Ankle Fractures
Conditions
Keywords
Syndesmotic malreduction, Ankle fracture fixation, Computed tomography, Postoperative imaging, Functional outcome, AOFAS score
Brief summary
This prospective observational cohort study aims to evaluate the ability of postoperative plain radiographs to detect syndesmotic reduction accuracy in patients with ankle fractures requiring syndesmotic fixation. All included patients have acceptable postoperative radiographs according to standard radiographic criteria and undergo postoperative computed tomography to further assess syndesmotic reduction. Functional outcomes are assessed at one year following surgery using a standardized ankle functional score. The study seeks to explore the association between computed tomography-detected syndesmotic malreduction and postoperative functional outcome.
Detailed description
Accurate reduction of the distal tibiofibular syndesmosis is essential for restoring ankle stability and achieving favorable functional outcomes after ankle fracture fixation. Plain radiographs are routinely used to assess postoperative syndesmotic reduction; however, subtle malreductions may not be detected using standard radiographic views alone. This prospective observational cohort study includes adult patients with ankle fractures requiring operative fixation and syndesmotic stabilization who demonstrate acceptable postoperative plain radiographs. As part of postoperative evaluation, all included patients undergo computed tomography imaging to provide a more detailed assessment of syndesmotic reduction, particularly with respect to rotational and translational alignment of the distal fibula relative to the tibia. Based on computed tomography findings, syndesmotic reduction is categorized according to predefined criteria. Functional outcomes are assessed at 12 months postoperatively using the American Orthopaedic Foot and Ankle Society ankle-hindfoot score. The study is observational in nature, and imaging findings do not influence postoperative management or treatment decisions. The objective of this study is to assess the limitations of plain radiographs in detecting syndesmotic malreduction and to evaluate the association between computed tomography findings and functional outcomes following ankle fracture fixation.
Interventions
None listed
Sponsors
Cairo University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Adults aged 18 to 65 years * Acute ankle fractures requiring operative fixation with syndesmotic stabilization * Acceptable postoperative plain radiographs based on standard radiographic criteria * Ability to comply with follow-up and functional assessment
Exclusion criteria
* Open ankle fractures * Previous surgery on the affected ankle * Polytrauma patients * Pathological fractures * Incomplete imaging or follow-up data
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Functional outcome assessed by the American Orthopaedic Foot and Ankle Society ankle-hindfoot score | 12 months postoperatively | Functional outcome of the affected ankle assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, which evaluates pain, function, and alignment on a 0-100 point scale, with higher scores indicating better function. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Syndesmotic reduction accuracy assessed by postoperative computed tomography | within 1 week after surgery | Accuracy of distal tibiofibular syndesmotic reduction assessed using postoperative computed tomography imaging, based on predefined radiological criteria evaluating translational and rotational alignment of the distal fibula relative to the tibia. |
Countries
Egypt
Outcome results
None listed