Research on the treatment of chronic lateral ankle instability combined with grade 1 inferior tibiofibular syndesmosis injury

BACKGROUND: Chronic lateral ankle instability (CLAI) with concomitant Grade I inferior tibiofibular syndesmosis injury (ITSI) is frequently overlooked, leading to residual symptoms after isolated ligament repair. PURPOSE: To compare outcomes of arthroscopic modified Broström procedure (AMBP) alone versus AMBP plus syndesmotic fixation for CLAI with Grade I ITSI. STUDY DESIGN: Retrospective comparative cohort study. METHODS: From January 2021 to December 2022, 24 patients with chronic lateral ankle instability concomitant with Grade I inferior tibiofibular syndesmosis injury were assigned to either isolated AMBP (Group A, n = 13) or AMBP with elastic syndesmotic fixation (Group B, n = 11).Functional outcomes including the American Orthopedic Foot and Ankle Society score, Karlsson ankle joint function score, and pain visual analog scale score were assessed at final follow-up. Comparative analysis was conducted and the incidence of residual instability or recurrence was statistically analyzed. RESULTS: All patients in groups A and B were followed up until the last visit, with an average follow-up time of 25.7 ± 5 months (range: 18-37 months). There was a significant difference in functional scores between pre- and post-surgery for more than 1 year (P < 0.05). Arthroscopic modified Broström procedure combined with inferior tibiofibular syndesmosis fixation achieved higher scores compared with the two different treatment methods, and the difference was statistically significant (P < 0.05). CONCLUSION: When lateral ankle instability and Grade I inferior tibiofibular syndesmosis injury coexist, simultaneous repair of both injuries is more effective than isolated repair of the ATFL.