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Related Concept Videos

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The ankle is formed by the talocrural joint (crural = leg). It consists of the articulations between the talus bone of the foot and the distal ends of the tibia and fibula of the leg. The superior aspect of the talus bone is square-shaped and has three areas of articulation. The top of the talus articulates with the inferior tibia. This is the portion of the ankle joint that carries the body weight between the leg and foot. The sides of the talus are firmly held in position by the articulations...
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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
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Structural Joints: Fibrous Joints01:03

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Fibrous joints are a type of joint where the bones are connected by fibrous connective tissue. These joints provide stability and minimal to no movement between the articulating bones. There are three types of fibrous joints.
Suture
All the bones of the skull, except for the mandible, are joined to each other by a fibrous joint called a suture. The fibrous connective tissue found at a suture strongly unites the adjacent skull bones and thus helps to protect the brain and form the face. In...
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The tibia is the main weight-bearing bone of the lower leg. It is larger than the fibula with which it is paired. The tibia is also the second longest bone in the body and is located right below the skin. The proximal end of the tibia forms the medial and the lateral condyle, which articulates with the condyles of the femur to form the knee joint. Between the articulating surfaces is the irregular elevated area known as the intercondylar eminence that serves as the inferior attachment point for...
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Functional Classification of Joints
The functional classification of joints is determined by the amount of mobility between the adjacent bones. Joints are functionally classified as a synarthrosis or immobile joint, an amphiarthrosis or slightly moveable joint, or as a diarthrosis, a freely moveable joint. Fibrous and cartilaginous joints can be functionally classified as either synarthroses  or amphiarthroses, whereas all synovial joints are classified as diarthroses.
Synarthrosis
An...
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Synovial joints are the most common type of joint in the body. A key structural characteristic for a synovial joint is the presence of a joint cavity. This fluid-filled space is where the articulating surfaces of the bones contact each other. Also, unlike fibrous or cartilaginous joints, the articulating bone surfaces at a synovial joint are not directly connected to each other with fibrous connective tissue or cartilage. This gives the bones of a synovial joint the ability to move smoothly...
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Syndesmotic Ankle Fractures.

James D Michelson1, Michael Wright, Michael Blankstein

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The quality of studies on syndesmotic ankle fractures is poor. Screw number, placement, or breakage did not impact outcomes, but evidence for alternative fixation and stress-test-indicated fixation is weak.

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Area of Science:

  • Orthopedic Surgery
  • Traumatology

Background:

  • Syndesmotic ankle fractures present diagnostic and treatment challenges.
  • Current understanding of optimal management strategies remains controversial.

Purpose of the Study:

  • To systematically review the literature on syndesmotic ankle fractures.
  • To address key clinical questions regarding diagnosis and treatment.

Main Methods:

  • Comprehensive literature search of PubMed, EMBASE, and Web of Science (1967-2015).
  • Inclusion criteria: >20 patients, age ≥18, follow-up ≥1 year, reported classification, surgical criteria, technique, and validated outcomes.
  • Exclusion criteria: biomechanical or imaging-only studies. Quality assessed using modified CONSORT and Coleman criteria.

Main Results:

  • Overall study quality was poor.
  • Syndesmotic screw number, placement, or postoperative breakage did not adversely affect outcomes (moderate strength of evidence).
  • Limited evidence supports alternative fixation devices or fixation for stress-test-positive, non-displaced injuries.

Conclusions:

  • The evidence base for syndesmotic ankle fracture management is weak.
  • Screw characteristics do not appear to influence outcomes.
  • Further high-quality research is needed to guide treatment, particularly regarding malreduction and alternative fixation methods.