靭帯結合
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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/12/20 00:36:23」(JST)
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| Syndesmosis |
| Identifiers |
| TA |
A03.0.00.005 |
| FMA |
7494 |
| Anatomical terminology
[edit on Wikidata]
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A syndesmosis is a slightly movable fibrous joint in which bones such as the tibia and fibula are joined together by connective tissue. Examples include the distal tibiofibular joint as well as the radioulnar joint. Injuries to the ankle syndesmosis are commonly known as a "high ankle sprain". Although the syndesmosis is a joint, in the literature the term syndesmotic injury is used to describe injury of the syndesmotic ligaments. It comes from the Greek σύν, syn (meaning "with") and δεσμός, desmos (meaning "a band").[1] Syndesmosis sprains have received increasing recognition during recent years because of a heightened awareness of the mechanism, symptoms, and signs of injury.[2]
Contents
- 1 Diagnosis of a syndesmotic injury
- 2 Syndesmotic tear
- 3 See also
- 4 References
- 5 External links
Diagnosis of a syndesmotic injury
Diagnosis of syndesmosis injuries by physical examination is often straightforward. Physical examination findings that are often positive include the squeeze test and the external rotation test. Patients with high-grade syndesmosis injuries often cannot perform a single-leg heel raise. Patients report pain over the anterior and often posterior distal fibular joint.[3]
Syndesmotic tear
The severity of acute syndesmosis injury is rated from grade I to III by several authors. A grade I injury is a partial anteroinferior tibiofibular ligament tear, meaning the exorotation and squeeze tests are negative for this grade. Grade II injury is a complete anteroinferior tibiofibular ligament and inferior interossesus ligament tear, meaning that squeeze test and exorotation are positive. This results in the injury being stabilized with immobilization but not operatively stabilized. A grade III injury is a complete anteroinferior tibiofibular ligament tear including a (partial) interosseous ligament tear and deltoid ligament avulsion, meaning the joint is unstable and positive on the exorotation and squeeze tests. This grade requires operative stabilization.[4] If the syndesmosis is torn apart as result of bone fracture, surgeons will sometimes fix the relevant bones together with a syndesmotic screw, temporarily replacing the syndesmosis, or with a tightrope fixation , which is called Syndesmosis Procedure.[5][6] The screw inhibits normal movement of the bones and, thereby, the corresponding joint(s). When the natural articulation is healed, the screw may be removed. The tightrope fixation with elastic fiberwire suture on the other hand allows physiologic motion of the ankle and may be permanent.
See also
References
This article incorporates text in the public domain from the 20th edition of Gray's Anatomy (1918)
- ^ Dr. M. A. (Toby) Arnold; Deborah Bryce. "Arnold's Glossary of Anatomy". The University of Sydney.
- ^ Jones, MH; Amendola, A. "Syndesmosis sprains of the ankle". Lippincott Williams & Wilkins, 2007, p.173-75.
- ^ Johnson, Darren L, MD; Metzler, Adam V, MD. "Dynamically Unstable Syndesmosis Injuries". Slack Incorporated, 2013, p.209-11.
- ^ Valkering, Kars P, MD; Vergroesen, Diederik, A, MD; Nolte, Peter A, MD, PhD. "Isolated Syndesmosis Ankle Injury". Slack Incorporated, 2012, p.e1705-10.
- ^ http://www.aaos.org/news/aaosnow/may08/clinical4.asp
- ^ http://www.arthrex.com/foot-ankle/tightrope
External links
- http://commons.bcit.ca/biology/articulations/fibrous.html
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Joints
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| Types |
- Fibrous
- Gomphosis
- Suture
- Syndesmosis
- Interosseous membrane
- Cartilaginous
- synovial: Plane joint
- 1°
- 2°
- Condyloid joint
- Saddle joint
- 3°
- by range of motion: Synarthrosis
- Amphiarthrosis
- Diarthrosis
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| Terminology |
- Kinesiology
- Anatomical terms of motion
- Agonist/Antagonist
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| Motions |
- general: Flexion/Extension
- Adduction/Abduction
- Internal rotation/External rotation
- Elevation/Depression
- specialized/upper limbs: Protraction/Retraction
- Supination/Pronation
- specialized/lower limbs: Plantarflexion/Dorsiflexion
- Eversion/Inversion
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| Components |
- capsular: Joint capsule
- Synovial membrane
- Fibrous membrane
- Synovial fluid
- Synovial bursa
- Articular disk/Meniscus
- extracapsular: Ligament
- Enthesis
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UpToDate Contents
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English Journal
- Imaging in syndesmotic injury: a systematic literature review.
- Krähenbühl N1, Weinberg MW1, Davidson NP1, Mills MK2, Hintermann B3, Saltzman CL1, Barg A4.
- Skeletal radiology.Skeletal Radiol.2018 May;47(5):631-648. doi: 10.1007/s00256-017-2823-2. Epub 2017 Nov 30.
- PMID 29188345
- Evaluation of Transsyndesmotic Fixation and Primary Deltoid Ligament Repair in Ankle Fractures With Suspected Combined Deltoid Ligament Injury.
- Wu K1, Lin J1, Huang J2, Wang Q3.
- The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons.J Foot Ankle Surg.2018 Apr 13. pii: S1067-2516(17)30701-9. doi: 10.1053/j.jfas.2017.12.007. [Epub ahead of print]
- PMID 29661674
- [Injuries of ligaments and tendons of foot and ankle : What every radiologist should know].
- Thierfelder KM1, Gemescu IN2, Weber MA3, Meier R4.
- Der Radiologe.Radiologe.2018 Apr 13. doi: 10.1007/s00117-018-0383-7. [Epub ahead of print]
- PMID 29654331
Japanese Journal
- Gender difference in distance of tibiofibular syndesmosis to joint dynamics of lower extremities during squat
Related Links
- syndesmosis [sin″dez-mo´sis] (Gr.) a joint in which the bones are united by fibrous connective tissue forming an interosseous membrane or ligament. syn·des·mo·sis, pl. syn·des·mo·ses (sin'dez-mō'sis, -sēz), [TA] A form of fibrous ...
- :an articulation in which the contiguous surfaces of the bones are rough and are bound together by a ligament ... Seen and Heard What made you want to look up syndesmosis? Please tell us where you read or heard it (including the ...
Related Pictures
★リンクテーブル★
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- 英
- syndesmodial joint, syndesmotic joint
- ラ
- syndesmosis