SciELO - Scientific Electronic Library Online

vol.7 número1An evaluation of firework injuries to the hand - New Year 2007The treatment of tibial defects following chronic pyogenic haematogenous osteomyelitis in children índice de autoresíndice de materiabúsqueda de artículos
Home Pagelista alfabética de revistas  

Servicios Personalizados



Links relacionados

  • En proceso de indezaciónCitado por Google
  • En proceso de indezaciónSimilares en Google


SA Orthopaedic Journal

versión On-line ISSN 2309-8309
versión impresa ISSN 1681-150X

SA orthop. j. vol.7 no.1 Pretoria ene./mar. 2008




Incidence of syndesmotic injuries in all different types of ankle fractures



Dr GN du PlessisI; Dr LD GrieselI; Dr D LourensI; Prof RP GräbeII

IMBChB (UP), Registrar. Department of Orthopaedic Surgery, University of Pretoria, Pretoria
IISenior consultant. Department of Orthopaedic Surgery, University of Pretoria, Pretoria

Reprint requests




AIM: To determine the incidence of syndesmotic injuries in ankle fractures within the division of Orthopaedic Surgery, University of Pretoria.
METHODS: A total of 94 serial patients with ankle fractures were assessed for syndesmotic injury by means of ankle mortise stress views and manual traction with a bone hook. Each fracture was classified according to both the Weber and Lauge Hansen classification and the incidence of syndesmosis injury in each group was determined.
RESULTS: In total, 94 patients were evaluated over a 6-month period. There were 54 males and 40 females. The mean age was 39.3 years with a range of 13 to 85 years. An overall incidence of syndesmotic injuries of 32.97% (31 injuries) was found in our series. Of these 31 syndesmotic injuries 3% were Weber A, 29% Weber B, 65% Weber C, and 3% were isolated medial-malleolus fractures. According to the Lauge-Hansen classification, 3% were abduction injuries, 61% pronation-external rotation, 29% supination-external rotation and 7% vertical-compression dorsiflexion injuries.
CONCLUSION: The overall incidence of 33% of syndesmotic injuries was much higher than expected. Due to the fact that an incidence of 3% in Weber A fractures and 29% in Weber B fractures was found, we suggest that all types of ankle fractures should be stressed in theatre.



“Full text available only in PDF format”



1. Pena FA, Coetzee JC. Ankle syndesmosis injuries. Foot Ankle Clin N Am 2006;11:35-50.         [ Links ]

2. Ogilvie-Harris DJ, Reed SC, Hedman TP. Disruption of the ankle syndesmosis: biomechanical study of the ligamentous restraints. Arthroscopy 1994;10:558-60.         [ Links ]

3. Karrholm J, Hansson LI, Selvik G. Mobility of the lateral malleolus. Acta Orthop Scand 1985;56:479-83.         [ Links ]

4. Beumer A, van Hemert WLW, Niesing R et al. Radiographic measurement of the tibio-fibular syndesmosis has limited use. Clin Orthop 2004;423:227-34.         [ Links ]

5. Van Dijk CN. Syndesmotic injuries. Techniques in Foot and Ankle Surgery 2006;5(1):34-7.         [ Links ]

6. Hopkinson WJ, Pierre PS, Ryan JB, et al. Syndesmosis sprains of the ankle. Foot Ankle 1990;10(6):325-30.         [ Links ]

7. Fallat L, Grimm MS, Saracco JA. Sprained ankle syndrome: prevalence and analysis of 639 acute injuries. J Foot Ankle Surg 1998;37:280-5.         [ Links ]

8. Boytin MJ, Fischer DA, Nemann L. Syndesmotic ankle sprains. Am J Sports Med 1991;19(3):294-8.         [ Links ]

9. Lui TH, Ip K, Chow HT. Comparison of radiologic and arthroscopic diagnoses of distal tibiofibular syndesmosis disruption in acute ankle fracture. Arthroscopy 2005, Nov;21(11):1370.         [ Links ]

10. Jenkinson RJ, Sanders DW, Macleod MD, et al. Intraoperative diagnosis of syndesmosis injuries in external rotation ankle fractures. J Orthop Trauma 2005, Oct;19(9):604-9.         [ Links ]

11. Weening B, Bhandari M. Predictors of functional outcome following transsyndesmotic screw fixation of ankle fractures. J Orthop Trauma 2005, Feb;19(2):102-8.         [ Links ]

12. Harris IA, Jones HP. The fate of the syndesmosis in type C ankle fractures: a cadaveric study. Injury 1997 May;28(4):275-7.         [ Links ]



Reprint requests:
Prof RP Gräbe
Senior consultant, Department of Orthopaedic Surgery, University of Pretoria
Private Bag X 169, Pretoria, 0001
Tel: (012) 354-6528; Fax: (012) 354-6161



No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. This research was not submitted to an ethical committee. This article is free of plagiarism.

Creative Commons License Todo el contenido de esta revista, excepto dónde está identificado, está bajo una Licencia Creative Commons