![]() ![]() ![]() There were 40 cases (43.3%) of distal tibiofibular syndesmosis separation, of which 39 (97.5%) were diagnosed as ankle-joint dislocation, with an average post-injury operation period of 4.3 days (range, 6 hours-7 days).Īll patients were treated with open reduction and internal fixation the posterolateral approach to the lateral malleolus was used in 20 cases, and the lateral approach was used in the remaining cases. Wound infection (treated with continuous dressing until the wound healed) and superficial nerve injury were present in 8 patients (4.7%) and 9 patients (5.2%), respectively. The deltoid ligament was intact in 158 patients (91.9%) and ruptured in 14 patients (8.1%). According to the Lauge-Hansen classification system, the sample included 17 (9.9%) supination-adduction (SA) fractures, 98 (57.0%) supination-external rotation (SE) fractures, 31 (18.0%) pronation-external rotation (PE) fractures, and 26 (15.1%) pronation-abduction (PA) fractures. With respect to comorbidities, 35 (20.3%) patients had systemic diseases, including 19 (11.0%) with hypertension, 13 (7.6%) with type 2 diabetes, 2 (1.2%) with gout, and 1 (0.6%) with chronic rheumatoid arthritis.Īccording to the AO (Danis-Weber) classification system, 54/172 fractures (31.0%) were type A, 78 (45.3%) were type B, and 40 (23.3%) were type C. The cohort included 64 underweight patients (37.2%), 82 normal-weight patients (47.7%), and 26 overweight patients (15.1%). The sample was comprised of 172 patients (121 men, 51 women) who were treated for ankle fracture, with a mean age of 46.6 years (range, 22–71 years) 74 (43%) patients were >50 years old. We hypothesized that TFSO would be related to the morphology of the fibular fracture and to screw fixation. We conducted a radiological study and retrospective analysis of surgically treated ankle fractures in the past 3 years to examine relevant risk factors for the complication of synostosis. However, no definitive conclusion has been reached about the main causes of such ossification or whether it is related primarily to the severity of the primary injury or the surgical treatment (e.g., syndesmosis screw use). Some recent case reports have suggested that tibiofibular syndesmosis separation and screw fixation are independent risk factors for postoperative synostosis 12, 14, 15. ![]() However, reports on tibiofibular syndesmosis synostosis are currently inadequate.Įarly research showed that calcification of the anterior inferior tibiofibular ligament after distal tibiofibular syndesmosis sprain was the main cause of ossification 13. Tibiofibular syndesmosis ossification (TFSO) after surgical treatment of ankle fracture occurs in about 3–7% of cases 11, with a rate exceeding 10% in a large case series 12. Anatomical reduction, rigid fixation, and early functional rehabilitation have become classical principles for the treatment of ankle fracture, and surgical fixation based on these principles has achieved optimal outcomes 7, 8, 9, 10. The occurrence rate of ankle fracture is increasing, particularly among older patients due to aging associated increases in fragility fractures 5, 6. In conclusion, AO type C fracture, syndesmosis separation, and high fibular fracture were associated with distal TFSO following ankle fracture fixation.Īnkle fracture is a common clinical finding, with recent epidemiological data showing occurrence rates of 120–150/100,000 1, 2, 3, 4. Multivariate logistic regression revealed the following independent risk factors for TFSO were: AO classification, distal tibiofibular syndesmosis separation, and fibular fracture morphology. It was observed in 36 (20.9%) cases (11 complete ossification cases 25 partial ossification cases). Multiple factor analysis was conducted to examine risk factors for TFSO. The average injury to operation interval was 4.3 days (6 hours-7 days). According to the Lauge-Hansen classification, there were 17 supination-adduction (SA) fractures, 98 supination-external rotation (SE) fractures, 31 pronation-external rotation (PE) fractures, and 26 pronation-abduction (PA) fractures. According to the Danis-Weber AO classification rubric, 54 fractures were type A, 78 were type B, and 40 were type C. Between August 2012 and January 2015, 172 patients with ankle fractures (121 men) with an average age of 46.6 years (range, 22–71 years) were treated surgically with an average follow-up period of 26 months (range, 16–34 months). This clinical retrospective study explored factors associated with distal tibiofibular syndesmosis ossification (TFSO) after ankle fracture fixation. ![]()
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