[Risk Factors for the Development of Distal Tibiofibular Synostosis after Unstable Ankle Fractures]

Area of Science:

• Orthopedic Surgery
• Traumatology
• Radiology

Background:

• Distal tibiofibular synostoses are a potential complication following ankle fractures.
• Understanding the factors influencing their development is crucial for surgical decision-making.
• The relationship between fracture type, dislocation severity, and surgical approach requires further investigation.

Purpose of the Study:

• To analyze the occurrence of complete distal tibiofibular synostoses in surgically treated ankle fractures.
• To investigate the association between synostosis development, tibiotalar dislocation extent, and Weber classification.
• To evaluate the impact of different surgical strategies on synostosis formation.

Main Methods:

• Retrospective analysis of 824 patients with Weber type B and C ankle fractures over 9 years.
• Evaluation of trauma X-rays for Weber classification and tibiotalar dislocation (>10 mm, <10 mm, regular).
• Categorization of surgical treatments into one-stage osteosynthesis, secondary conversion, and definitive external fixation.

Main Results:

• Synostosis observed in 15.9% of patients, significantly higher in men (21.1%) and older individuals (mean age 54.4 years).
• Higher incidence in Weber type C (25.5%) vs. type B (12.7%) fractures; significant association with large tibiotalar dislocation (>10 mm) in type B fractures.
• One-stage osteosynthesis group had significantly lower synostosis rates (12.5%) compared to secondary conversion (30.3%).

Conclusions:

• Male gender, older age, Weber type C fractures, and larger tibiotalar dislocations (in type B) are associated with increased synostosis risk.
• Surgical timing significantly impacts synostosis development, with one-stage osteosynthesis showing better outcomes.
• These findings aid in optimizing surgical management for ankle fractures to minimize synostosis complications.