Abstract
Introduction
Injury to the syndesmosis is not always clearly demonstrated on radiographs and different tests have been described to assess for injury. In the presence of a significant injury to the syndesmosis, surgical fixation is often indicated and various fixation methods have been described. If the result of surgery is any mal-reduction of the fibula, this may result in ongoing ankle pain. Assessing how well the fibula has been reduced intra-operatively is currently limited to image intensifier views. We have previously developed a simple assessment, which has been shown to give accurate intra-operative demonstration of an injury to the syndesmosis. Our objective was to ascertain if the same test could demonstrate any malreduction of the fibular after repair of a syndesmosis injury.
Methods
Seven fresh frozen cadavers had complete sydesmosis disruption performed before fixation using a well-recognised technique with a single 3.5 mm small fragment screw. Purposeful malreduction was performed in three ankles and standard reduction in the remaining four. 2–5mls of contrast medium was then injected into the ankle joint.
Results
When there had been a malreduction, an obvious ‘blush’ of dye leaked superiorly into the surrounding soft tissues, whereas a normal ankle arthrogram was shown when the fibular had been anatomically reduced into the incisura and well fixed.
Conclusion
This cadaveric study showed the test to be an easy and reliable adjuct to assess for acute malreduction of a syndesmosis injury.
