Sakarya University Research and Training Hospital, Adapazari, Sakarya.
University of Health Sciences Konya City Hospital Orthopedics and Traumatology.
Medicine (Baltimore). 2021 Apr 2;100(13):e25328. doi: 10.1097/MD.0000000000025328.
Different methods have been used throughout the years for syndesmotic injury but there is no consensus on the ideal treatment. Some methods are expensive and some have more complications. The aim of this study is to compare single suture endobutton with double suture endobutton and screw fixation for syndesmotic injury.Sixty nine patients with syndesmotic injury with fibular fractures whom were treated with a single interosseous suture endobutton system (ZipTightTM, Zimmer Biomet), a double interosseous suture endobutton system (ZipTightTM, Zimmer Biomet) and 1 syndesmotic screw (TST, Istanbul, Turkey) were included in this study. Functional and radiological results from patient records between 2015 and 2018 were retrospectively evaluated.Twenty patients were treated with the double interosseous suture endobutton, 23 were treated with the single interosseous suture endobutton, and 26 were treated with traditional AO screw fixation. Three patients from the screw fixation group (11.5%) required revision surgery (P < .05). All the radiologic and clinical outcomes were statistical similar in all 3 groups.Our findings showed that the interosseous suture endobutton system is at least as safe as the screw fixation technique for treatment of syndesmosis joint injuries and can be used as an alternative to the screw method. The interosseous suture endobutton system eliminates the need for a second surgery to remove the hardware, which minimizes the probability of re-diastasis. Since our results showed no statistical difference between single and double interosseous suture endobutton systems, the less costly single endobutton system may be the better alternative.
多年来，人们一直在使用不同的方法治疗下胫腓联合损伤，但对于理想的治疗方法尚未达成共识。有些方法昂贵，有些则并发症更多。本研究旨在比较单钉与双钉固定治疗下胫腓联合损伤。本研究纳入了 2015 年至 2018 年间采用单枚骨间缝合纽扣系统（ZipTightTM，Zimmer Biomet）、双枚骨间缝合纽扣系统（ZipTightTM，Zimmer Biomet）和 1 枚下胫腓螺钉（TST，伊斯坦布尔，土耳其）治疗的 69 例下胫腓联合损伤合并腓骨骨折患者。回顾性评估了患者记录中的功能和影像学结果。20 例患者采用双枚骨间缝合纽扣固定，23 例患者采用单枚骨间缝合纽扣固定，26 例患者采用传统 AO 螺钉固定。螺钉固定组有 3 例（11.5%）患者需要翻修手术（P<0.05）。所有 3 组的影像学和临床结果均相似。我们的研究结果表明，纽扣内固定系统至少与螺钉固定技术一样安全，可作为螺钉方法的替代方法。纽扣内固定系统无需进行第二次手术取出内固定物，从而最大限度地减少了再分离的可能性。由于我们的结果显示单枚与双枚骨间缝合纽扣系统之间无统计学差异，因此费用较低的单枚纽扣系统可能是更好的选择。
