Novel flexible suture fixation for the distal tibiofibular syndesmotic joint injury: a cadaveric biomechanical model

Brandon E Gough; Alexander C M Chong; Steven J Howell; Joseph W Galvin; Paul H Wooley

doi:10.1053/j.jfas.2014.04.022

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Novel flexible suture fixation for the distal tibiofibular syndesmotic joint injury: a cadaveric biomechanical model

Journal article

Peer reviewed

Novel flexible suture fixation for the distal tibiofibular syndesmotic joint injury: a cadaveric biomechanical model

Brandon E Gough, Alexander C M Chong, Steven J Howell, Joseph W Galvin and Paul H Wooley

The Journal of foot and ankle surgery, Vol.53(6), pp.706-711

11/01/2014

DOI: 10.1053/j.jfas.2014.04.022

PMID: 24846162

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Abstract

Syndesmotic injuries of the ankle commonly occur by an external rotation force applied to the ankle joint. Ten fresh-frozen lower extremities from cadavers were used. A specially designed apparatus was used to stabilize the specimen and rotate the ankle joint from internally rotated 25° to externally rotated 35° at a rate of 6°/s for 10 cycles. Two stages were tested (stage I, specimens intact; and stage II, simulated pronation external rotation type injury with fixation). Group 1 was fixed with a novel suture construct across the syndesmotic joint, and group 2 was fixed with a single metallic screw. The torque, rotational angle, and 3-dimensional syndesmotic diastasis readings were recorded. Three-dimensional tibiofibular diastasis was identified. The fibula of the intact specimens displaced an average of 8.6 ± 1.7, 2.4 ± 1.0, and 1.4 ± 1.0 mm in the anterior, lateral, and superior direction, respectively, when the foot was externally rotated 35°. The sectioning of the syndesmostic ligaments and deltoid ligament resulted in a significant decrease in syndesmotic diastasis and foot torsional force (p < .05). The ligament-sectioned specimen lost 57% (externally rotated) and 17% (internally rotated) torsional strength compared with the intact specimen. Groups 1 and 2 provided similar biomechanical stability in this cadaveric model of a syndesmosis deficiency.

Aged

Ankle Injuries - physiopathology

Ankle Injuries - surgery

Ankle Joint - physiopathology

Ankle Joint - surgery

Biomechanical Phenomena

Cadaver

Fibula - physiopathology

Humans

Middle Aged

Models, Anatomic

Rotation

Suture Techniques

Tibia - physiopathology

Details

Title: Subtitle: Novel flexible suture fixation for the distal tibiofibular syndesmotic joint injury: a cadaveric biomechanical model
Creators: Brandon E Gough - University of Kansas
Alexander C M Chong - Ascension Via Christi
Steven J Howell - Wichita State University
Joseph W Galvin - University of Kansas
Paul H Wooley - Ascension Via Christi
Resource Type: Journal article
Publication Details: The Journal of foot and ankle surgery, Vol.53(6), pp.706-711
DOI: 10.1053/j.jfas.2014.04.022
PMID: 24846162
ISSN: 1067-2516
eISSN: 1542-2224
Language: English
Date published: 11/01/2014
Academic Unit: Orthopedics and Rehabilitation
Record Identifier: 9984618632202771

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7 Times Cited - Web of Science