DOS 2018

256 · DOS Abstracts Complication and reoperation rates after osteosynthesis of ankle fractures involving fixation of the syndesmosis - a retrospective cohort study Mads Terndrup, Jonas Fredriksen, Catarina Malmberg, Andersen Troelsen, Ilija Ban, Peter Toft Tengberg Department of Orthopedics, Copenhagen University Hospital Hvidovre Background: Indication for fixation of the syndesmosis is intraoperative insta- bility. Complication rates are reported to be high. Suture button technique is gaining popularity and the incidence of syndesmotic fixation could be reduced with posterior malleolar fixation Purpose / Aim of Study: To examine complication rates after osteosynthesis of ankle fractures involving fixation of the syndesmosis Materials and Methods: Adult patients with ankle fractures treated surgically from June 2011 to December 2015 at our institution were assessed for eligibil- ity. Exclusion criteria were: non-Danish citizen, non-operative treatment, treat- ment >4 weeks after injury or staged procedures, follow-up at an alternative institution, and patients lost to follow-up. Demographics and injury-related risk factors, as well as procedural data, were recorded and fractures were classified from standard radiographs and, if present, CT-scans. Postoperative data includ- ed immobilization regime, access to physiotherapy, complications, unplanned reoperation, and implant removal. Minimum follow-up was 18 months Findings / Results: 186 (24.3%) of 764 patients eligible for review received syndesmodesis. 97% were fixed with 1-2 syndesmotic screws. 94 patients (50%) had fractures involving the posterior malleolus. 70% of patients present- ed with Weber C type fractures. 35 patients (19%) were fixed using 1-2 screws alone. 98% of patients were not allowed to fully weight bear from day one. 36 patients (19%) suffered complications leading to reoperation in 20 cases (11%). 82 patients (44%) required implant removal Conclusions: Complication and reoperation rates after fixation of the syn- desmosis seem high. Stability can often be achieved with posterior malleolar fixation. Optimal fixation technique, as well as standardization of intraoperative testing, should be the focus of future prospective studies 197.