Published in:
01-08-2021 | Ankle Fracture | Original Article
Influence of syndesmotic injuries and posterior malleolar ankle fractures on fibula position in the ankle joint: a cadaveric study
Published in: European Journal of Trauma and Emergency Surgery | Issue 4/2021
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Purpose
The aim of this study was to identify to what extent a dissection of the syndesmosis and an avulsed posterior edge of the tibia can change the tibiofibular diastasis and fibular rotation.
Methods
Three-dimensional scans with a mobile C-arm of 22 cadaver legs were taken of the intact fibula, after dissection of the anterior part of the syndesmosis and the interosseous membrane, osteotomy of the posterior malleolus, and osteosynthesis. The tibiofibular diastasis as well as the angle of fibular rotation was identified in the four steps and the means compared to each other using a t test for paired samples.
Results
The distinction between the intact fibula vs. the osteotomy of the posterior tibia was 0.082 ± 0.332 mm for the tibiofibular distance in the incisura tibiofibularis (p 0.261) and 0.046 ± 0.486 degrees for the angle of the fibular rotation (p 0.665).
Conclusion
Neither the dissection of the syndesmosis nor the osteotomy of the posterior malleolus significantly influenced the position of the fibula in the incisura tibiofibularis in the cadaveric model. However, in the nonweight-bearing situation, a lesion of the syndesmotic complex might not be evident in intraoperative three-dimensional imaging.