FOOT & ANKLE SYMPOSIUM & SURGICAL TECHNIQUES July 24, 2020 to July 26, 2020 Syndesmotic Fixation Controversies John G. Anderson, M.D. Orthopaedic Associates of Grand Rapids Clinical Professor Michigan State University College of Human Medicine and College of Osteopathic Medicine Co-director GR Orthopaedic Foot and Ankle Fellowship
Disclosure I am a consultant for the following organizations: – Stryker – Wright Medical Group – Zimmer Biomet – Nextremity Solutions, Inc. – Paragon 28
Why did this fail?
Any experience with Zwipp syndesmotic ligament reconstruction?
Painful synostosis
Proximal tib fib dislocation
Does distal joint need stabilizing?
Dilemma: the high shaft fracture
Revision ORIF with fibular osteotomy
Revision ORIF with syndesmotic fusion
Dilemma: The high fibula fracture
Can syndesmosis can be overtightened?
Take home message • Fibular length and rotation are key • Posterior malleolus reduction is key • Need to address length, rotation, medial/lateral stability, rotational stability • Many syndesmotic fixation options are available and all seem to work as long as these principles are respected
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