Speaker: Look out for issues during syndesmotic fixation
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KOLOA, Hawaii — When performing syndesmotic fixation of complex ankle injuries, surgeons need to look out for any issues, which may occur even among simple ankle injuries, according to a presenter here.
In his presentation at Orthopedics Today Hawaii, Frank A. Liporace, MD, also noted that anatomic reduction is the most important aspect when it comes to syndesmotic fixation.
“Your reduction is the number one thing. This has been proven time and time again to restore all the lines that we know, all the relationships of the fibula and talus, that we’re well aware of, and the stability,” Liporace said.
Surgeons should also line up the posterior border of the fibula with the posterior border of the tibia articular surface throughout range of motion on a lateral view, according to Liporace. If the bones are lined up correctly, Liporace said over compression will not occur.
“No matter what fancy intraoperative studies you use, regardless, open reduction should be done and that is the way you are going to guarantee an anatomic result,” he said.
Liporace noted that screws and tightrope are the hardware options for syndesmotic fixation, each of which has pros and cons.
“The outcomes [with screws or tightrope] are similar in some studies, maybe even slightly more advantageous one over the other if you started with a malreduction, but malreduction is the only independent variable that affects clinical outcomes,” Liporace said.
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Liporace FA. Complex ankle injuries requiring syndesmotic fixation: Screw fixation of syndesmosis is the answer. Presented at: Orthopedics Today Hawaii; Jan. 8-12, 2023; Koloa, Hawaii.
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