External rotation stress imaging in syndesmotic injuries of the ankle:​ comparison of lateral radiography and radiostereometry in a cadaveric model

Beumer, Annechien; Valstar, Edward R.; Garling, Eric H.; van Leeuwen, Wibeke J.; Sikma, Willy; Niesing, Ruud; Ranstam, Jonas; Swierstra, Bart A.

Affiliations

¹Department of Orthopaedics, Erasmus University Medical Center Rotterdam, The Netherlands

²Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands

³Department of Radiology, Erasmus University Medical Center Rotterdam, The Netherlands

⁴Department of Biomedical Physics and Technology, Erasmus University Medical Center Rotterdam, The Netherlands

⁵Department of Community Health, Lund University, Lund, Sweden

Abstract

We compared the value of 7.5 Nm external rotation stress in diagnosing tibiofibular syndesmotic injuries of the ankle on lateral radiographs with radiostereometric analysis (RSA) in 10 cadaveric legs. After sectioning 2 ligaments, RSA showed an increase in posterior translation and external rotation of the fibula. This increase in posterior translation was smaller than the posterior displacement of the fibula on the lateral radiograph, and RSA showed mainly an increase in external rotation of the fibula that can not be measured on conventional radiographs. We conclude that instability of the syndesmosis in cadaveric ankles can be detected with 7.5 Nm external rotation stress RSA, but that external rotation stress lateral radiography is unreliable.

Links

DOI: 10.1080/00016470310013969

PubMed: 12807330

WoS: 000183080500016

History

Received: 2001-11-15

Accepted: 2002-05-29

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Cited By (14)

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2003	Beumer A, Valstar E, Garling E, Niesing R, Ranstam J, Löfvenberg R, Swierstra B. Kinematics of the distal tibiofibular syndesmosis: radiostereometry in 11 normal ankles. Acta Orthop Scand. June 2003;74(3):337-343.
2016	Hsu AR, Anderson RB. Foot and ankle injuries in American football. Am J Orthop (Belle Meade, NJ). ;45(6):358-367.
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2011	Kellett JJ. The clinical features of ankle syndesmosis injuries: a general review. Clin J Sport Med. November 2011;21(6):524-529.
2011	Pakarinen HJ, Flinkkilä TE, Ohtonen PP, Hyvönen PH, Lakovaara MT, Leppilahti JI, Ristiniemi JY. Syndesmotic fixation in supination-external rotation ankle fractures: a prospective randomized study. Foot Ankle Int. December 2011;32(12):1103-1109.
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2018	Roach KE. Development, Validation, and Application of Dynamic Imaging to Quantify in Vivo Kinematics of the Foot and Ankle [PhD thesis]. University of Utah; December 2018.