Vol. 9, Issue 4, Part A (2025)

Background: Ankle fractures with syndesmotic injury are common in orthopedic practice and represent the second most frequent significant lower extremity fractures. Surgical management is essential for syndesmotic injuries to prevent long-term disabilities. These injuries disrupt the normal functioning of the ankle joint, requiring precise diagnosis and careful management to ensure optimal recovery.

Objective: The objective of this study was to evaluate the functional outcome of surgically treated ankle fractures with syndesmotic diastasis using the American Orthopaedic Foot and Ankle Society (AOFAS) score.

Methods: This study included 20 patients diagnosed with ankle fractures accompanied by syndesmotic diastasis. All patients underwent syndesmotic screw fixation using 3.5 mm cortical screws, in addition to anatomical fixation of the medial and lateral malleoli. The functional outcomes were assessed at 6 months post-surgery using the AOFAS score.

Results: Of the 20 patients, (7 patients) achieved an excellent outcome, (7 patients) had a good outcome, (5 patients) had a fair outcome, and (1 patients) had a poor outcome. Two patients developed superficial wound infections, which were treated successfully with intravenous antibiotics. One patient experienced nonunion, while another had delayed union.

Conclusion: In cases of ankle fractures with syndesmotic diastasis, open reduction and internal fixation with syndesmotic screw fixation effectively resulted in good fracture union, a stable, pain-free ankle joint, and facilitated early mobilization of patients. This approach is a reliable method for achieving optimal functional recovery in these challenging injuries.