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Influence of syndesmotic injuries and posterior malleolar ankle fractures on fibula position in the ankle joint: a cadaveric study

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to identify to what extent a dissection of the syndesmosis and an avulsed posterior edge of the tibia can change the tibiofibular diastasis and fibular rotation.

Methods

Three-dimensional scans with a mobile C-arm of 22 cadaver legs were taken of the intact fibula, after dissection of the anterior part of the syndesmosis and the interosseous membrane, osteotomy of the posterior malleolus, and osteosynthesis. The tibiofibular diastasis as well as the angle of fibular rotation was identified in the four steps and the means compared to each other using a t test for paired samples.

Results

The distinction between the intact fibula vs. the osteotomy of the posterior tibia was 0.082 ± 0.332 mm for the tibiofibular distance in the incisura tibiofibularis (p 0.261) and 0.046 ± 0.486 degrees for the angle of the fibular rotation (p 0.665).

Conclusion

Neither the dissection of the syndesmosis nor the osteotomy of the posterior malleolus significantly influenced the position of the fibula in the incisura tibiofibularis in the cadaveric model. However, in the nonweight-bearing situation, a lesion of the syndesmotic complex might not be evident in intraoperative three-dimensional imaging.

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Data availability

The datasets used and analysed during the current study are available from the corresponding author on reasonable request.

Abbreviations

AiTFL:

Anterior inferior tibiofibular ligament

CT:

Computed tomography

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Acknowledgements

We thank Prof. Weiss, University of Mannheim, for the statistical analysis and supervision of this study.

Funding

There was no funding for this specific study.

Author information

Authors and Affiliations

  1. MINTOS-Medical Imaging and Navigation in Trauma and Orthopaedic Surgery, BG Trauma Center Ludwigshafen at Heidelberg University Hospital, Ludwig-Guttmannstr. 13, 67071, Ludwigshafen, Germany

    Sven Y. Vetter, Nora Palesche, Nils Beisemann, Marc Schnetzke, Holger Keil, Paul Alfred Grützner & Jochen Franke

  2. Institute for Anatomy and Cell Biology, University of Heidelberg, Heidelberg, Germany

    Joachim Kirsch

Authors
  1. Sven Y. Vetter
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  2. Nora Palesche
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  3. Nils Beisemann
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  4. Marc Schnetzke
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  5. Holger Keil
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  6. Joachim Kirsch
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  7. Paul Alfred Grützner
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  8. Jochen Franke
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Contributions

Dr. Sven Vetter: study design, writing manuscript. Nora Palesche: carried out experiment, performed calculations. Dr. Jochen Franke: developed the theoretical framework. Dr. Nils Beisemann, Dr. Marc Schnetzke, Dr. Holger Keil, Prof. Dr. Joachim Kirsch, Prof. Dr. Paul Alfred Grützner: all authors provided critical feedback and helped shape the study, the analysis and the manuscript.

Corresponding author

Correspondence to Jochen Franke.

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Conflict of interest

The authors declare that they have no competing interests.

Ethics approval and consent to participate

The application was submitted to the local ethics committee on 13.01.2014 and was accepted on 17.02.2014 with the registration number S-013/2014.

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Vetter, S.Y., Palesche, N., Beisemann, N. et al. Influence of syndesmotic injuries and posterior malleolar ankle fractures on fibula position in the ankle joint: a cadaveric study. Eur J Trauma Emerg Surg 47, 905–912 (2021). https://doi.org/10.1007/s00068-019-01292-1

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  • DOI: https://doi.org/10.1007/s00068-019-01292-1

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