Syndesmotic repair

What is the recovery time after ankle surgery? Tensioning handles and a new trocar-tipped drill bit have been added to the implant system. It is available in stainless steel and titanium.

A general anesthetic typically is used and a nerve block may also be used during surgery or to provide pain relief after surgery. The syndesmosis is put into its proper position.

It is held in place with screws or suture implants. A plate also may be used. The focus is on healing and regaining full range of motion and normal strength.

Syndesmotic (Maisonneuve Injury) Closed. ORIF and syndesmotic screw to akle? Surgical management of syndesmotic injury is imperative to prevent ankle instability and secondary osteoarthritis.

Surgery When the syndesmosis is repaired surgically , this is usually done with metal screws that pass through the fibula and into the tibia. Assessment of the syndesmotic complex.

After stabilization of all fractures as appropriate , the stability and reduction of the syndesmotic complex must be assessed. Use a small bone hook to pull the fibula laterally to examine the syndesmotic complex. Remove any bony fragments from the distal tibiofibular joint. In the quest to promote normal biomechanics and avoid complications , surgeons continue to debate appropriate fixation , screw size and other components of surgical repair for syndesmotic ankle injuries. Accordingly, these authors offer pertinent surgical pearls, discuss the intricacies of screw fixation and provide two helpful case studies.

Traditionally, severe syndesmotic injuries with diastasis have been treated surgically with screw fixation. This case series details an ankle syndesmosis tightrope repair and an accelerated rehabilitation protocol that reduces the amount of time to return to professional rugby league in the UK. The fracture of the proximal fibula is only indirectly reduced and not directly fixed. This fracture type is the most unstable type, always resulting in an instability of the syndesmotic complex.

Restoration of length, axis and rotation of the fibula are of primary concern. Accompanying fractures are fixed thereafter. Rotational injuries to the ankle often result in malleolar fractures, which can be combined with ankle joint or syndesmotic ligament injuries.

Whole-foot rotation angles at 7. Nm of applied torque were measured for comparison of the different repair strategies, and reflective markers mounted on the tibia, fibula, and talus were used to track translations and rotations of the talus and the fibula relative to the tibia during testing. Rehab protocol created with help by: Braidy Solie, DPT, CSCS, EMR. Secondary surgical procedures (Ankle Fracture Treatment, Deltoid Repair ) and the ongoing tissue status must be considered during rehabilitation with appropriate protocol modification.

General Notes: The type of fracture and required fixation may dictate alterations to the general protocol below.

Some patients may not progress as quickly as the protocol allows. Seyhan M, Donmez F, et al, Comparison of screw fixation with elastic fixation methods in the treatment of syndesmosis injuries in ankle fractures, Injury, Int. This technique is used to stabilize an ankle after injury. It can be used to repair a high ankle sprain, which damages the soft tissue structures between the tibia and fibula and causes these bones to separate.

It can also be used to stabilize a fracture of the fibula. The TightRope system anchors the ends of the tibia and fibula together with a braided polyethylene cor rather than with a rigid surgical screw, to restore the original position of the bones and to allow for proper healing. Ankle fractures can also involve the articular surface of the tibia, known as pilon fractures.

To provide stability and allow for an anatomic reduction, some of these fractures are treated surgically. With the increased availability and usage of locking plates in some unstable injuries this enhances the knowledge that syndesmotic screws incorporated through a plate construct can aid the syndesmotic fixation.