[Long-term radiological and clinical observations following surgery for tibio-fibular syndesmosis after fractures of the upper ankle joint (author's transl)].

Forty-two patients treated surgically for tibio-fibular syndesmosis were observed radiologically and clinically for a period of five years; the lesions followed fracture-dislocations type B, type C and following intra-articular fractures. Surgery consisted, as usual, of bone reconstruction and, where necessary, of transfixation of the syndesmosis with a horizontal screw introduced 2 cm. above the syndesmosis at a 30 degree angle to the frontal plane (15 cases). A new classification of the severity of subsequent arthrosis, as seen radiologically, was introduced and its correlation with clinical findings were determined. There was good agreement between the degree of arthrosis and functional results. The earliest signs of posttraumatic arthrosis following an incompletely treated lesion can be seen within the first year following the injury. An arthrosis of severity O due to sclerosis is of no, or only little, significance; it does not share the poor prognosis of severity grades I to III which, once they have developed, always show further deterioration.