CT scan assessment of the syndesmosis: a new reproducible method.

Abstract:

OBJECTIVES:Anatomic reduction of the fibula with regard to the tibia is the goal when treating syndesmotic injuries. No objective method exists to describe the distal tibiofibular relationship. The primary and secondary objectives of this study was to describe and validate radiologic measurements of the syndesmosis and to establish a set of normal values, respectively. METHODS:A set of 6 measurements and 2 angles were defined on axial computed tomography scans. These measures describe distal tibiofibular anatomy in rotation, lateral translation, and anteroposterior position. A series of 100 ankle computed tomography scans were measured by 2 evaluators. Interobserver reliability was assessed on a subset of 30 scans by 3 different evaluators. Measurements were repeated 6 weeks later by 2 evaluators for intraobserver reliability. All correlations were evaluated with intraclass correlation coefficients. RESULTS:Good correlations for nearly all measurements were found, with intraclass correlation coefficients over 0.5. The lateral translation was the most reliable measure with a mean value of 2.8 mm. The mean ratio of anterior tibiofibular distance to posterior tibiofibular distance was 0.54. Proximal to tibial plafond, the fibula is internally rotated 8.7 degrees and at the talar dome level it is in 6.9 degrees of external rotation. CONCLUSIONS:Several studies have shown that the reduction of the syndesmosis is essential to restore normal ankle mechanics and prevent secondary degenerative changes. The evaluation criteria developed in this study can give the surgeon a guideline for evaluating syndesmosis anatomy with reliable parameters. Concerning the normal range of motion, our radiologic measurements of 100 normal ankles showed that a significant amount of variability exists in the uninjured distal tibiofibular relationship.

journal_name

J Orthop Trauma

authors

Nault ML,Hébert-Davies J,Laflamme GY,Leduc S

doi

10.1097/BOT.0b013e318284785a

subject

Has Abstract

pub_date

2013-11-01 00:00:00

pages

638-41

issue

11

eissn

0890-5339

issn

1531-2291

journal_volume

27

pub_type

杂志文章
  • Knee arthrodesis with simultaneous lengthening using the Ilizarov method.

    abstract:OBJECTIVE:To determine whether knee arthrodesis with simultaneous lengthening using the Ilizarov method for a nonreconstructable knee joint with bone loss and infection is a successful salvage procedure. DESIGN:Retrospective review of patients. SETTING:University hospital-based orthopaedic practice. PATIENTS:From 19...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-200503000-00004

    authors: Rozbruch SR,Ilizarov S,Blyakher A

    更新日期:2005-03-01 00:00:00

  • Vascular abnormalities as assessed with CT angiography in high-energy tibial plafond fractures.

    abstract:OBJECTIVE:The purpose of this study was to examine the results of computed tomography angiography (CTA) obtained in patients with high-energy tibial plafond fractures and assess if the information gleaned from CTA could be useful to the treating orthopedic surgeon. DESIGN:Consecutive patient series. SETTING:Level 2 t...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e31815cf6e9

    authors: LeBus GF,Collinge C

    更新日期:2008-01-01 00:00:00

  • A new ankle spanning fixator construct for distal tibia fractures: optimizing visualization, minimizing pin problems, and protecting the heel.

    abstract::Pilon and ankle fractures and ligamentous injuries about the ankle often require external fixation to allow for soft tissue stabilization before definitive surgery. Often used external fixator constructs can cause obscuring of the site of injury on radiographs, pin tract infections, loosening of calcaenal pin fixation...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e3182604639

    authors: Ziran BH,Morrison T,Little J,Hileman B

    更新日期:2013-02-01 00:00:00

  • Importance of Mechanoreceptors and Other Neural Structures Within the Anterior Intermeniscal Ligament in the Etiology of Anterior Knee Pain After Tibial Nailing.

    abstract:BACKGROUND:Anterior knee pain is the most common complication after intramedullary tibial nailing. The cause is often multifactorial and varies among individuals. Violation of the anterior intermeniscal ligament (AIL) during intramedullary tibial nailing might be a possible source of postsurgical anterior knee pain. Al...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000001258

    authors: Franke J,Brobeil A,Lips KS,Gattenloehner S,Franke AP,Hohendorff B,Alt V,Schnettler R

    更新日期:2018-10-01 00:00:00

  • A Machine Learning Algorithm to Predict the Probability of (Occult) Posterior Malleolar Fractures Associated With Tibial Shaft Fractures to Guide "Malleolus First" Fixation.

    abstract:OBJECTIVES:To develop an accurate machine learning (ML) predictive model incorporating patient, fracture, and trauma characteristics to identify individual patients at risk of an (occult) PMF. METHODS:Databases of 2 studies including patients with TSFs from 2 Level 1 trauma centers were combined for analysis. Using te...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000001663

    authors: Hendrickx LAM,Sobol GL,Langerhuizen DWG,Bulstra AEJ,Hreha J,Sprague S,Sirkin MS,Ring D,Kerkhoffs GMMJ,Jaarsma RL,Doornberg JN,Machine Learning Consortium.

