Long-term Clinical Outcomes After Syndesmosis Fixation With K-wires in Ankle Fractures With Syndesmotic Instability
Background: Syndesmotic instability is a significant concern in the management of unstable ankle fractures, occurring in approximately 10% to 13% of these cases. Early recognition and stabilization of syndesmotic injuries are essential to ensure optimal long-term outcomes. Several techniques are cur...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2025-01-01
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| Series: | Foot & Ankle Orthopaedics |
| Online Access: | https://doi.org/10.1177/24730114241310425 |
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| author | Diogo Vieira Cardoso MD Filippo Pierobon MD Anne Lübbeke-Wolff DSc Victor Dubois-Ferrière MD |
| author_facet | Diogo Vieira Cardoso MD Filippo Pierobon MD Anne Lübbeke-Wolff DSc Victor Dubois-Ferrière MD |
| author_sort | Diogo Vieira Cardoso MD |
| collection | DOAJ |
| description | Background: Syndesmotic instability is a significant concern in the management of unstable ankle fractures, occurring in approximately 10% to 13% of these cases. Early recognition and stabilization of syndesmotic injuries are essential to ensure optimal long-term outcomes. Several techniques are currently in use, often involving complex procedure and/or costly devices. Our study presents a syndesmosis fixation technique using K-wires that is both simple and cost-effective. Methods: This is a retrospective single-center case series. Three hundred seventy-seven ankle fractures with intraoperative syndesmosis instability and subsequent syndesmosis fixation with a K-wire were treated between 2002 and 2012. Of the 377 patients, 51 died and we were able to obtain long-term questionnaire completions from 94 patients (29% of presumed living patients), with a mean follow-up of 10.6 ± 3.0 years. Results: The mean age was 46.6 ± 18.5 years; 42% were Danis-Weber type B and 58% type C fractures. Syndesmosis fixation failure was observed in 9 (2%) patients, and 5 (1%) patients had K-wire displacement without loss of syndesmosis reduction. The Manchester-Oxford Foot Questionnaire (MOXFQ) was obtained 10±3 years after surgery. The mean MOXFQ pain score was 25.9 ± 25.4, the mean functional score was 18 ± 24.8, and the mean social score was 13.7 ± 22.2. Conclusion: We report long-term (10.6 ± 3 years) functional outcomes using a validated patient-reported questionnaire in patients who underwent syndesmosis fixation with 2 K-wires for unstable ankle fractures. In the subset of patients we were able to find in follow-up, we found low rates of syndesmosis fixation failure, low pain scores, and excellent functional outcomes. The availability and low cost of these implants make this technique an accessible and cost-effective solution to consider for syndesmosis fixation. Level of Evidence: Level IV, retrospective case series. |
| format | Article |
| id | doaj-art-04976eb544f54080b435426f72593822 |
| institution | Kabale University |
| issn | 2473-0114 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Foot & Ankle Orthopaedics |
| spelling | doaj-art-04976eb544f54080b435426f725938222025-01-22T14:03:35ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142025-01-011010.1177/24730114241310425Long-term Clinical Outcomes After Syndesmosis Fixation With K-wires in Ankle Fractures With Syndesmotic InstabilityDiogo Vieira Cardoso MD0Filippo Pierobon MD1Anne Lübbeke-Wolff DSc2Victor Dubois-Ferrière MD3University Medical Center, University of Geneva, Geneva, SwitzerlandFoot and Ankle Surgery Centre, Centre Assal, Clinique La Colline, Hirslanden Geneva, Geneva, SwitzerlandUniversity Medical Center, University of Geneva, Geneva, SwitzerlandFoot and Ankle Surgery Centre, Centre Assal, Clinique La Colline, Hirslanden Geneva, Geneva, SwitzerlandBackground: Syndesmotic instability is a significant concern in the management of unstable ankle fractures, occurring in approximately 10% to 13% of these cases. Early recognition and stabilization of syndesmotic injuries are essential to ensure optimal long-term outcomes. Several techniques are currently in use, often involving complex procedure and/or costly devices. Our study presents a syndesmosis fixation technique using K-wires that is both simple and cost-effective. Methods: This is a retrospective single-center case series. Three hundred seventy-seven ankle fractures with intraoperative syndesmosis instability and subsequent syndesmosis fixation with a K-wire were treated between 2002 and 2012. Of the 377 patients, 51 died and we were able to obtain long-term questionnaire completions from 94 patients (29% of presumed living patients), with a mean follow-up of 10.6 ± 3.0 years. Results: The mean age was 46.6 ± 18.5 years; 42% were Danis-Weber type B and 58% type C fractures. Syndesmosis fixation failure was observed in 9 (2%) patients, and 5 (1%) patients had K-wire displacement without loss of syndesmosis reduction. The Manchester-Oxford Foot Questionnaire (MOXFQ) was obtained 10±3 years after surgery. The mean MOXFQ pain score was 25.9 ± 25.4, the mean functional score was 18 ± 24.8, and the mean social score was 13.7 ± 22.2. Conclusion: We report long-term (10.6 ± 3 years) functional outcomes using a validated patient-reported questionnaire in patients who underwent syndesmosis fixation with 2 K-wires for unstable ankle fractures. In the subset of patients we were able to find in follow-up, we found low rates of syndesmosis fixation failure, low pain scores, and excellent functional outcomes. The availability and low cost of these implants make this technique an accessible and cost-effective solution to consider for syndesmosis fixation. Level of Evidence: Level IV, retrospective case series.https://doi.org/10.1177/24730114241310425 |
| spellingShingle | Diogo Vieira Cardoso MD Filippo Pierobon MD Anne Lübbeke-Wolff DSc Victor Dubois-Ferrière MD Long-term Clinical Outcomes After Syndesmosis Fixation With K-wires in Ankle Fractures With Syndesmotic Instability Foot & Ankle Orthopaedics |
| title | Long-term Clinical Outcomes After Syndesmosis Fixation With K-wires in Ankle Fractures With Syndesmotic Instability |
| title_full | Long-term Clinical Outcomes After Syndesmosis Fixation With K-wires in Ankle Fractures With Syndesmotic Instability |
| title_fullStr | Long-term Clinical Outcomes After Syndesmosis Fixation With K-wires in Ankle Fractures With Syndesmotic Instability |
| title_full_unstemmed | Long-term Clinical Outcomes After Syndesmosis Fixation With K-wires in Ankle Fractures With Syndesmotic Instability |
| title_short | Long-term Clinical Outcomes After Syndesmosis Fixation With K-wires in Ankle Fractures With Syndesmotic Instability |
| title_sort | long term clinical outcomes after syndesmosis fixation with k wires in ankle fractures with syndesmotic instability |
| url | https://doi.org/10.1177/24730114241310425 |
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