• Arch Orthop Trauma Surg · Jul 2006

    The distal tibiofibular syndesmosis during passive foot flexion. RSA-based study on intact, ligament injured and screw fixed cadaver specimens.

    • Laura Bragonzoni, Alessandro Russo, Mauro Girolami, Ugo Albisinni, Andrea Visani, Nicoletta Mazzotti, and Maurilio Marcacci.
    • Biomechanics Laboratory, Centro di Ricerca Codivilla-Putti, Istituti Ortopedici Rizzoli, Via di Barbiano 1/10, 40136 Bologna, Italy. l.bragonzoni@biomec.ior.it
    • Arch Orthop Trauma Surg. 2006 Jul 1; 126 (5): 304-8.

    IntroductionThe aim of the study was to investigate the kinematics of the distal tibiofibular syndesmosis in intact and ligament injured ankles and to assess how effective is the syndesmotic screw in restraining mortise width variations during passive foot flexion.Materials And MethodsThe trials were carried out on seven fresh frozen cadaver specimens. The distal tibiofibular syndesmosis widening was investigated using Roentgen stereophotogrammetric analysis, in intact and ligament injured ankles and after the fixation of the syndesmotic screw. The AO-ASIF recommendations were followed for screw implant.ResultsInjury to the syndesmotic and deltoid ligaments of the ankle did not result in a significant variation of the syndesmosis behavior during passive foot flexion. The 4.5-mm diameter cortical screw used in this study proved effective in restraining mortise width variation during foot flexion. The recorded mortise widening in the flexion arc extending from the neutral to the maximally dorsiflexed position was negligible in intact and ligament injured joints.ConclusionThe result does not endorse the recommendation of placing the foot in full dorsal flexion during screw implantation. The choice of screw fixation as a treatment for ankle syndesmosis disruption should be carefully evaluated.

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