000			03882nam a22004817a 4500
008			240807s20242024 xxu||||| |||| 00| 0 eng d
022			_a2473-0114
024			_a10.1177_24730114241255356 [pii]
024			_aPMC11128177 [pmc]
040			_aOvid MEDLINE(R)
099			_a38798904
245			_aEffect of Distal Tibiofibular Destabilization and Syndesmosis Compression on the Flexibility Kinematics of the Ankle Bones: An In Vitro Human Cadaveric Model.
251			_aFoot & Ankle Orthopaedics. 9(2):24730114241255356, 2024 Apr.
252			_aFoot Ankle Orthop. 9(2):24730114241255356, 2024 Apr.
253			_aFoot & ankle orthopaedics
260			_c2024
260			_fFY2024
260			_p2024 Apr
265			_sepublish
265			_tPubMed-not-MEDLINE
266			_d2024-08-07
266			_z2024/05/27 04:14
520			_aBackground: Overcompression of the distal tibiofibular syndesmosis during open reduction and internal fixation of ankle fracture may affect multidirectional flexibility of the ankle bones.
520			_aClinical Relevance: These biomechanical data suggest that inadvertent overcompression of the distal tibiofibular syndesmosis when fixing ankle fractures does not restrict subsequent ankle bone ROM. The AITFL is an important stabilizer of the distal tibiofibular syndesmosis in external rotation.
520			_aConclusion: As assessed by direct visualization, overcompression of the distal tibiofibular syndesmosis did not reduce ROM of the ankle bones. Distal tibiofibular axial rotation was significantly lower with IOM+AITFL fixation compared with IOM augmentation alone. Distal tibiofibular axial rotation did not differ significantly from the intact condition after combined IOM+AITFL fixation. Dynamic fixation of the distal tibiofibular syndesmosis resulted in increased axial rotation at the proximal tibiofibular syndesmosis.
520			_aLevel of Evidence: controlled laboratory study. Copyright © The Author(s) 2024.
520			_aMethods: Ten cadaveric lower limbs (78.3+/-13.0 years, 4 female, 6 male) underwent biomechanical testing in sagittal, coronal, and axial rotation with degrees of motion quantified. The intact force (100%) was the force needed to compress the syndesmosis just beyond the intact position, and overcompression was defined as 150% of the intact force. After intact testing, the anterior inferior tibiofibular ligament (AITFL), interosseus membrane (IOM), and posterior inferior tibiofibular ligament (PITFL) were sectioned and testing was repeated. The IOM and AITFL were reconstructed in sequence and tested at 100% and 150% compression.
520			_aResults: Overcompression of the syndesmosis did not significantly reduce ROM of the ankle bones for any loading modality (P > .05). IOM+AITFL reconstruction restored distal tibiofibular axial rotation to the intact condition. Axial rotation motion was significantly lower with AITFL fixation compared with IOM fixation alone (P < .05). The proximal tibiofibular syndesmosis demonstrated significantly higher motion in axial rotation with all distal reconstruction conditions.
546			_aEnglish
650			_zAutomated
651			_aMedStar Union Memorial Hospital
656			_aFoot and Ankle Surgery Fellowship
656			_aOrthopaedic Surgery
657			_aJournal Article
700			_aBrooks, Daina M _bMUMH
700			_aCunningham, Bryan W _bMUMH
700			_aHembree, Walter C _bMUMH
700			_aPasternack, Jordan _bMUMH _cFoot and Ankle Surgery Fellowship _dMD
790			_aHembree WC, Brooks DM, Rosenthal B, Winters C, Pasternack JB, Cunningham BW
856			_uhttps://dx.doi.org/10.1177/24730114241255356 _zhttps://dx.doi.org/10.1177/24730114241255356
858			_yHembree, Walter C _uhttps://orcid.org/0000-0003-2552-8621 _zhttps://orcid.org/0000-0003-2552-8621
942			_cART _dArticle
999			_c14496 _d14496