Indirect Reduction of Posterior Malleolar Fractures by Syndesmotic Screw: Prospective Case Series Study

Abstract

Abstract Background The posterior malleolus is an important soft tissue attachment for the posterior inferior tibiofibular ligament. Recent studies suggested that indirect reduction of posterior malleolus fracture through fixation of syndesmosis using syndesmotic screw is effective and avoid higher wound complication associated with posterior-lateral approach utilized for direct fixation of posterior malleolus. Aim and Objectives To assess the radiological outcomes of indirect reduction of posterior malleolus fragment using syndesmotic screw. Subjects and Methods The study was a prospective case series study at Orthopedic surgery department at Ain Shams university. Patients With posterior malleolar fractures <25% of tibial plafond surface were included. 15 patients undergo indirect reduction of posterior malleolar fractures by syndesmotic screw. The mean outcomes are reduction quality, time to union and infection rate. Result as regard outcomes among the studied group, 73.3%, of them were well reduced (proper alignment of the fragment with the tibial plafond and congruence of the ankle joint and alignment of the ankle mortise) and 26.7% of them not reduced postoperative and need to revision ,80%of them with no infection, finally 80%of the patient had no pain on follow up. Conclusion Open reduction and internal fixation by indirect surgical technique with Syndesmotic screw achieved acceptable reduction of posterior malleolus fragments.