Clinical Considerations to Reduce Saphenous Neurovascular Bundle Injury During Suture Button Fixation of Syndesmosis Injuries

Objective: To document angles, from 2 difference starting points, or danger zones that should be avoided to minimize risk of injury or irritation to the saphenous neurovascular bundle (SNVB) during suture button (SB) fixation for distal tibiofibular syndesmosis injuries. Design: Retrospective imaging study. Setting: Academic Level 1 trauma center. Patients: Forty-eight randomly selected patients with healthy ankles and computed tomography scans for nonankle diagnoses. Main Outcome Measures: Computed tomography scans and 3D reconstructed images were used to define the angle between the SNVB and 2 different fibular starting points, using the direct lateral (DL) and the posterolateral (PL) starting points. Descriptive analyses were performed to identify angles that should be avoided during suture button fixation. Distances from the SNVB using preset angles of 0, 10, 20, and 30 degrees were analyzed. In addition, the width of the SNVB, the midsubstance angle of the SNVB, and the distance from the 30-degree point to the tibialis anterior were recorded. Results: The mean angle between the SNVB and the standard DL starting point was 13.7 ± 5.0 degrees (P
Source: Journal of Orthopaedic Trauma - Category: Orthopaedics Tags: Original Article Source Type: research