Sindesmose tibiofibular: diagnóstico, métodos de fixação e artroscopia
DOI:
https://doi.org/10.5281/zenodo.7768163Palavras-chave:
sindesmose tibiofibular, tomografia computadorizada, métodos de fixação, placas e parafusos, artroscopia do tornozeloResumo
Introdução: as lesões da sindesmose tibiofibular são frequentes isoladamente ou associadas a fraturas do maléolo posterior. O diagnóstico clínico é confirmado por exames de imagem. Os métodos de fixação podem ser rígidos ou dinâmicos.
bjetivo: atualizar aspectos das lesões da sindesmose tibiofibular quanto ao diagnóstico, métodos de fixação e uso da abordagem artroscópica.
Método: a busca e análise das informações foi realizada em um período de 61 dias (1º de outubro a 30 de novembro de 2022) e foram utilizadas as seguintes palavras: syndesmosis injury, ankle syndesmosis instability, syndesmosis instability AND tight rope ankle instability, posterior maleolar fracture. Com base nas informações obtidas, foi realizada uma revisão bibliográfica de um total de 258 artigos publicados nas bases de dados PubMed, Hinari, SciELO e Medline, utilizando o gerenciador de busca e Gerenciador de referências do EndNote.
Desenvolvimento: foi feita referência a manobras clínicas para diagnóstico e classificações tomográficas em caso de fractura associada do maléolo posterior. Foram citados métodos de fixação rígidos e dinâmicos, onde foram descritas as características de cada um com base em vários fatores. As vantagens da abordagem artroscópica tanto para o diagnóstico quanto para o tratamento foram discutidas.
Conclusões: as lesões da sindesmose tibiofibular distal são frequentes. Os estudos tomográficos oferecem vantagens na determinação da extensão da fratura do maléolo posterior. A abordagem artroscópica oferece múltiplas vantagens diagnósticas e terapêuticas.
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Referências
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3. Xie W, Lu H, Quan Y, Liu Y, Fu Z, Zhang D, et al. Morphological analysis of posterior malleolar fractures with intra-articular impacted fragment in computed tomography scans. J Orthop Traumatol [Internet]. 2021 [citado 20 Nov 2022]; 22(1):52. DOI: https://doi.org/10.1186/s10195-021-00615-6
4. Baltes TPA, Al-Sayrafi O, Arnáiz J, Al-Naimi MR, Geertsema C, Geertsema L, et al. Acute clinical evaluation for syndesmosis injury has high diagnostic value. Knee Surg Sports Traumatol Arthrosc [Internet]. 2022 Nov [citado 20 Nov 2022]; 30(11):3871-3880. DOI: https://doi.org/10.1007%2Fs00167-022-06989-2
5. Chen KH, Chen CH, Huang YM, Lee HH, Tsuang YH. Injury mechanism affects the stability of suture-button syndesmosis fixation. J Orthop Surg Res [Internet]. 2020 Dec [citado 20 Nov 2022]; 15(1):599. DOI: https://doi.org/10.1186/s13018-020-02141-3
