2017, Number 5
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Acta Ortop Mex 2017; 31 (5)
Functional comparison in the treatment of Weber type B ankle fractures with suture device versus screw
Rius-Zavala MM, Gil-Orbezo FI, Trueba-Davalillo CA, Trueba-Vasavilbaso C, Acuña-Tovar M
Language: Spanish
References: 24
Page: 212-216
PDF size: 161.94 Kb.
ABSTRACT
Background: Ten percent of all ankle fractures, 20% of the fractures treated surgically, and 1-18% of all sprains involve a syndesmosis injury. The methods used for reduction are metal or bioabsorbable syndesmotic set screws, direct repair, and sutures with or without buttons. The purpose of this study was to compare the clinical function of patients who sustained Weber B ankle fractures and were treated with the TightRope system or a syndesmotic set screw.
Material and methods: An observational, comparative, cross-sectional study was conducted between March 2012 and March 2015. The AOFAS ankle scale was used to assess function in patients with Weber B fractures with a syndesmosis injury treated with a 3.5 mm tricortical set screw or with the TightRope system.
Results: Forty-three patients were included, their mean age was 47 years. The single-factor ANOVA test was used to compare the results of both groups. The latter showed that at 3, 6 and 12 months the TightRope group showed a significant improvement based on the AOFAS score, compared with the set screw group (p = 0.05).
Discussion: The use of the TightRope system results in better clinical function in the short term compared with the 3.5 mm tricortical set screw, according to the AOFAS scale.
REFERENCES
Peña FA, Coetzee JC: Ankle syndesmosis injuries. Foot Ankle Clin. 2006; 11(1): 35-50, viii.
Porucznik MA: Screw vs. TightRope fixation for syndesmotic fractures. AAOS Now. May 2008 Issue.
Michelson JD: Fracturas del tobillo por rotación. J Am Acad Orthop Surg (ed Esp). 2004; 3(1): 31-40.
Seyhan M, Donmez F, Mahirogullari M, Cakmak S, Mutlu S, Guler O: Comparison of screw fixation with elastic fixation methods in the treatment of syndesmosis injuries in ankle fractures. Injury. 2015; 46 Suppl 2: S19-23.
Weber BG: Lesiones traumáticas de la articulación del tobillo. Suiza/Barcelona: Ed. Científico Médica; 1982.
Porter DA, Jaggers RR, Barnes AF, Rund AM: Optimal management of ankle syndesmosis injuries. Open Access J Sports Med. 2014; 5: 173-82.
Hsu YT, Wu CC, Lee WC, Fan KF, Tseng IC, Lee PC: Surgical treatment of syndesmotic diastasis: emphasis on effect of syndesmotic screw on ankle function. Int Orthop. 2011; 35(3): 359-64.
Makkozzay-Pichardo TH: Complicaciones de las fracturas de tobillo. Ortho-tips. 2006; 2(4): 262-9.
Clasificación AO-OTA. J Orthop Trauma. 2007; 21(Sup 10): S10-129.
Goost H, Wimmer MD, Barg A, Kabir K, Valderrabano V, Burger C: Fractures of the ankle joint: investigation and treatment options. Dtsch Arztebl Int. 2014; 111(21): 377-88.
Hak DJ, Egol KA, Gardner MJ, Haskell A: The “not so simple” ankle fracture: avoiding problems and pitfalls to improve patient outcomes. Instr Course Lect. 2011; 60: 73-88.
Lieberman JR: AAOS Comprehensive orthopaedic review. Rosemont, Il USA: AAOS; 2009. Chapter 60; Sanders D: 659-69.
Schepers T: To retain or remove the syndesmotic screw: a review of literature. Arch Orthop Trauma Surg. 2011; 131(7): 879-83.
van der Eng DM, Schep NW, Schepers T: Bioabsorbable versus metallic screw fixation for tibiofibular syndesmotic ruptures: a meta-analysis. J Foot Ankle Surg. 2015; 54(4): 657-62.
Noh JH, Roh YH, Yang BG, Kim SW, Lee JS, Oh MK: Outcomes of operative treatment of unstable ankle fractures: a comparison of metallic and biodegradable implants. J Bone Joint Surg Am. 2012; 94(22): e166.
Lalli TA, Matthews LJ, Hanselman AE, Hubbard DF, Bramer MA, Santrock RD: Economic impact of syndesmosis hardware removal. Foot (Edinb). 2015; 25(3): 131-3.
Coetzee JC, Ebeling P: Treatment of syndesmosis disruptions with TightRope fixation. Techniques in Foot and Ankle Surgery. 2008; 7(3): 196-202.
Schepers T: Acute distal tibiofibular syndesmosis injury: a systematic review of suture-button versus syndesmotic screw repair. Int Orthop. 2012; 36(6): 1199-206.
Pirozzi KM, Creech CL, Meyr AJ: Assessment of anatomic risk during syndesmotic stabilization with the suture button technique. J Foot Ankle Surg. 2015; 54(5): 917-9.
Arthrex TightRope™, Thornes B. Syndesmosis fixation surgical technique. Arthrex Inc. 2012, LT0426K.
Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS, Sanders M: Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int. 1994; 15(7): 349-53.
Ağır İ, Tunçer N, Küçükdurmaz F, Gümüstaş S, Akgül ED, Akpinar F: Functional comparison of immediate and late weight bearing after ankle bimalleolar fracture surgery. Open Orthop J. 2015; 9: 188-90.
Tartaglione JP, Rosenbaum AJ, Abousayed M, DiPreta JA: Classifications in brief: Lauge-Hansen classification of ankle fractures. Clin Orthop Relat Res. 2015; 473(10): 3323-8.
Kortekangas T, Savola O, Flinkkilä T, Lepojärvi S, Nortunen S, Ohtonen P, et al: A prospective randomised study comparing TightRope and syndesmotic screw fixation for accuracy and maintenance of syndesmotic reduction assessed with bilateral computed tomography. Injury. 2015; 46(6): 1119-26.