The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Jun 1995
The tibiofibular syndesmosis. Evaluation of the ligamentous structures, methods of fixation, and radiographic assessment.
Twenty-five fresh-frozen cadaveric specimens were used to evaluate the role of the syndesmotic ligaments when the ankle is loaded with external rotation torque. An apparatus was constructed that allowed pure external-rotation torque to be applied through the ankle with the foot in neutral flexion. The apparatus provided solid fixation of the tibia while allowing free movement of the fibula in all planes. ⋯ Additionally, interobserver correlation was significantly higher for the measurements on the lateral radiographs (r = 0.87, p < 0.0001) than for those on the mortise radiographs (r = 0.56, p < 0.0001). Intraobserver correlation for the three observers was poor with regard to the measurements on the mortise radiographs (r = 0.12, 0.42, and 0.25). The respective correlations for the measurements on the lateral radiographs were r = 0.81, 0.90, and 0.89.(ABSTRACT TRUNCATED AT 400 WORDS)
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We conducted a retrospective review of the results of twenty-seven consecutive osteotomies for malunited fractures of the forearm performed at the Mayo Clinic from 1976 to 1991. There were seventeen male patients and ten female patients who were an average of nineteen years old (range, nine to forty-one years old) at the time of the osteotomy. The corrective osteotomy was performed an average of seventy-three months (range, two to 324 months) after the fracture. ⋯ Those who were managed late gained an average of only 30 degrees (range, -25 to 95 degrees). A pain-free, stable wrist was achieved in three of the six patients who were managed for an unstable and painful distal radio-ulnar joint. However, these six patients lost an average of 7 degrees (range, -25 to 25 degrees) of rotation of the forearm.(ABSTRACT TRUNCATED AT 250 WORDS)