Treatments

Syndesmosis Surgery

Syndesmosis surgery is a procedure aimed at treating injuries to the syndesmosis, a critical stabilizing structure in the ankle joint formed by the tibia and fibula bones. This surgery becomes necessary when the syndesmosis is disrupted due to traumatic injury, such as ankle sprains or fractures, leading to instability and pain. Here's everything you need to know about syndesmosis surgery:

The syndesmosis is a fibrous joint located just above the ankle joint, connecting the tibia and fibula bones. Its primary function is to provide stability to the ankle joint and allow controlled movement. Syndesmosis surgery involves realigning and stabilizing the joint to facilitate proper healing of the injured ligaments.

Injuries to the syndesmosis commonly occur as a result of twisting or rotational forces applied to the ankle. These injuries can range from mild sprains to severe ligament tears, often requiring surgical intervention to restore stability and function. Syndesmosis surgery is typically recommended for patients who have failed to respond to conservative treatments or have significant ligament damage.

Diagnosis

Dr. Kamel will conduct a thorough evaluation of your ankle, including physical examination and imaging studies such as X-rays or MRI scans. A stress X-ray may be performed to assess the stability of the syndesmosis under load-bearing conditions. Surgical intervention is usually indicated if instability is detected.

Treatment

Syndesmosis surgery is typically performed on an outpatient basis under general anesthesia. The surgeon will carefully realign the syndesmosis and stabilize it using screws, suture implants, or plates. In some cases, arthroscopic techniques may be utilized to assess and treat concomitant injuries within the ankle joint.

Surgical Technique

During the procedure, an incision is made over the outside of the ankle to access the syndesmosis. The surgeon realigns the bones and may use screws or suture devices to secure them in place. Live X-ray guidance helps ensure accurate placement of implants. Additional procedures, such as fracture repair, may be performed if necessary.

Recovery

Following surgery, you may be immobilized in a splint or CAM boot for the initial healing period. Non-weight bearing is typically advised for 6-8 weeks, followed by gradual weight bearing in a boot. Physical therapy is often prescribed to restore mobility and strength. Swelling and stiffness may persist for several months post-surgery.

Risks and Complications

As with any surgical procedure, syndesmosis surgery carries certain risks, including infection, nerve or vessel damage, and hardware irritation. Complications such as hardware failure or syndesmosis nonunion may occur, necessitating additional interventions. Close monitoring and adherence to post-operative instructions are essential to minimize these risks.

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Frequently Asked Questions

Will the hardware need to be removed?

In some cases, the screws used for stabilization may cause discomfort or limit motion. Dr. Kamel may recommend their removal once the syndesmosis has healed sufficiently. This decision will be based on individual factors and discussed with your surgeon.

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