![]() One could also use a combination of the suture and a surgical screw (top right), or two surgical screws (bottom left) that traverse all four cortices of the bone to provide very strong reduction of the syndesmotic dysruption. Arthrex, Inc.- Tightrope) is placed throught drill holes to secure the reduction (top left). There are different fixation techniques that can be used to repair this type of injury. This creates a highy unstable and non-functional ankle. Note the even joint spacing across the ankle mortise after correction (left) that is not evenly spaced in the pre-surgical picture (above right).īelow is an flouroscopic image of a complete disruption of the anterior and posterior tibia-fibular ligaments as well as the syndesmosis. The x-ray images below demonstrate another case of a bimalleolar ankle fracture in both and oblique view (left) and anterior - posterior view (right).īelow is the same patient seen above after surgical repair with open reduction and internal fixation with screws for the medial malleolar fracture and screws and plates for the lateral mallolar fracture. Surgical correction does require open reduction with internal fixation with allows appropriate healing of the fractures and re-aligns the talus within the reduced ankle joint mortise (right). This injury has cause a shift in the talus laterally within the joint mortise (left). This is case where the fracture on the fibula is at the level of the ankle joint and not above which has not disrupted the articular between the tibia and the fibula. This injury requires open reduction with internal fixation to reduced the fibular fracture with plate and screws and re-aproximation of the syndesmosis with a screw in order to re-align the ankle joint and allow the torn ligaments to heal appropriately (bottom left).īelow are image of pre and post - surgical repair of the an bimalleolar ankle fracture. The foot was in a pronated position planted and the force of the impact causing external rotation of the limp on that planted foot resutls in disruption of the deltoid ligament medially, tears of the anterior and posterior tibia-fibular ligaments, disruption of the tibia-fibula syndesmosis and ending with a high fibular fracture (both top images). This injury requires open reduction with internal fixation in order to re-align the fractured bones and prevent disability (Bottom left).īelow is case of a fracture of the ankle classified as PER IV injury meaning pronation with external rotation. The fractures can be seen from a view at the top of the foot (left) and side of the foot (right). In the x-rays below there are fractures seen in the midtarsal bones that can occur with a high impact twisting injury where the foot is caught in something like the stirrup of a horse saddle or from direct high impact traums to the middle of the foot. We bore a hole in the bone at the prior screw sites, added two syndesmotic screws that went across both bones for added stability as well as 2 Arthrex tightopes. On the Post operative films by our physicians, the space between the medial malleolus and talus is decreased and the joint is congruent and symmetrical. This is Pre and Post op xrays of surgical correction of a syndesmotic rupture that failed the first time by a different physician due to screw break. Complete reduction and fixation can be seen in the last pic. The Widening of the Lis Franc joint can be seen on the first pic and second magnified pic. 2004 69:111.Pre and Post-op X-rays Status Post ORIF Lis Franc Fracture/Dislocation. Vertebral compression fractures in the elderly. Eponyms in imaging of the upper limb: A historical review. Acute knee effusions: a systematic approach to diagnosis. Dense bone-too much bone: radiological considerations and differential diagnosis. Musculoskeletal eponyms: who are those guys? Radiographics : a review publication of the Radiological Society of North America, Inc. Radiographic Assessment of Osteoarthritis. Fractures of the ankle joint: investigation and treatment options. Goost H, Wimmer MD, Barg A, Kabir K, Valderrabano V, Burger C. Journal of the American Academy of Orthopaedic Surgeons. Hip Dislocation: Evaluation and Management.
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