Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Trauma - Ankle / Foot
Abstract number: 23750
SURGICAL TREATMENT OF FIBULA MALUNION WITH RUPTURE OF
TIBIOFIBULAR SYNDESMOSIS.
Christos LYRTZIS, Pavlos PAPADOPOULOS, Merkourios VLAGOPOULOS, Nikos
MARKOPOULOS, Christos KRISTALLIS
Hospital Kilkis, Kilkis (GREECE)
Introduction The unstable ankle fractures must be treated operatively. Malunion of
the distal fibula in these fractures can lead to shortening and ankle instability.
Frequently, ankle fractures are associated with widening of tibiofibular syndesmosis.
Aim: The aim of this study is to present the surgical treatment of distal fibula
malunion with rupture of tibiofibular syndesmosis. Patient-Method: Thirty years old
patient has visited our hospital four months after an ankle fracture. He complained of
persistent pain, edema and limitation of his daily activities. Valgus of the ankle and
restricted ankle range of movement were obvious in clinical examination. AOFAS
score was 6 of 100 (0/6/0). Ankle radiographs revealed widening of the syndesmosis
and fibula malunion. We designed surgical treatment. The surgical treatment
included horizontal osteotomy of the fibula over the malunion and lengthening using
cortical bone graft and anatomical plate. The widening of the syndesmosis was
treated with a syndesmosis screw. The length of fibula and the ankle mortise were
repaired. The ankle was immobilized in a below knee plaster with the foot in inversion
for 6 weeks. The patient followed intensive rehabilitation programResults Two
months later the patient started walking without crutches. AOFAS score was 46
(20/16/10). At six months follow up he returned to his daily activities and his AOFAS
score was 77 (30/37/10). Conclusion: The lengthening of malunited and shortened
fibula must be combined with syndesmosis screw when there is a widening of
mortise.
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