Looking for information about various injuries of ligaments and joints, you can find the term "syndesmosis." This word denotes a sedentary or motionless joint of the bones of the human body. Injuries to this ligament are common, especially when it comes to athletes or people whose work involves intense physical activity. So what is syndesmosis and what are the results of his injury? Is rupture of this joint dangerous and what treatment methods can modern medicine offer?
What is syndesmosis?
As you know, in the musculoskeletal system of a person, the bones are articulated with each other both movably and motionless. For example, joints connect the elements of the skeleton, providing the ability to move. If we are talking about motionless joints, then here definitely be called syndesmosis. This is the connection path through strands of dense connective tissue. Such structures do not provide for movement. For example, this is how the bones of the skull, spinous processes of the vertebrae, bones of the forearm and lower leg are articulated.
Of course, there are several varieties of such a connection. Membrane syndesmosis is what you can see, consider the articulation of the fibula and tibia. But the bones of the skull are interconnected by different types of “sutures”.
Features of syndesmosis injuries
Alas, injuries of syndesmosis can hardly be considered a rarity. Quite often, membranes rupture between the tibia. Ankle injuries are often reported in athletes while jumping or running. Ballerinas, gymnasts and circus acrobats are prone to the same damage.
With craniocerebral injuries, as well as damage to the spine, a violation of the joints between the bones is possible. In newborns, a gap of syndesmosis between the structures of the skull sometimes occurs during passage through the birth canal. But with a compression fracture of the spine , the patient also reveals partial damage or stretching of the fibers - ligaments between the vertebrae.
Distal tibiofibular syndesmosis and its rupture
According to statistics, 10% of ankle sprain injuries are associated precisely with a trauma to the structure called “tibiofibular syndesmosis”. It is worth saying that no one is safe from this damage, since the membrane can stretch or become damaged when the foot is turned outward strongly while the toe is turned inward.
On the other hand, there are people who are more prone to this type of injury due to the profession - these are athletes, dancers, acrobats, etc. By the way, the constant wearing of high-heeled shoes, especially with unstable lifting, also increases the likelihood of stretching the tibial membrane.
Symptoms of a tibial membrane injury
Damaged distal syndesmosis is a common problem, and it is accompanied by a fairly pronounced clinical picture. As a rule, the first symptom is a sharp pain. Unpleasant sensations are greatly amplified during movement or when trying to change the position of the foot. Soreness is also aggravated by palpation.
Another symptom is swelling of the soft tissue around the injury - swelling builds up rapidly, increasing in a matter of minutes. The patient’s foot, as a rule, acquires a forced, unnatural position - in most cases it is turned out. In addition, the skin in the area of the injury blushes, on it you can often notice small subcutaneous hemorrhages.
Of course, in order to diagnose a rupture of the tibiofibular syndesmosis, some testing is necessary. During a physical examination, the doctor may already suspect the presence of stretching or damage to the membrane, but in order to make an accurate diagnosis and determine the treatment regimen, an X-ray examination is necessary. In the pictures, a specialist can clearly see the expansion of the gap between the bones, as well as determine the line of rupture and notice the presence of fractures.
Conservative treatment and its features
To begin with, conservative treatment is performed. In order to alleviate the condition of the patient, the pain is stopped by conducting novocaine blockade. The main goal of therapy during this period is to immobilize the extremities, squeeze the tibial cleft and allow the tissues to recover on their own. That is why an indispensable element of treatment is a plaster cast, which is applied in the form of a boot. Gypsum will take about 5-6 weeks.
After this, the bandage is removed and replaced with a removable tire - during this period, active movements are contraindicated, but the patient needs rehabilitation. For this purpose, people are usually prescribed various physiotherapy procedures and regular massage sessions. A special therapeutic gymnastics is also required, which is carried out under the supervision of a specialist, it is he who selects a set of exercises, determines the time and the corresponding loads.
Often a rupture of syndesmosis is associated with other injuries, including impaired normal circulation. As an example of complications, venous vascular thrombosis can be cited, therefore, the patient's condition should be monitored very carefully and, if necessary, the administration of anticoagulants should be introduced into the treatment regimen.
Immediately it is worth saying that conservative therapy is a long process. Often, in order to fully restore mobility and physical capabilities, the patient needs more than 6 months.
When is surgery necessary?
Unfortunately, conservative treatment is far from effective in every case. In case of severe injuries, improper bone fusion and in the absence of the effect of physiotherapeutic treatment, the doctor may decide on surgical intervention.
Today, there are many techniques for restoring ligaments. Quite often, a new ligament is implanted during the procedure. It is formed from a canned tendon, a wide fascia of the thigh and a ribbon of lavsan. In the tibia, special channels are made, to which the ligament is attached. By the way, in 92% of cases, the operation is successful, and mobility returns to the patient.
There is another way, namely the use of a compression screw made of an alloy of metals. Such a screw is a reliable tightening mechanism - it fixes the lower leg bones at a certain distance, preventing them from moving or growing together.
In any case, it is worthwhile to understand that damaged syndesmosis is a serious problem, and self-medication is inappropriate here. Immediately after receiving an injury, consult a doctor.