Treatment of Distal Tibiofibular Syndesmosis Diastasis and Fractures of Ankle

Objective To appraise the advantages and disadvantages in the treatment of distal tibiofibular syndesmosis diastasis with syndesmosis screw.Methods Thirty-one cases of ankle fractures combined with distal tibiofibular syndesmosis diastasis were studied retrospectively.Among them,12 cases were fixated the separation of syndesmosis with screws or syndesmotic hooks,and the rest of 19 cases were not fixated.Results None of the patients without distal tibiofibular syndesmosis diastasis fixation had significant unstable syndesmosis.In two cases of fixation,the screws loosed.In 10 patients of fixation,the screws and syndesmotic hooks were removed at 6～12 weeks after operation.Conclusion If medial and lateral joint fixation is rigid anatomically and the deltoid ligament complex is intact,syndesmotic screw fixation is generally not necessary for maintaining the integrity of the tibiofibular joint.