Pogliacomi Francesco, Artoni Carlotta, Riccoboni Sara, Calderazzi Filippo, Vaienti Enrico, Ceccarelli Francesco
PARMA UNIVERSITY DEPARTMENT OF SURGICAL SCIENCES ORTHOPAEDIC AND TRAUMATOLOGY SECTION.
Acta Biomed. 2018 Dec 20;90(1-S):146-149. doi: 10.23750/abm.v90i1-S.8015.
There is a wide debate about the number, diameter and length of the syndesmotic screw and necessity and timing for its removal. The aim of this study is to determine whether functional and radiological outcomes differ in patients operated for Weber type B and C ankle fractures who had syndesmotic screws removed (group 1) compared to those who did not (group 2). Furthermore, authors want to define if it is really necessary to remove this device and its correct timing.
90 patients were eligible for the study. The functional outcomes were analyzed 1 year after surgery using OMAS and AOFAS scores. Radiographic evaluation assessed the tibiofibular distance immediately and 12 months after surgery and fracture's healing.
Clinical and x-rays results were similar in both groups at follow-up.
Fractures with interruption of syndesmosis are lesions that, if not well treated, are complicated by joint stiffness, residual pain and post-traumatic osteoarthritis. Syndesmotic screw removal is not routinely performed, thus accepting the risk of rupture but avoiding a new surgery.
Results observed suggest that syndesmotic screw removal is not necessary. If surgeon decide to remove this device correct timing is mandatory in order to obtain satisfactory long-term results.
关于下胫腓联合螺钉的数量、直径、长度以及取出的必要性和时机存在广泛争议。本研究的目的是确定在接受手术治疗的Weber B型和C型踝关节骨折患者中，取出下胫腓联合螺钉的患者（第1组）与未取出的患者（第2组）在功能和影像学结果上是否存在差异。此外，作者想要明确是否真的有必要取出该装置以及其正确的时机。
90例患者符合研究条件。术后1年使用OMAS和AOFAS评分分析功能结果。影像学评估在术后即刻和12个月时评估胫腓骨间距以及骨折愈合情况。
随访时两组的临床和X线结果相似。
下胫腓联合中断的骨折是一种如果治疗不当会并发关节僵硬、残留疼痛和创伤后骨关节炎的损伤。下胫腓联合螺钉通常不取出，因此接受了断裂的风险但避免了再次手术。
观察结果表明下胫腓联合螺钉取出没有必要。如果外科医生决定取出该装置，正确的时机是获得满意长期结果的关键。
