The most responsive foot position for non-invasive detection of isolated unstable syndesmotic injuries - a 3D analysis.

Autor: Souleiman F; AO Research Institute Davos, Davos, Switzerland. firas.souleiman@medizin.uni-leipzig.de.; Department of Orthopedics, Trauma and Plastic Surgery, University of Leipzig, Leipzig, Germany. firas.souleiman@medizin.uni-leipzig.de., Heilemann M; Department of Orthopedics, Trauma and Plastic Surgery, University of Leipzig, Leipzig, Germany.; ZESBO - Center for Research on Musculoskeletal Systems, Leipzig University, Leipzig, Germany., Osterhoff G; Department of Orthopedics, Trauma and Plastic Surgery, University of Leipzig, Leipzig, Germany., Hepp P; Department of Orthopedics, Trauma and Plastic Surgery, University of Leipzig, Leipzig, Germany., Gueorguiev B; AO Research Institute Davos, Davos, Switzerland., Richards RG; AO Research Institute Davos, Davos, Switzerland., Gehweiler D; AO Research Institute Davos, Davos, Switzerland., Hennings R; Department of Orthopedics, Trauma and Plastic Surgery, University of Leipzig, Leipzig, Germany.
Jazyk: angličtina
Zdroj: Journal of orthopaedic surgery and research [J Orthop Surg Res] 2024 Nov 02; Vol. 19 (1), pp. 715. Date of Electronic Publication: 2024 Nov 02.
DOI: 10.1186/s13018-024-05211-y
Abstrakt: Background: The aim of this study was to identify the most responsive foot position for detection of isolated unstable syndesmotic injury.
Methods: Fourteen paired human cadaveric lower legs were positioned in a pressure-controlled radiolucent frame and loaded under 700 N. Computed tomography scans were performed in neutral position, 15° internal / external rotation, and 20° dorsal / plantar flexion of the foot before and after cutting all syndesmotic ligaments. For each position, generated 3D models of the intact and injured distal tibiofibular joints were matched and analyzed by calculating three parameters: diastasis, anteroposterior displacement, and shortening of the fibula.
Results: Transection of syndesmotic ligaments resulted in significant posterior translation of the fibula (4.34°, SD 1.63°, p < 0.01) compared to uninjured state for external rotation, significant anterior translation (-2.08°, SD 1.65°, p < 0.01) for internal rotation, and significant posterior translation (1.32°, SD 1.16°, p = 0.01) for dorsiflexion. Furthermore, the syndesmotic injury led to significantly increased clear space (0.46 mm, SD 0.46 mm, p = 0.03) in external rotation of the foot.
Conclusion: External rotation of the foot under loading seems to be the most responsive position for detection of isolated syndesmotic instability. Under external rotational stress, anteroposterior instability and increased clear space resulting from a complete isolated unstable syndesmotic lesion were most evident.
(© 2024. The Author(s).)
Databáze: MEDLINE
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