Resumo

ROBLES, Diogo Santos et al. Dor Persistente Após Entorse Do Tornozelo: Um Caso Clínico De Sinostose Do Ligamento Tíbio-Peroneal Anterior Distal. Rev. Port. Ortop. Traum. [online]. 2015, vol.23, n.3, pp.257-264. ISSN 1646-2122.

Ankle Sprains are one of the most frequently observed injuries by orthopaedic surgeons, and 5-10% of them involve injury to the distal tibiofibular syndesmosis, which is considered the most important predictor for chronic ankle dysfunction. Heterotopic ossification after a syndesmotic ankle sprain is a rare but important complication, because of the functional deficit it entails, which must be considered in situations of persistent pain complaints after ankle sprain. Its pathophysiology is still largely unknown, but it is presumed that may be due to calcification of the hematoma resulting from ligament injury, associated with local subperiosteal dissection. Surgical excision of these, when painful, is the recommended treatment, with expectation of pain resolution and improvement in ankle mobility. The authors report the case of a 44 year old female patient, with complaints of ankle sprain. There was history of a previous sprain of the same ankle, the year before that healed uneventfully with conservative treatment. On physical examination, the patient presented with pain at the level of the syndesmosis, with limited dorsiflexion. Radiographs and CT scan showed a synostosis at the level of the anterior syndesmosis, due to a heterotopic ossification of the anterior inferior tibiofibular ligament. The patient underwent initial conservative treatment without clinical improvement, and later underwent surgical excision of the anterior syndesmosis synostosis. During follow-up, the patient showed complete resolution of pain complaints and restoration of the ankle range of motion.

Palavras-chave : Ankle sprain; syndesmosis; anterior inferior tibiofibular ligament; heterotopic ossification; synostosis.

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