Influence of reduction quality of the syndesmosis in combined tibiofibular elastic fixation for rotary ankle fractures following military training

Huang Jun; Cheng Yi; Li Dongyang

doi:10.3969/j.issn.1009-4237.2024.11.003

Abstract：Objective To evaluate whether the reduction quality of the syndesmosis in tibiofibular elastic fixation affects the short-term clinical results in patients with rotational ankle fractures.Methods A total of 59 pa-tients(32 males and 27 females aged 19-29 years,mean 19.3 years)with rotational ankle fractures who underwent elastic fixation of the distal tibiofibular syndesmosis at the First Navy Hospital,Southern Theater Command between Feb.2015 and Feb.2020 were retrospectively studied.There were 48 supination external rotation(SER)type Ⅳcases and 11 promation external rotation(PER)type Ⅳ cases.The reduction quality of the syndesmosis was as-sessed by CT scan within 3 d after surgery.The distance between the anterior and posterior notches 1 cm above the articular surface of the distal tibia was measured to evaluate the degree of rotation of the fibula relative to the tibia.According to the imaging results,patients were divided into anatomical reduction group(n=24)and poor reduction group(n=35).Twelve months after surgery,the foot and ankle functional recovery was evaluated using the Ameri-can Orthopaedic Foot and Ankle Society(AOFAS)ankle-hindfoot score as well as foot and ankle outcome score(FAOS).The pain was evaluated using the subjective visual analogue scale(VAS).Results For all the 59 pa-tients,the implant was removed at 12 months after surgery and ankle arthroscopy was performed again to identify the stability of the syndesmosis.At 12 months,the AOFAS ankle-hindfoot score,FAOS,and VAS were respectively 90.3±3.8,94.2±2.4,2.4±0.3,in the anatomical reduction group,and 90.6±2.6,94.5±2.1 and 1.4±0.6,in the poor reduction group,revealing no significant difference between the two groups(P＞0.05).Conclusion Early re-duction quality of the distal tibiofibular syndesmosis in combined tibiofibular elastic fixation for rotational ankle frac-tures does not affect the clinical outcome at 12 months.