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European Journal of Trauma and Emergency Surgery

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01-04-2022 | Ankle Fracture | Original Article

Influence of unstable ankle fracture (type Weber C), osteosynthesis and syndesmotic transfixation on position of fibula in tibiofibular notch: a cadaveric study

Authors: Maxim Privalov, Benedict Swartman, Nils Beisemann, Jan El Barbari, Jochen Franke, Paul Alfred Grützner, Sven Vetter

Published in: European Journal of Trauma and Emergency Surgery | Issue 2/2022

Abstract

Purpose

The aim of the cadaveric study was to determine the effects of an unstable ankle fracture on the position of the fibula in the incisural notch and subsequently to evaluate the alterations resulting from the individual steps of a guideline-based osteosynthesis.

Methods

In a specimen model with 20 uninjured fresh-frozen lower legs with induced unstable fracture of the fibula (type Weber C), a guideline-based osteosynthesis was performed. The distances between the anterior and posterior edges of the tibia and fibula and in the center of the incisural notch, as well as the rotation angle of the fibula, were measured in the acquired 3D image data sets and were compared with the intact condition of the ankle mortise.

Results

The dissection of the syndesmosis and osteotomy of the fibula results in an external rotation the fibula by 3.6° (p = 0.000), while the distance between the anterior edge of the tibia and the fibula widens by 1.86 mm (p = 0.000). After osteosynthesis of the fibula and transfixation of the syndesmotic region using a positioning screw, the posterior distance is no longer substantially increased by 0.22 mm (p = 0.103) but also reduced by 0.1 mm (p = 0.104) in the tibiofibular notch. The external rotation of the fibula remains slightly increased by just 0.45° (p = 0.009).

Conclusion

The results indicate that there is a tendency for over-compression when adjusting the tibiofibular distance and that the fibula in the tibiofibular notch tends to remain slightly rotated externally.

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Title: Influence of unstable ankle fracture (type Weber C), osteosynthesis and syndesmotic transfixation on position of fibula in tibiofibular notch: a cadaveric study
Authors: Maxim Privalov
Benedict Swartman
Nils Beisemann
Jan El Barbari
Jochen Franke
Paul Alfred Grützner
Sven Vetter
Publication date: 01-04-2022
Publisher: Springer Berlin Heidelberg
Keyword: Ankle Fracture
Published in: European Journal of Trauma and Emergency Surgery / Issue 2/2022
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-021-01721-0

At a glance: The STEP trials

Springer Medicine

Influence of unstable ankle fracture (type Weber C), osteosynthesis and syndesmotic transfixation on position of fibula in tibiofibular notch: a cadaveric study

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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