Description
This presentation covers syndesmotic injuries, a highly debated topic in foot and ankle management. Tim Schepers discusses various treatment modalities drawing from the latest literature, acknowledging the challenges of reaching consensus due to the growing number of publications on the subject.
Syndesmotic injuries involve the ligaments that stabilize the tibia and fibula, which must function dynamically during ankle movement. Accurate diagnosis can be challenging, and it often requires specific tests during surgery, such as the hook test or utilizing tools like a Weber clamp for stability assessment.
Schepers highlights the importance of considering avulsion fractures in treatment decisions and discusses the biomechanical implications of using different fixation strategies. He debates the use of bio-absorbable versus metallic screws, noting no significant differences in clinical outcomes, while emphasizing the cost-effectiveness and lower complication rates associated with metallic options. The discussion extends to the number of screws used for fixation, their placement, and considerations surrounding the timing and necessity of screw removal.
The analysis incorporates various recent studies and clinical experiences to advocate for careful planning in surgical approaches, emphasizing anatomical reduction's critical role in patient outcomes. Throughout the presentation, Schepers provides clinical insights alongside literature findings, concluding with recommendations for screw usage, advocating for on-demand removal rather than routine practices.