Title: Aggressive Surgical Treatment and Early Return to Sports in Athletes with Grade III Syndesmosis Sprains
Authors: Taylor, Dean C.; Tenuta, Joachim J.; Uhorchak, John M.; Arciero, Robert A.
Source: American Journal of Sports Medicine. November 2007; Volume 35(11); 1833-1838.
PODIATRIC RELEVANCE:
Podiatrists are often sought for the evaluation and treatment of sports related injuries. Athletes seeking treatment for syndesmotic ankle sprains desire to return to activity as soon as possible without the need for lengthy rehabilitation. This article investigates the effectiveness of using internal fixation to stabilize syndesmotic ankle sprains.
METHODS:
A retrospective observational study was conducted on 6 intercollegiate athletes treated operatively with 4.5 mm cortical screw fixation for grade III syndesmotic ankle sprains. Criteria for being included in this study were 1) the patient had to be an intercollegiate athlete injured in season or just prior to summer training, requiring early return to activity; 2) participants had to have a grade III syndesmotic ankle sprain diagnosed by widening of the ankle mortise on x-ray or external rotation stress radiograph; and 3) athletes had to be allowed to return to full activity with screw fixation intact.
RESULTS:
All six athletes were cleared to return to full activity at 41 days, on average. Patients were allowed to begin range of motion and progressive weightbearing as tolerated 1 week postoperatively. These athletes returned to participaion at a Division 1 level with screw fixation intact with no complications, reinjury, or disruption of hardware. The screws were removed an average of 74 days post-operatively, once the season was over. Patients did demonstrate bony wear of the tibia and fibula adjacent to the screw at time of removal. Only one case resulted in a screw breaking upon removal, but no other complications were noted in study.
COMMENTS:
This retrospective study evaluates the effectiveness of internal fixation for stabilization of grade III syndesmotic ankle sprains in athletes who desire early return to activity.
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Disclaimer:
Scientific Abstract Monthly postings are submitted by podiatric surgical residents. The ideas presented are not the opinions of the American College of Foot and Ankle Surgeons (ACFAS), nor are they presented as facts. ACFAS presents this information without any warranty of any kind, expressed or implied, and is not liable for its accuracy nor for any loss or damage caused by the user's reliance on information obtained in these areas.