Comparison Of Endobutton Fixation And Cortical Screws In The Treatment Of Acute Injury Of Distal Tibiofibular Syndesmosis

Objective: Comparison of Endobutton fixation and cortical screws in the treatment of acute injury of distal tibiofibular syndesmosis.And to provide the basis for the clinical treatment of acute tibiofibular joint injury with ankle joint fracture.Methods: Retrospective analysis of 66 cases of acute injury of distaltibiofibular syndesmosis treated in our hospital from August 2013 to June 2015.31 patients received Endobutton fixation and 35 patients received cortical screws treatment.First,two kinds of therapy and preoperative indicators as independent variables,treatment results as the dependent variable for Logistic regression analysis,Two methods were used as independent variables,and the results were treated as the dependent variables for Logistic regression analysis.Than two methods were compared by mean blood loss,operation time,burdened time,TBCS(One Year Postoperation),TBOL(One Year Post-operation),AOFAS score and rate of complications.In order to eliminate the influence of the operation technique on the curative effect,all the operations were completed by the deputy director or above level doctors.Results: By comparison,we found that gender was an independent risk factor for treatment outcome,but there was no significant correlation between different methods and outcomes.All patients were followed up for 12-18 months,The average amount of the operation time 、weight bearing time 、Hospitalization expenses in the cortical screws group was(74.98±6.32)min,(12.93±1.26)w,(13076.16)yuan,The average amount of the Endobutton fixation group was(78.29±5.97)min,(8.09±0.79)w,((19632.79)yuan。 And the operation time of treatment by Endobutton fixation was longer than that of treatment by cortical screws(t=2.203,P=0.031).The weight bearing time of treatment by Endobutton fixation was shorter than that of treatment by cortical screws(t=-18.459,P<0.001).The hospitalization expenses of treatment by Endobutton fixation was more expensive than that of treatment by cortical screws(t=23.759,P<0.001).But the difference was not statistically significant by mean blood loss(t=0.543,P=0.589),TBCS(One Year Post-operation)(t=0.025,P=0.980),TBOL(One Year Post-operation)(t=0.711,P=0.480),AOFAS score(t=0.577,P=0.566)and rate of complications(2=0.020,P=0.888).The average amount of mean blood loss 、TBCS(One Year Post-operation)、TBOL(One Year Post-operation)in the cortical screws group was(69.14±7.99)ml,(4.56±0.29)mm,(7.39±0.39)mm,The average amount of the Endobutton fixation group was(70.16±7.13)ml,(4.57±0.25)mm,(7.45±0.35)mm。The Endobutton group ankle function classification: excellent in 9 cases,good in 14 cases,fairin 5 cases,poor in 3 cases;and the cortical screws group ankle function classification: excellent in 10 cases,good in 16 cases,fair in 7 cases,poor in 2 cases.There was no significant differen ce between the two groups(t = 0.000,P = 0.993).The Endobutton group,complications occurred in 3 cases,including 1 cases of Invagination: 1 cases of local osteolysis and because of ankle joint pain two times surgery to remove the int ernal fixation in 1 cases.There were 2 cases of complication of cortical screw group,including 1 case of Retired screw and 1 case of broken screw.There was no significant difference between the two groups(t=0.020,P=0.888).Conclusion: There was no significant difference between these two methods in the treatment of acute injury of distaltibiofibular syndesmosis.The appropriate method should be considered before operation.