Surgical management of post-traumatic distal tibiofibular synostosis: a technical note

Post-traumatic distal tibiofibular synostosis (DTFS) is a rare complication following distal tibiofibular fracture treatment in pediatric patients. Hence, there is a paucity of literature on the management of DTFS. DTFS can lead to ankle pain, ankle valgus, fibular shortening, and can alter the biomechanical function of the ankle joint. Two pediatric cases of DTFS are presented, highlighting the complication after a comminuted ankle fracture. Both underwent surgical excision of synostosis and interposition of a silastic sheet and fat graft between the tibia and fibula. At 1-year follow-up, there was complete resolution of symptoms and no recurrence of synostosis.