{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T00:43:41Z","timestamp":1784335421264,"version":"3.55.0"},"reference-count":29,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T00:00:00Z","timestamp":1739318400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Acute ankle sprains are common injuries that significantly affect both sports and daily activities. Syndesmotic injuries, a specific type of ligamentous damage, can occur as a part of a sprain or alongside fractures, affecting approximately 20% of ankle fractures. The aim of this study was to evaluate negative prognostic factors influencing surgical outcomes in tibiofibular syndesmotic injuries associated with ankle fractures. Methods: Data from 246 patients were analyzed to examine the impact of initial ankle dislocation, fracture type, and fixation method on postoperative complications and reoperation rates. Ankle joint fractures were treated with open reduction and internal fixation using an anatomically contoured plate designed for optimal tibia and fibula fixation. Four methods of syndesmosis fixation were recorded: one three-cortical screw, one four-cortical screw, two screws (either both four-cortex screws or one three-cortex and one four-cortex screw), or one endobutton. Data analysis was performed using SPSS version 25 (IBM Corp., Armonk, NY, USA). Results: Key findings reveal no significant association between initial dislocation and the necessity for reoperation (p = 0.613). However, smoking combined with dislocation significantly increases reoperation rates (35% vs. 15.5%, p = 0.026). Fixation type influenced outcomes, with single four-cortex screws linked to pain but fewer infections. Infection was the most common complication (33.3%), predominantly after fixation with a single three-cortex screw. Men had higher rates of fixation destabilization and infections, while women experienced pain persisting beyond six months postoperatively Conclusions: Patient-specific factors influence syndesmotic injury outcomes. Smoking, gender, and fixation type impact complications, emphasizing the need for tailored surgical approaches to enhance recovery and minimize reoperation risks. Future research should aim to corroborate these findings in larger, multicentric cohorts to refine surgical strategies for syndesmotic injury management.<\/jats:p>","DOI":"10.3390\/jcm14041215","type":"journal-article","created":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T10:25:57Z","timestamp":1739355957000},"page":"1215","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Primary Ankle Fracture Dislocation Is Not a Negative Prognostic Factor for the Surgical Treatment of Syndesmotic Injury\u2014A Retrospective Analysis of 246 Patients"],"prefix":"10.3390","volume":"14","author":[{"given":"B\u0142a\u017cej Grzegorz","family":"W\u00f3jtowicz","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Trauma, Medical University of Lodz, Veteran\u2019s Memorial Hospital, Zeromskiego 113 St., 90-549 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6499-1661","authenticated-orcid":false,"given":"Katarzyna","family":"Chawrylak","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Medical University of Lublin, Radziwi\u0142\u0142owska 13 St., 20-080 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4545-8077","authenticated-orcid":false,"given":"J\u0119drzej","family":"Lesman","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma, Medical University of Lodz, Veteran\u2019s Memorial Hospital, Zeromskiego 113 St., 90-549 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3561-3511","authenticated-orcid":false,"given":"Hubert","family":"Makowski","sequence":"additional","affiliation":[{"name":"Student Scientific Group, Department of Orthopedics and Trauma Medical University of Lodz, Al. Tadeusza Ko\u015bciuszki 4, 90-419 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kacper","family":"Kuczy\u0144ski","sequence":"additional","affiliation":[{"name":"Student Scientific Group, Department of Orthopedics and Trauma Medical University of Lodz, Al. Tadeusza Ko\u015bciuszki 4, 90-419 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Micha\u0142","family":"Maciejowski","sequence":"additional","affiliation":[{"name":"Student Scientific Group, Department of Orthopedics and Trauma Medical University of Lodz, Al. Tadeusza Ko\u015bciuszki 4, 90-419 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6554-1831","authenticated-orcid":false,"given":"Alicja","family":"Majos","sequence":"additional","affiliation":[{"name":"General and Trasplant Surgery Department, Medical University of Lodz, Al. Tadeusza Ko\u015bciuszki 4, 90-419 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcin","family":"Dom\u017calski","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma, Medical University of Lodz, Veteran\u2019s Memorial Hospital, Zeromskiego 113 St., 90-549 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"603","DOI":"10.4085\/1062-6050-447-17","article-title":"Epidemiology of ankle sprains and chronic ankle instability","volume":"54","author":"Herzog","year":"2019","journal-title":"J. Athl. 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Surg."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/4\/1215\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:32:22Z","timestamp":1760027542000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/4\/1215"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,12]]},"references-count":29,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,2]]}},"alternative-id":["jcm14041215"],"URL":"https:\/\/doi.org\/10.3390\/jcm14041215","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,12]]}}}