Download PDF
Sportphysio 2022; 10(02): 59-65
DOI: 10.1055/a-1777-1620
Focus
Einführung

Syndesmosenverletzungen – Anatomie, Verletzungsmuster und Diagnostik

Markus Walther
,
Hubert Hörterer
,
Oliver Gottschalk
› Further Information
Also available at
    Permissions and Reprints

Viele Verletzungen der Außenbänder des Sprunggelenks heilen ohne langfristige Folgen. Ist aber die Syndesmose mit verletzt, drohen spätere Komplikationen. Eine gründliche Diagnose ist daher unabdingbar.



Publication History

Article published online:
03 May 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • Literatur

  • 1 Beumer A, Valstar ER, Garling EH. et al. Effects of ligament sectioning on the kinematics of the distal tibiofibular syndesmosis: A radiostereometric study of 10 cadaveric specimens based on presumed trauma mechanisms with suggestions for treatment. Acta Orthop 2006; 77: 531-540
    CrossrefPubMedSearch in Google Scholar
  • 2 Clanton TO, Ho CP, Williams BT. et al. Magnetic resonance imaging characterization of individual ankle syndesmosis structures in asymptomatic and surgically treated cohorts. Knee Surg Sports Traumatol Arthrosc 2016; 24: 2089-2102
    CrossrefPubMedSearch in Google Scholar
  • 3 Clanton TO, Williams BT, Backus JD. et al. Biomechanical analysis of the individual ligament contributions to syndesmotic stability. Foot Ankle Int 2017; 38: 66-75
    CrossrefPubMedSearch in Google Scholar
  • 4 Cosgrove CT, Putnam SM, Cherney SM. et al. Medial clamp tine positioning affects ankle syndesmosis malreduction. J Orthop Trauma 2017; 31: 440-446
    CrossrefPubMedSearch in Google Scholar
  • 5 Del Rio A, Bewsher SM, Roshan-Zamir S. et al. Weightbearing cone-beam computed tomography of acute ankle syndesmosis injuries. J Foot Ankle Surg 2020; 59: 258-263
    CrossrefPubMedSearch in Google Scholar
  • 6 Dikos GD, Heisler J, Choplin RH. et al. Normal tibiofibular relationships at the syndesmosis on axial CT imaging. J Orthop Trauma 2012; 26: 433-438
    CrossrefPubMedSearch in Google Scholar
  • 7 Ebraheim NA, Lu J, Yang H. et al. Radiographic and CT evaluation of tibiofibular syndesmotic diastasis: A cadaver study. Foot Ankle Int 1997; 18: 693-698
    CrossrefPubMedSearch in Google Scholar
  • 8 Elgafy H, Semaan HB, Blessinger B. et al. Computed tomography of normal distal tibiofibular syndesmosis. Skeletal Radiol 2010; 39: 559-564
    CrossrefPubMedSearch in Google Scholar
  • 9 Fort NM, Aiyer AA, Kaplan JR. et al. Management of acute injuries of the tibiofibular syndesmosis. Eur J Orthop Surg Traumatol 2017; 27: 449-459
    CrossrefPubMedSearch in Google Scholar
  • 10 Grossterlinden LG, Hartel M, Yamamura J. et al. Isolated syndesmotic injuries in acute ankle sprains: Diagnostic significance of clinical examination and MRI. Knee Surg Sports Traumatol Arthrosc 2016; 24: 1180-1186
    CrossrefPubMedSearch in Google Scholar
  • 11 Hamard M, Neroladaki A, Bagetakos I. et al. Accuracy of cone-beam computed tomography for syndesmosis injury diagnosis compared to conventional computed tomography. Foot Ankle Surg 2020; 26: 265-272
    CrossrefPubMedSearch in Google Scholar
