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A CLINICO-RADIOLOGICAL ASSESSMENT OF SYNDESMOSIS IN ISOLATED WEBER C. FRACTURES



Abstract

Percutaneous fixation of syndesmosis is an accepted treatment of isolated Weber C fractures of the ankle. However, the status of syndesmosis after removal of the screws has never been studied to our knowledge. We studied eight patients for any residual diastasis and its clinical significance. CT scan was used to study the residual diastasis of syndesmosis after the removal of screws by comparing with the normal side. Patients were clinically assessed using Maryland and International Foot Scoring systems. The talocrural angles were measured and were compared with the normal side.

Ten patients of isolated Weber C fractures were treated with percutaneous application of syndesmotic position scres from November ’97 to July ’99. Eight were available for follow up and two were lost to follow up. The average follow up was 427.9 days (14.26 months) with a range 167–744 days. There were 7 males and 3 females. The average age was 32.2 years (range 17–66). Left side was involved in 6 cases and right side in 4. The scres were removed after an average period of 78.3 days (11.8 weeks) with a range of 45–189 days.

All patients were found to be having diastasis ranging from 1 mm to 3 mm with an average of 2.06 mm. The Maryland score ranged from 76 to 100 with an average of 90. The international score ranged from 78 to 100 with an average of 87.62. The diastasis roughly paralleled with the Foot scores.

All patients who had percutaneous fixation of syndesmosis had residual diastasis following removal of the screws and this may be clinically significant.

The abstracts were prepared by Mr Ray Moran. Correspondence should be addressed to him at the Irish Orthopaedic Association, Secretariat, c/o Cappagh Orthopaedic Hospital, Finglas, Dublin