Abstract
Ankle fractures are very common, and although algorithms are in place for osseous
management, consensus has not been reached regarding treatment of associated ligamentous
injuries. Although tibiofibular syndesmotic stabilization can be done using different
forms of fixation, the biomedical literature has long emphasized the risk of long-term
restriction of ankle mobility with the use of lagged transfixation. However, when
reduction cannot be maintained with positional fixation, we found that lagging the
syndesmotic screw helped to maintain the reduction without causing functional restriction.
In this report, we describe our experience with patients who had undergone lagged
tibiofibular transfixation and were available for short- to intermediate-term follow-up
to assess ankle function. A total of 31 patients (32.63% of 95 consecutive patients)
were available at a mean of 34.87 (range 18 to 52) months to complete the American
Orthopedic Foot and Ankle Society ankle-hindfoot questionnaire. The mean score was
88.38 (range 42 to 100) points at a mean follow-up interval of 34.87 (range 18 to
52) months. Of 31 patients, 19 had an AOFAS score of 90 points, 9 an AOFAS score of
80 to 89 points, 2 an AOFAS score of 60 to 69 points, and 1 an AOFAS score of <60
points. Because all syndesmotic screws were placed using the lag technique, unrestricted
motion compared with the uninjured limb was used as the endpoint. All subjects had
unrestricted motion compared with the uninjured limb, refuting the assertion that
lagged syndesmotic screw fixation confers more restriction in ankle kinematics than
positional syndesmotic fixation.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: February 28, 2015
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
Video online only at http://www.jfas.org
Identification
Copyright
© 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
