Bilateral arthrodesis of the distal tibiofibular joint for deforming osteochondromatas

APKASS Consensus Statement on Chronic Syndesmosis Injury, Part 3: Fusion Techniques, Comorbidity Treatments, Postoperative Rehabilitation, and Return-to-Sport Indications

Background:

Questions regarding surgical fusion techniques, postoperative treatment, and indications for return to sport after chronic syndesmosis injury or its comorbidities remain unanswered.

Purpose:

An international group of experts representing the field of injuries in the foot and ankle area was invited to collaboratively advance toward consensus opinions based on the best available evidence regarding chronic syndesmosis injury. 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 6 clinical questions and statements were related to surgical fusion techniques, comorbidity treatments, postoperative rehabilitation, and return-to-sports indications 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%; and unanimous, 100%.

Results:

Of the 6 questions and statements, 5 achieved unanimous support and 1 reached strong consensus.

Conclusion:

This APKASS consensus statement, developed by international experts in the field, will assist surgeons and physical therapists with surgical and postoperative treatment strategies for chronic syndesmosis injury.

Distal Fibular Osteochondroma Resulting in Tarsal Tunnel Syndrome: Case Report and Literature Review

BACKGROUND

Osteochondromas are benign osseous tumors encountered most routinely by physicians responsible for diagnosing musculoskeletal disorders. Often, these osseous lesions are identified following symptoms related to their impingement on adjacent soft tissue or bone.

METHODS

This article presents a unique case of an asymptomatic osteochondroma of the distal fibula in a 29-year-old Caucasian woman that manifested clinically as an impingement on the tibial nerve.

RESULTS

After resection of the osteochondroma, the patient's tarsal tunnel syndrome symptoms resolved.

CONCLUSIONS

This case report demonstrates a never-before-described osteochondroma of the distal fibula traversing posterior to the ankle joint and impinging on the tibial nerve. After resection, the patient's symptoms resolved.