Predisposing factors for chronic syndesmotic instability following syndesmotic fixation in ankle fracture: Minimum 5-year follow-up outcomes

Background: This study aimed to identify risk factors for chronic syndesmotic instability following syndesmotic fixation. Methods: We performed a retrospective review of consecutive patients who had sustained ankle fractures requiring syndesmotic fixation. Patients available fora minimum 5 years of follow-up were classified into 2 groups according to the presence of syndesmotic instability. Statistical binary logistic regression analyses were performed to investigate the significance of various risk factors. Functional outcomes were assessed using the FAOS. Results: In total, 166 patients who met the study inclusion criteria underwent analysis. The overall postoperative instability rate was 20.5%, which was significantly affected due to BMI (p = 0.018; OR 6.72), and concomitant posterior malleolar fracture (p = 0.032, OR 2.77). The mean scores in the syndesmotic instability (SI) group were significantly lower than those in the no syndesmotic instability (NSI) group (p = 0.021). Conclusions: Obesity and concomitant posterior malleolar fracture were significant risk factors for postoperative syndesmotic instability. (C) 2020 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.