6. Egol KA, Koval KJ, Zuckerman J. Handbook of fractures. 6ed. Philadelphia: Wolter Kluwer; 2020.
7. Chun DI, Cho JH, Min TH, Park SY, Kim KH, Kim JH, et al. Diagnostic accuracy of radiologic methods for ankle syndesmosis injury: a systematic review and meta-analysis. J Clin Med [Internet]. 2019 Jul [citado 20 Nov 2022]; 8(7):968. DOI: https://doi.org/10.3390/jcm8070968
8. Sharif B, Welck M, Saifuddin A. MRI of the distal tibiofibular joint. Skeletal Radiol [Internet]. 2020 Jan [citado 20 Nov 2022]; 49(1):1-17. Disponible en: https://doi.org/10.1007/s00256-019-03260-7
9. Teramoto A, Shoji H, Anzai K, Kamiya T, Watanabe K, Yamashita T. Tibiofibular space widening assessment with a ball-tipped probe in a syndesmosis injury model. J Foot Ankle Surg [Internet]. 2020 Nov-Dec [Citado 20 Nov 2022]; 59(6):1215-1218. DOI: https://doi.org/10.1053/j.jfas.2020.03.024
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11. Cornu O, Manon J, Tribak K, Putineanu D. Traumatic injuries of the distal tibiofibular syndesmosis. Orthop Traumatol Surg Res [Internet]. 2021 Feb [citado 20 Nov 2022]; 107(1S). DOI: https://doi.org/10.1016/j.otsr.2020.102778
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13. Bejarano-Pineda L, Guss D, Waryasz G, DiGiovanni CW, Kwon JY. The syndesmosis, Part I: anatomy, injury mechanism, classification, and diagnosis. Orthop Clin North Am [Internet]. 2021 Oct [citado 20 Nov 2022]; 52(4):403-415. DOI: https://doi.org/10.1016/j.ocl.2021.05.010
14. Çaglar C, Akçaalan S, Akkaya M. Anatomically fixed posterior malleolar fractures in syndesmosis injuries without transsyndesmotic screw fixation. Foot Ankle Int [Internet]. 2022 Apr [citado 20 Nov 2022]; 43(4):486-494. DOI: https://doi.org/10.1177/10711007211060067
15. Sin YH, Lui TH. Arthroscopically assisted reduction of sagittal-plane disruption of distal tibiofibular syndesmosis. Arthrosc Tech [Internet]. 2019 Apr [citado 20 Nov 2022]; 8(5):E521-E525. DOI: https://doi.org/10.1016/j.eats.2019.01.014
16. Pogliacomi F, Filippo M de, Casalini D, Longhi A, Tacci F, Perotta R, et al. Acute syndesmotic injuries in ankle fractures: from diagnosis to treatment and current concepts. World J Orthop [Internet]. 2021 May [citado 20 Nov 2022]; 12(5):270-291. DOI: https://doi.org/10.5312/wjo.v12.i5.270
17. Spennacchio P, Seil R, Gathen M, Cucchi D. Diagnosing instability of ligamentous syndesmotic injuries: A biomechanical perspective. Clin Biomech (Bristol, Avon) [Internet]. 2021 Apr [citado 20 Nov 2022]; 84:105312. DOI: https://doi.org/10.1016/j.clinbiomech.2021.105312
18. Tourné Y, Molinier F, Andrieu M, Porta J, Barbier G. Diagnosis and treatment of tibiofibular syndesmosis lesions. Orthop Traumatol Surg Res [Internet]. 2019 Dec [citado 20 Nov 2022]; 105(8S):S275-S286. DOI: https://doi.org/10.1016/j.otsr.2019.09.014
19. Yu GS, Lin YB, Xiong GS, Xu HB, Liu YY. Diagnosis and treatment of ankle syndesmosis injuries with associated interosseous membrane injury: a current concept review. Int Orthop [Internet]. 2019 Nov [citado 20 Nov 2022]; 43(11):2539-2547. DOI: https://doi.org/10.1007/s00264-019-04396-w
20. White T, Bugler K. Ankle fractures. En: Tornetta P, Ricci WM, Ostrum RF, McQueen MM, McKee MD. Court Brown CM. Rockwood and Green's Fractures in Adults. 9ed. Philadelphia: Wolter Kluwer; 2020.
21. Williams C, Momenzadeh K, Michalski M, Kwon JY, Nazarian A, Miller CP. Anatomic and radiographic safe zone for posterior malleolar screw placement. Foot Ankle Int [Internet]. 2021 Dec [citado 20 Nov 2022]; 42(12):1598-1605. DOI: https://doi.org/10.1177/10711007211022747
22. Grambart ST, Prusa RD, Ternent KM. Revision of the chronic syndesmotic injury. Clin Podiatr Med Surg [Internet]. 2020 Jul [citado 20 Nov 2022]; 37(3):577-592. DOI: https://doi.org/10.1016/j.cpm.2020.03.011
23. Haraguchi N, Haruyama H, Toga H. Pathoanatomy of posterior malleolar fractures of the ankle. J Bone Joint Surg Am [Internet]. 2006 May [citado 20 Nov 2022]; 88(5):1085-1092. DOI: https://doi.org/10.2106/jbjs.e.00856
24. Bartoníček J, Rammelt S, Kostlivy, Vanĕček V, Klika D, Trešl I. Anatomy and classification of the posterior tibial fragment in ankle fracture. Arch Orthop Trauma Surg [Internet]. 2015 Apr [citado 20 Nov 2022]; 135(4):505-516. DOI: https://doi.org/10.1007/s00402-015-2171-4
25. Carr JB, Gebhard F. Malleolar fractures and soft tissue injuries of the ankle. En: Browner BD, Jupiter JB, Krettek C, Anderson PA. Skeletal Trauma. 5ed. Philadelphia: Elsevier; 2015. p.2189-2249.
