Stabilisation of the ankle syndesmosis using the internal brace (Arthrex) - early results

N. Harris, M. Farndon

Introduction: The use of the internal brace to stabilize the ankle syndesmosis has previously been described by Regauer et al. We describe the early results of 9 traumatic syndesmotic injuries treated in this way.

Methods: There 8 male patients and 1 female patient. Mean age 25 years(17-47 years). Included in the study were 5 professional rugby players, 1 semi professional rugby player and 1 semi professional footballer. 4 patients had isolated unstable anterior syndesmotic injuries. 3 patients had associated high fibula fractures and 2 patients posterior malleolar fractures. 1 patient had a deltoid ligament repair and another an ATFL repair at the same time. Patients were followed up at 2 weeks,6 weeks,12 weeks and approximately 6 months post surgery. AOFAS scores and range of movement in particular knee to wall distance were recorded and compared to the non-injured side. All patients underwent radiological examination at 6 weeks,12 weeks and approximately 6 months post surgery. Time to return to sports was also recorded.

Results: The early results appear encouraging with no complications related to the internal brace itself. Those patients with associated injuries had lower AOFAS scores, greater restriction in range of movement and longer return to sports.

Conclusion: We believe the internal brace provides comparable results with existing techniques to stabilize the syndesmosis. The anatomic technique we believe may have some functional advantages particularly with regard to initial stability. Further longer term larger studies are required to fully evaluate this technique.