THE USE OF SYNDESMOTİC SCREW AT DISTAL TIBIOFIBULAR DIASTASIS

Abstract

Although ankle fractures are frequently seen, the explanation, use of syndesmotic screw, and removal of this screw are still debateable. For this purpose 16 cases including, 1 malleol fracture, 11 bimalleoler fractures, and 4 trimalleoler fractures with distal tibiofibular diastasis, were evaluated in this study group. For diastasis tibiofibular screw in additional to medial stabilization was applied. Weight bearing was allowed with below knee cast at the postoperatif second week in bimalleoler fractures, at the postoperatif 3rd week in trimalleoler fractures. Transfixation screw was removed at the postoperative 6th week in all cases. A-P, lateral and mortis x-rays of the patients compared with the normal ankles were used for the evaluation preoperatively, postoperatively and 3rd month controls. Distal tibiofibular distance, medial mortise width (medial clear space) and lateral fibular distance were measured. Distal tibiofibular distance was significantly decreased postoperatively both in Weber B and Weber C fractures (p<0.01). However, both this distance and difference of this distances were not meaningly changed in Weber B and Weber C fractures (p>0.01). This parameter wasn’t change at postoperative period and 3rd month controls. As a result in ankle fractures if there is diastasis, stabilization with screw is necessary and removal of this screw at the 6th week is safe.