The management of acute distal tibio-fibular syndesmotic injuries: Results of a nationwide survey

Tim Schepers, WJ van Zuuren, MPJ Van den Bekerom, LMM Vogels, Esther M.M. Van Lieshout

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Introduction: Ankle fractures are one of the most frequently encountered musculoskeletal injuries, and 10% of patients have a concomitant distal tibiofibular syndesmotic disruption necessitating surgical repair. A national survey was conducted to gain more insight into the current approaches in the management of syndesmotic injuries in the Netherlands. Materials and methods: A postal survey was sent to one or two staff members of the trauma and orthopaedic surgery departments in each of the 86 hospitals in the Netherlands. Questions concerned the pre-, per- and postoperative strategies and the different ideas on the type, number and placement of the syndesmotic screw. Results: A total of 85.2% of the trauma surgeons and 61.9% of the orthopaedic surgeons responded (representing 87% of all hospitals). Syndesmotic injury was judged mainly using the 'Hook test'. Syndesmotic injuries in a Weber-B ankle fracture were treated with one screw in 81.2% of cases and in Maisonneuve injuries mainly with two screws. The 3.5-mm screw was used most frequently over three cortices at 2.1-4.0 cm above the tibial plafond. Removal of the syndesmotic screw was routinely done by 87 Conclusion: Compared with previous surveys our survey is more complete, has the highest response rate and has almost national coverage. Most individual items reviewed compare well with current literature, except for the routine removal of the syndesmotic screw, which might not be encouraged from a literature point of view. For this reason, the results of the current survey will be used in the development of a multicentre randomised controlled trial comparing the functional outcome in routine rem
Original languageUndefined/Unknown
Pages (from-to)1718-1723
Number of pages6
JournalInjury-International Journal of the Care of the Injured
Issue number10
Publication statusPublished - 2012

Research programs

  • EMC MUSC-01-47-01

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