Abstract
Concomitant syndesmotic injury occurs in 10% of ankle fractures. Anatomic reduction
and maintenance of this reduction is critical in ensuring ankle stability and preventing
long-term complications. This is a retrospective cohort study aimed at evaluating
the mid-term radiological outcomes of syndesmotic injuries in ankle fracture patients
after surgical fixation with suture button device. The study group included 33 patients.
Plain radiographs including anteroposterior, lateral and mortise views of the affected
ankle were performed preoperatively, postoperatively and at 3-month follow-up. Anteroposterior
views were used to measure the amount of tibiofibular overlap and tibiofibular clear
space. Paired Student's t test and linear model regression were performed. Between the immediate postoperative
and 3-month follow-up period, there was a mean decrease in tibiofibular overlap of
0.841 (±2.07) mm (p = .0259). There was a mean increase in tibiofibular clear space of 0.621 (±1.46)
mm (p = .0201). In addition, we found significant correlation between fracture type and
change in tibiofibular clear space (p = .047). Our study showed that there is statistically significant widening of the
syndesmosis after suture button fixation at 3-month follow-up as evidenced by reduced
tibiofibular overlap and increase in tibiofibular clear space. However, they remain
within the maximum threshold for acceptable syndesmotic widening of 1.5 mm. Further
correlation between radiological outcomes and patient function is needed to determine
clinical significance of these changes.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: September 18, 2021
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: The authors declare that there is no conflict of interest.
Identification
Copyright
© 2021 by the American College of Foot and Ankle Surgeons. All rights reserved.