26. Baumbach SF, Böcker W, Polzer H. Open reduction and internal fixation of posterior malleolus fractures. Oper Orthop Traumatol [Internet]. 2021 Apr [citado 20 Nov 2022]; 33(2):112-124. DOI: https://doi.org/10.1007/s00064-021-00705-y
27. Tomar L, Govil G, Dhawan P. Isolated posterior malleolar fracture: a case report of a rare presentation with narrative review of literature. Cureus [Internet]. 2022 Jan [citado 20 Nov 2022]; 14(1):e21658. DOI: https://doi.org/10.7759/cureus.21658
28. Fernández-Rojas E, Herrera-Pérez M, Vilá-Rico J. Posterior malleolar fractures: Indications and surgical approaches. Rev Esp Cir Ortop Traumatol [Internet]. 2022 Nov [citado 20 Nov 2022]:160-169. DOI: https://doi.org/10.1016/j.recot.2022.10.019
29. Elghazy MA, Hagemeijer NC, Guss D, El-Hawary A, Johnson AH, El-Mowafi H, et al. Screw versus suture button in treatment of syndesmosis instability: comparison using weightbearing CT scan. Foot Ankle Surg [Internet]. 2021 Apr [citado 20 Nov 2022]; 27(3):285-290. DOI: https://doi.org/10.1016/j.fas.2021.01.001
30. Balso C del, Hamam AW, Chohan MBY, Tieszer C, Lawendy AR, Sanders DW. Anatomic repair vs closed reduction of the syndesmosis. Foot Ankle Int [Internet]. 2021 Jul [citado 20 Nov 2022]; 42(7):877-885. DOI: https://doi.org/10.1177/1071100721990008
31. Kurtoglu A, Kochai A, Inanmaz ME, Sukur E, Keskin D, Türker M, et al. A comparison of double single suture-button fixation, suture-button fixation, and screw fixation for ankle syndesmosis injury: a retrospective cohort study. Medicine (Baltimore) [Internet]. 2021 Apr [citado 20 Nov 2022]; 100(13):e25328. DOI: https://doi.org/10.1097/md.0000000000025328
32. Bafna KR, Jordan R, Yatsonsky D, Dick S, Liu J, Ebraheim NA. Revision of syndesmosis screw fixation. Foot Ankle Spec [Internet]. 2020 Apr [citado 20 Nov 2022]; 13(2):138-143. DOI: https://doi.org/10.1177/1938640019843328
33. Huang CT, Huang PJ, Lu CC, Shih CL, Cheng YM, Chen SJ. Syndesmosis changes before and after syndesmotic screw removal: a retrospective radiographic study. Medicina (Kaunas) [Internet]. 2022 Mar [citado 20 Nov 2022]; 58(3):445. DOI: https://doi.org/10.3390/medicina58030445
34. Mercan N, Yildirim A, Dere Y. Biomechanical analysis of tibiofibular syndesmosis injury fixation methods: a finite element analysis. J Foot Ankle Surg [Internet]. 2022 May [citado 20 Nov 2022]; 62(1):P107-114. DOI: https://doi.org/10.1053/j.jfas.2022.05.007
35. Gan K, Xu D, Hu K, Wu W, Shen Y. Dynamic fixation is superior in terms of clinical outcomes to static fixation in managing distal tibiofibular syndesmosis injury. Knee Surg Sports Traumatol Arthrosc [Internet]. 2020 Jan [citado 20 Nov 2022]; 28(1):270-280. DOI: https://doi.org/10.1007/s00167-019-05659-0
36. Lehtola R, Leskelä HV, Flinkkilä T, Pakarinen H, Niinimäki J, Savola O, et al. Suture button versus syndesmosis screw fixation in pronation-external rotation ankle fractures: a minimum 6-year follow-up of a randomised controlled trial. Injury [Internet]. 2021 Oct [citado 20 Nov 2022]; 52(10):P3143-3149. DOI: https://doi.org/10.1016/j.injury.2021.06.025
