Open Reduction Internal Fixation of a Bimalleolar Ankle Fracture With Syndesmotic Injury. (August 2016)

• Record Type: Journal Article
• Authors: Ostrum, Robert F.; Avery, Matthew C.
• Is Part Of: Journal of orthopaedic trauma. Volume 30(2016)Supplement 2
• Publication Date: 2016-08
• Subjects: antiglide plate -- syndesmosis -- bimalleolar ankle fracture -- fibula fracture; Orthopedics -- Periodicals; Wounds and injuries -- Periodicals; Orthopedics -- Periodicals; Wounds and Injuries -- therapy -- Periodicals; Periodicals; 617.47044
• DOI: 10.1097/BOT.0000000000000588
• Languages: English
• ISSNs: 0890-5339

Abstract

Abstract : Summary: Rotational ankle fractures are incredibly common, resulting in a wide spectrum of bony and ligamentous injury patterns. After open reduction of an ankle fracture, the treating surgeon must always evaluate syndesmotic stability. If the syndesmosis is determined to be unstable, a reduction of the distal tibiofibular joint should be performed. Failure to adequately identify and treat injuries to the syndesmosis may result in continued ankle instability and poor patient outcomes. Lateral fluoroscopic images are necessary to assess a closed reduction of the syndesmosis before stabilization, although the accuracy of this tool has been questioned in several studies. Significant controversy surrounds many aspects of this injury and its treatment, including methods of diagnosis, ideal reduction clamp positioning, diameter and number of syndesmotic screws, and number of tibial cortices to be engaged. In the accompanying video, we describe our approach for the treatment of a bimalleolar ankle fracture with syndesmotic injury, using a posterior fibular plate and single tricortical syndesmotic screw.