title: Distal tibiofibular synostosis after surgically resolved ankle fractures: An epidemiological, clinical and morphological evaluation of a patient sample.
abstract: BACKGROUND
  Ankle fractures comprise a highly morphologically and etiologically diverse group of injuries, which includes various degrees of impairment of bone and ligamentous structures. The complete synostosis and incomplete bony bridging of tibiofibular syndesmosis are among the local late complications after surgically treated ankle fractures.
  
  
  METHODS
  269 patients were evaluated, including 203 patients with Weber type-B fractures, and 66 patients with Weber type-C fractures. All patients underwent ankle radiography at standard intervals (post-operatively, 6 and 12 weeks, 6 and 12 months). The final assessment one year after osteosynthesis was performed. The study analyzed age, sex, fracture morphology, the location and morphology of ossification, functional outcomes and subjective evaluations of patient status.
  
  
  RESULTS
  As risk factors there were found male sex, tibiotalar dislocation, syndesmotic screw fixation and Weber type-C fractures. The severity of subjective difficulties and objective status were not dependent on the size of distal tibiofibular synostosis.
  
  
  CONCLUSIONS
  Despite relatively extensive imaging findings of complete synostosis or incomplete bony bridging, they only limited functional outcomes to a minimal extent.
authors.affiliation: Department of Orthopaedics and Traumatology, Third Faculty of Medicine, Charles University and FNKV, Prague, Czech Republic.
authors.forename: Jiri
authors.initials: J
authors.lastname: Marvan
authors.affiliation: Department of Orthopaedics and Traumatology, Third Faculty of Medicine, Charles University and FNKV, Prague, Czech Republic; Center for Integrated Study of Pelvis, Third Faculty of Medicine, Charles University, Prague, Czech Republic.
authors.forename: Valer
authors.initials: V
authors.lastname: Dzupa
authors.affiliation: Department of Orthopaedics and Traumatology, Third Faculty of Medicine, Charles University and FNKV, Prague, Czech Republic.
authors.forename: Martin
authors.initials: M
authors.lastname: Krbec
authors.affiliation: Department of Orthopaedics and Traumatology, Third Faculty of Medicine, Charles University and FNKV, Prague, Czech Republic.
authors.forename: Jiri
authors.initials: J
authors.lastname: Skala-Rosenbaum
authors.affiliation: Department of Orthopaedics and Traumatology, Third Faculty of Medicine, Charles University and FNKV, Prague, Czech Republic.
authors.forename: Radek
authors.initials: R
authors.lastname: Bartoska
authors.affiliation: Department of Anatomy, Second Faculty of Medicine, Charles University, Prague, Czech Republic; Department of Health Care Studies, College of Polytechnics Jihlava, Jihlava, Czech Republic.
authors.forename: David
authors.initials: D
authors.lastname: Kachlik
authors.affiliation: Department of Health Care Studies, College of Polytechnics Jihlava, Jihlava, Czech Republic; Department of Anatomy, Third Faculty of Medicine, Charles University, Prague, Czech Republic. Electronic address: vaclav.baca@vspj.cz.
authors.forename: Vaclav
authors.initials: V
authors.lastname: Baca
mesh_terms: D000328:Adult; D064386:Ankle Fractures / Q000150:complications* / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D001863:Bone Screws; D018153:Czech Republic / Q000453:epidemiology; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013580:Synostosis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D016896:Treatment Outcome
keywords: Ankle fracture; Epidemiology; Morphology; Olerud-Molander score; Syndesmosis; Tibiofibular synostosis; Weber classification