 DOI: 10.1097/00005131-199406000-00006. (PMID: 8027890)
- 6 Carr 2nd JC, Werner BC, Yarboro SR. An Update on Management of Syndesmosis Injury: A National US Database Study. Am J Orthop (Belle Mead NJ) 2016; 45: E472-E477 (PMID: 28005114)
- 7 Bartonicek J, Rammelt S, Kostlivy K. et al. Anatomy and classification of the posterior tibial fragment in ankle fractures. Arch Orthop Trauma Surg 2015; 135: 505-516 DOI: 10.1007/s00402-015-2171-4. (PMID: 25708027)
- 8 Rammelt S, Zwipp H, Grass R. Injuries to the distal tibiofibular syndesmosis: an evidence-based approach to acute and chronic lesions. Foot Ankle Clin 2008; 13: 611-633 DOI: 10.1016/j.fcl.2008.08.001. (PMID: 19013399)
- 9 Steinmetz S, Puliero B, Brinkert D. et al. Tibiofemoral syndesmosis injury treated by temporary screw fixation and ligament repair. Orthop Traumatol Surg Res 2016; 102: 1069-1073 DOI: 10.1016/j.otsr.2016.06.015. (PMID: 27592847)
- 10 Williams GN, Jones MH, Amendola A. Syndesmotic ankle sprains in athletes. Am J Sports Med 2007; 35: 1197-1207 DOI: 10.1177/0363546507302545. (PMID: 17519439)
- 11 Vopat ML, Vopat BG, Lubberts B. et al. Current trends in the diagnosis and management of syndesmotic injury. Curr Rev Musculoskelet Med 2017; 10: 94-103 DOI: 10.1007/s12178-017-9389-4. (PMID: 28101828)
- 12 Haraguchi N, Haruyama H, Toga H. et al. Pathoanatomy of posterior malleolar fractures of the ankle. J Bone Joint Surg Am 2006; 88: 1085-1092 DOI: 10.2106/JBJS.E.00856. (PMID: 16651584)
- 13 Mason LW, Marlow WJ, Widnall J. et al. Pathoanatomy and Associated Injuries of Posterior Malleolus Fracture of the Ankle. Foot Ankle Int 2017; 38: 1229-1235 DOI: 10.1177/1071100717719533. (PMID: 28758439)
- 14 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. (PMID: 28391516)
- 15 Beumer A, Swierstra BA, Mulder PG. Clinical diagnosis of syndesmotic ankle instability: evaluation of stress tests behind the curtains. Acta Orthop Scand 2002; 73: 667-669 DOI: 10.1080/000164702321039642. (PMID: 12553515)
- 16 Frick H. Zur Entstehung, Klinik, Diagnostik und Therapie der isolierten Verletzung der tibiofibularen Syndesmose. Unfallheilkunde 1978; 81: 542-545 (PMID: 356382)
- 17 de Cesar PC, Avila EM, de Abreu MR. Comparison of magnetic resonance imaging to physical examination for syndesmotic injury after lateral ankle sprain. Foot Ankle Int 2011; 32: 1110-1114 DOI: 10.3113/FAI.2011.1110. (PMID: 22381194)
- 18 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.
- 19 Sman AD, Hiller CE, Rae K. et al. Diagnostic accuracy of clinical tests for ankle syndesmosis injury. Br J Sports Med 2015; 49: 323-329 DOI: 10.1136/bjsports-2013-092787. (PMID: 24255766)
- 20 Lubberts B, Guss D, Vopat BG. et al. The effect of ankle distraction on arthroscopic evaluation of syndesmotic instability: A cadaveric study. Clin Biomech (Bristol, Avon) 2017; 50: 16-20 DOI: 10.1016/j.clinbiomech.2017.09.013.
- 21 Wagener ML, Beumer A, Swierstra BA. Chronic instability of the anterior tibiofibular syndesmosis of the ankle. Arthroscopic findings and results of anatomical reconstruction. BMC Musculoskeletal Disorders 2011; 12 DOI: 10.1186/1471-2474-12-212. (PMID: 21951619)
- 22 Spindler FT, Herterich V, Holzapfel BM. et al. A systematic review and meta-analysis on the value of the external rotation stress test under fluoroscopy to detect syndesmotic injuries. EFORT Open Rev 2022; 7: 671-679 DOI: 10.1530/EOR-22-0037. (PMID: 36287127)
- 23 Phillips WA, Schwartz HS, Keller CS. et al. A prospective, randomized study of the management of severe ankle fractures. J Bone Joint Surg Am 1985; 67: 67-78 (PMID: 3881447)
- 24 Weber BG. Die Verletzungen des oberen Sprunggelenkes. In: Aktuelle Probleme in der Chirurgie, Band 3. Bern, Stuttgart: Huber; 1966
- 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. (PMID: 19336613)
- 26 Hagemeijer NC, Saengsin J, Chang SH. et al. Diagnosing syndesmotic instability with dynamic ultrasound – establishing the natural variations in normal motion. Injury 2020; 51: 2703-2709 DOI: 10.1016/j.injury.2020.07.060.
