radiologic assessment for evaluating the post-operative reduction of syndesmosis: a retrospective study

Background: assessing the reduction of syndesmosis is highly recommended due to the complications occurring after the malreduction of the syndesmosis. this study evaluated the post-operative computed tomography (ct) scans and standard plain radiographs for assessing the reduction of syndesmosis post-operatively. objectives: evaluating the radiologic assessments of post-operative reduction of syndesmosis. methods: in this retrospective cohort study, 45 patients presented with ankle fractures and syndesmosis failure to the emergency department of our hospital between 2015 and 2019 were evaluated by post-operative ct scans and plain radiographs. results: diastasis was demonstrated in 18 patients (40%) in plain radiographs, in 4 patients (8%) by tibial clear space, in 5 patients (11%) by medial clear space, in 10 patients (22%) by ap tibiofibular overlap, and in patients 8 (17%) by mortise tibiofibular overlap. diastasis was demonstrated in 24 patients (53%) in ct scans, of whom 18 patients had abnormal radiographic parameters, while 6 patients had normal radiographic parameters. conclusion: we found a post-operative ct scan more useful than standard plain radiographic measurement for assessing the reduction of the syndesmosis. we suggest the use of post-operative ct scan as a routine to evaluate the syndesmosis reduction.