Efficacy and endurability of tricortical syndesmotic screw fixation in ankle fractures: a clinical prospective study

Abstract

Background: Ankle fractures represent 10% of all fractures with an incidence of around 137/105 population per year. These fractures are most of the times associated with syndesmotic injuries due to rotation of the limb with foot fixed/axial loading as a result of high velocity injuries. The syndesmosis is ruptured as a result of a torsional movement of the talus or as a result of a severe abduction force. Diastasis requires the rupture of three strong ligaments and the interosseous membrane and therefore represents a very substantial insult to the ankle at tibio-fibular joint and requires fixation. A syndesmosis screw through fibular plate prevents normal movement between the distal tibia and the fibula to allow healing and stability. Tricortical fixation provides more endurability during axial loading and ankle movements while walking. The present clinical prospective study was carried out with an aim to evaluate the efficacy and endurability of tricortical fixation of syndesmotic injuries, by one 3.5 mm screw through fibular plate.Methods: The present clinical prospective study was carried out at a tertiary institute of Punjab on 50 IPD patients admitted through emergency/outdoor patient department.Results: The 70% of the cases with surgical fixation of diastasis of syndesmosis gained normal range of motion at ankle joint after six weeks of immobilization in plaster of Paris (POP) back slab.Conclusions: Tricortical fixation of syndesmotic injuries, by one 3.5 mm screw through fibular plate is a must as it provides stability and endurability during axial loading and ankle movements while walking.