orthopedics-2019-scientifictracks

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November 13-14, 2019 | London, UK
ORTHOPEDICS, OSTEOPOROSIS & TRAUMA
12th International Conference on
Journal of Orthopaedics Trauma Surgery and
Related Research
Orthopedics 2019
November 13-14, 2019
J Orthop Trauma Surg Rel Res, Volume 14
Volume: 14 | ISSN: 1897-2276
Comparison of 2 different methods to evaluate the ankle syndesmosis on lateral
radiographs
Atul Kamat
West Hertfordshire Hospitals NHS Trust, UK
Introduction: Ankle fractures with syndesmotic injuries treated surgically have a high rate of syndesmotic malreduction, up to
52% in some series. Plain radiography may be misleading and intra operative imaging may not be accurate. Several methods have
been described for assessment of the syndesmosis on ankle lateral radiographs. We compare 2 methods in our study.
Aims: 1. To compare 2 different methods of assessing the integrity of the ankle syndesmosis on lateral radiographs- the
Anteroposterior Tibiofibular Ratio (APTF) described by Grenier et al 2013 and Anterior Tibiofibular Ratio (ATFR) described
by Croft et al 2015.
2. To validate the above methods of assessing the syndesmosis in our series.
Study design: Retrospective review of notes and radiographs
Method : 200 ankle lateral radiographs from patients presenting to our A/E with suspected ankle injuries studied by 2 authors
together in agreement. ATFR and APTFR calculated. Any patient who needed syndesmotic fixation was considered as having
sustained a true syndesmotic injury.
Results:
APTF: 20 patients had normal syndesmotic values, 4 of whom underwent surgical fixation of the syndesmosis (20%). 93 patients
had abnormal values, of whom 29 patients needed syndesmotic fixation (31%)
ATFR: 40 patients had normal syndesmotic values, of whom 10 underwent surgical fixation (25%). 73 patients had abnormal
syndesmotic values, of whom 23 needed surgical fixation (31.5%)
Discussion: Assessment of the syndesmosis on lateral radiographs is not a commonly used technique in clinical practice. Several
authors have attempted to describe radiological measurement techniques on the lateral radiograph including Summers Grenier
Croft and Park. Grenier and Croft excluded ankle fractures in their reported series of patients. In our study we have attempted
to assess the syndesmosis in all patients who presented with ankle injuries, including fractures. The low rate of diagnosis using
these measurements makes both techniques unsuitable for routine clinical use.
Conclusion : The presence of displaced bony landmarks in a fractured ankle alters the measurements and hence the calculated
values of APTF and ATFR are not reliable in the presence of displaced ankle fractures. Both techniques have a low rate of
diagnosis in the presence of ankle fractures and hence cannot be used in routine clinical practice for the diagnosis of syndesmotic
disruption.
Biography
Atul Kamat currently working at The West Hertfordshire Hospitals NHS Trust in Trauma and Orthopedic Surgery Department. He has
more than fifteen years of experience in Trauma & Orthopedic Surgery. He joined Goa Medical College and completed MBBS during
this time I developed an interest in Trauma and Orthopedic Surgery. He decided to come to the United Kingdom to continue my pursuit
and passed the PLAB examination. He has been working in the National Health Service has been a very satisfying experience and this
has helped to gain valuable experience of working in a very diverse culture.