37. Marasco D, Russo J, Izzo A, Vallefuoco S, Coppola F, Patel S, et al. Static versus dynamic fixation of distal tibiofibular syndesmosis: a systematic review of overlapping meta-analyses. Knee Surg Sports Traumatol Arthrosc [Internet]. 2021 Nov [citado 20 Nov 2022]; 29(11):3534-3542. DOI: https://doi.org/10.1007/s00167-021-06721-6
38. Yüce A, Misir A, Yerli M, Bayraktar TO, Tekin AÇ, Dedeoglu SS, et al. The effect of syndesmotic screw level on postoperative syndesmosis malreduction. J Foot Ankle Surg [Internet]. 2022 May-Jun [citado 20 Nov 2022]; 61(3):P482-485. Disponible en: https://doi.org/10.1053/j.jfas.2021.09.022
39. Kaiser PB, Bejarano-Pineda L, Kwon JY, DiGiovanni CW, Guss D. The syndesmosis, Part II: surgical treatment strategies. Orthop Clin North Am [Internet]. 2021 Oct [citado 20 Nov 2022]; 52(4):417-432. DOI: https://doi.org/10.1016/j.ocl.2021.05.011
40. Xu K, Zhang J, Zhang P, Liang Y, Hu JL, Wang X, et al. Comparison of suture-button versus syndesmotic screw in the treatment of distal tibiofibular syndesmosis injury: a meta-analysis. J Foot Ankle Surg [Internet]. 2021 May-Jun [citado 20 Nov 2022]; 60(3):P555-566. DOI: https://doi.org/10.1053/j.jfas.2020.08.005
41. Xu Y, Kang R, Li M, Li Z, Ma T, Ren C, et al. The clinical efficacy of suture-button fixation and trans-syndesmotic screw fixation in the treatment of ankle fracture combined with distal tibiofibular syndesmosis injury: a retrospective study. J Foot Ankle Surg [Internet]. 2022 Jan-Feb [citado 20 Nov 2022]; 61(1):143-148. DOI: https://doi.org/10.1053/j.jfas.2021.07.009
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43. Cândido Nishikawa DR, Honda Saito G, Oliveira Junior AS de, Moreira Mendes AA, Piovesana Devito L, Pires Prado M. Clinical outcomes of isolated acute instability of the syndesmosis treated with arthroscopy and percutaneous suture-button fixation. Arch Orthop Trauma Surg [Internet]. 2021 Sep [citado 20 Nov 2022]; 141(9):1567-1574. DOI: https://doi.org/10.1007/s00402-021-03813-3
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2. Hagemeijer NC, Elghazy MA, Waryasz G, Guss D, DiGiovanni CW, Kerkhoffs GM. Arthroscopic coronal plane syndesmotic instability has been over-diagnosed. Knee Surg Sports Traumatol Arthrosc [Internet]. 2021 [citado 20 Nov 2022]; 29:310-323. DOI: https://doi.org/10.1007/s00167-020-06067-5
3. Xie W, Lu H, Quan Y, Liu Y, Fu Z, Zhang D, et al. Morphological analysis of posterior malleolar fractures with intra-articular impacted fragment in computed tomography scans. J Orthop Traumatol [Internet]. 2021 [citado 20 Nov 2022]; 22(1):52. DOI: https://doi.org/10.1186/s10195-021-00615-6
4. Baltes TPA, Al-Sayrafi O, Arnáiz J, Al-Naimi MR, Geertsema C, Geertsema L, et al. Acute clinical evaluation for syndesmosis injury has high diagnostic value. Knee Surg Sports Traumatol Arthrosc [Internet]. 2022 Nov [citado 20 Nov 2022]; 30(11):3871-3880. DOI: https://doi.org/10.1007%2Fs00167-022-06989-2
5. Chen KH, Chen CH, Huang YM, Lee HH, Tsuang YH. Injury mechanism affects the stability of suture-button syndesmosis fixation. J Orthop Surg Res [Internet]. 2020 Dec [citado 20 Nov 2022]; 15(1):599. DOI: https://doi.org/10.1186/s13018-020-02141-3
