Wuest TK
Orthopedic Healthcare Northwest, Eugene, Ore, and Oregon Health Sciences University, Portland.
J Am Acad Orthop Surg. 1997 May;5(3):172-181. doi: 10.5435/00124635-199705000-00006.
Disruption of the distal syndesmosis of the lower extremity is most commonly associated with ankle fractures but can also occur without gross bone injury. Definitive management of these injuries remains controversial. The current indications for syndesmosis fixation are based on tibiotalar joint mechanics as determined in cadaveric and biomechanical studies, as well as radiologic evaluation and an understanding of the pertinent anatomy and the etiology of these injuries. Such data support the use of syndesmotic screws in selected fractures that include a disruption of the syndesmosis. However, definitive fixation recommendations for syndesmosis disruption with or without ankle fracture remain under investigation. Distal lower extremity syndesmosis sprains without fracture or subluxation consistently require longer recovery time than typical lateral sprains and can be associated with greater long-term disability.
下肢远侧胫腓联合损伤最常见于踝关节骨折，但也可在无明显骨损伤的情况下发生。这些损伤的确切治疗方法仍存在争议。目前胫腓联合固定的指征是基于尸体和生物力学研究确定的胫距关节力学，以及影像学评估，并了解这些损伤的相关解剖结构和病因。这些数据支持在包括胫腓联合损伤的特定骨折中使用胫腓联合螺钉。然而，对于伴有或不伴有踝关节骨折的胫腓联合损伤的确切固定建议仍在研究中。无骨折或半脱位的下肢远侧胫腓联合扭伤持续恢复时间通常比典型的外侧扭伤更长，并且可能与更大的长期残疾相关。
