What is the frequency of anterior syndesmosis injury in posterior malleolus fracture?
Abstract Background Posterior malleolus fractures may be fixed to restore syndesmosis stability. However, these fractures are often accompanied by ruptures of other ligaments that stabilize the syndesmosis. This study investigates the frequency of anterior syndesmosis injury in posterior malleolus f...
Saved in:
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-01-01
|
| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-025-05450-7 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832594573704036352 |
|---|---|
| author | Krzysztof Janik Dariusz Grzelecki |
| author_facet | Krzysztof Janik Dariusz Grzelecki |
| author_sort | Krzysztof Janik |
| collection | DOAJ |
| description | Abstract Background Posterior malleolus fractures may be fixed to restore syndesmosis stability. However, these fractures are often accompanied by ruptures of other ligaments that stabilize the syndesmosis. This study investigates the frequency of anterior syndesmosis injury in posterior malleolus fractures and its effect on rotational stability. Methods Seventy-five consecutive patients who underwent surgery for ankle fractures involving posterior malleolus were prospectively included. Preoperative computed tomography scans in two planes (transverse and sagittal) were used to assess the presence and size of avulsion fractures (LeFort-Wagstaffe and Tillaux-Chaput). Intraoperatively, anterior syndesmosis injuries and rotational stability (determined via the external rotation test) were assessed through direct visualization. Results In 73 patients (97%), a complete injury of the anterior tibiofibular ligament was observed intraoperatively, manifesting as avulsion fractures (8%), ligament injuries (44%), or a combination of both (45%). The mean dimensions of the avulsion fractures were 12.6 mm × 7.5 mm for LeFort-Wagstaffe fractures and 12.4 mm × 7.9 mm for Tillaux-Chaput fractures. Posterior malleolus fractures were stabilized in 57 patients. In 52 of these cases (92%), syndesmosis instability in the direction of external rotation persisted despite fixation of the posterior malleolus. Conclusions Fixation of posterior malleolus fractures is rarely sufficient to fully restore syndesmosis stability. Post-fixation assessment of syndesmosis stability, particularly in external rotation, is essential. |
| format | Article |
| id | doaj-art-c63ac09bad7e4dce89964c049cb8de7a |
| institution | Kabale University |
| issn | 1749-799X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj-art-c63ac09bad7e4dce89964c049cb8de7a2025-01-19T12:32:49ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-01-0120111110.1186/s13018-025-05450-7What is the frequency of anterior syndesmosis injury in posterior malleolus fracture?Krzysztof Janik0Dariusz Grzelecki1Department of Trauma and Orthopedic Surgery of the Voivodeship Hospital in OpoleDepartment of Orthopedics and Rheumoorthopedics, Centre of Postgraduate Medical Education, Prof. Adam Gruca Orthopedic and Trauma Teaching HospitalAbstract Background Posterior malleolus fractures may be fixed to restore syndesmosis stability. However, these fractures are often accompanied by ruptures of other ligaments that stabilize the syndesmosis. This study investigates the frequency of anterior syndesmosis injury in posterior malleolus fractures and its effect on rotational stability. Methods Seventy-five consecutive patients who underwent surgery for ankle fractures involving posterior malleolus were prospectively included. Preoperative computed tomography scans in two planes (transverse and sagittal) were used to assess the presence and size of avulsion fractures (LeFort-Wagstaffe and Tillaux-Chaput). Intraoperatively, anterior syndesmosis injuries and rotational stability (determined via the external rotation test) were assessed through direct visualization. Results In 73 patients (97%), a complete injury of the anterior tibiofibular ligament was observed intraoperatively, manifesting as avulsion fractures (8%), ligament injuries (44%), or a combination of both (45%). The mean dimensions of the avulsion fractures were 12.6 mm × 7.5 mm for LeFort-Wagstaffe fractures and 12.4 mm × 7.9 mm for Tillaux-Chaput fractures. Posterior malleolus fractures were stabilized in 57 patients. In 52 of these cases (92%), syndesmosis instability in the direction of external rotation persisted despite fixation of the posterior malleolus. Conclusions Fixation of posterior malleolus fractures is rarely sufficient to fully restore syndesmosis stability. Post-fixation assessment of syndesmosis stability, particularly in external rotation, is essential.https://doi.org/10.1186/s13018-025-05450-7Posterior malleolusWagstaffe fractureChaput fractureAITFLSyndesmosis stability |
| spellingShingle | Krzysztof Janik Dariusz Grzelecki What is the frequency of anterior syndesmosis injury in posterior malleolus fracture? Journal of Orthopaedic Surgery and Research Posterior malleolus Wagstaffe fracture Chaput fracture AITFL Syndesmosis stability |
| title | What is the frequency of anterior syndesmosis injury in posterior malleolus fracture? |
| title_full | What is the frequency of anterior syndesmosis injury in posterior malleolus fracture? |
| title_fullStr | What is the frequency of anterior syndesmosis injury in posterior malleolus fracture? |
| title_full_unstemmed | What is the frequency of anterior syndesmosis injury in posterior malleolus fracture? |
| title_short | What is the frequency of anterior syndesmosis injury in posterior malleolus fracture? |
| title_sort | what is the frequency of anterior syndesmosis injury in posterior malleolus fracture |
| topic | Posterior malleolus Wagstaffe fracture Chaput fracture AITFL Syndesmosis stability |
| url | https://doi.org/10.1186/s13018-025-05450-7 |
| work_keys_str_mv | AT krzysztofjanik whatisthefrequencyofanteriorsyndesmosisinjuryinposteriormalleolusfracture AT dariuszgrzelecki whatisthefrequencyofanteriorsyndesmosisinjuryinposteriormalleolusfracture |