Abstract: Introduction and Purpose: Improper alignment, malreduction and neglecting to foresee syndesmotic injuries in ankle trauma led to persistent post-operative ankle pain, delay in recovery and early arthritic changes of ankle joint. The treatment of distal tibiofibular syndesmotic injuries is a major concern in ankle injuries. The objectives of this study are to have Preoperative suspicious, assessment of mode of injury, stress x-rays and intraoperative test for all ankle injuries to avoid missing syndesmotic injuries and thereby the treatment.
Materials and Methods: This is a prospective study of 28 ankle injuries diagnosed to have a syndesmotic injury. All cases are due to RTA or falls while walking. Mostly of Weber type b and c. Compound grades I, II & III A were also included. After clinical and radiological investigations, the diagnosis was confirmed and intraoperative test was done and bimalleolar fracture was fixed first then syndesmotic injury fixed with either single or double cortical screws and with 3 or 4 cortex purchase. Postoperative check x-rays taken for checking the proper reduction of the syndesmotic joint and level of screw placement. Postoperative outcome were measured using the AOFAS score chart.
Results and Discussion: Results of our study show excellent (AOFAS 90-100) in 17 cases, good (AOFAS 80-89) in 9 cases, fair (AOFAS 70-79) in 1 case and poor (AOFAS less than 70) in 1 case. With this, we come to the conclusion that (1) pronation external rotation injury is the common type. (2) Diagnosis of distal syndesmotic injuries and fixing it is very much important for having a pain-free stable ankle joint, early mobilization and preventing ankle joint arthritis. (3) Three cortical or four cortical purchase of syndesmotic screw is not significant in postoperative maintenance of reduction. (4) There is no definitive disadvantage if the syndesmotic screws were not removed.