- 27 Salat P, Le V, Veljkovic A. et al. Imaging in Foot and Ankle Instability. Foot Ankle Clin 2018; 23: 499-522.e28 DOI: 10.1016/j.fcl.2018.07.011.
- 28 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. (PMID: 28865579)
- 29 Hocker K, Pachucki A. [The fibular incisure of the tibia. The cross-sectional position of the fibula in distal syndesmosis]. Unfallchirurg 1989; 92: 401-406 (PMID: 2799399)
- 30 Rammelt S. Syndesmotic Injuries. In: Dohle J, Rammelt S. Expertise Fuß und Sprunggelenk. Stuttgart: Thieme; 2021. DOI: 10.1055/b-006-149527
- 31 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. (PMID: 17371657)
- 32 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. (PMID: 25398368)
- 33 Volmer E, Mittlmeier T, Weber MA. [Ligamentous injuries of the ankle joint: Importance of radiological imaging procedures]. Radiologie (Heidelb) 2023; 63: 617-627 DOI: 10.1007/s00117-023-01181-0. (PMID: 37642697)
- 34 Valkering KP, Vergroesen DA, Nolte PA. Isolated syndesmosis ankle injury. Orthopedics 2012; 35: e1705-e1710 DOI: 10.3928/01477447-20121120-13. (PMID: 23218625)
- 35 Hao KA, Vander Griend RA, Nichols JA. et al. Intraoperative Assessment of Reduction of the Ankle Syndesmosis. Curr Rev Musculoskelet Med 2022; 15: 344-352 DOI: 10.1007/s12178-022-09769-0.
- 36 Lubberts B, Guss D, Vopat BG. et al. The arthroscopic syndesmotic assessment tool can differentiate between stable and unstable ankle syndesmoses. Knee Surg Sports Traumatol Arthrosc 2020; 28: 193-201 DOI: 10.1007/s00167-018-5229-3.
- 37 Bhimani R, Ashkani-Esfahani S, Lubberts B. et al. Utility of Volumetric Measurement via Weight-Bearing Computed Tomography Scan to Diagnose Syndesmotic Instability. Foot Ankle Int 2020; 41: 859-865 DOI: 10.1177/1071100720917682. (PMID: 32419488)
- 38 de Carvalho KAM, Walt JS, Ehret A. et al. Comparison between Weightbearing-CT semiautomatic and manual measurements in Hallux Valgus. Foot Ankle Surg 2022; 28: 518-525 DOI: 10.1016/j.fas.2022.02.014.
- 39 Del Buono A, Florio A, Boccanera MS. et al. Syndesmosis injuries of the ankle. Curr Rev Musculoskelet Med 2013; 6: 313-319 DOI: 10.1007/s12178-013-9183-x. (PMID: 23943273)
- 40 van Dijk CN, Longo UG, Loppini M. et al. Classification and diagnosis of acute isolated syndesmotic injuries: ESSKA-AFAS consensus and guidelines. Knee Surg Sports Traumatol Arthrosc 2016; 24: 1200-1216 DOI: 10.1007/s00167-015-3942-8. (PMID: 26704800)
- 41 van Dijk CN, Longo UG, Loppini M. et al. Conservative and surgical management of acute isolated syndesmotic injuries: ESSKA-AFAS consensus and guidelines. Knee Surg Sports Traumatol Arthrosc 2016; 24: 1217-1227 DOI: 10.1007/s00167-016-4017-1. (PMID: 26846658)
- 42 Miller AN, Carroll EA, Parker RJ. et al. Direct visualization for syndesmotic stabilization of ankle fractures. Foot Ankle Int 2009; 30: 419-426 DOI: 10.3113/FAI-2009-0419. (PMID: 19439142)
- 43 Stenquist DS, Kwon JY. Strategies to Avoid Syndesmosis Malreduction in Ankle Fractures. Foot Ankle Clin 2020; 25: 613-630 DOI: 10.1016/j.fcl.2020.08.001. (PMID: 33543719)
- 44 Koenig SJ, Tornetta 3rd P, Merlin G. et al. Can We Tell if the Syndesmosis Is Reduced Using Fluoroscopy?. J Orthop Trauma 2015; 29: e326-e330 DOI: 10.1097/BOT.0000000000000296. (PMID: 25635357)
- 45 Marmor M, Hansen E, Han HK. et al. Limitations of standard fluoroscopy in detecting rotational malreduction of the syndesmosis in an ankle fracture model. Foot Ankle Int 2011; 32: 616-622 DOI: 10.3113/FAI.2011.0616. (PMID: 21733425)
- 46 Wake J, Martin KD. Syndesmosis Injury From Diagnosis to Repair: Physical Examination, Diagnosis, and Arthroscopic-assisted Reduction. J Am Acad Orthop Surg 2020; 28: 517-527 DOI: 10.5435/JAAOS-D-19-00358. (PMID: 32109919)
- 47 Rellensmann K, Behzadi C, Usseglio J. et al. Acute, isolated and unstable syndesmotic injuries are frequently associated with intra-articular pathologies. Knee Surg Sports Traumatol Arthrosc 2021; 29: 1516-1522 DOI: 10.1007/s00167-020-06141-y.