    更新日期:2020-03-01 00:00:00

  • Reconstructive amputation after grade IIIC open tibial fracture. One method of preserving residual limb length.

    abstract::A high percentage of patients with grade IIIC open tibial fractures eventually undergo amputation. Maintaining an adequate residual limb length is advantageous with regard to biomechanics, energy expenditure, and prosthetic fitting. This case report presents new considerations for maintaining residual limb length in t...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-199408000-00014

    authors: Hartford JM,Abdu WA,Mayor MB

    更新日期:1994-08-01 00:00:00

  • Syndesmotic instability in Weber B ankle fractures: a clinical evaluation.

    abstract:OBJECTIVE:Syndesmotic instability may coexist with unstable Weber B supination-external rotation (SE) lateral malleolar fractures. Current recommendations suggest that Weber B injuries should not have associated syndesmotic instability after open reduction and internal fixation of the lateral malleolus. The purpose of ...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e318157a63a

    authors: Stark E,Tornetta P 3rd,Creevy WR

    更新日期:2007-10-01 00:00:00

  • Mortality after pelvic fractures in the elderly.

    abstract::Theoretically, fissures and minor fractures of the pelvis sustained by the elderly after low-energy trauma may lead to thromboembolic complications. Few studies exist, but clinically, these injuries had been considered to have an excellent prognosis until a recent study reported a 10% fatality rate from pulmonary embo...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章,评审

    doi:10.1097/00005131-198906000-00005

    authors: Rossvoll I,Finsen V

    更新日期:1989-01-01 00:00:00

  • Brachial plexus palsy following proximal humerus fracture in patients who are skeletally immature.

    abstract::From 1998 to 2006, 578 patients who were skeletally immature with proximal humerus fractures were treated at our institution. During that time period, 4 patients (0.7%) had associated brachial plexus and major peripheral nerve palsies. Average age at the time of injury was 12.3 years (range 10-14 years). Two fractures...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e31816b7898

    authors: Hwang RW,Bae DS,Waters PM

    更新日期:2008-04-01 00:00:00

  • Complications of nailing in closed tibial fractures.

    abstract::Reamed intramedullary nailing was used to treat 102 closed tibial shaft fractures. Although a high rate of union was achieved (98%), we noted a higher incidence of complications than previously reported. Thirty-five (37%) patients exhibited one or more components of malunion. In 17 (18%) patients, further operative pr...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-199509060-00004

    authors: Williams J,Gibbons M,Trundle H,Murray D,Worlock P

    更新日期:1995-01-01 00:00:00

  • Closed elbow dislocation and brachial artery damage.

    abstract::Damage to the brachial artery associated with closed elbow dislocation but without accompanying fracture is rare. Only 25 cases have been reported to date. We present a case that responded well to brachial artery vein grafting, and review the literature on this subject. Operative repair is recommended in this uncommon...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章,评审

    doi:10.1097/00005131-199312000-00012

    authors: Slowik GM,Fitzimmons M,Rayhack JM

    更新日期:1993-01-01 00:00:00

  • The protective effect of locking screw placement on nonlocking screw extraction torque in an osteoporotic supracondylar femur fracture model.

    abstract:OBJECTIVE:To examine the impact of number and position of locking screws in the diaphyseal portion of an osteoporotic distal femoral fracture model with hybrid fixation. METHODS:Four groups containing 5 osteoporotic bone models were used with varying combinations of diaphyseal screw fixation: 4 nonlocking screws (cont...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e318238c086

    authors: Dalstrom DJ,Nelles DB,Patel V,Goswami T,Markert RJ,Prayson MJ

    更新日期:2012-09-01 00:00:00

  • The effects of locked and unlocked neutralization plates on load bearing of fractures fixed with a lag screw.

    abstract:OBJECTIVES:Because locked plates as a neutralization device for lag screw fracture fixation have different biomechanics than that of unlocked plates, we investigated how this would affect lag screw load at the fracture site. The purpose of this study was to assess the load at a fracture site compressed with a lag screw...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e31823b3dd1

    authors: Takemoto RC,Sugi MT,Kummer F,Koval KJ,Egol KA

    更新日期:2012-09-01 00:00:00

  • Temporary bridge plating of the medial column in severe midfoot injuries.

