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ORIGINAL ARTICLE
Year : 2011  |  Volume : 45  |  Issue : 5  |  Page : 454-458

Evaluation of the syndesmotic-only fixation for Weber-C ankle fractures with syndesmotic injury


1 Department of Trauma & Orthopedics, Hywel Dda NHS Trust, Carmarthen, United Kingdom
2 Royal Orthopedic Hospital NHS Trust, Birmingham, United Kingdom
3 Sri Venkateswara Trauma & Orthopedic Clinic, Kadapa, Andhra Pradesh, India
4 University Hospital of Birmingham NHS Trust, Birmingham, B29 6JD, United Kingdom

Correspondence Address:
R Mohammed
Department of Trauma & Orthopedics, Hywel Dda NHS Trust, Carmarthen, SA31 2AF
United Kingdom
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5413.83953

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Background: With the length of the fibula restored and the syndesmosis reduced anatomically, internal fixation using a plating device may not be necessary for supra-syndesmotic fibular fractures combined with diastasis of inferior tibio-fibular joint. A retrospective observational study was performed in patients who had this injury pattern treated with syndesmosis-only fixation. Materials and Methods: 12 patients who had Weber type-C injury pattern were treated with syndesmosis only fixation. The treatment plan was followed only if the fibular length could be restored and if the syndesmosis could be anatomically reduced. Through a percutaneous or mini-open reduction and clamp stabilization of the syndesmosis, all but one patient had a single tricortical screw fixation across the syndesmosis. Patients were kept non-weight-bearing for 6 weeks, followed by screw removal at an average of 8 weeks. Outcomes were assessed using an objective ankle scoring system (Olerud and Molander scale) and by radiographic assessment of the ankle mortise. Results: At a mean follow-up of 13 months, the functional outcome score was 75. Excellent to good outcomes were noted in 83% of the patients. Ankle mortise was reduced in all cases, and all but one fibular fracture united without loss of fixation. Six patients had more than one malleolar injury, needing either screw or anchor fixations. One patient had late diastasis after removal of the syndesmotic screw and underwent revision surgery with bone grafting of the fibula. This was probably due to early screw removal, before union of the fibular fracture had occurred. Conclusion: We recommend syndesmosis-only fixation as an effective treatment option for a combination of syndesmosis disruption and Weber type-C lateral malleolar fractures.


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