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Improving Operating Room Efficiency, Part 2: Intraoperative and Postoperative Strategies

JBJS Reviews, ISSN: 2329-9185, Vol: 3, Issue: 10, Page: 1-10
2015
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Review Description

« Ankle syndesmotic injuries are common with or without malleolar ankle fractures. » The ankle syndesmosis is made of the anterior inferior tibiofibular ligament, posterior inferior tibiofibular ligament, inferior transverse ligament, and interosseous ligament. « Normal syndesmosis widening can be up to 1.5 mm. » The syndesmosis helps to prevent excessive fibular motion during locomotion. « Clinical examinations to diagnose a syndesmotic injury are inaccurate. » Initial injury and intraoperative stress radiographs help to confirm the diagnosis. « Effective treatment requires accurate reduction and stable fixation allowing syndesmotic ankle ligament healing, limited syndesmotic motion, and restoration of stable ankle mechanics. » Nonoperative treatment for isolated syndesmotic injury is appropriate in a majority of cases. « Screw or suture-button methods of stabilization are similar in results and outcome. » Optimal screw size, length, and position have not been fully elucidated. « Timing of weight-bearing is controversial. » Timing and option of fixation removal are controversial.

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