Development of Synostosis and Determination of the Risk Factors After Surgical Treatment of Ankle...

ObjectiveThis study aimed to identify the possible risk factors for the development of partial bridging and synostosis in the distal tibiofibular joint following surgically treated ankle fracture-dislocations and to examine the effects of these conditions on ankle function.Materials and MethodsThis retrospective cohort study included patients who presented to our hospital with a diagnosis of ankle fracture-dislocation and had a minimum follow-up duration of 1 year. A total of 37 patients (13 men, 35.1%; 24 women, 64.9%) were included in the study. Ankle radiographs and low-dose computed tomography were performed on the patients during their final check-ups to assess the ankle joint. The presence of partial bridging and synostosis in the distal tibiofibular joint was recorded. Postoperative ankle functions were evaluated using AOFAS and MOXFQ scores.ResultsThe ankle fracture-dislocations were on the right side in 23 patients (62.1%) and on the left in 14 patients (37.9%). The mean age of the patients was 46.5 years (range: 22-72), and the total follow-up duration was 46 months (range: 14-60). Partial bridging was detected in 9 patients 24.3%, and synostosis was detected in 7 patients 18.9%. It was found that the side of the fracture and the fracture classification had no significant effect on distal tibiofibular synostosis. The incidence of partial bridging was significantly higher in men than in women (P = .013). The use of syndesmosis screws was identified as a risk factor for the development of partial bridging and synostosis (P = .014). It was observed that synostosis restricted the ankle joint range of motion, but this was not statistically significant. Furthermore, no difference was found between the groups regarding AOFAS and MOXFQ scores.ConclusionMale sex and cortical syndesmotic screw fixation were associated with an increased risk of distal tibiofibular bridging and synostosis.Level of Clinical Evidence4.