Comparative study between syndesmotic and suprasyndesmotic technique in syndesmotic ankle injury

TarekAsaad, "Comparative study between syndesmotic and suprasyndesmotic technique in syndesmotic ankle injury", Journal of Arthroscopy and Joint Surgery, vol. 7, no. 2, pp. 91-97, 2020.


One of the most common injuries treated by orthopedic surgeons is the ankle injuries. Syndesmosis injuries account for 1%–18% of ankle sprains and much more in athletes 32%. The proper classification of syndesmosis injuries and the proper management depends mainly on the clinical and radiological assessment. Objectives to compare between the suprasyndesmotic and syndesmotic technique in management of syndesmotic injury regarding the functional outcome and time to weight bearing and to assess factors affecting the outcome of syndesmotic injuries management. Methods This prospective case series study was conducted on thirty patients attending to Kasr Alainy orthopedic surgery department with ankle fractures, they were divided into two groups each contains fifteen patients: Group 1:underwent and supra-syndesmotic screw fixation. Group 2: underwent syndesmotic screw fixation. Radiological evaluation of fixations using AP, lateral and mortise X-ray. Assessment of post-operative range of motion. Evaluation of functional outcome using FAOS (Foot and ankle outcome score). Patients were followed up for 24 months, with an average of 22 months. Results Patients scored 80–100% on the foot & ankle outcome score, with an average of 91.6 ± 5.4; (63.3%) had FAOS of 90% or above. Regaining weight bearing took 6–12 with an average of 8.2 ± 1.8 weeks; in (70%) wt bearing occurred within 6–8 weeks. Only one patient (3.3%) had post-operative infection, while no other patient (96.7%) had any postoperative complications. The mean FAOS score in supra-syndesmotic fixation was 92.5 and in the syndesmotic is 90 with an insignificant difference between the two groups (P = 0.4). The mean time to weight bearing was 8.1 and 8.3 weeks (P = 0.84) in supra-syndesmotic and syndesmotic fixation respectively. Conclusion there were no significant difference in terms of functional score and time to weight between syndesmotic and suprasyndesmotic techniques however; the functional score was significantly affected by the presence of associated injury and patient age while time to weight bearing was prolonged by the presence of associated injury and comorbidities, patient age as well as operative time.



Related External Link