CLINICAL ARTICLE

 

Incidence of syndesmotic injuries in all different types of ankle fractures

 

 

Dr GN du Plessis^I; Dr LD Griesel^I; Dr D Lourens^I; Prof RP Gräbe^II

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

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ABSTRACT

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.

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References

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.