ABSTRACT
Assessment of syndesmotic instability is not precise with existing evaluation methods.
This study was conducted to investigate the use of a ball-tipped probe under arthroscopy
for quantitative assessment of tibiofibular space widening in a syndesmosis injury
model. The test specimens were 5 uninjured ankles from Thiel-fixed cadavers of 2 male
subjects and 3 female subjects of mean age of 82.4 years at death. The ball-tipped
probe consisted of a metal probe having a ball at each end with diameters ranging
from of 1.5 mm to 5.0 mm, in increments of 0.5 mm. The tibiofibular joint was observed
arthroscopically as the largest-diameter ball probe as possible was inserted into
its anterior third, middle, or posterior third portion with the ankle in natural plantarflexion
or under external rotational stress. These measurements were performed for the uninjured
ankle and then performed following Bassett's ligament sectioning, anterior inferior
tibiofibular ligament sectioning, interosseous membrane distal 15 cm sectioning, or
deltoid ligament, and posterior inferior tibiofibular ligament sectioning, with the
sections added in this sequence and each followed by a similar assessment. The results
of quantitative assessment of tibiofibular space widening with the ball-tipped probe
in the syndesmosis injury model under arthroscopy were that the maximum possible diameter
of ball probe that could be inserted was 1.5 to 2.0 mm in the uninjured state, 3.0
to 3.5 mm in the sectioned anterior inferior tibiofibular ligament model, and 5.0
mm in the severe-state model. The ball probe can serve as an effective tool for quantitative
assessment of the intraoperative instability in cases of syndesmosis injury.
Level of Clinical Evidence
Key words
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Article info
Publication history
Published online: July 07, 2020
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
Identification
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© 2020 by the American College of Foot and Ankle Surgeons. All rights reserved.
