To examine the correlation between syndesmotic malreduction and functional outcome.
Design: Prospective evaluation of bilateral computed tomography scans and functional outcome scores.
Setting: Level I regional trauma center.
Materials and Methods: From January 1, 2004, to December 31, 2006, 107 of 681 operatively treated ankle fractures (15.7%) had associated syndesmotic injuries requiring reduction and fixation. All patients available at a minimum of 2 years postindex procedure underwent clinical and radiographic examination, computed tomographic (CT) scanning of both ankles (injured and uninjured), and functional outcome scoring using the Short Form Musculoskeletal Assessment and Olerud/Molander questionnaires.
At a minimum of 2 years follow-up, patients with malreduced syndesmotic injuries demonstrated significantly worse functional outcome using the Short Form Musculoskeletal Assessment and Olerud/Molander questionnaires. Open reduction of the syndesmosis resulted in a substantially lower rate of malreduction when evaluated by postoperative CT scan. Based on these findings, we recommend that surgeons not only perform a direct, open visualization of the syndesmosis during the reduction maneuver, but obtain a postoperative CT scan with comparison to the contralateral extremity as well. If the syndesmosis is found to be malreduced, consideration must be given to revising the osteosynthesis.
Level of evidence: Prognostic Level II. Copyright remains with the authors and publisher.
To examine the correlation between syndesmotic malreduction and functional outcome.
Design: Prospective evaluation of bilateral computed tomography scans and functional outcome scores.
Setting: Level I regional trauma center.
Materials and Methods: From January 1, 2004, to December 31, 2006, 107 of 681 operatively treated ankle fractures (15.7%) had associated syndesmotic injuries requiring reduction and fixation. All patients available at a minimum of 2 years postindex procedure underwent clinical and radiographic examination, computed tomographic (CT) scanning of both ankles (injured and uninjured), and functional outcome scoring using the Short Form Musculoskeletal Assessment and Olerud/Molander questionnaires.
At a minimum of 2 years follow-up, patients with malreduced syndesmotic injuries demonstrated significantly worse functional outcome using the Short Form Musculoskeletal Assessment and Olerud/Molander questionnaires. Open reduction of the syndesmosis resulted in a substantially lower rate of malreduction when evaluated by postoperative CT scan. Based on these findings, we recommend that surgeons not only perform a direct, open visualization of the syndesmosis during the reduction maneuver, but obtain a postoperative CT scan with comparison to the contralateral extremity as well. If the syndesmosis is found to be malreduced, consideration must be given to revising the osteosynthesis.
Level of evidence: Prognostic Level II. Copyright remains with the authors and publisher.