A Short-term Clinical Efficacy Of Anterior-inferior Tibiofibular Ligament Repair Versus Trans-syndesmosis Screw Fixation In The Treatment Of Syndesmotic Injury

Objective: Syndesmosis injury is common in external-rotation type of ankle fracture,conservative treatment is ineffective when ankle fracture combine with Syndesmosis injury,that often lead to long-term ankle pain and osteoarthritis.therefore,surgical treatment has reached consensus.Transsyndesmosis screw fixation,the gold-standard treatment in the past.With further research,More and more research find the inadequacy of tibiofibular screws.This study in purpose to evaluate the functional of anterior-inferior tibiofibular ligament repair and trans-syndesmosis screw fixation in the treatment of syndesmotic injury.Methods: Retrospective analysis of 41 patients of ankle fracture,and the syndesmosis was still unstable after fracture fixation,in our hospital during July 2014 to July 2017.According to the different treatment methods are divided into two groups.Ligament repair group and trans-syndesmosis screw group.The ligament repair group: including 16 patients(7 males,9 females),aging from 20 to 54 years,(the average age 40.06years);According to Weber and Lauge–Hansen classification,12 were Weber B,4 were Weber C;11 were supination external rotation,5 were pronation external rotation.The trans-syndesmosis screw group:including 25 patients(13 males,12 females),aging from 18 to 59 years,(the average age 35.84years);19 were Weber B,6 were Weber C;20 were supination external rotation,5 were pronation external rotation.The operative time,intraoperative blood loss,hospitalization time,fracture healing time,Postoperative complications and visual analogue score(VAS)and ankle joint AOFAS score were compared between the two groups.Results: All 41 patients in both groups had been treated with surgery.There was no statistical significance in the time of operation and intraoperative blood loss and hospitalization time and the time of fracture healing between the two groups(P>0.05).The followed up time of the two groups were 12 months.About the Postoperative complications,the two groups have statistical significance(P< 0.05).The VAS score of the last followed up in the two groups were 1.8±0.9 and 2.3±1.1.There was no significant difference with the VAS score in the two groups(P <0.05).AOFAS score in ligament repair group and screw group was 75.0±3.5,80.7±3.7 and 69.8±3.7,74.3±4.2 at 3,6-month follow-up(P < 0.05).AOFAS score in the two group was 89.6±2.9 and 88.1±2.5 at 12-month follow-up(P < 0.05).Conclusion: Two groups had an equivalent reduction,ligament repair group has Postoperative functional recovery better and less postoperative complications.