  • 12 Han SH, Lee JW, Kim S. et al. Chronic tibiofibular syndesmosis injury: The diagnostic efficiency of magnetic resonance imaging and comparative analysis of operative treatment. Foot Ankle Int 2007; 28: 336-342
    CrossrefPubMedSearch in Google Scholar
  • 13 Harper MC. An anatomic and radiographic investigation of the tibiofibular clear space. Foot Ankle 1993; 14: 455-458
    CrossrefPubMedSearch in Google Scholar
  • 14 Harper MC, Keller TS. A radiographic evaluation of the tibiofibular syndesmosis. Foot Ankle 1989; 10: 156-160
    CrossrefPubMedSearch in Google Scholar
  • 15 Hermans JJ, Beumer A, de Jong TA. et al. Anatomy of the distal tibiofibular syndesmosis in adults: A pictorial essay with a multimodality approach. J Anat 2010; 217: 633-645
    CrossrefPubMedSearch in Google Scholar
  • 16 Hunt KJ, George E, Harris AH. et al. Epidemiology of syndesmosis injuries in intercollegiate football: Incidence and risk factors from National Collegiate Athletic Association injury surveillance system data from 2004–2005 to 2008–2009. Clin J Sport Med 2013; 23: 278-282
    CrossrefPubMedSearch in Google Scholar
  • 17 Hunt KJ, Phisitkul P, Pirolo J. et al. High ankle sprains and syndesmotic injuries in athletes. J Am Acad Orthop Surg 2015; 23: 661-673
    CrossrefPubMedSearch in Google Scholar
  • 18 Kaplan LD, Jost PW, Honkamp N. et al. Incidence and variance of foot and ankle injuries in elite college football players. Am J Orthop (Belle Mead NJ) 2011; 40: 40-44
    PubMedSearch in Google Scholar
  • 19 Kellett JJ, Lovell GA, Eriksen DA. et al. Diagnostic imaging of ankle syndesmosis injuries: A general review. J Med Imaging Radiat Oncol 2018; 62: 159-168
    CrossrefPubMedSearch in Google Scholar
  • 20 Kim S, Huh YM, Song HT. et al. Chronic tibiofibular syndesmosis injury of ankle: Evaluation with contrast-enhanced fat-suppressed 3 D fast spoiled gradient-recalled acquisition in the steady state MR imaging. Radiology 2007; 242: 225-235
    CrossrefPubMedSearch in Google Scholar
  • 21 Lamb SE, Marsh JL, Hutton JL. et al. Mechanical supports for acute, severe ankle sprain: A pragmatic, multicentre, randomised controlled trial. Lancet 2009; 373: 575-581
    CrossrefPubMedSearch in Google Scholar
  • 22 Lepojarvi S, Pakarinen H, Savola O. et al. Posterior translation of the fibula may indicate malreduction: CT study of normal variation in uninjured ankles. J Orthop Trauma 2014; 28: 205-209
    CrossrefPubMedSearch in Google Scholar
  • 23 Lilyquist M, Shaw A, Latz K. et al. Cadaveric analysis of the distal tibiofibular syndesmosis. Foot Ankle Int 2016; 37: 882-890
    CrossrefPubMedSearch in Google Scholar
  • 24 Mei-Dan O, Carmont M, Laver L. et al. Standardization of the functional syndesmosis widening by dynamic US examination. BMC Sports Sci Med Rehabil 2013; 5: 9
    CrossrefPubMedSearch in Google Scholar
  • 25 Mei-Dan O, Kots E, Barchilon V. et al. A dynamic ultrasound examination for the diagnosis of ankle syndesmotic injury in professional athletes: A preliminary study. Am J Sports Med 2009; 37: 1009-1016
    CrossrefPubMedSearch in Google Scholar
  • 26 Milz P, Milz S, Putz R. et al. 13 MHz high-frequency sonography of the lateral ankle joint ligaments and the tibiofibular syndesmosis in anatomic specimens. J Ultrasound Med 1996; 15: 277-284
