External torque application during assessment of syndesmotic ankle lesions: A systematic review

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-09-05 DOI:10.1016/j.clinbiomech.2025.106662

Axel Degrande , Louise Wittouck , Pieter D'Hooghe , Matthias Peiffer , Thomas Tampere , Sam Van der Jeught , Arne Burssens , Amélie Chevalier

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引用次数: 0

Abstract

Background

Syndesmotic ankle injuries, particularly those involving the distal tibiofibular joint, are challenging to diagnose due to subtle clinical presentation and complex ankle biomechanics. Both clinical and biomechanical studies struggle with accurately assessing the severity and extent of these injuries. External torque has recently shown promise in enhancing the detection and assessment of syndesmotic injuries, especially in weight-bearing computed tomography (WBCT). This study explores the impact of external torque on the assessment of syndesmotic ankle lesions in clinical versus biomechanical studies.

Methods

A systematic search was conducted using PubMed, Scopus, EMBASE, The Cochrane Library, and Web of Science. The review protocol was registered on PROSPERO (CRD42024535265). Inclusion criteria were biomechanical studies on lower limbs with intact and sectioned syndesmosis; clinical studies comparing injured ankles to healthy contralateral ones; and studies applying torque or weight-bearing to injured ankles. Exclusion criteria consisted of reviews, meta-analyses, studies on syndesmosis repair, acute injuries involving fractures, and studies lacking measurements.

Findings

Eleven studies met the inclusion criteria, including eight biomechanical and three clinical studies.

Interpretation

While biomechanical evidence provides a solid foundation, its translation into clinical practice requires further validation. The importance of assessment of the ankle syndesmosis under torque has been demonstrated, and the application of external torque shows promising results. Multiple studies indicate that applying an external torque between 4.5 and 7.5 [Nm] is sufficient to distinguish between intact and sectioned syndesmotic injuries. However, the need for a standardized diagnostic tool has yet to be established.

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评估关节联合病变时的外扭矩应用：系统回顾

踝关节联合损伤，特别是涉及胫腓骨远端关节的损伤，由于其微妙的临床表现和复杂的踝关节生物力学，诊断具有挑战性。临床和生物力学研究都在努力准确评估这些损伤的严重程度和范围。外扭矩最近在增强韧带联合损伤的检测和评估方面显示出前景，特别是在负重计算机断层扫描（WBCT）中。本研究在临床与生物力学研究中探讨了外部扭矩对踝关节联合病变评估的影响。方法系统检索PubMed、Scopus、EMBASE、The Cochrane Library、Web of Science。审查方案已在PROSPERO注册（CRD42024535265）。纳入标准为完整和切片的下肢联合的生物力学研究；损伤踝关节与对侧健康踝关节的临床比较研究研究对受伤的脚踝施加扭矩或负重。排除标准包括综述、荟萃分析、关于韧带联合修复的研究、涉及骨折的急性损伤和缺乏测量的研究。11项研究符合纳入标准，包括8项生物力学研究和3项临床研究。虽然生物力学证据提供了坚实的基础，但其转化为临床实践需要进一步验证。评估踝关节联合在扭矩作用下的重要性已被证明，外扭矩的应用显示出良好的结果。多项研究表明，施加4.5 - 7.5 [Nm]的外扭矩足以区分完整型和节裂型联合损伤。然而，对标准化诊断工具的需求尚未确定。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.