TY - JOUR
T1 - Salvage of Chronic Syndesmosis Instability
T2 - A Retrospective Review With Mid-Term Follow-Up
AU - Kingston, Kiera A.
AU - Lin, Ye
AU - Bradley, Alexander T.
AU - Strelzow, Jason
AU - Hynes, Kelly
AU - Toolan, Brian C.
N1 - Publisher Copyright:
© 2022 the American College of Foot and Ankle Surgeons
PY - 2023/3/1
Y1 - 2023/3/1
N2 - Malreduced syndesmotic injuries lead to poor outcomes. No consensus exists regarding preferred surgical treatment. This study aims to assess clinical and radiographic outcomes in patients undergoing distal tibiofibular arthrodesis or stabilization. Retrospective review identified patients undergoing distal tibiofibular arthrodesis or stabilization between 2003 and 2019. Surgical factors, revision surgeries, and American Orthopedic Foot and Ankle Score ankle-hindfoot scores were collected. Radiographs were independently evaluated by 4 surgeons. Seventy patients were included. Mean American Orthopedic Foot and Ankle Score scores (n = 33) improved from 48 ± 16 preoperatively to 85 ± 14 (p <.001) at a median follow-up of 31.1 months. Mean Kellgren scores (n = 47) increased from 2.1 ± 1 to 2.5 ± 1 (p <.001) and the mean medial clear space decreased from 3.2 mm ± 0.8 mm to 2.8 mm ± 0.8 mm (p <.001) with no differences between the arthrodesis and stabilization groups. Zero patients progressed to arthroplasty or fusion. Patients demonstrated significant functional improvement after distal tibiofibular arthrodesis and stabilization. Progression of arthritis, while statistically significant, was not clinically significant.
AB - Malreduced syndesmotic injuries lead to poor outcomes. No consensus exists regarding preferred surgical treatment. This study aims to assess clinical and radiographic outcomes in patients undergoing distal tibiofibular arthrodesis or stabilization. Retrospective review identified patients undergoing distal tibiofibular arthrodesis or stabilization between 2003 and 2019. Surgical factors, revision surgeries, and American Orthopedic Foot and Ankle Score ankle-hindfoot scores were collected. Radiographs were independently evaluated by 4 surgeons. Seventy patients were included. Mean American Orthopedic Foot and Ankle Score scores (n = 33) improved from 48 ± 16 preoperatively to 85 ± 14 (p <.001) at a median follow-up of 31.1 months. Mean Kellgren scores (n = 47) increased from 2.1 ± 1 to 2.5 ± 1 (p <.001) and the mean medial clear space decreased from 3.2 mm ± 0.8 mm to 2.8 mm ± 0.8 mm (p <.001) with no differences between the arthrodesis and stabilization groups. Zero patients progressed to arthroplasty or fusion. Patients demonstrated significant functional improvement after distal tibiofibular arthrodesis and stabilization. Progression of arthritis, while statistically significant, was not clinically significant.
KW - 3
KW - ankle arthritis
KW - chronic ankle instability
KW - distal tibiofibular arthrodesis
KW - revision syndesmotic fixation
KW - syndesmotic fixation
UR - http://www.scopus.com/inward/record.url?scp=85135299625&partnerID=8YFLogxK
U2 - 10.1053/j.jfas.2022.06.010
DO - 10.1053/j.jfas.2022.06.010
M3 - Article
C2 - 35927153
AN - SCOPUS:85135299625
SN - 1067-2516
VL - 62
SP - 210
EP - 217
JO - Journal of Foot and Ankle Surgery
JF - Journal of Foot and Ankle Surgery
IS - 2
ER -