Dynamic CT Shows Syndesmosis Position Varies with Ankle Range of Motion

Description

This transcript discusses a presentation by Murray Wong about syndesmosis injuries, which occur at the distal tibiofibular joint. Wong begins by explaining the anatomy and function of the syndesmosis ligaments, highlighting their role in facilitating fibular motion and joint stability during ankle movements. He mentions the prevalence of syndesmosis injuries in Canada and compares historical fixation methods, such as rigid screw fixation, to newer suture button constructs deemed more physiologic.



Wong emphasizes that the quality of reduction following injury repair is critical for functional outcomes, noting that malreduction can occur frequently. He proposes a shift in surgical approaches to focus on restoring the dynamic kinematics of the syndesmosis rather than just achieving static alignment, suggesting that traditional assessments may fail to account for positional changes in the ankle during motion.



To investigate these dynamics, Wong describes a study using dynamic CT imaging to assess syndesmosis positions through various ranges of motion. Results from the study, including measurements taken from both injured and healthy ankles, indicated less variability among patients when assessing syndesmosis width in a standardized position.



He reports that during plantar flexion, there is a notable decrease in syndesmosis width, while fibular rotation changes were also observed. Wong concludes by highlighting the necessity of considering ankle position during surgical fixation to achieve anatomical reduction and improve functional outcomes, and encourages further exploration of fixation techniques that can accommodate natural movement.

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