Xue Yang, Zhao Yongjie, Deng Mingming, Fu Bingjin, Yin Gang, Liu Ying, Sun Guangchao
Department of Foot and Ankle Surgery, Binzhou Medical University Hospital, Binzhou Shandong, 256603, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2023 Aug 15;37(8):964-969. doi: 10.7507/1002-1892.202305020.
To study the effectiveness of TightRope elastic fixation combined with functional total repair of the inferior tibiofibular ligament in the treatment of distal tibiofibular syndesmosis injury.
The clinical data of 34 patients with distal tibiofibular syndesmosis injury who met the selection criteria between January 2020 and January 2022 were retrospectively analyzed, and they were divided into improved group (TightRope elastic fixation combined with functional total repair of inferior tibiofibular ligament) and control group (distal tibiofibular screw fixation) according to the surgical methods, with 17 cases in each group. There was no significant difference in age, gender, body mass index, fracture type, and other baseline data between the two groups (0.05). The operation time, intraoperative blood loss, and complications were recorded in the two groups. The American Orthopaedic Foot and Ankle Society (AOFAS) score, ankle metatarsal flexion and dorsal extension range of motion were used to evaluate the ankle function. The patient satisfaction survey was conducted at last follow-up.
All 34 patients were followed up 8-20 months, with a median of 13 months. The operation time and intraoperative blood loss in the improved group were significantly longer than that in the control group (<0.05). In the improved group, no infection or poor reduction occurred, and only 1 patient had TightRope knot reaction at 6 months after operation. In the control group, there were 2 cases of poor reduction, 1 case of lower tibiofibular screw rupture, and 1 case of subcutaneous infection (cured after anti-infection treatment). There was no significant difference in the incidence of complications between the two groups (>0.05). At last follow-up, the AOFAS score and ankle metatarsal flexion and dorsal extension range of motion of the improved group were significantly better than those of the control group (<0.05). The satisfaction rates of patients in the improved group and the control group were 94.1% and 82.4%, respectively, showing significant difference (<0.05).
TightRope elastic fixation combined with functional total repair of inferior tibiofibular ligament in the treatment of distal tibiofibular syndesmosis injury has sufficient fixation strength, and can achieve better effectiveness and joint function compared with traditional screw fixation.
探讨TightRope弹性固定联合下胫腓韧带功能性全修复治疗下胫腓联合损伤的疗效。
回顾性分析2020年1月至2022年1月间34例符合入选标准的下胫腓联合损伤患者的临床资料，根据手术方式分为改良组（TightRope弹性固定联合下胫腓韧带功能性全修复）和对照组（下胫腓螺钉固定），每组17例。两组患者的年龄、性别、体重指数、骨折类型等基线资料比较，差异无统计学意义（P>0.05）。记录两组患者的手术时间、术中出血量及并发症情况。采用美国足踝外科协会（AOFAS）评分、踝关节跖屈和背伸活动度评估踝关节功能。末次随访时进行患者满意度调查。
34例患者均获随访，随访时间8～20个月，中位数为13个月。改良组手术时间和术中出血量均显著长于对照组（P<0.05）。改良组无感染及复位不良发生，仅1例患者术后6个月出现TightRope结反应。对照组有2例复位不良，1例下胫腓螺钉断裂，1例皮下感染（抗感染治疗后治愈）。两组并发症发生率比较，差异无统计学意义（P>0.05）。末次随访时，改良组AOFAS评分及踝关节跖屈和背伸活动度均显著优于对照组（P<0.05）。改良组和对照组患者满意度分别为94.1%和82.4%，差异有统计学意义（P<0.05）。
TightRope弹性固定联合下胫腓韧带功能性全修复治疗下胫腓联合损伤具有足够的固定强度，与传统螺钉固定相比，能取得更好的疗效及关节功能。