    CrossrefPubMedSearch in Google Scholar
  • 27 Mousavian A, Shakoor D, Hafezi-Nejad N. et al. Tibiofibular syndesmosis in asymptomatic ankles: Initial kinematic analysis using four-dimensional CT. Clin Radiol 2019; 74: 571 e571-571 e8
    CrossrefPubMedSearch in Google Scholar
  • 28 Nielson JH, Gardner MJ, Peterson MG. et al. Radiographic measurements do not predict syndesmotic injury in ankle fractures: An MRI study. Clin Orthop Relat Res 2005; 216-221
    CrossrefPubMedSearch in Google Scholar
  • 29 Nussbaum ED, Hosea TM, Sieler SD. et al. Prospective evaluation of syndesmotic ankle sprains without diastasis. Am J Sports Med 2001; 29: 31-35
    CrossrefPubMedSearch in Google Scholar
  • 30 Ochmann S. Knochen- und Knorpelläsionen am oberen Sprunggelenk. In: Dohle J, Rammelt S. Expertise Orthopädie und Unfallchirurgie. Fuß und Sprunggelenk. Stuttgart: Thieme; 2021
    Search in Google Scholar
  • 31 Patel S, Malhotra K, Cullen NP. et al. Defining reference values for the normal tibiofibular syndesmosis in adults using weight-bearing CT. Bone Joint J 2019; 101-B: 348-352
    CrossrefPubMedSearch in Google Scholar
  • 32 Schoennagel BP, Karul M, Avanesov M. et al. Isolated syndesmotic injury in acute ankle trauma: Comparison of plain film radiography with 3 T MRI. Eur J Radiol 2014; 83: 1856-1861
    CrossrefPubMedSearch in Google Scholar
  • 33 Sclafani SJ. Ligamentous injury of the lower tibiofibular syndesmosis: Radiographic evidence. Radiology 1985; 156: 21-27
    CrossrefPubMedSearch in Google Scholar
  • 34 Shakoor D, Osgood GM, Brehler M. et al. Cone-beam CT measurements of distal tibio-fibular syndesmosis in asymptomatic uninjured ankles: Does weight-bearing matter?. Skeletal Radiol 2019; 48: 583-594
    CrossrefPubMedSearch in Google Scholar
  • 35 Szeimies U, Staebler A, Walther M. Diagnostic imaging of the foot and ankle. Stuttgart: Thieme; 2015
    Search in Google Scholar
  • 36 Takao M, Ochi M, Naito K. et al. Arthroscopic diagnosis of tibiofibular syndesmosis disruption. Arthroscopy 2001; 17: 836-843
    CrossrefPubMedSearch in Google Scholar
  • 37 Takao M, Ochi M, Oae K. et al. Diagnosis of a tear of the tibiofibular syndesmosis. The role of arthroscopy of the ankle. J Bone Joint Surg Br 2003; 85: 324-329
    CrossrefPubMedSearch in Google Scholar
  • 38 Uys HD, Rijke AM. Clinical association of acute lateral ankle sprain with syndesmotic involvement: A stress radiography and magnetic resonance imaging study. Am J Sports Med 2002; 30: 816-822
    CrossrefPubMedSearch in Google Scholar
  • 39 van Zuuren WJ, Schepers T, Beumer A. et al. Acute syndesmotic instability in ankle fractures: A review. Foot Ankle Surg 2017; 23: 135-141
    CrossrefPubMedSearch in Google Scholar
  • 40 Williams GN, Jones MH, Amendola A. Syndesmotic ankle sprains in athletes. Am J Sports Med 2007; 35: 1197-1207
    CrossrefPubMedSearch in Google Scholar
  • 41 Xenos JS, Hopkinson WJ, Mulligan ME. et al. The tibiofibular syndesmosis. Evaluation of the ligamentous structures, methods of fixation, and radiographic assessment. J Bone Joint Surg Am 1995; 77: 847-856
    CrossrefPubMedSearch in Google Scholar