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Posterior inferior tibiofibular ligament repair shows improvement in immediate syndesmotic reduction
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Treatment of supination external rotation type IV equivalent ankle fractures with posterior inferior tibiofibular ligament repair showed improvement in immediate postoperative syndesmotic reduction and eliminated the need for reoperation to remove transsyndesmotic screws, according to study results.
Researchers compared deltoid and posterior inferior tibiofibular ligament (PITFL) repair in addition to lateral malleolus fixation with transsyndesmotic screw fixation among 45 patients with supination external rotation type IV equivalent ankle fractures. Main outcome measures included syndesmotic reduction compared with contralateral extremity on a postoperative CT scan and maintenance of reduction based on final postoperative radiographs.
Results showed no significant difference in mean postoperative tibiofibular clear space, medial clear space or change in tibiofibular or medial clear space between the cohorts. However, compared with the transsyndesmotic cohort, patients who underwent PITFL experienced significantly better postoperative syndesmotic reduction, according to study results.
The researchers found 14 patients in the transsyndesmotic screw cohort underwent removal vs. three patients in the PITFL group who required secondary procedures; however, statistically significant better mean dorsiflexion of the ankle was found in the transsyndesmotic screw cohort. – by Casey Tingle
Disclosure: The researchers report no relevant financial disclosures.
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