Postoperative CT Evaluation of Anterior-inferior Tibiofibular Ligament Anatomical Repair and Augmentation with an Anchor-rope System

Background This study aimed to evaluate syndesmosis injury treatment involving anatomical repair of the anterior-inferior tibiofibular ligament (AITFL) and augmentation with an anchor-rope system and to evaluate the reduction of the syndesmosis through computed tomography (CT). Methods This retrospective analysis included 34 patients treated for syndesmotic injuries at our hospital between July 2018 and February 2022. All 34 patients underwent anatomical repair of the AITFL and augmentation with an anchor-rope system. Plain radiography and CT scans were obtained preoperatively. Postoperative radiographic assessments included anteroposterior and lateral radiographs and CT scans of both ankles. Additionally, the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score was used for postoperative assessment of the ankle. Results The mean age of the patients was 38.3 ± 16.0 (range, 16–72) years. The mean follow-up time was 16.2 ± 4.1 (range, 12–25) months. Malreduction occurred in five cases (14.7%) in our study. No significant differences were observed in any of the measurements between the affected and normal sides in the remaining patients after surgery. No complications, such as delayed wound healing, lateral pain, or fracture nonunion, occurred in any patient. The mean AOFAS score at the last follow-up was 95.9 ± 5.2 points (range, 82–100 points). Conclusions The results of this study suggest that anatomical repair of the AITFL and augmentation with an anchor-rope system can effectively reduce syndesmosis and achieve good radiologic and patient-reported outcomes.