Dépistage des Entorses Syndesmotiques et Mise en Oeuvre d'un Suivi Systématique (DESMOSIS)

 

Marie-Lyne Nault

Centre de recherche du CHU Sainte-Justine

 

Domaine :  Appareil locomoteur et arthrite

Programme chercheurs-boursiers-cliniciens - Junior 1

Concours 2017-2018

Ankle sprain is one of the most frequent injury of the extremities and the population the most at risk is between 10 and 19 years old. Twenty to 40% of patients will suffer from chronic symptoms afterward (pain, instability, stiffness). One factor that could explain a bad outcome would be a concomitant injury to the syndesmotic ligaments (torn ligaments between the tibia and fibula at the level of the ankle). Syndesmotic sprain diagnosis is only possible with MRI, a diagnostic tool that is not easily available.

The first objective of this project is to improve the outcome after an ankle sprain by identifying the risk factors of bad prognostic and improve the treatment plan. The second objective is to develop diagnostic tools for syndesmotic injuries. Two different modalities will be investigated. The first one is the use of dynamic ultrasound, a technique that is easily available and that can be performed by different medical specialists. The second one will use 3D reconstructions of weight bearing ankles. An asymmetry between the injured and healthy ankle will be evaluated.

A prospective cohort study will be performed at CHU Sainte-Justine. All patients with inclusion/exclusion criteria will be included and will follow the study protocol. Patients with syndesmotic sprain suspicion will do an MRI and a dynamic ultrasound. At each visit patients will answer a quality of life questionnaire. A statistical analysis will lead to the identification of bad prognostic outcome using the quality of life scores at 6 months and 1 year. For the two new diagnostic methods an optimal threshold will be set to decide between operative and non operative treatment.