Introduction: Ankle fractures involving syndesmotic disruption represent a significant challenge in orthopedic surgery. Weber B and C fractures frequently involve the tibiofibular syndesmosis, and inadequate treatment can lead to chronic instability and post-traumatic osteoarthritis. The objective of this study is to evaluate the outcomes of rigid syndesmotic fixation in Weber B and C ankle fractures, analyze screw-related complications, and assess maintenance of syndesmotic reduction. Methods: Retrospective case series of 100 consecutive patients who underwent screw fixation for Weber B or C ankle fractures with syndesmotic instability. Parameters evaluated included screw position (suprasyndesmotic vs. transsyndesmotic), implant-related complications, hardware removal rates, and maintenance of reduction. Results: The cohort comprised 43 Weber B (43%) and 57 Weber C (57%) fractures. Suprasyndesmotic placement was used in 39 patients (39%), transsyndesmotic in 61 patients (61%). Suprasyndesmotic screws had a 30.8% breakage rate compared with 3.3% for transsyndesmotic screws (p = 0.0006). Syndesmotic reduction was maintained in 98% of cases. Both cases of lost reduction occurred after screw removal.Conclusion: Rigid screw fixation demonstrates excellent reliability for maintaining syndesmotic reduction. Transsyndesmotic placement significantly reduces implant failure rates. Hardware removal may compromise ankle stability.
Bergamasco et al. (Sat,) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: