Miller Anna N, Paul Omesh, Boraiah Sreevathsa, Parker Robert J, Helfet David L, Lorich Dean G
Orthopaedic Trauma Service, Hospital for Special Surgery, New York, NY 10021, USA.
J Orthop Trauma. 2010 Jan;24(1):12-6. doi: 10.1097/BOT.0b013e3181c6e199.
Ankle fractures with a syndesmotic injury have historically been treated with syndesmotic screw fixation. We compared range of motion and functional outcomes' scores to assess patient benefit from syndesmotic screw and plate removal.
Level IV--case series.
Level I--trauma center.
PATIENTS/PARTICIPANTS: Twenty-five consecutive patients with unstable ankle fractures and syndesmotic injury confirmed on magnetic resonance imaging.
Locked syndesmotic screws and plates were removed; functional outcomes and range of motion were measured before and after screw removal.
Foot and Ankle Outcome Score, Olerud and Molander Ankle Score, and physical examination
There was a significant improvement in range of motion, Foot and Ankle Outcome, and Olerud and Molander Ankle scores at the immediate postoperative visit. This was not significantly changed at longer follow-up. There were no adverse events or complications in these patients. No patient had radiographic loss of syndesmotic reduction after screw removal.
Locked screw and plate removal improved function both subjectively and objectively. Transsyndesmotic implant removal seems to assist improvements in the speed of rehabilitation.
伴有下胫腓联合损伤的踝关节骨折，传统上采用下胫腓联合螺钉固定治疗。我们比较了活动范围和功能结果评分，以评估取出下胫腓联合螺钉和钢板对患者的益处。
IV级——病例系列。
I级——创伤中心。
患者/参与者：连续25例经磁共振成像证实为不稳定踝关节骨折且伴有下胫腓联合损伤的患者。
取出锁定的下胫腓联合螺钉和钢板；在取出螺钉前后测量功能结果和活动范围。
足踝结果评分、奥勒鲁德和莫兰德踝关节评分以及体格检查
术后即刻，活动范围、足踝结果以及奥勒鲁德和莫兰德踝关节评分有显著改善。在更长时间的随访中，这一情况没有明显变化。这些患者没有不良事件或并发症。取出螺钉后，没有患者出现下胫腓联合复位的影像学丢失。
取出锁定螺钉和钢板在主观和客观上都改善了功能。取出经下胫腓联合植入物似乎有助于提高康复速度。
