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Different Fixation Methods in the Treatment of Distal Tibiofibular Syndesmosis Injury |
CHEN Dingzhong, WANG Longhui, LI Chaoyi |
The Second Affiliated Hospital of Hainan Medical University, Hainan Haikou 570311, China |
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Abstract Objective: To observe the effect of Nice knot elastic fixation and screw rigid fixation in the treatment of distal tibiofibular syndesmosis injury. Methods: 167 patients with distal tibiofibular syndesmosis injury admitted to the hospital between December 2019 and December 2020 were retrospectively analyzed. Among them, 80 cases adopted screws to fix distal tibiofibular syndesmosis (screw group) and 87 cases were fixed with NICE knot for distal tibiofibular syndesmosis (NICE knot group). The intraoperative distal tibiofibular fixation time, intraoperative blood loss, wound healing time and postoperative walking time and weight-bearing time (time of walking down the ground, partial weight-bearing time, complete weight-bearing time) were compared between the two groups. Foot ankle score, ankle joint score, angle of dorsiflexion and angle of plantar flexion before surgery and at 6 months after surgery and occurrence of complications at half a year of follow-up were compared. Results: During surgery, the distal tibiofibular fixation time in NICE knot group was significantly shorter than that in screw group (P<0.05), and there were no significant differences in blood loss and significant wound healing time (P>0.05). After surgery, time of walking down the ground, partial weight-bearing time and complete weight-bearing time were significantly earlier in NICE knot group than those in screw group (P<0.05). After 6 months of surgical treatment, the foot ankle score (AOFAS) and ankle score (Kofoed) of the two groups were significantly enhanced compared with those before surgery (P<0.05), and the scores and ranges of score change of NICE knot group were significantly higher than those of screw group (P<0.05). After surgery, the dorsiflexion angle and plantar flexion angle of the two groups were significantly larger than those before surgery (P<0.05), and the two indicators were significantly larger in NICE knot group compared with those in screw group (P<0.05). The change range of plantar flexion Angle in NICE knot group was significantly higher than that in screw group (P<0.05), but there was no significant difference in change range of dorsiflexion angle (P>0.05). Within half a year of postoperative follow-up, the incidence rate of complications was 4.60% in NICE group and was 10.00% in screw group respectively (P>0.05). Conclusion: Compared with screw fixation, NICE knot fixation of distal tibiofibular syndesmosis injury is more beneficial to the early recovery of ankle joint function, and it has lower incidence of complications and is worthy of clinical promotion.
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