Surgical outcome in chronic syndesmotic injury: A systematic literature review.


Journal

Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons
ISSN: 1460-9584
Titre abrégé: Foot Ankle Surg
Pays: France
ID NLM: 9609647

Informations de publication

Date de publication:
Oct 2019
Historique:
received: 09 05 2018
revised: 18 07 2018
accepted: 20 08 2018
pubmed: 17 10 2018
medline: 23 1 2020
entrez: 17 10 2018
Statut: ppublish

Résumé

Chronic injuries of the distal tibio-fibular syndesmosis often present with non-specific clinical and radiographic findings. If chronic instability to the distal tibio-fibular syndesmosis is verified, various reconstruction options are available. The purpose of this article is to give a systematic review of current surgical treatment options in patients with chronic syndesmotic injury. Three major medical databases were searched from inception through December 12, 2017: PubMed, ScienceDirect, and SpringerLink. Studies were included if they were original research studies which assessed the outcome of patients treated surgically for chronic syndesmotic instability. Only studies written in English were considered. The following data were extracted from each study: number of patients and ankles included, average patients' age, gender, study design, preoperative examination, time between the initial injury and the operation, postoperative follow-up time, operative technique, complication rates, and clinical outcome. The modified Coleman Score was used to assess the methodologic quality of the included studies. Seventeen (17) studies were included. All studies were retrospective or prospective case series. Each study was performed at a single center. In general, good functional outcomes and low complication rates were reported. The American Orthopaedic Foot and Ankle (AOFAS) score was most frequently used outcome tool to measure postoperative outcomes. The quality of the included studies was overall satisfactory. A few studies have reported on the operative outcomes after treating chronic syndesmotic instability. Several different techniques were used to treat this problem. The quality of current studies is overall satisfactory but could be improved with larger patient numbers and prospective analysis. Recognition of this clinical entity as an identifiable and treatable cause of ankle pain requires vigilant clinical investigation. Level IV; Systematic Review of Level IV Studies.

Sections du résumé

BACKGROUND BACKGROUND
Chronic injuries of the distal tibio-fibular syndesmosis often present with non-specific clinical and radiographic findings. If chronic instability to the distal tibio-fibular syndesmosis is verified, various reconstruction options are available. The purpose of this article is to give a systematic review of current surgical treatment options in patients with chronic syndesmotic injury.
METHODS METHODS
Three major medical databases were searched from inception through December 12, 2017: PubMed, ScienceDirect, and SpringerLink. Studies were included if they were original research studies which assessed the outcome of patients treated surgically for chronic syndesmotic instability. Only studies written in English were considered. The following data were extracted from each study: number of patients and ankles included, average patients' age, gender, study design, preoperative examination, time between the initial injury and the operation, postoperative follow-up time, operative technique, complication rates, and clinical outcome. The modified Coleman Score was used to assess the methodologic quality of the included studies.
RESULTS RESULTS
Seventeen (17) studies were included. All studies were retrospective or prospective case series. Each study was performed at a single center. In general, good functional outcomes and low complication rates were reported. The American Orthopaedic Foot and Ankle (AOFAS) score was most frequently used outcome tool to measure postoperative outcomes. The quality of the included studies was overall satisfactory.
CONCLUSIONS CONCLUSIONS
A few studies have reported on the operative outcomes after treating chronic syndesmotic instability. Several different techniques were used to treat this problem. The quality of current studies is overall satisfactory but could be improved with larger patient numbers and prospective analysis. Recognition of this clinical entity as an identifiable and treatable cause of ankle pain requires vigilant clinical investigation.
LEVEL OF EVIDENCE METHODS
Level IV; Systematic Review of Level IV Studies.

Identifiants

pubmed: 30321922
pii: S1268-7731(18)30172-3
doi: 10.1016/j.fas.2018.08.008
pii:
doi:

Types de publication

Journal Article Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

691-697

Informations de copyright

Copyright © 2018. Published by Elsevier Ltd.

Auteurs

Nicola Krähenbühl (N)

Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA.

Maxwell W Weinberg (MW)

Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA.

Beat Hintermann (B)

Department of Orthopaedics, Kantonsspital Baselland, Rheinstrasse 26, 4410 Liestal, Switzerland.

Justin M Haller (JM)

Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA.

Charles L Saltzman (CL)

Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA.

Alexej Barg (A)

Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA. Electronic address: alexej.barg@hsc.utah.edu.

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Classifications MeSH