    abstract::Severe crush injuries to the midfoot often involve comminuted cuneiform or tarsal navicular fractures. Treatment principles for the bony injury of the crushed midfoot include maintenance of the medial column length and alignment, as well as appropriate stable fixation after open or closed fracture reductions. This is ...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章,评审

    doi:10.1097/00005131-200308000-00007

    authors: Schildhauer TA,Nork SE,Sangeorzan BJ

    更新日期:2003-08-01 00:00:00

  • Minimally invasive plate osteosynthesis of humeral shaft fractures: a technique to aid fracture reduction and minimize complications.

    abstract:OBJECTIVES:To introduce a modified operative technique for minimally invasive plate osteosynthesis (MIPO) for acute displaced humeral shaft fractures and to evaluate the clinical and radiological outcomes. DESIGN:: Prospective clinical series study. SETTING:University hospital. PATIENTS:Twenty-one patients with acut...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e318254895f

    authors: Shin SJ,Sohn HS,Do NH

    更新日期:2012-10-01 00:00:00

  • Chipping and lengthening technique for delayed unions and nonunions with shortening or bone loss.

    abstract::Autologous bone graft is usually necessary for reconstruction of nonunions with shortening or bone loss. We developed a new technique to reconstruct such nonunions or delayed unions without bone grafting by chipping and lengthening of bone at the original fracture site. Five in six nonunions with shortening or bone lo...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e318041f6d1

    authors: Matsushita T,Watanabe Y

    更新日期:2007-07-01 00:00:00

  • Outcomes of Surgical Treatment of Periprosthetic Acetabular Fractures.

    abstract::Periprosthetic acetabular fractures sustained following acute trauma after total hip arthroplasty are rare and historically have poor outcomes. This article reviews 5 cases and the treatment algorithm used by a single orthopaedic surgeon specializing in acetabular fracture care with a co-surgeon specializing in arthro...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000001400

    authors: Hickerson LE,Zbeda RM,Gadinsky NE,Wellman DS,Helfet DL

    更新日期:2019-02-01 00:00:00

  • Biomechanical testing of a new design for Schanz pedicle screws.

    abstract::Standard 5-mm AO Schanz pedicle screws were biomechanically compared with a new design, featuring 6-mm threads with a 5-mm core diameter continuous with the shaft. One each of the two screw designs was surgically inserted into the matching pedicles of 32 cadaveric vertebrae. The pull-out strengths of the screws were t...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-199308000-00015

    authors: Willett K,Hearn TC,Cuncins AV

    更新日期:1993-01-01 00:00:00

  • Regional anesthesia improves outcome after distal radius fracture fixation over general anesthesia.

    abstract:OBJECTIVE:To compare the efficacy of anesthetic type on clinical outcomes after operative treatment of distal radius fractures. DESIGN:Retrospective review of prospectively collected data. SETTING:Academic medical center. PATIENTS:One hundred eighty-seven patients with a distal radius fracture (OTA type 23) were ide...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e318238becb

    authors: Egol KA,Soojian MG,Walsh M,Katz J,Rosenberg AD,Paksima N

    更新日期:2012-09-01 00:00:00

  • Healing patterns of transverse and oblique osteotomies in the canine tibia under external fixation.

    abstract::Healing patterns were compared between transverse and 60 degrees oblique osteotomies in canine tibiae stabilized under external fixation. Under similar in vitro testing conditions (osteotomy ends in contact), the axial stiffness of the oblique osteotomy under external fixation was 45% of the paired transverse osteotom...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-199109000-00016

    authors: Aro HT,Wahner HT,Chao EY

    更新日期:1991-01-01 00:00:00

  • The realities of relationship failure.

    abstract::Young surgeons and their spouses experience a myriad of stresses in the first few years of practice. Issues related to job search, moving to a new community, learning one's craft, time management, changes to spouse's career, child rearing, and the ever blurring line between work time and free time may all contribute t...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e3182641fd8

    authors: Dunbar RP Jr

    更新日期:2012-09-01 00:00:00

  • The American Academy of Orthopaedic Surgeons/Society of Military Orthopaedic Surgeons/Orthopaedic Trauma Associations/Pediatric Orthopaedic Association Disaster Response and Preparedness Course.

    abstract::A disaster is a catastrophic event that disrupts normal infrastructure to such a degree that normal response mechanisms and capabilities cannot manage what is required to respond appropriately to the event. Launched after the largest urban disaster in modern history--the 2010 Haiti Earthquake--the American Academy of ...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000000405

    authors: Johnson AE,Gerlinger TL,Born CT

    更新日期:2015-10-01 00:00:00

  • Pelvic emergency clamps: anatomic landmarks for a safe primary application.