6. Egol KA, Koval KJ, Zuckerman J. Handbook of fractures. 6ed. Philadelphia: Wolter Kluwer; 2020.
7. Chun DI, Cho JH, Min TH, Park SY, Kim KH, Kim JH, et al. Diagnostic accuracy of radiologic methods for ankle syndesmosis injury: a systematic review and meta-analysis. J Clin Med [Internet]. 2019 Jul [citado 20 Nov 2022]; 8(7):968. DOI: https://doi.org/10.3390/jcm8070968
8. Sharif B, Welck M, Saifuddin A. MRI of the distal tibiofibular joint. Skeletal Radiol [Internet]. 2020 Jan [citado 20 Nov 2022]; 49(1):1-17. Disponible en: https://doi.org/10.1007/s00256-019-03260-7
9. Teramoto A, Shoji H, Anzai K, Kamiya T, Watanabe K, Yamashita T. Tibiofibular space widening assessment with a ball-tipped probe in a syndesmosis injury model. J Foot Ankle Surg [Internet]. 2020 Nov-Dec [Citado 20 Nov 2022]; 59(6):1215-1218. DOI: https://doi.org/10.1053/j.jfas.2020.03.024
10. Hookway S, Lambers A, Page R, Bedi H. The Australian ankle syndesmosis injury survey. Injury [Internet]. 2022 Jun [citado 20 Nov 2022]; 53(6):2304-2310. DOI: https://doi.org/10.1016/j.injury.2022.02.024
11. Cornu O, Manon J, Tribak K, Putineanu D. Traumatic injuries of the distal tibiofibular syndesmosis. Orthop Traumatol Surg Res [Internet]. 2021 Feb [citado 20 Nov 2022]; 107(1S). DOI: https://doi.org/10.1016/j.otsr.2020.102778
12. Rudloff MI. Fractures of the lower extremities. En: Azar FM, Beaty JH. Campbell's Operative Orthopaedics. 14ed. Philadelphia: Elsevier; 2022. p.2812-2838.
13. Bejarano-Pineda L, Guss D, Waryasz G, DiGiovanni CW, Kwon JY. The syndesmosis, Part I: anatomy, injury mechanism, classification, and diagnosis. Orthop Clin North Am [Internet]. 2021 Oct [citado 20 Nov 2022]; 52(4):403-415. DOI: https://doi.org/10.1016/j.ocl.2021.05.010
14. Çaglar C, Akçaalan S, Akkaya M. Anatomically fixed posterior malleolar fractures in syndesmosis injuries without transsyndesmotic screw fixation. Foot Ankle Int [Internet]. 2022 Apr [citado 20 Nov 2022]; 43(4):486-494. DOI: https://doi.org/10.1177/10711007211060067
15. Sin YH, Lui TH. Arthroscopically assisted reduction of sagittal-plane disruption of distal tibiofibular syndesmosis. Arthrosc Tech [Internet]. 2019 Apr [citado 20 Nov 2022]; 8(5):E521-E525. DOI: https://doi.org/10.1016/j.eats.2019.01.014
16. Pogliacomi F, Filippo M de, Casalini D, Longhi A, Tacci F, Perotta R, et al. Acute syndesmotic injuries in ankle fractures: from diagnosis to treatment and current concepts. World J Orthop [Internet]. 2021 May [citado 20 Nov 2022]; 12(5):270-291. DOI: https://doi.org/10.5312/wjo.v12.i5.270
17. Spennacchio P, Seil R, Gathen M, Cucchi D. Diagnosing instability of ligamentous syndesmotic injuries: A biomechanical perspective. Clin Biomech (Bristol, Avon) [Internet]. 2021 Apr [citado 20 Nov 2022]; 84:105312. DOI: https://doi.org/10.1016/j.clinbiomech.2021.105312
18. Tourné Y, Molinier F, Andrieu M, Porta J, Barbier G. Diagnosis and treatment of tibiofibular syndesmosis lesions. Orthop Traumatol Surg Res [Internet]. 2019 Dec [citado 20 Nov 2022]; 105(8S):S275-S286. DOI: https://doi.org/10.1016/j.otsr.2019.09.014
19. Yu GS, Lin YB, Xiong GS, Xu HB, Liu YY. Diagnosis and treatment of ankle syndesmosis injuries with associated interosseous membrane injury: a current concept review. Int Orthop [Internet]. 2019 Nov [citado 20 Nov 2022]; 43(11):2539-2547. DOI: https://doi.org/10.1007/s00264-019-04396-w
20. White T, Bugler K. Ankle fractures. En: Tornetta P, Ricci WM, Ostrum RF, McQueen MM, McKee MD. Court Brown CM. Rockwood and Green's Fractures in Adults. 9ed. Philadelphia: Wolter Kluwer; 2020.
