Endoscopic detection of syndesmosis damages in patients with ankle fractures including external rotation

Background: Syndesmosis injury is a frequent and severe complication in the setting of ankle fracture, especially external rotation-type. Early, precise diagnosis is necessary for proper management to avoid long-term disability. Intraoperative Syndesmosis integrity assessment is important in planning the need for surgery. Aim: The purpose of the research is to assess the efficacy of intraoperative diagnostic techniques in diagnosing Syndesmosis injuries in patients with ankle fractures caused by external rotation, and to evaluate the precision of clinical assessment, imaging modalities, and direct intraoperative evaluation. 100 patients were enrolled in the research to provide credible and statistically significant results. Methods: A group of 100 patients with ankle fracture, i.e., those due to external rotation mechanisms, was evaluated by clinical examination, preoperative imaging (CT scans, MRI), and intraoperative testing (stress tests, fluoroscopy). Surgical exploration was used to confirm intraoperative diagnosis. Sensitivity, specificity, and accuracy of all the methods were compared to decide the most appropriate diagnostic method. Results: The intraoperative assessment was most accurate in diagnosing Syndesmosis injuries than preoperative imaging and clinical examinations. Stress tests and fluoroscopic control were most useful in detecting subtle syndesmotic disruptions, with a sensitivity of 92.7% and specificity of 86.7%. Preoperative imaging had moderate accuracy, while clinical examinations were less accurate in detecting occult injuries.