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Operative Setup to Improve Sagittal Syndesmotic Reduction: Technical Tip.
Andrzej Boszczyk1, Bartłomiej Kordasiewicz1, Maciej Kiciński1
1Department of Traumatology and Orthopaedics, Centre of Postgraduate Medical Education, Gruca Clinical Hospital, Otwock, Poland.
Journal of Orthopaedic Trauma
|September 14, 2018
Summary
Avoid heel support during syndesmotic reduction for ankle fractures to prevent fibular malreduction. Using calf support ensures accurate fibular positioning within the syndesmosis, improving surgical outcomes.
Area of Science:
- Orthopedic Surgery
- Biomechanics
- Anatomy
Background:
- Sagittal syndesmotic malreduction is a complication in ankle fracture fixation.
- Accurate reduction of the syndesmosis is crucial for restoring ankle stability.
Purpose of the Study:
- To propose a technical modification to prevent sagittal plane malreduction of the fibula during syndesmotic reduction.
- To identify optimal leg support methods for accurate syndesmotic reduction.
Main Methods:
- Analysis of operative measures for reducing sagittal syndesmotic malreduction.
- Cadaveric study (6 specimens) evaluating fibular positioning with different leg supports (heel vs. calf).
Main Results:
- Supporting the leg under the heel during syndesmotic reduction led to significant anterior subluxation of the fibula.
- Supporting the leg under the calf did not result in significant fibular malalignment in either intact or unstable states.
Conclusions:
- Heel support should be avoided during supine syndesmotic reduction and fixation for unstable malleolar fractures.
- Calf support is recommended to ensure accurate fibular positioning and prevent malreduction.
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