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Designing for Lower Torso and Leg Anatomy
Published in Karen L. LaBat, Karen S. Ryan, Human Body, 2019
The tibia and fibula share a minimally mobile syndesmosis joint, with upper and lower components, between the knee and ankle. A tear in the distal segment of the syndesmotic ligament is called a high ankle sprain, a different injury than the more common sprain at the lateral and/or medial malleoli (discussed in Chapter 8). Roemer et al. (2014) used MRI to study sport-related ankle sprains in young men and found about 20% included a syndesmotic injury. Williams, Jones, and Amendola (2007, p. 1199) note high ankle sprains are more common in “collision” sports (i.e. football, rugby, lacrosse) and sports whose athletes wear boots—hockey, skiing. Historically, this injury has been underdiagnosed and optimal treatment is not clear; however, it generally includes immobilization (Williams et al., 2007). Wearable devices for high ankle sprains include casts (fixed-in-place) or removable walking boots to stabilize a severe or recently injured syndesmotic joint. Stirrup style braces with good lateral support or ankle taping are used for minor injuries, sub-acute recovery periods, or to try to prevent recurrent injury (Figure 5.13-C).
Musculoskeletal system
Published in David A Lisle, Imaging for Students, 2012
Ankle injuries may include fractures of the distal fibula (lateral malleolus), medial distal tibia (medial malleolus) and posterior distal tibia; talar shift and displacement; fracture of the talus; separation of the distal tibiofibular joint (syndesmosis injury); ligament rupture with joint instability. Salter–Harris fractures of the distal tibia and fibula are common in children.
A novel synergistic device for joint inflammation – efficacy on ankle sprain cases
Published in Journal of Medical Engineering & Technology, 2022
The ankle contains three joints (a) – talo-crural is a synovial hinge joint, (b) – inferior tibio-fibular a syndesmosis and (c) – subtalar joint; they all are formed by the tibia, fibula and talus/calcaneus. Both tibia and fibula have raised bony edges at lower end – called malleoli which give ankle its characteristic diamond shape. The soft tissue structures tendons, ligaments, etc. are in the recesses (space) between these malleoli, and this gives the potential space for collection of fluid as well during an injury. (15th Ed – Cunnigham’s Vol-1, Romanes) [11]. Deep Fascia of the leg and foot is very strong, and it is attached to the borders at the malleoli, at ankle it forms retinacula – the thick bands which hold the tendons. First aim after ankle sprain or any surgery around ankle is to reduce swelling. Compression garments and other devices which cover the ankle completely may give substantial amount of compression to the bony prominences – the malleoli; whereas if we leave the bony prominence and compress only the soft tissue recesses, the retinacula and the tendons movement is regained faster and thus, the effectiveness of edoema reduction around malleoli can be increased.
Early functional treatment or trivialization? – current treatment strategies in lateral ligament injuries of the ankle
Published in European Journal of Sport Science, 2021
Daniel Popp, Johannes Weber, Maximilian Kerschbaum, Andreas Schicho, Florian Baumann, Franz Hilber, Werner Krutsch, Volker Alt, Christian Pfeifer
Ankle injuries are the most common injuries in sports as well as the most common domestic and work related injuries (Doherty, Bleakley, Delahunt, & Holden, 2017; Hubbard-Turner, Wikstrom, Guderian, & Turner, 2015; Krutsch et al., 2018). Athletes performing high-impact sports like football, handball or basketball have a higher incidence for these injuries (Halabchi, Angoorani, Mirshahi, Pourgharib Shahi, & Mansournia, 2016; Rodas et al., 2019; Wiener, Linder, & Giattini, 1997; Zwitser & Breederveld, 2010). Especially the lateral ligament complex of the ankle joint shows a high incidence of injuries with different injury mechanisms. Related to biomechanics, the ankle joint complex has been evaluated in several studies (Fong, Ha, Mok, Chan, & Chan, 2012; Li et al., 2019). The lateral ligaments of the ankle joint, in combination with the articular surface and bony structures, are relevant for stability, range of motion and physiologic load distribution in case of weight bearing (Court-Brown & Caesar, 2006). 20–40% of all patients develop chronic ankle instability after recurrent ankle injuries, especially in combined injuries of the syndesmosis (Smeeing et al., 2015). Recurrent injuries of the lateral ankle ligaments and chronic ankle instability are a positive predictor for osteoarthritis of the ankle (Khlopas et al., 2019).
Computational biomechanical analysis of postoperative inferior tibiofibular syndesmosis: a modified modeling method
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2018
Haobo Li, Yanxi Chen, Minfei Qiang, Kun Zhang, Yuchen Jiang, Yijie Zhang, Xiaoyang Jia
Currently, different kinds of treatment for inferior tibiofibular syndesmosis injury have been used, while the syndesmotic screw fixation is the most applied method (Manjoo et al. 2010). As a common complication of ankle fracture (5–10%) (Egol et al. 2010), inferior tibiofibular syndesmosis injury with improper treatment can lead to instability of the ankle, which may cause chronic pain, traumatic arthritis, and other complications (Wang et al. 2015). Nevertheless, various methods of screw fixation such as those involving different numbers, materials, diameters, and positions of the screw and different number of cortices the screw gets through are still under-discussed and different research conclusions have been reported (Hoiness and Stromsoe 2004; Manjoo, Sanders, Tieszer and MacLeod 2010).