원위경비인대결합의 손상

• Published in: 대한족부족관절학회지 Vol. 26; no. 1; pp. 9 - 15
• Main Authors: 안정태, 박문수, 정비오, Ahn, Jungtae, Park, Moon Su, Jeong, Bi O
• Format: Journal Article
• Language: Korean
• Published: 대한족부족관절학회 01.03.2022
• Subjects: 정형외과학; Collateral ligament; Fracture fixation; Open fracture reduction; Ankle injury
• ISSN: 1738-3757; 2288-8551
• DOI: 10.14193/jkfas.2022.26.1.9

Syndesmotic injuries are found frequently in clinical practice, and they remain controversial because of the variety of diagnostic techniques 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 transfixation screws or suture button implants are being proposed as a means of fixation. Recently, suture button fixation has shown more favorable outcomes, but the outcomes can still be controversial. Syndesmotic malreduction can lead to hardware failure, adhesions, heterotopic 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.