Three-Cortex Syndesmotic Fixation for Weber Type B/C Lateral Malleolus Fractures with Syndesmotic Disruption:...

Area of Science:

• Orthopedics
• Traumatology
• Radiology

Background:

• Ankle injuries, particularly syndesmotic ones, lack consensus in orthopedic management.
• Weber type B/C lateral malleolus fractures often involve syndesmotic injury, complicating treatment.
• Current diagnostic and treatment strategies for syndesmotic injuries require further evaluation.

Purpose of the Study:

• To evaluate the clinical and radiological outcomes of three-cortex syndesmotic fixation.
• To assess the efficacy of this fixation method in Weber type B/C lateral malleolus fractures with syndesmotic injury.
• To analyze functional recovery using the American Orthopedic Foot and Ankle Society (AOFAS) scale.

Main Methods:

• Retrospective analysis of 36 patients with Weber type B/C fractures and syndesmotic injury (2011-2022).
• Surgical fixation included open reduction, malleolar plates/screws, and 3.5 mm cortical syndesmosis fixation with three engagements.
• Radiological parameters (TFCS, TFO, MCS, ATFR) and AOFAS scores were assessed pre- and postoperatively.

Main Results:

• Postoperative AOFAS scores averaged 91.08, indicating good functional outcomes.
• Excellent inter-observer agreement was noted for most preoperative radiological parameters (ICC > 0.9).
• Significant improvements in radiological parameters post-fixation indicated enhanced ankle stability and reduced diastasis.

Conclusions:

• Three-cortex syndesmotic screw fixation provides excellent mid-term results for Weber type B/C fractures with syndesmotic injuries.
• The technique demonstrates robust radiological and functional outcomes.
• This method offers a reliable solution for complex ankle fractures involving syndesmotic disruption.