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Posterior and anterior malleolus fixation is associated with lower syndesmosis malreduction rates
Krzysztof Janik1, Dariusz Grzelecki2
1Centre of Postgraduate Medical Education, 99/103 Marymoncka Street, Warsaw 01-813, Poland; Department of Trauma and Orthopedic Surgery of the Voivodeship Hospital in Opole, Katowicka Street 64, Opole 45-061, Poland.
Background:
Syndesmotic malreduction after ankle fracture fixation is associated with poor outcomes. This study evaluated the association between posterior and anterior malleolus fixation and the accuracy of syndesmotic reduction.
Methods:
Seventy-four patients with posterior malleolus fractures were prospectively enrolled and divided into three groups: no posterior or anterior malleolus fixation (Group 1), posterior malleolus fixation only (Group 2), and combined posterior and anterior malleolus fixation (Group 3). Syndesmotic reduction was assessed using three CT-derived parameters.
Results:
CT reduction indices improved in Groups 2 and 3 compared with Group 1, with the greatest improvement observed in Group 3. Syndesmotic malreduction occurred in 29% of Group 1, 10% of Group 2, and 0% of Group 3 patients.
Conclusion:
Posterior malleolus fixation was associated with improved syndesmotic reduction, while no malreductions were observed after combined posterior and anterior malleolus fixation in this cohort. Level II evidence.
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