21. Williams C, Momenzadeh K, Michalski M, Kwon JY, Nazarian A, Miller CP. Anatomic and radiographic safe zone for posterior malleolar screw placement. Foot Ankle Int [Internet]. 2021 Dec [citado 20 Nov 2022]; 42(12):1598-1605. DOI: https://doi.org/10.1177/10711007211022747
22. Grambart ST, Prusa RD, Ternent KM. Revision of the chronic syndesmotic injury. Clin Podiatr Med Surg [Internet]. 2020 Jul [citado 20 Nov 2022]; 37(3):577-592. DOI: https://doi.org/10.1016/j.cpm.2020.03.011
23. Haraguchi N, Haruyama H, Toga H. Pathoanatomy of posterior malleolar fractures of the ankle. J Bone Joint Surg Am [Internet]. 2006 May [citado 20 Nov 2022]; 88(5):1085-1092. DOI: https://doi.org/10.2106/jbjs.e.00856
24. Bartoníček J, Rammelt S, Kostlivy, Vanĕček V, Klika D, Trešl I. Anatomy and classification of the posterior tibial fragment in ankle fracture. Arch Orthop Trauma Surg [Internet]. 2015 Apr [citado 20 Nov 2022]; 135(4):505-516. DOI: https://doi.org/10.1007/s00402-015-2171-4
25. Carr JB, Gebhard F. Malleolar fractures and soft tissue injuries of the ankle. En: Browner BD, Jupiter JB, Krettek C, Anderson PA. Skeletal Trauma. 5ed. Philadelphia: Elsevier; 2015. p.2189-2249.
26. Baumbach SF, Böcker W, Polzer H. Open reduction and internal fixation of posterior malleolus fractures. Oper Orthop Traumatol [Internet]. 2021 Apr [citado 20 Nov 2022]; 33(2):112-124. DOI: https://doi.org/10.1007/s00064-021-00705-y
27. Tomar L, Govil G, Dhawan P. Isolated posterior malleolar fracture: a case report of a rare presentation with narrative review of literature. Cureus [Internet]. 2022 Jan [citado 20 Nov 2022]; 14(1):e21658. DOI: https://doi.org/10.7759/cureus.21658
28. Fernández-Rojas E, Herrera-Pérez M, Vilá-Rico J. Posterior malleolar fractures: Indications and surgical approaches. Rev Esp Cir Ortop Traumatol [Internet]. 2022 Nov [citado 20 Nov 2022]:160-169. DOI: https://doi.org/10.1016/j.recot.2022.10.019
29. Elghazy MA, Hagemeijer NC, Guss D, El-Hawary A, Johnson AH, El-Mowafi H, et al. Screw versus suture button in treatment of syndesmosis instability: comparison using weightbearing CT scan. Foot Ankle Surg [Internet]. 2021 Apr [citado 20 Nov 2022]; 27(3):285-290. DOI: https://doi.org/10.1016/j.fas.2021.01.001
30. Balso C del, Hamam AW, Chohan MBY, Tieszer C, Lawendy AR, Sanders DW. Anatomic repair vs closed reduction of the syndesmosis. Foot Ankle Int [Internet]. 2021 Jul [citado 20 Nov 2022]; 42(7):877-885. DOI: https://doi.org/10.1177/1071100721990008
31. Kurtoglu A, Kochai A, Inanmaz ME, Sukur E, Keskin D, Türker M, et al. A comparison of double single suture-button fixation, suture-button fixation, and screw fixation for ankle syndesmosis injury: a retrospective cohort study. Medicine (Baltimore) [Internet]. 2021 Apr [citado 20 Nov 2022]; 100(13):e25328. DOI: https://doi.org/10.1097/md.0000000000025328