- 48 Abarca M, Besa P, Mora E. et al. The use of intraoperative comparative fluoroscopy allows for assessing sagittal reduction and predicting syndesmosis reduction in ankle fractures. Foot Ankle Surg 2022; 28: 750-755 DOI: 10.1016/j.fas.2021.10.003. (PMID: 34686414)
- 49 Cunningham BA, Warner S, Berkes M. et al. Effect of Intraoperative Multidimensional Fluoroscopy Versus Conventional Fluoroscopy on Syndesmotic Reduction. Foot Ankle Int 2021; 42: 132-136 DOI: 10.1177/1071100720959025. (PMID: 32945190)
- 50 Franke J, von Recum J, Suda AJ. et al. Intraoperative three-dimensional imaging in the treatment of acute unstable syndesmotic injuries. J Bone Joint Surg Am 2012; 94: 1386-1390 DOI: 10.2106/JBJS.K.01122.
- 51 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. (PMID: 28471914)
- 52 Phisitkul P, Ebinger T, Goetz J. et al. Forceps reduction of the syndesmosis in rotational ankle fractures: a cadaveric study. J Bone Joint Surg Am 2012; 94: 2256-2261 DOI: 10.2106/JBJS.K.01726. (PMID: 23318616)
- 53 Miller AN, Barei DP, Iaquinto JM. et al. Iatrogenic syndesmosis malreduction via clamp and screw placement. J Orthop Trauma 2013; 27: 100-106 DOI: 10.1097/BOT.0b013e31825197cb. (PMID: 22549032)
- 54 Harris MC, Lause G, Unangst A. et al. Prospective Results of the Modified Glide Path Technique for Improved Syndesmotic Reduction During Ankle Fracture Fixation. Foot Ankle Int 2022; 43: 923-927 DOI: 10.1177/10711007221081868.
- 55 McBryde A, Chiasson B, Wilhelm A. et al. Syndesmotic screw placement: a biomechanical analysis. Foot Ankle Int 1997; 18: 262-266 DOI: 10.1177/107110079701800503. (PMID: 9167924)
- 56 Schepers T, Dingemans SA, de Jong VM. et al. Overlooked Syndesmotic Injuries. J Foot Ankle Surg 2016; 55: 894-896 DOI: 10.1053/j.jfas.2016.02.013. (PMID: 27079307)
- 57 Schepers T, van der Linden H, van Lieshout EM. et al. Technical aspects of the syndesmotic screw and their effect on functional outcome following acute distal tibiofibular syndesmosis injury. Injury 2014; 45: 775-779 DOI: 10.1016/j.injury.2013.09.035.
- 58 Wikeroy AK, Hoiness PR, Andreassen GS. et al. No difference in functional and radiographic results 8.4 years after quadricortical compared with tricortical syndesmosis fixation in ankle fractures. J Orthop Trauma 2010; 24: 17-23 DOI: 10.1097/BOT.0b013e3181bedca1.
- 59 Rammelt S, Schepers T. Chopart Injuries: When to Fix and When to Fuse?. Foot Ankle Clin 2017; 22: 163-180 DOI: 10.1016/j.fcl.2016.09.011. (PMID: 28167061)
- 60 Raeder BW, Stake IK, Madsen JE. et al. Randomized trial comparing suture button with single 3.5 mm syndesmotic screw for ankle syndesmosis injury: similar results at 2 years. Acta Orthop 2020; 91: 770-775 DOI: 10.1080/17453674.2020.1818175.
