Post-traumatic tibio-fibular synostosis in adults

Background: Post-traumatic tibio-fibular synostosis is a rare complication of tibial and ankle fractures. Distal tibio-fibular synostosis is the most common, but midshaft, or proximal tibio-fibular synostosis are also found. Proximal tibio-fibular synostosis is difficult to detect on routine X-rays, but is clearly discernible on computed tomography scans. Methods: Fifteen patients (5 females and 10 males) suffering from post-traumatic tibio-fibular synostosis were followed up. Age at time of initial trauma ranged from 18 to 57 years (mean, 35.9 years). Follow-up time from initial trauma ranged from 2 to 22 years (mean, 5.2 years). Results: Most of the patients suffered from pain and/or limitation of ankle movement. The mild symptoms and mild-to-moderate decrease in ankle motion did not justify surgical excision of the bony bridge. No signs of osteoarthrosis were detected in any of the recent radiographs. Conclusion: Even symptomatic patients should be treated by conservative methods.