Intraoperative reduction of distal tibiofibular joint aided by three-dimensional fluoroscopy

Abstract

The aim of the study was to demonstrate the surgical work-flow of the intraoperative 3D fluoroscopy (Acadis)-aided reduction for distal tibiofibular joint. Ten ankle fracture patients with dislocated syndesmosis were treated. The surgical work-flow of intraoperative 3D (Acadis)-fluoroscopy-aided reduction was described. Axial imaging was measured for quality of syndesmotic reduction by measuring the distance between the fibular and the posterior and anterior facet of tibial incisura along a line perpendicular to joint space. Acadis 3D scan was successfully accomplished. The syndesmosis of the healthy side was symmetrical. The asymmetry of syndesmosis prior to transsyndesmotic fixation (D) was 3.7 mm on average (2.2-8.2 mm). The asymmetry of syndesmosis after transsyndesmotic fixation (E) was 1.7 mm on average (1.2-4.2 mm). Intraoperative 3D-fluoroscopy was able to detect subtle malreduction of the syndesmosis in the operative treaetment of ankle fractures. The intraoperative 3D-fluoroscopy-aided reduction for the distal tibiofibular syndesmosis is effective.