Look for Syndesmosis Widening Before Lateral Reconstruction

It takes more widening than we thought to make a difference — but it does seem to make a difference

Smart Practice: Look for major (>4 mm) syndesmosis widening during arthroscopy before ankle instability surgery, and consider treating it separately from the lateral reconstruction itself.

What’s the Claim?

Among patients having diagnostic ankle arthroscopy and an open Broström-Gould procedure for lateral ankle instability, a retrospective comparative study found that patients with tibiofibular syndesmosis widening of >4 mm took longer to return to work and sport than those with milder (or no) syndesmosis widening, and were more likely than those with little or no (<2 mm) widening to have another ankle sprain. The authors claimed that a lower percentage of those with widening returned to sport, but their statistics did not seem to support this claim. The groups did not differ in terms of patient-reported outcomes achieved.

How’s It Stack Up?