원위경비인대결합의 손상
Syndesmotic Injury
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초록
Syndesmotic injuries are found frequently in clinical practice, and they remain controversial because of the variety of diagnostic tech- niques and management options. Bony avulsions or malleolar fractures are commonly associated with syndesmotic disruptions. Even unstable isolated syndesmosis injuries are associated with a latent or frank tibiofibular diastasis and should not be ignored in the early phase. A relevant instability of the syndesmosis with diastasis results from collateral ligaments tears and requires operative stabilization. The treatment involves an anatomic reduction of the distal tibiofibular articulations followed by stable fixation. Syndesmotic transfix- ation screws or suture button implants are being proposed as a means of fixation. Recently, suture button fixation has shown more favor- able outcomes, but the outcomes can still be controversial. Syndesmotic malreduction can lead to hardware failure, adhesions, heterotop- ic ossification, tibiofibular synostosis, chronic instability, and posttraumatic arthritis. In particular, the correct diagnosis and evidence- based treatment options for unstable syndesmotic injury should be considered.
Abstract
Syndesmotic injuries are found frequently in clinical practice, and they remain controversial because of the variety of diagnostic tech- niques and management options. Bony avulsions or malleolar fractures are commonly associated with syndesmotic disruptions. Even unstable isolated syndesmosis injuries are associated with a latent or frank tibiofibular diastasis and should not be ignored in the early phase. A relevant instability of the syndesmosis with diastasis results from collateral ligaments tears and requires operative stabilization. The treatment involves an anatomic reduction of the distal tibiofibular articulations followed by stable fixation. Syndesmotic transfix- ation screws or suture button implants are being proposed as a means of fixation. Recently, suture button fixation has shown more favor- able outcomes, but the outcomes can still be controversial. Syndesmotic malreduction can lead to hardware failure, adhesions, heterotop- ic ossification, tibiofibular synostosis, chronic instability, and posttraumatic arthritis. In particular, the correct diagnosis and evidence- based treatment options for unstable syndesmotic injury should be considered.
참고문헌 (50)
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