Clinical Manifestations, Diagnosis and Management of Synovial Fistula Associated Lateral Ankle Sprain or Instability: A Retrospective Study of 19 Surgically Confirmed Patients

Jahyung Kim, Bum-Jin Shim, Jae-Shin Yang, Altanzul Bat-Ulzii and Jaeho Cho
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Jahyung Kim: Department of Orthopaedic Surgery, Armed Force Gangneung Hospital, Gangneung 25422, Korea
Bum-Jin Shim: Department of Orthopaedic Surgery, Chuncheon Sacred Heart Hospital, Hallym University, Chuncheon 24253, Korea
Jae-Shin Yang: Department of Orthopaedic Surgery, Chuncheon Sacred Heart Hospital, Hallym University, Chuncheon 24253, Korea
Altanzul Bat-Ulzii: Institute for Skeletal Aging and Orthopedic Surgery, Chuncheon Sacred Heart Hospital, Hallym University, Chuncheon 24253, Korea
Jaeho Cho: Department of Orthopaedic Surgery, Chuncheon Sacred Heart Hospital, Hallym University, Chuncheon 24253, Korea

IJERPH, 2022, vol. 19, issue 4, 1-10

Abstract: We aimed to investigate the preoperative history, clinical manifestations, imaging findings, and postoperative clinical outcomes for patients with surgically confirmed synovial fistula around the ankle joint. 19 consecutive patients who were confirmed to have synovial fistula in the surgical field were enrolled in this study. Medical records of all patients in terms of preoperative details, operative findings, and postoperative outcomes at 1 year after the surgery were retrieved. As a diagnostic modality, the normal saline test or MRI was used. Intraoperatively, the synovial fistula was repaired with the capsuloligamentous repair or additional periosteal augmentation. All patients had a history of ankle sprain prior to symptoms and showed positive results in the saline load test. One patient had recurred symptom after the surgery, so needed a revisional periosteal augmentation. At 1 year follow-up period, the average Foot ankle outcome score was 87.65 and no surgery-related complication was detected. Synovial fistula of the ankle joint needs to be taken into consideration as a possible complication in patients with ankle sprain history and recurrent joint swelling. The saline load test would be useful for its diagnosis, and treatment should be focused on the complete closure of capsular opening along with restoration of its surrounding pathologic conditions.

Keywords: ankle; synovial fistula; ankle sprain; lateral ankle instability (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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