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. 2021 Jun 21;9(6):23259671211021057.
doi: 10.1177/23259671211021057. eCollection 2021 Jun.

APKASS Consensus Statement on Chronic Syndesmosis Injury, Part 1: Clinical Manifestation, Radiologic Examination, Diagnosis Criteria, Classification, and Nonoperative Treatment

Chen Jiao  1 , Jianchao Gui  2 , Hiroaki Kurokawa  3 , Yasuhito Tanaka  3 , Patrick Yung  4 , Seung Hwan Han  5 , Chayanin Angthong  6 , Yujie Song  7 , Yinghui Hua  7 , Hongyun Li  7 , Zhongmin Shi  8 , Qi Li  9 , Samuel K K Ling  4
Affiliations

APKASS Consensus Statement on Chronic Syndesmosis Injury, Part 1: Clinical Manifestation, Radiologic Examination, Diagnosis Criteria, Classification, and Nonoperative Treatment

Chen Jiao et al. Orthop J Sports Med. .

Abstract

Background: Clinical manifestation, radiologic examination, diagnostic criteria, classification, and nonoperative treatment strategies regarding chronic syndesmosis injury remain unclear.

Purpose: An international group of experts representing the fields of sports injuries in the foot and ankle area were invited to collaboratively advance toward consensus opinions based on the best available evidence regarding chronic syndesmosis injuries. All were members of the Asia-Pacific Knee, Arthroscopy and Sports Medicine Society (APKASS).

Study design: Consensus statement.

Methods: From November to December 2020, a total of 111 international experts on sports medicine or ankle surgery participated in a 2-stage Delphi process that included an anonymous online survey and an online meeting. A total of 13 items with 38 statements were drafted by 13 core authors. Of these, 4 items with 15 clinical questions and statements were related to the clinical manifestation, radiologic examination, diagnostic criteria, classification, and nonoperative treatment strategies for chronic syndesmosis injury and are presented here. Each statement was individually presented and discussed, followed by a general vote. The strength of consensus was characterized as follows: consensus, 51% to 74%; strong consensus, 75% to 99%; unanimous, 100%.

Results: Of the 15 questions and statements, 5 reached unanimous support and 10 achieved strong consensus.

Conclusion: This APKASS consensus statement, developed by international experts in the field, will assist surgeons and physical therapists with diagnosis, classification, and nonoperative treatment strategies for chronic syndesmosis injury.

Keywords: ankle; clinical manifestation; consensus; diagnosis; syndesmosis injury.

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References

    1. Ahn TK, Choi SM, Kim JY, Lee WC. Isolated syndesmosis diastasis: computed tomography scan assessment with arthroscopic correlation. Arthroscopy. 2017;33(4):828–834. - PubMed
    1. Boytim MJ, Fischer DA, Neumann L. Syndesmotic ankle sprains. Am J Sports Med. 1991;19(3):294–298. - PubMed
    1. Chun DI, Cho JH, Min TH, et al. Diagnostic accuracy of radiologic methods for ankle syndesmosis injury: a systematic review and meta-analysis. J Clin Med. 2019;8(7):968. - PMC - PubMed
    1. Colcuc C, Fischer S, Colcuc S, et al. Treatment strategies for partial chronic instability of the distal syndesmosis: an arthroscopic grading scale and operative staging concept. Arch Orthop Trauma Surg. 2016;136(2):157–163. - PubMed
    1. de César PC, Avila EM, de Abreu MR. Comparison of magnetic resonance imaging to physical examination for syndesmotic injury after lateral ankle sprain. Foot Ankle Int. 2011;32(12):1110–1114. - PubMed

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