- 61 Xu B, Wang S, Tan J. et al. Comparison of Suture Button and Syndesmotic Screw for Ankle Syndesmotic Injuries: A Meta-analysis of Randomized Controlled Trials. Orthop J Sports Med 2023; 11 DOI: 10.1177/23259671221127665. (PMID: 36636033)
- 62 Baumbach SF, Synek A, Spindler FT. et al. Safe drilling zones for anteriorly, central, and posteriorly angulated syndesmotic stabilization devices. Knee Surg Sports Traumatol Arthrosc 2023; 31: 2199-2207 DOI: 10.1007/s00167-022-07291-x. (PMID: 36547696)
- 63 McKenzie AC, Hesselholt KE, Larsen MS. et al. A Systematic Review and Meta-Analysis on Treatment of Ankle Fractures With Syndesmotic Rupture: Suture-Button Fixation Versus Cortical Screw Fixation. J Foot Ankle Surg 2019; 58: 946-953 DOI: 10.1053/j.jfas.2018.12.006.
- 64 Lee JS, Curnutte B, Pan K. et al. Biomechanical comparison of suture-button, bioabsorbable screw, and metal screw for ankle syndesmotic repair: A meta-analysis. Foot Ankle Surg 2021; 27: 117-122 DOI: 10.1016/j.fas.2020.03.008. (PMID: 32466876)
- 65 Schermann H, Ogawa T, Lubberts B. et al. Comparison of Several Combinations of Suture Tape Reinforcement and Suture Button Constructs for Fixation of Unstable Syndesmosis. J Am Acad Orthop Surg 2022; 30: e769-e778 DOI: 10.5435/JAAOS-D-21-00508.
- 66 Jamieson MD, Stake IK, Brady AW. et al. Anterior Inferior Tibiofibular Ligament Suture Tape Augmentation for Isolated Syndesmotic Injuries. Foot Ankle Int 2022; 43: 994-1003 DOI: 10.1177/10711007221082933. (PMID: 35403468)
- 67 Shoji H, Teramoto A, Suzuki D. et al. Suture-button fixation and anterior inferior tibiofibular ligament augmentation with suture-tape for syndesmosis injury: A biomechanical cadaveric study. Clin Biomech (Bristol, Avon) 2018; 60: 121-126 DOI: 10.1016/j.clinbiomech.2018.10.014.
- 68 Takahashi K, Teramoto A, Murahashi Y. et al. Comparison of Treatment Methods for Syndesmotic Injuries With Posterior Tibiofibular Ligament Ruptures: A Cadaveric Biomechanical Study. Orthop J Sports Med 2022; 10 DOI: 10.1177/23259671221122811.
- 69 Kim JS, Shin HS. Suture Anchor Augmentation for Acute Unstable Isolated Ankle Syndesmosis Disruption in Athletes. Foot Ankle Int 2021; 42: 1130-1137 DOI: 10.1177/10711007211015188. (PMID: 34088225)
- 70 Naqvi GA, Cunningham P, Lynch B. et al. Fixation of ankle syndesmotic injuries: comparison of tightrope fixation and syndesmotic screw fixation for accuracy of syndesmotic reduction. Am J Sports Med 2012; 40: 2828-2835 DOI: 10.1177/0363546512461480. (PMID: 23051785)
- 71 Harper MC, Keller TS. A radiographic evaluation of the tibiofibular syndesmosis. Foot Ankle 1989; 10: 156-160 DOI: 10.1177/107110078901000308. (PMID: 2613128)
- 72 Kroker L, Neumann AP, Beyer F. et al. Ankle fractures involving the anterolateral distal tibia: medium-term clinical results of 50 cases. Eur J Trauma Emerg Surg 2023; 49: 941-949 DOI: 10.1007/s00068-022-02161-0. (PMID: 36414696)
- 73 Grass R, Herzmann K, Biewener A. et al. [Injuries of the inferior tibiofibular syndesmosis]. Unfallchirurg 2000; 103: 520-532 (PMID: 10969538)
- 74 Grass R, Rammelt S, Biewener A. et al. Peroneus longus ligamentoplasty for chronic instability of the distal tibiofibular syndesmosis. Foot Ankle Int 2003; 24: 392-397 DOI: 10.1177/107110070302400503. (PMID: 12801194)
- 75 Schepers T. To retain or remove the syndesmotic screw: a review of literature. Arch Orthop Trauma Surg 2011; 131: 879-883 DOI: 10.1007/s00402-010-1225-x. (PMID: 21161662)