Morales Muñoz P, Barroso Gómez V, de Los Santos Real R, de Dios Pérez M, Escalera Alonso J, Varas Navas J
Unidad de pie y tobillo, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Infanta Sofía, San Sebastián de Los Reyes, Madrid, España.
Unidad de pie y tobillo, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Infanta Sofía, San Sebastián de Los Reyes, Madrid, España.
Rev Esp Cir Ortop Traumatol. 2022 Nov-Dec;66(6):491-499. doi: 10.1016/j.recot.2022.01.007. Epub 2022 Mar 17.
Classically acute syndesmosis injuries have been treated using screws. A few years ago more flexible implants appeared evolving to current TighRope® Knotless. The primary aim of this study is to compare clinical and radiographic outcome of both implants.
From April 2019 to September 2020 68 patients diagnosed with acute syndesmosis injury were randomized to use screws or TighRope® Knotless. Syndesmosis reduction was assessed using bilateral CT potsoperatively. Outcomes were clinically and radiologically assessed at three, six, and twelve months after surgery.
No significant differences were identified in the AOFAS Scale between groups at three months (83.1 vs. 81.80; P=1.03), nor at six (88.27 vs. 88; P=.26) or at twelve (93.03 vs. 92.10; P=,93). There were also no differences in Olerud-Molander scale at three (65 vs. 61.50; P=3.5), six (82.33 vs. 80.67; P=1.67) and twelve months (92.67 vs. 90; P=2.67). Likewise, there were no differences in rate of postoperative malreduction (no cases in both groups), loss of reduction (three cases in screw group vs. four in TighRope® Knotless group, P=.54) or complications (P=1).
Treatment of acute syndesmosis injuries with screws or the TighRope® Knotless implant is similar in both clinical and radiological results.
传统上，急性下胫腓联合损伤采用螺钉进行治疗。几年前，出现了更灵活的植入物，并发展到目前的TighRope®无结系统。本研究的主要目的是比较两种植入物的临床和影像学结果。
2019年4月至2020年9月，68例诊断为急性下胫腓联合损伤的患者被随机分配使用螺钉或TighRope®无结系统。术后使用双侧CT评估下胫腓联合复位情况。在术后3个月、6个月和12个月对结果进行临床和影像学评估。
两组在术后3个月（83.1对81.80；P=1.03）、6个月（88.27对88；P=0.26）或12个月（93.03对92.10；P=0.93）时，美国足踝外科协会（AOFAS）评分均无显著差异。在Olerud-Molander量表评分方面，术后3个月（65对61.50；P=3.5）、6个月（82.33对80.67；P=1.67）和12个月（92.67对90；P=2.67）时也无差异。同样，两组在术后复位不良率（两组均无病例）、复位丢失率（螺钉组3例对TighRope®无结系统组4例，P=0.54）或并发症发生率（P=1）方面也无差异。
使用螺钉或TighRope®无结植入物治疗急性下胫腓联合损伤，在临床和影像学结果方面相似。
