Arthroscopic diagnosis of tibiofibular syndesmosis disruption

Purpose: We have been able to diagnose tibiofibular syndesmosis injury by a nkle arthroscopy, and in the present study we compare these results with th e results from plain radiographs. Type of Study: Case series. Methods: Thir ty-eight type-B (Weber system) distal fibular fractures in 38 patients were diagnosed to determine whether tibiofibular syndesmosis disruption was pre sent, According to the Lauge-Hansen system, 16 patients had supination-exte rnal rotation fractures and 22 had pronation-abduction fractures. Standard non-weight-bearing anteroposterior radiographs and mortise radiographs were evaluated. Furthermore, ankle arthroscopy was performed on all patients. R esults: Tibiofibular syndesmosis disruptions were diagnosed in 16 of the 38 patients (42%) by anteroposterior radiography, 21 of 38 patients (55%) by mortise radiography, and 33 of 38 patients (87%) by ankle arthroscopy. All of the patients who were diagnosed with tibiofibular syndesmosis disruption by anteroposterior radiography and mortise radiography were also confirmed by ankle arthroscopy to have injured their tibiofibular syndesmosis. In 12 patients, ankle arthroscopy was the only method used to diagnose the tibio fibular syndesmosis disruption. Conclusions: Ankle arthroscopy excels in te rm of the diagnosis ratio for tibiofibular syndesmosis disruption compared with both anteroposterior and mortise radiography. Therefore, we conclude t hat ankle arthroscopy is necessary for the correct diagnosis of tibiofibula r syndesmosis disruption.