Assessment of the lower limb biomechanics in patients after tibiofibular syndesmosis injury treatment

Purpose: There is no consensus as to the number of bone cortices engaged in tibiofibular syndesmosis treatment. The purpose of our study was to assess the weight distribution on the lower limbs after tricortical or quadricortical syndesmosis fixation and different timing of screw removal. Methods: A total of 55 patients who underwent treatment for acute tibiofibular syndesmosis injury were analyzed in this study. The Zebris pedobarographic platform was used to measure the distribution of body weight on the lower limbs. The study population was stratified by the time to syndesmotic screw removal (8–15 weeks versus 16–22 weeks) and the number of bone cortices involved in fixation (three [tricortical fixation] versus four [quadricortical fixation]). Results: The weight distribution on the operated and healthy limbs in patients with tricortical syndesmosis fixation was asymmetrical, with the mean load on the operated and healthy limbs of 48.38% and 51.62%, respectively. The patients who underwent quadricortical syndesmosis fixation exhibited a symmetrical distribution of weight on the operated and healthy limb. There was a symmetrical distribution of the load of body weight on the operated and healthy limbs both in the group with different times to syndesmotic screw removal. Conclusion: Tricortical syndesmosis fixation is associated with an asymmetrical weight distribution on the operated and healthy limbs. In treating tibiofibular syndesmosis injuries, based on our pedobarographic research, quadricortical syndesmosis fixation and leaving the syndesmotic screw in place for up to 15 weeks, seems more beneficial to the patient.