Syndesmosis fixation in unstable ankle fractures using a partially threaded 5.0-mm cannulated screw

Abstract

The present study evaluated the radiographic outcomes of syndesmosis injuries treated with a partially threaded 5.0-mm cannulated screw. The present study included 58 consecutive patients with syndesmosis injuries concurrent with ankle fractures who had undergone operative fixation with a partially threaded 5.0-mm cannulated screw to repair the syndesmosis injury. Radiographic indexes, including the medial clear space, tibiofibular overlap, tibiofibular clear space, and fibular position on the lateral radiograph, were measured on the preoperative, immediate postoperative, and final follow-up radiographs. The measurements were compared between the injured and intact ankles. All preoperative radiographic indexes, including the medial clear space (p < .001), tibiofibular overlap (p < .001), tibiofibular clear space (p < .001), and fibular position on the lateral radiograph (p = .026), were significantly different between the injured and intact ankles. The medial clear space of the injured ankle was significantly wider than that of the intact ankle preoperatively (p < .001) and had become significantly narrower immediately postoperatively (p < .001). Finally, the medial clear space was not significantly different between the injured and intact ankles at the final follow-up examination (p = .522). No screw breakage or repeat fractures were observed. A 5.0-mm partially threaded cannulated screw effectively restored and maintained the normal relationship between the tibia and fibula within the ankle mortise with a low risk of complications. This appears to be an effective alternative technique to treat syndesmosis injuries concurrent with ankle fractures. (C) 2018 by the American College of Foot and Ankle Surgeons. All rights reserved.