Clinical outcome of distal tibiofibular arthrodesis with plate fixation for the treatment of chronic frank syndesmosis instability

Abstract

BackgroundNumerous treatment strategies have been reported for the treatment of chronic frank distal tibiofibular syndesmosis instability, including several small case series treated by syndesmosis arthrodesis. The aim of this study is to report the treatment of this condition using a specially contoured plate and the associated clinical outcomes. MethodsOver a period of 8 years, patients presented in our institution with chronic frank distal tibiofibular syndesmosis instability were eligible to participate. All patients were managed with plating and screw fixation. The average follow-up period was 58 months (range, 12-99). Clinical outcome was evaluated using the American Orthopaedic Foot & Ankle Society ankle-hindfoot score. ResultsIn total, 8 patients met the inclusion criteria and formed the basis of this study. All patients could tolerate full weightbearing 3 months after surgery. The mean Visual Analog Scale pain score and the American Orthopaedic Foot & Ankle Society ankle-hindfoot score were significantly improved at the last follow-up (P<0.05). All patients were satisfied with the result and 7 patients returned to sports. 4 patients had mild limitation of ankle range of motion compared with the unaffected side. ConclusionSyndesmosis arthrodesis was a feasible method for the treatment of chronic frank syndesmosis instability according to our findings. Syndesmosis arthrodesis with plate and screw stabilization is another viable option to be considered into the surgeon's armamentarium. Larger scale studies are desirable to provide further evidence of this method of treatment.