| Objective To compare the clinical efficacy and complications of a novel inferior tibiofibular combined elastic hook plate(ESHP)with the suture button technique in patients with ankle fractures complicated by an inferior tibiofibular joint injury using a prospective clinical randomized controlled study,thereby providing a better choice in the treatment of combined inferior tibiofibular injuries.Methods The study was a prospective clinical randomized controlled study and included 53 ankle fracture patients with combined inferior tibiofibular injury who met the diagnostic criteria in our Orthopedic Center from October 2018 to October 2019 and were randomly divided into group A:using a novel inferior tibiofibular fixation combined with elastic hook plate fixation for the treatment of distal tibiofibular syndesmosis;group B:using Suture-button technique for the treatment of distal tibiofibular syndesmosis.Their general data were analyzed in which group a contained 28 patients,15 males and 13females,aged(38.5 ± 9.1)years and group B contained 25 patients,14 males and 11 females,aged(39.6 ± 9.0)years.The differences in general data such as gender,age,ankle fracture classification,and inferior tibiofibular syndesmosis injury classification were not statistically significant between the two groups of patients(P>0.05).The operative time,postoperative incision drainage,hospital stay,partial weigh t-bearing time,and time to full weight-bearing were compared between the two groups,and the maximum plantar flexion and dorsal extension angles of the ankles at 3 and 6 months and l year after surgery were compared,and the function of the ankles was evaluated using the Baird-Jackson scoring system.Results Fifty-three patients completed the operation successfully,and there were no abnormal conditions during the operation.The time of fixation of tibiofibular syndesmosis[(9.69±2.24)min]and postoperative incision drainage[(49.29 ± 10.42)ml]in group A were significantly less than those in group B[(16.25±1.42)min,(62.40±6.3 1)ml].The maximum plantarflexion angle at 3 months after surgery(29.89±1.31)° was significantly greater than that in group B(22.80±1.32)°,and the Baird-Jackson score at 3 months after surgery(87.18 ± 2.88)was significantly greater than that in group B(78.72 ± 4.09),all of which were statistically significant(P<0.05).The partial weight-bearing time[(6.02±0.78)weeks]and full weight-bearing time[(12.08 ± 0.95)weeks]in group A were significantly earlier than those in group B[(7.18±0.72)weeks,(13.40 ± 0.78)weeks],with significant differences(P<0.05).The differences in hospital stay,maximum plantar flexion angle at 6 months and 1 year,maximum dorsiflexion angle at 3,6 months and 1 year after surgery,and Baird-Jackson score at 6 months and 1 year after surgery were not statistically significant(P>0.05).In the ESHP group of the year,there was 1 case of complication and failure of internal fixation caused by metal fatigue.In group B,there were 4 complications,including 1 fixation irritation,2 fixation failure,and 1 fixation subsidence and osteolysis.Conclusion Compares with Suture-button technique,ESHP treatment of inferior tibiofibular syndesmosis injury has shorter operation time,less postoperative bleeding and complications,and faster recovery of ankle function,so it is a recommended and applied fixation method... |
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