Medial Structure Injury During Suture Button Insertion Using the Center-Center Technique for Syndesmotic Stabilization.
Foot Ankle Int
; 39(8): 984-989, 2018 08.
Article
em En
| MEDLINE
| ID: mdl-29641268
ABSTRACT
BACKGROUND:
The center-center technique for syndesmosis fixation has been described as an improved and reliable technique for proper reduction of the syndesmosis during ankle fracture repair. Concurrently, the use of flexible fixation with a suture button is becoming an established means of syndesmosis stabilization. The purpose of this cadaveric study was to assess for medial structure injury during the placement of a suture button using the center-center technique for ankle syndesmosis repair at 3 insertion intervals.METHODS:
Simulated open syndesmosis repair was performed on 10 cadaveric specimens. Three intervals were measured at 10 mm, 20 mm, and 30 mm proximal to the level of the distal tibial articular surface along the fibula. Proper longitudinal alignment of the center-center technique was completed under fluoroscopic guidance and was marked on the medial aspect of the tibia. The 3 intervals were drilled in the appropriate technique trajectory. The suture button was subsequently passed through each drill-hole interval. A single observer used a digital caliper to measure the distance from each suture button aperture with respect to the tibialis anterior tendon, tibialis posterior tendon, and greater saphenous vein and nerve.RESULTS:
A total of 30 interval measurements (10 cadavers with 3 suture button segments each) were used for data analysis. Direct impingement on the greater saphenous vein was seen in 11 of 30 (36.6%) interval measurements. Six of the 11 (54.5%) observed saphenous structure impingement events occurred at the 10-mm drill hole.CONCLUSION:
The results of the present study suggest that the use of the center-center technique for syndesmosis repair with suture button fixation risks preventable injury to the greater saphenous neurovasculature. CLINICAL RELEVANCE To understand the medial ankle anatomy, as it pertains to insertion of flexible syndesmotic fixation in a cadaveric model, to aid in prevention of clinical iatrogenic injury.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
1_ASSA2030
Base de dados:
MEDLINE
Assunto principal:
Veia Safena
/
Técnicas de Sutura
/
Procedimentos Ortopédicos
/
Âncoras de Sutura
/
Traumatismos dos Nervos Periféricos
/
Fraturas do Tornozelo
/
Articulação do Tornozelo
Tipo de estudo:
Guideline
Limite:
Humans
Idioma:
En
Revista:
Foot Ankle Int
Ano de publicação:
2018
Tipo de documento:
Article