Department of Orthopaedic Trauma, The Second Hospital of Tangshan, Tangshan, China.
Department of General Medicine, Tangshan Gongren Hospital, Tangshan, China.
Medicine (Baltimore). 2023 Oct 20;102(42):e35691. doi: 10.1097/MD.0000000000035691.
In order to overcome the shortcomings of common surgical fixation methods for Distal Tibiofibular Syndesmosis (DTS) injuries, which include the inability to exercise early, significant surgical trauma, and the risk of loosening and breakage of implants, we have designed and implemented a new technique using steel cable fixation to treat DTS injuries.
Twenty-six patients treated with steel cable fixation for DTS injury between March 2013 and March 2019 in the Second Hospital of Tangshan City trauma department were followed up to monitor the efficacy of treatment. There were 16 males and 10 females between the ages of 19 and 64, with a mean age of 41.81 ± 9.54 years. All patients were examined by X-ray and CT for 3 days before and after surgery. The patients were then reexamined by X-ray 6 and 9 weeks postoperatively, and by CT 1 year later. The treatment results were evaluated by comparing the distal tibiofibular anterior, middle, and posterior gap changes and the Baird-Jackson score.
The 26 patients attained good postoperative repositioning, with a fracture healing time of 2.5 to 3 months. and the Baird-Jackson score was 96 ± 2.78. After surgery, the DTS gaps observed in the CT scans taken 3 days and 1 year postoperatively in all patients were significantly reduced compared to the preoperative measurements, with statistical significance (P < .05). However, when comparing the CT scans taken 1 year postoperatively to those at 3 days postoperatively, there was no significant change in the anterior gap. The middle and posterior gaps of DTS showed a slight increase with statistical significance (P < .05), but all measurements remained within the normal range.
Steel cable fixation for DTS injury has the advantages of reliable fixation, early functional exercise, and reduction in the number of operations, and no adverse effects or complications were found.
为了克服常见的下胫腓联合（DTS）损伤的外科固定方法的缺点，包括无法早期锻炼、手术创伤大、植入物松动和断裂的风险，我们设计并实施了一种使用钢缆固定治疗 DTS 损伤的新技术。
2013 年 3 月至 2019 年 3 月，唐山市第二医院创伤科采用钢缆固定治疗 DTS 损伤患者 26 例，随访观察治疗效果。男 16 例，女 10 例；年龄 19～64 岁，平均 41.81±9.54 岁。所有患者术前 3d 和术后均行 X 线和 CT 检查，术后 6、9 周行 X 线检查，1 年后行 CT 检查。通过比较术后远端胫腓骨前、中、后间隙变化和 Baird-Jackson 评分评估治疗效果。
26 例患者术后复位良好，骨折愈合时间为 2.5～3 个月。Baird-Jackson 评分为 96±2.78。术后所有患者 CT 扫描显示 3d 和 1 年后的 DTS 间隙均明显小于术前，差异有统计学意义（P<0.05）。但与术后 3d 比较，1 年后 CT 扫描显示前间隙无明显变化，中、后间隙 DTS 稍有增加，差异有统计学意义（P<0.05），但所有测量值均在正常范围内。
钢缆固定治疗 DTS 损伤具有固定可靠、早期功能锻炼、减少手术次数等优点，无不良影响或并发症。
