Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/26443
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dc.contributor.authorRegauer, Markusen_UK
dc.contributor.authorMackay, Gordonen_UK
dc.contributor.authorLange, Mirjamen_UK
dc.contributor.authorKammerlander, Christianen_UK
dc.contributor.authorBocker, Wolfgangen_UK
dc.date.accessioned2017-12-22T23:13:12Z-
dc.date.available2017-12-22T23:13:12Z-
dc.date.issued2017-04-18en_UK
dc.identifier.urihttp://hdl.handle.net/1893/26443-
dc.description.abstractReconstruction of unstable syndesmotic injuries is not trivial, and there is no generally accepted treatment guidelines. Thus, there still remain considerable controversies regarding diagnosis, classification and treatment of syndesmotic injuries. Syndesmotic malreduction is the most common indication for early re-operation after ankle fracture surgery, and widening of the ankle mortise by only 1 mm decreases the contact area of the tibiotalar joint by 42%. Outcome of ankle fractures with syndesmosis injury is worse than without, even after surgical syndesmotic stabilization. This may be due to a high incidence of syndesmotic malreduction revealed by increasing postoperative computed tomography controls. Therefore, even open visualization of the syndesmosis during the reduction maneuver has been recommended. Thus, the most important clinical predictor of outcome is consistently reported as accuracy of anatomic reduction of the injured syndesmosis. In this context the TightRope® system is reported to have advantages compared to classical syndesmotic screws. However, rotational instability of the distal fibula cannot be safely limited by use of 1 or even 2 TightRopes®. Therefore, we developed a new syndesmotic InternalBraceTM technique for improved anatomic distal tibiofibular ligament augmentation to protect healing of the injured native ligaments. The InternalBraceTM technique was developed by Gordon Mackay from Scotland in 2012 using SwiveLocks® for knotless aperture fixation of a FiberTape® at the anatomic footprints of the augmented ligaments, and augmentation of the anterior talofibular ligament, the deltoid ligament, the spring ligament and the medial collateral ligaments of the knee have been published so far. According to the individual injury pattern, patients can either be treated by the new syndesmotic InternalBraceTM technique alone as a single anterior stabilization, or in combination with one posteriorly directed TightRope® as a double stabilization, or in combination with one TightRope® and a posterolateral malleolar screw fixation as a triple stabilization. Moreover, the syndesmotic InternalBraceTM technique is suitable for anatomic refixation of displaced bony avulsion fragments too small for screw fixation and for indirect reduction of small posterolateral tibial avulsion fragments by anatomic reduction of the anterior syndesmosis with an InternalBraceTM after osteosynthesis of the distal fibula. In this paper, comprehensively illustrated clinical examples show that anatomic reconstruction with rotational stabilization of the syndesmosis can be realized by use of our new syndesmotic InternalBraceTM technique. A clinical trial for evaluation of the functional outcomes has been started at our hospital.en_UK
dc.language.isoenen_UK
dc.publisherBaishideng Publishing Groupen_UK
dc.relationRegauer M, Mackay G, Lange M, Kammerlander C & Bocker W (2017) Syndesmotic Internal Brace™ for anatomic distal tibiofibular ligament augmentation. World Journal of Orthopedics, 8 (4), pp. 301-309. https://doi.org/10.5312/wjo.v8.i4.301en_UK
dc.rightsThis article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/en_UK
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/en_UK
dc.subjectSyndesmosis injuryen_UK
dc.subjectRotational instabilityen_UK
dc.subjectStabilizationen_UK
dc.subjectAnatomic repairen_UK
dc.subjectInternalBraceTMen_UK
dc.subjectSurgical techniqueen_UK
dc.titleSyndesmotic Internal Brace™ for anatomic distal tibiofibular ligament augmentationen_UK
dc.typeJournal Articleen_UK
dc.identifier.doi10.5312/wjo.v8.i4.301en_UK
dc.identifier.pmid28473957en_UK
dc.citation.jtitleWorld Journal of Orthopedicsen_UK
dc.citation.issn2218-5836en_UK
dc.citation.volume8en_UK
dc.citation.issue4en_UK
dc.citation.spage301en_UK
dc.citation.epage309en_UK
dc.citation.publicationstatusPublisheden_UK
dc.citation.peerreviewedRefereeden_UK
dc.type.statusVoR - Version of Recorden_UK
dc.citation.date18/04/2017en_UK
dc.contributor.affiliationLudwig Maximilian University, Germanyen_UK
dc.contributor.affiliationSporten_UK
dc.contributor.affiliationLudwig Maximilian University, Germanyen_UK
dc.contributor.affiliationLudwig Maximilian University, Germanyen_UK
dc.contributor.affiliationLudwig Maximilian University, Germanyen_UK
dc.identifier.isiWOS:000404169900003en_UK
dc.identifier.scopusid2-s2.0-85017508154en_UK
dc.identifier.wtid530590en_UK
dc.date.accepted2017-02-08en_UK
dcterms.dateAccepted2017-02-08en_UK
dc.date.filedepositdate2017-12-22en_UK
rioxxterms.apcnot requireden_UK
rioxxterms.typeJournal Article/Reviewen_UK
rioxxterms.versionVoRen_UK
local.rioxx.authorRegauer, Markus|en_UK
local.rioxx.authorMackay, Gordon|en_UK
local.rioxx.authorLange, Mirjam|en_UK
local.rioxx.authorKammerlander, Christian|en_UK
local.rioxx.authorBocker, Wolfgang|en_UK
local.rioxx.projectInternal Project|University of Stirling|https://isni.org/isni/0000000122484331en_UK
local.rioxx.freetoreaddate2021-03-02en_UK
local.rioxx.licencehttp://creativecommons.org/licenses/by-nc/4.0/|2021-03-02|en_UK
local.rioxx.filenameWJO-8-301.pdfen_UK
local.rioxx.filecount1en_UK
local.rioxx.source2218-5836en_UK
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