What is the tibiofibular syndesmosis?

Which radiographic markers can surgeons use to diagnose Syndesmotic injuries?

The ATFR is a radiographic measure on the lateral view of the ankle that will add to the current diagnostic tools that delineate the ankle syndesmosis.

Where is the tibiofibular syndesmosis located?

The syndesmosis is a fibrous joint held together by ligaments. It’s located near the ankle joint, between the tibia, or shinbone, and the distal fibula, or outside leg bone. That’s why it’s also called the distal tibiofibular syndesmosis.

How is syndesmosis injury diagnosed?

Clinical diagnosis The diagnosis of syndesmosis injury is based on injury pattern, thorough physical examination, and radiographic findings. When no fracture is present, clinical findings will include ankle pain, tenderness directly over the anterior syndesmosis, and positive squeeze and external rotation tests.

Is the tibiofibular joint a syndesmosis?

A syndesmosis is a complex fibrous joint between two bones and connected by ligaments and a strong membrane with slightly movement allowed. The distal tibiofibular syndesmosis/inferior tibiofibular joint is a syndesmotic joint.

What is the purpose of the distal tibiofibular syndesmosis?

Structure and Function [2] The primary function of the distal ligaments of the tibiofibular syndesmosis is to prevent the fibula from displacing (laterally, and/or anteriorly/posteriorly) from its groove in the tibia.

What is a Syndesmotic injury?

A syndesmotic ankle sprain is an injury to one or more of the ligaments comprising the distal tibiofibular syndesmosis; it is often referred to as a “high ankle sprain.” Compared with the more common lateral ankle sprain, the high ankle sprain causes pain more proximally, just above the ankle joint, and is associated …

How do you measure tibiofibular clear space?

Measurement. The horizontal distance between the deepest point of the fibular groove or posterior tibial tubercle and the medial edge of the distal fibula 1 cm above the tibial plafond are measured in a normal anteroposterior view of the ankle 1-3.

Where are Syndesmoses found in the body?

Syndesmoses are found between the bones of the forearm (radius and ulna) and the leg (tibia and fibula). Fibrous joints strongly unite adjacent bones and thus serve to provide protection for internal organs, strength to body regions, or weight-bearing stability.

What does a syndesmosis injury feel like?

Symptoms. The most common symptoms associated with a syndesmosis sprain are pain, inflammation, and lack of movement. You might also feel more severe pain when you bear any weight on the ankle. There are also different levels of pain and symptoms depending on the degree of the syndesmosis sprain.

Which test for a syndesmosis injury has the highest sensitivity?

Syndesmosis ligament tenderness (92%) and the dorsiflexion-external rotation stress test (71%) had the highest sensitivity values and negative LR of 0.28 (95% CI 0.09 to 0.89) and 0.46 (95% CI 0.27 to 0.79), respectively.

What type of joint is the tibiofibular joint?

plane type synovial joint
The proximal tibiofibular joint (PTFJ) is a plane type synovial joint. The primary function of the PTFJ is dissipation of torsional stresses applied at the ankle and the lateral tibial bending moments besides a very significant tensile, rather than compressive weight bearing.

Can a distal tibiofibular syndesmosis injury be missed?

Distal syndesmotic injury can easily be inapparent and therefore missed on plain x-ray, especially if it is not accompanied by a nearby fracture or widening of the tibiofibular clear space. 2,3. Numerous measurements have been proposed for indirectly demonstrating syndesmotic injury but these vary across studies with no formed consensus.

What are the components of the tibiofibular syndesmosis?

The tibiofibular syndesmosis is a complex fibrous joint composed of multiple ligaments and a broad fibrous interosseous membrane that spans between the tibia and fibula throughout the length of both bones. The distal osseous part of this syndesmotic joint includes the following four components: 1.

What is the sensitivity of the tibiofibular overlap?

tibiofibular overlap <6 mm (AP view) <2.8 mm (mortise view) has a sensitivity of 36% and specificity of 87% for syndesmotic injuries medial clear space >4-5 mm (mortise view) is considered indicative of deltoid ligament rupture and an indirect sign of a syndesmotic injury

Is the medial clear space bigger than the medial tibiofibular?

Some tibiofibular overlap was present in all radiographs in any position of rotation. The medial clear space was smaller than or equal to the superior clear space in all radiographs. Intraclass correlation coefficients of the other parameters were too weak for reliable quantitative measurements, as was shown with a mixed model analysis of variance.

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