Syndesmosis Repair

Syndesmosis Repair: Acute vs Chronic

Mechanism of Injury

Syndesmotic Injury

  • Most commonly associated with external rotation injuries
  • More commonly associated with ankle fractures

Syndesmotic Fixation

  • Surgical fixation of the syndesmotic ligaments may be required for Acute or Chronic injuries

Acute repair is primarily open, direct reduction with screws while chronic repair is augmented with the Arthrex tightrope

Syndesmotic Repair Reconstruction (acute and chronic )
Post Operative Instructions

Cast:

  • You will have a plaster cast on your ankle and foot for 2 weeks following surgery
  • An aircast will be applied at 2 weeks
  • At 6-8 weeks, you will begin walking on the aircast and at 12 weeks the aircast will be removed

Wound:

  • The surgical incision has been closed with sutures
  • Do not get the cast or wound wet for the first two weeks. When showering place a bag over the cast and secure with tape to your leg to avoid the cast and wound getting wet
  • Stitches will be removed at your 2 week appointment
  • After the stitches are removed, you may begin to shower after 2-3 days
  • Do not immerse the foot in water (bath, hot tub, pool) for 4 weeks
  • Do not apply any lotions or creams on the wound for 6 weeks

Weight Bearing:

  • You will be non-weight bearing for the first 6 weeks while in an aircast
  • You will use a mobility device to offload your foot (crutches, walker, stirrup cast)
  • After 6-8 weeks you may begin fully walking on the foot

Medications:

  • You will be given a prescription for pain medication
  • Pain medication should be used regularly for the first 24-48 hours, when required for the first 1 to 2 weeks, followed by Regular ibuprofen
  • Aspirin may be prescribed as a blood thinner

Driving:

  • For right foot surgery you are not permitted to drive until you have completely weaned off the aircast
  • For left foot surgery, please contact your insurance company to see if you are permitted to drive
  • Driving is not permitted while on narcotics

Work:

  • Two weeks off work is recommended for initial recovery
  • If you can be transported to work and you have a sedentary occupation you may return to work when you are able and are off narcotics
  • From 2-8 weeks sedentary duties is recommended
  • By 12 weeks you can gradually return to full duties
  • If your job is physically demanding, return to full duties is usually possible around 12 weeks post operatively

Follow Up:

  • You will have your first appointment 2 weeks after surgery in the Fracture Clinic
  • Your next appointments will be at 6 weeks, 3 months then 6 months post operatively

Recovery:

  • It is normal to experience mild to moderate pain, numbness, or tingling for the first 2 weeks following surgery
  • You will get back to most of your activities by 6-12 months
  • Swelling often remains for 6-12 months
  • You are expected to experience a FULL recovery (no pain, no swelling, ability to walk, etc.) in 9-12 months

Physiotherapy: