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Reproducible and Reliable Method for Syndesmotic Screw Fixation: An MRI-Based Cross-Sectional Image Analysis.

Serdar Sargin¹, Aziz Atik¹, Ali Engin Ulusal²

¹Assistant Professor, Department of Orthopaedics and Traumatology, School of Medicine, Balıkesir University, Balıkesir, Turkey.

The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons

|January 2, 2022

Summary

This summary is machine-generated.

This study identifies reliable landmarks for syndesmotic screw placement in ankle injuries. Using the anterior tibial and Achilles tendons ensures precise screw positioning, preventing ankle arthrosis.

Keywords:

Achilles tendon angle anterior tibial tendon screw syndesmotic

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Area of Science:

Orthopedic Surgery
Radiology
Biomechanics

Background:

Syndesmotic injuries can lead to ankle instability and malreduction, potentially causing ankle arthrosis.
Accurate syndesmotic screw placement is critical for anatomical reduction and stabilization.
A reliable reference point is needed to guide syndesmotic screw insertion.

Purpose of the Study:

To identify a reliable reference point for syndesmotic screw placement.
To quantify the ideal angle for syndesmotic screw insertion.
To improve the precision of syndesmotic screw placement in ankle fracture treatment.

Main Methods:

Prospective cohort study involving 99 healthy volunteers.
Magnetic resonance (MR) imaging of the right ankle was performed.
Analysis of axial MR sections to define screw axis, reference lines, and angles 2 cm above the tibial plafond.

Main Results:

The mean syndesmotic screw position relative to the ground line was 28° ± 6.4°.
A precise angle of 26.2° ± 1.1° was determined using the axis perpendicular to the line connecting the anterior tibial and Achilles tendons.
High interobserver reliability was achieved in measurements.

Conclusions:

The anterior tibial and Achilles tendons serve as reproducible and reliable landmarks for syndesmotic screw placement.
This method enhances the precision of screw positioning, independent of lower extremity alignment or foot deformities.
Accurate placement is key to preventing post-traumatic ankle arthrosis.