Effects of three- or four-cortex syndesmotic fixation in ankle fractures.
BACKGROUND
There is no study comparing how Weber type C ankle fractures treated with either three- or four-cortex syndesmotic fixation affects the structure of the syndesmosis.


METHODS
In a retrospective study, 46 patients were separated into two groups: 22 patients with three-cortex fixation and 24 patients with four-cortex fixation. All of the patients were evaluated clinically and radiographically at least 1 year after removal of the syndesmosis screws.


RESULTS
There were three types of joint space obliteration: type 1, synostosis on plain radiographs; type 2, an incomplete bony bridge on magnetic resonance imaging with normal plain radiographs; and type 3, fibrous obliteration of the joint space. Although obliteration of the joint space was significant (P < .005) after four-cortex fixation, radiologic results did not affect the clinical outcome.


CONCLUSIONS
Four-cortex fixation for diastasis after an ankle fracture should not be a routine procedure. We advocate three-cortex fixation because the clinical results are no different and there is less syndesmotic space obliteration postoperatively.
Karapinar
Hasan
H
Orthopedics, State Hospital, Yesilyurt, Izmir, Turkey.
Kalenderer
Onder
O
Karapinar
Levent
L
Altay
Taskin
T
Manisali
Metin
M
Gunal
Izge
I
D000328:Adult; D000368:Aged; D016512:Ankle Injuries / Q000601:surgery*; D001863:Bone Screws; D015331:Cohort Studies; D005260:Female; D005592:Fracture Fixation / Q000379:methods*; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome