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Patients with syndesmotic reduction vs malreduction had no functional differences at 1 year
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Results published in the Journal of Orthopaedic Trauma showed no significant differences in patient-reported outcomes at 1-year follow-up among patients with syndesmotic reduction vs. malreduction.
Michael J. Gardner, MD, and colleagues used postoperative bilateral ankle CT scans to assess syndesmosis reduction accuracy in 69 patients treated for syndesmotic injuries with trans-syndesmotic stabilization with either one or two quadricortical position screws. At a minimum 1-year postoperative follow-up, researchers collected the Olerud-Molander ankle score, short musculoskeletal function assessment dysfunction and bother indices, and numeric pain rating scales in 80% of patients. Researchers measured malreductions of at least 2 mm or 10° in 65% of patients and of at least 3 mm or 15° in 30% of patients.
At the 1.5-mm, 2-mm and 3-mm thresholds for linear measurements, results showed no significant differences in functional outcomes at 1-year follow-up between reduced and malreduced groups. Researchers also noted the reduced and malreduced groups had no functional differences for rotational malreduction at a 10° or 15° threshold. Compared with patients with private insurance, Medicare or no insurance, patients with Medicaid had significantly worse functional scores and pain scores.
“As we learn more about the optimal treatment of ankle syndesmosis injuries, more studies have attempted to determine the appropriate threshold for malreduction that might require revision,” Gardner said. “As postoperative CT scans have become more commonplace, we are able to detect syndesmotic malreductions down to the millimeter. In this study, patients with syndesmotic malreductions up to 3 mm showed no difference in functional outcomes at 1 year compared to those with anatomic reduction.” – by Casey Tingle
Disclosures: Gardner reports he is a paid consultant for BoneSupport AB, KCI, Pacira Pharmaceuticals, Stryker and Synthes; is a board or committee member for Orthopaedic Trauma Association; and receives research support from Synthes. Please see the full study for a list of all other authors’ relevant financial disclosures.
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