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Lagged Syndesmotic Fixation: Our Clinical Experience
Kwasi Yiadom Kwaadu1, Justin James Fleming2, Trudy Salmon3
1Assistant Professor, Temple University School of Podiatric Medicine, Philadelphia, PA.
Summary
Lagged syndesmotic screw fixation for ankle fractures maintains reduction without restricting ankle mobility. This technique offers good functional outcomes, challenging previous beliefs about limited ankle kinematics.
Area of Science:
- Orthopedics
- Biomedical Engineering
- Sports Medicine
Background:
- Ankle fractures are common, with established protocols for bone management.
- Treatment of associated ligamentous injuries, particularly tibiofibular syndesmosis, lacks consensus.
- Concerns exist regarding long-term ankle mobility restriction with lagged transfixation fixation.
Purpose of the Study:
- To evaluate the functional outcomes and ankle mobility after lagged tibiofibular transfixation.
- To assess if lagged syndesmotic screw fixation causes functional restriction compared to positional fixation.
- To determine the efficacy of lagged screws in maintaining reduction without compromising ankle kinematics.
Main Methods:
- Retrospective analysis of 31 patients with ankle fractures treated with lagged tibiofibular transfixation.
- Short- to intermediate-term follow-up assessing ankle function using the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot questionnaire.
- Comparison of ankle motion with the uninjured limb as a functional endpoint.
Main Results:
- A mean AOFAS score of 88.38 was achieved at a mean follow-up of 34.87 months.
- 19 out of 31 patients scored 90 points or higher on the AOFAS questionnaire.
- All patients demonstrated unrestricted ankle motion compared to their uninjured limb.
Conclusions:
- Lagged tibiofibular transfixation effectively maintains reduction in ankle fractures.
- This technique does not lead to functional restriction or significant limitations in ankle kinematics.
- Lagged syndesmotic screw fixation is a viable option for managing tibiofibular syndesmotic injuries in ankle fractures.
