Syndesmotic Ankle Injuries

Question 1

Ligamentous anatomy

Answer 1

• ant. inf. tibiofibular
• interosseous
• post. inf. tibiofibular
• inf. transverse tibiofibular

Question 2

During dorsiflexion, what happens to the mortise and stability?

Answer 2

• widens

- increases

Question 3

Define: incisura fibularis

Answer 3

• concave surface of the distal lateral tibia

Question 4

Define: Weber A fx

Answer 4

• infrasyndesmotic distal fib fx

Question 5

Weber A fx tx

Answer 5

• stable, rarely require sx

Question 6

Define: Weber B fx

Answer 6

• transsyndesmotic distal fib fx

Question 7

Weber B tx

Answer 7

• variably unstable, test with ER or gravity stress XR

Question 8

Define Weber C fx

Answer 8

• suprasyndesmotic fx

Question 9

Weber C tx

Answer 9

• unstable, requires sx

Question 10

Worse outcomes s/p 1 yr are a/w how much displacement of post. mal fx?

Answer 10

• 2mm

Question 11

Ant compartment M. (med to lat)

Answer 11

• ant. tib
• EHL
• EDL
• peroneus tertius

Question 12

Lat compartment M. (sup to deep)

Answer 12

• peroneus longus

- peroneus brevis

Question 13

Superficial post. compartment M. (sup to deep)

Answer 13

• gastroc
• soleus
• plantaris

Question 14

Deep post. compartment M. (sup to deep)

Answer 14

• popliteus
• FHL
• FDL
• post. tib

Question 15

Dissection for a lateral ankle approach

Answer 15

• subQ for ORIF

Question 16

Risks of a lateral ankle approach

Answer 16

• sural n. (postlat)

- superficial peronal n. (ant)

Question 17

Interval for a postlat ankle approach

Answer 17

• b/t peroneus brevis and FHL

Question 18

Dissection for a postlat ankle approach

Answer 18

• ID peroneal tendons
• Incise peroneal retinaculum to mobilize tendons lat, which exposes FHL
• Retract FHL medially to expose tibia and ankle joint

Question 19

Risks for a postlat ankle approach

Answer 19

• lesser saphenous v

- sural n. (post to lat mal)