Department of Orthopedics, The First People'S Hospital of Yibin City, Yibin, Sichuan, China.
Department of Orthopedics, Affiliated Hospital of Jianghan University, Wuhan, Hubei, China.
J Orthop Surg (Hong Kong). 2021 Jan-Apr;29(1):2309499020975215. doi: 10.1177/2309499020975215.
To compare the clinical effect of the self-made wire-rope button plate and cortical screw in the treatment of the distal tibiofibular syndesmosis separation.
Total 26 patients with distal tibiofibular syndesmosis separation were treated with internal fixation with a self-made wire-rope button plate and cortical screw. They were divided into a self-made wire-rope button plate group and cortical screw group. self-made wire-rope button plate group: 12 cases of inferior tibiofibular syndesmosis were reconstructed by self-made wire-rope button plate. Cortical screw group: 14 cases of inferior tibiofibular syndesmosis were reconstructed by cortical screw. The follow-up data of 2, 6, 12 weeks and 6 and 12 months after operation were collected.
There was no significant difference in operative time, the amount of intraoperative bleeding and postoperative complications between the two groups (P > 0.05). Comparison of postoperative complications: There was no loosening and rupturing of internal fixation in the self-made wire-rope button plate group. In the cortical screw group, the rupture of screws was found in 1 case, which occurred in the 10th weeks after the operation, and the broken screws were removed after 1 year with other internal fixations. Within 12 weeks of reoperation to remove the internal fixation rate: There was a significant difference in the rate of reoperation to remove the internal fixation within 12 weeks (p < 0.05). At the last follow-up, the AOFAS score of the ankle joint were 94 ± 4.79 in the self-made wire-rope button plate group and 92.8 ± 6.73 in the cortical screw group. There was no significant difference (P > 0. 05).
The self-made wire-rope button plate and cortical screw can effectively treat the separation of the tibiofibular syndesmosis. It provides a new choice for the treatment of inferior tibiofibular syndesmosis.
比较自制钢丝绳纽扣板与皮质螺钉治疗下胫腓联合分离的临床效果。
采用自制钢丝绳纽扣板与皮质螺钉内固定治疗下胫腓联合分离患者 26 例,分为自制钢丝绳纽扣板组和皮质螺钉组。自制钢丝绳纽扣板组:12 例下胫腓联合采用自制钢丝绳纽扣板重建。皮质螺钉组:14 例下胫腓联合采用皮质螺钉重建。收集术后 2、6、12 周及术后 6、12 个月随访资料。
两组手术时间、术中出血量、术后并发症比较差异均无统计学意义(P>0.05)。术后并发症比较:自制钢丝绳纽扣板组内固定无松动、断裂。皮质螺钉组术后第 10 周出现螺钉断裂 1 例,取出断裂螺钉后改用其他内固定 1 年。内固定取出再手术率:12 周内再手术取内固定率比较差异有统计学意义(p<0.05)。末次随访时,自制钢丝绳纽扣板组踝关节 AOFAS 评分为 94±4.79,皮质螺钉组为 92.8±6.73,两组比较差异无统计学意义(P>0.05)。
自制钢丝绳纽扣板与皮质螺钉均可有效治疗下胫腓联合分离,为下胫腓联合损伤的治疗提供了新的选择。