Syndesmosis.

As every month, we have gathered for our Journal Club, on February too! The theme of this meeting has been, unlike previous times, a decisive theme for orthopedics in general, which every orthopedist can come across in his daily activity: syndesmosis, that is, the joint point between tibia and fibula, at ankle level.

Howewer, this is an extremely important topic for us and we are very closely interested in it. In fact, this structure is affected every time we proceed with the implementation of a ankle prosthesis with lateral access.

The selected articles were quite a lot, in order to give us a true overview of this immense topic.

Other news about this Journal Club are two newcomers: Federico and Jacopo, from Rome and Varese respectively!

We are glad to have them with us and to work all together, trying to improve ourselves everytime.

Reading about Syndesmonis

Let’s start from Jacopo, the youngest of the group! As already done in the previous meetings as well, we like having clear ideas and starting from the beginning. Therefore, a mention of anatomy is fundamental.

So, Jacopo has talked to us about syndesmosic anatomy through the article:
– Ankle Syndesmosis: A Qualitative and Quantitative Anatomic Analysis, Am J Sports Med 2015 Williams BT et al.

Then Riccardo continued by helping us in injuries classification which can affect this particular articulation:
– Classification and diagnosis of acute isolated syndesmotic injuries: ESSKA AFAS consensus and guidelines. KSSTA 2015

Luigi had to analise and diversify the acute event from the chronic one, by studying the articles:
– Acute and Chronic Syndesmosis Injuries: Pathomechanisms, Diagnosis
and Management. Espinosa N et al. Foot Ankle Clin N Am 2006
– The Lambda Sign: A New Radiographic Indicator of Latent Syndesmosis Instability Paul Ryan et al FAI 2014

Camilla, following the wide “acute vs. chronic injuries” topic, has expounded Switaj’s article, so that she could have a precise summary and evaluate potential differences with the previous Espinosa’s article, a little bit more dated (2006).
– Acute and Chronic Injuries to the Syndesmosis. Paul J. Switaj et al. Clin Sports Med 2015.

Andrea, instead, mainly explored the surgical details with a review on surgical treatment with screws:
– Syndesmosis screws: How many, what diameter, where and should they be removed? A literature review. Peek AC Injury 2014

Still analysing the surgical gesture and the available materials up close, Claudia has evalued the Tightrope role:
– Treatment of Syndesmotic Disruptions with the Arthrex Tightrope: A Report
of 25 Cases Cottom JM et al. FAI 2008
– Comparison of screw fixation with elastic fixation methods in the treatment of syndesmosis injuries in ankle fractures. Seyhan et al. Injury 2015

Cristian has deepened another fundamental topic which the orthopedic often finds himself dealing with: the chronic instability of syndesmosis. The articles he analysed were:
– Delayed operative treatment of syndesmotic instability. Current concepts review. Niek van Dijk Injury 2008
– Treatment of chronic syndesmotic injury: a systematic review and meta-analysis. Niek van Dijk & Karlsson KSSTA 2013

Last but not least, Miriam has drawn the attention on a very specific patient typology, well-beloved to us, by analysing the treatment of syndesmotic injuries in the professional athlete:
– Management of Syndesmosis Injuries in the Elite Athlete. Pearce CJ Foot Ankle Clin N Am 2013

As always, thank you for your professionalism and precision in the presentation of the selected articles, and for you enthusiasm.

Once again: welcome, newcomers! It’s good to see ourselves growing up day by day!