32. Bafna KR, Jordan R, Yatsonsky D, Dick S, Liu J, Ebraheim NA. Revision of syndesmosis screw fixation. Foot Ankle Spec [Internet]. 2020 Apr [citado 20 Nov 2022]; 13(2):138-143. DOI: https://doi.org/10.1177/1938640019843328
33. Huang CT, Huang PJ, Lu CC, Shih CL, Cheng YM, Chen SJ. Syndesmosis changes before and after syndesmotic screw removal: a retrospective radiographic study. Medicina (Kaunas) [Internet]. 2022 Mar [citado 20 Nov 2022]; 58(3):445. DOI: https://doi.org/10.3390/medicina58030445
34. Mercan N, Yildirim A, Dere Y. Biomechanical analysis of tibiofibular syndesmosis injury fixation methods: a finite element analysis. J Foot Ankle Surg [Internet]. 2022 May [citado 20 Nov 2022]; 62(1):P107-114. DOI: https://doi.org/10.1053/j.jfas.2022.05.007
35. Gan K, Xu D, Hu K, Wu W, Shen Y. Dynamic fixation is superior in terms of clinical outcomes to static fixation in managing distal tibiofibular syndesmosis injury. Knee Surg Sports Traumatol Arthrosc [Internet]. 2020 Jan [citado 20 Nov 2022]; 28(1):270-280. DOI: https://doi.org/10.1007/s00167-019-05659-0
36. Lehtola R, Leskelä HV, Flinkkilä T, Pakarinen H, Niinimäki J, Savola O, et al. Suture button versus syndesmosis screw fixation in pronation-external rotation ankle fractures: a minimum 6-year follow-up of a randomised controlled trial. Injury [Internet]. 2021 Oct [citado 20 Nov 2022]; 52(10):P3143-3149. DOI: https://doi.org/10.1016/j.injury.2021.06.025
37. Marasco D, Russo J, Izzo A, Vallefuoco S, Coppola F, Patel S, et al. Static versus dynamic fixation of distal tibiofibular syndesmosis: a systematic review of overlapping meta-analyses. Knee Surg Sports Traumatol Arthrosc [Internet]. 2021 Nov [citado 20 Nov 2022]; 29(11):3534-3542. DOI: https://doi.org/10.1007/s00167-021-06721-6
38. Yüce A, Misir A, Yerli M, Bayraktar TO, Tekin AÇ, Dedeoglu SS, et al. The effect of syndesmotic screw level on postoperative syndesmosis malreduction. J Foot Ankle Surg [Internet]. 2022 May-Jun [citado 20 Nov 2022]; 61(3):P482-485. Disponible en: https://doi.org/10.1053/j.jfas.2021.09.022
39. Kaiser PB, Bejarano-Pineda L, Kwon JY, DiGiovanni CW, Guss D. The syndesmosis, Part II: surgical treatment strategies. Orthop Clin North Am [Internet]. 2021 Oct [citado 20 Nov 2022]; 52(4):417-432. DOI: https://doi.org/10.1016/j.ocl.2021.05.011
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2023-03-24
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Alvarez-López A, Valdebenito-Aceitón V, Soto-Carrasco SR. Sindesmose tibiofibular: diagnóstico, métodos de fixação e artroscopia. Rev Inf Cient [Internet]. 24º de março de 2023 [citado 3º de abril de 2025];102:4087. Disponível em: https://revinfcientifica.sld.cu/index.php/ric/article/view/4087
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