    abstract::The application of the pelvic clamp as a tool for emergency stabilization of unstable pelvic ring fractures has proved to be a life-saving procedure. Using correct technique, the pelvic clamp can be applied within a few minutes after the patient's admission. To avoid severe complications (eg, pin perforation into the ...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-200402000-00008

    authors: Pohlemann T,Braune C,Gänsslen A,Hüfner T,Partenheimer A

    更新日期:2004-02-01 00:00:00

  • Regeneration of segmental diaphyseal defects in sheep tibiae using resorbable polymeric membranes: a preliminary study.

    abstract:OBJECTIVE:To investigate whether a long bone cortex of well-defined thickness can be regenerated by using an anatomically designed membranous resorbable "tube-in-tube" implant and to establish the functions of membranes in the healing of segmental diaphyseal bone defects larger than the "critical size." DESIGN:Bone he...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-199903000-00006

    authors: Gugala Z,Gogolewski S

    更新日期:1999-03-01 00:00:00

  • A prospective, randomized study of intramedullary nails inserted with and without reaming for the treatment of open and closed fractures of the tibial shaft.

    abstract:OBJECTIVES:To determine if there are differences in healing, complications, or number of procedures required to obtain union among open and closed tibia fractures treated with intramedullary (IM) nails inserted with and without reaming. DESIGN:Prospective, surgeon-randomized comparative study. SETTING:Level One traum...

    journal_title:Journal of orthopaedic trauma

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00005131-200003000-00007

    authors: Finkemeier CG,Schmidt AH,Kyle RF,Templeman DC,Varecka TF

    更新日期:2000-03-01 00:00:00

  • The effects of pronator quadratus repair on outcomes after volar plating of distal radius fractures.

    abstract:OBJECTIVES:The purpose of this study was to evaluate forearm rotation after volar plating of the distal radius fractures with and without pronator quadratus repair. DESIGN:This was an institutional review board-approved retrospective review of prospectively collected data. SETTING:The study was conducted at an Academ...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e3182539333

    authors: Hershman SH,Immerman I,Bechtel C,Lekic N,Paksima N,Egol KA

    更新日期:2013-03-01 00:00:00

  • rhBMP-2 enhances the bone healing response in a diabetic rat segmental defect model.

    abstract:OBJECTIVE:Recombinant human bone morphogenetic protein-2 (rhBMP-2) has been shown to enhance new bone formation in fracture and bone defect models in both normal and diabetic rats. Effects of rhBMP-2 in a segmental femoral defect model in diabetes mellitus (DM) BB Wistar rats have not been reported. METHODS:Collagen s...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e31819f290e

    authors: Azad V,Breitbart E,Al-Zube L,Yeh S,O'Connor JP,Lin SS

    更新日期:2009-04-01 00:00:00

  • Surgical treatment of a displaced lateral malleolus fracture: the antiglide technique versus lateral plate fixation.

    abstract:OBJECTIVES:To assess the outcomes of the surgical management of "isolated" displaced lateral malleolar fractures, comparing the techniques of lateral plating and antiglide plating as described previously. DESIGN:This is a retrospective review, being largely a surgeon-randomized comparative study. SETTING:The study wa...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-200208000-00008

    authors: Lamontagne J,Blachut PA,Broekhuyse HM,O'Brien PJ,Meek RN

    更新日期:2002-08-01 00:00:00

  • Can locking screws allow smaller, low-profile plates to achieve comparable stability to larger, standard plates?

    abstract:OBJECTIVE:The open reduction and internal fixation of radial shaft fractures and osteotomies with standard 3.5-mm plates can be complicated by tendon irritation, hardware prominence, and fracture through the screw holes. With the advent of locking plate technology, implant companies and some surgeons have recommended e...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e3181f8bf9b

    authors: Garrigues GE,Glisson RR,Garrigues NW,Richard MJ,Ruch DS

    更新日期:2011-06-01 00:00:00

  • Comparison of Early Fatigue Failure of the TFNa and Gamma 3 Cephalomedullary Nails in the United States From 2015 to 2019.

    abstract:OBJECTIVES:To compare reports of implant fatigue failure submitted to the FDA of 2 commonly used cephalomedullary nails. METHODS:In total, 2724 medical device reports from the FDA's MAUDE database from Jan 2015 to Oct 2019 were reviewed for the Trochanteric Femoral Nail-Advanced (TFNa) and Gamma 3 implants. RESULTS:D...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000001864

    authors: Klima ML

    更新日期:2021-02-01 00:00:00