Li Yanwei, Hong Haisen, Liu Hui, Ding Zhenqi
Department of Orthopedics, Xiamen University Affiliated Southeast Hospital, Zhangzhou Fujian, 363000, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2016 Aug 8;30(8):971-974. doi: 10.7507/1002-1892.20160197.
To summarize the short-term effectiveness of TightRope system for the treatment of syndesmotic tibiofibular diastasis.
Between June 2013 and June 2015, 23 patients with syndesmotic tibiofibular diastasis were treated by TightRope system, including 15 males and 8 females with an average age of 32.3 years (range, 16-63 years). Injury was caused by sports in 13 cases, by traffic accident in 6 cases, and by falling from height in 4 cases. The locations were the left side in 13 cases and the right side in 10 cases. The time from injury to operation was 6 hours to 12 days (mean, 3.8 days). According to Lauge-Hansen classification, 13 cases were rated as supination-external rotation type, 7 cases as pronation-abduction type, and 3 cases as pronation-external rotation type; according to Weber classification, 5 cases were rated as type A, 11 cases as type B, and 7 cases as type C.
The mean operative time was 68.1 minutes (range, 48-93 minutes); the mean intraoperative blood loss was 70.3 mL (range, 20-150 mL); and the mean hospitalization days were 7 days (range, 5-13 days). Superficial local skin necrosis occurred in 6 cases, and primary healing of incision was obtained in the others. All patients were followed up 8-30 months (mean, 16.4 months). X-ray films showed bone union was achieved within 6-12 weeks (mean, 9.4 weeks). No related complications of reduction failure and re-fracture occurred. The internal fixators were removed at 10-18 months postoperatively (mean, 13.3 months). According to American Orthopaedic Foot and Ankle Society (AOFAS) score for ankle function evaluation, the results were excellent in 19 cases and good in 4 cases at last follow-up.
TightRope system is a good method to treat syndesmotic tibiofibular diastasis, because of safety, convenient operation, and satisfactory short-term effectiveness.
总结TightRope系统治疗下胫腓联合分离的短期疗效。
2013年6月至2015年6月,采用TightRope系统治疗23例下胫腓联合分离患者,其中男15例,女8例,平均年龄32.3岁(16 - 63岁)。损伤原因:运动伤13例,交通事故伤6例,高处坠落伤4例。部位:左侧13例,右侧10例。受伤至手术时间为6小时至12天(平均3.8天)。按Lauge-Hansen分型:旋后-外旋型13例,旋前-外展型7例,旋前-外旋型3例;按Weber分型:A型5例,B型11例,C型7例。
平均手术时间68.1分钟(48 - 93分钟);平均术中出血量70.3毫升(20 - 150毫升);平均住院天数7天(5 - 13天)。6例出现局部皮肤浅坏死,其余切口均一期愈合。所有患者均获随访,随访时间8 - 30个月(平均16.4个月)。X线片显示6 - 12周(平均9.4周)达到骨愈合。未发生复位失败及再骨折等相关并发症。内固定物于术后10 - 18个月(平均13.3个月)取出。末次随访时按美国足踝外科协会(AOFAS)踝关节功能评分标准:优19例,良4例。
TightRope系统治疗下胫腓联合分离安全、操作简便、短期疗效满意,是一种较好的治疗方法。