Research on the treatment of chronic lateral ankle instability combined with grade 1 inferior tibiofibular syndesmosis injury.

Abstract

Chronic lateral ankle instability (CLAI) with concomitant Grade I inferior tibiofibular syndesmosis injury (ITSI) is frequently overlooked, leading to residual symptoms after isolated ligament repair. To compare outcomes of arthroscopic modified Broström procedure (AMBP) alone versus AMBP plus syndesmotic fixation for CLAI with Grade I ITSI. Retrospective comparative cohort study. From January 2021 to December 2022, 24 patients with chronic lateral ankle instability concomitant with Grade I inferior tibiofibular syndesmosis injury were assigned to either isolated AMBP (Group A, n = 13) or AMBP with elastic syndesmotic fixation (Group B, n = 11).Functional outcomes including the American Orthopedic Foot and Ankle Society score, Karlsson ankle joint function score, and pain visual analog scale score were assessed at final follow-up. Comparative analysis was conducted and the incidence of residual instability or recurrence was statistically analyzed. All patients in groups A and B were followed up until the last visit, with an average follow-up time of 25.7 ± 5 months (range: 18-37 months). There was a significant difference in functional scores between pre- and post-surgery for more than 1 year (P < 0.05). Arthroscopic modified Broström procedure combined with inferior tibiofibular syndesmosis fixation achieved higher scores compared with the two different treatment methods, and the difference was statistically significant (P < 0.05). When lateral ankle instability and Grade I inferior tibiofibular syndesmosis injury coexist, simultaneous repair of both injuries is more effective than isolated repair of the ATFL.