Clinical Efficacy Of Elastic Fixation Versus Screw Fixation In The Treatent Of Syndesmotic Injury

Objective: To compare the clinical efficacy of elastic fixation and trans-syndesmosis screw fixation in the treatment of syndesmotic injury.Methods: A retrospective case-control study was conducted to analyze the clinical data of 28 patients with ankle fracture combined with syndesmotic injury,they all underwent surgery in our hospital from August2016 to August 2018.Among them,18 were males and 10 were females,aged from 23 to 65 years,all of whom suffered from ankle aprain.According to Lange-Hansen classification,10 were supination external rotation type,14 were pronation external rotation type and 4 were pronation abduction type.According to Weber classification,10 were Weber type B and 18 were Weber type C.Elastic fixation technique was used to treat 13 patients with syndesmotic injury.trans-syndesmosis screw fixation was used to treat 15 patients with syndesmotic injury.The operation time,hospitalization time,fracture healing time,tibiofibular clear space(TFCS),tibiofibular overlap(TFO)and AOFAS scores were compared between the two groups.Results: All patients were followed up for 14-26 months,with anaverage 18 months.There was no significant difference between the two groups in operation time,hospitalization time,fracture healing time,Tibiofibular clear space(TFCS)and Tibiofibular overlap(TFO)at the last follow-up(P>0.05).According to the AOFAS score at the last follow-up,the excellent and good rate was 92.3% in group A and 86% in group B.The difference between the two groups was statistically significant(P<0.05).Conclusions: Elastic fixation technology and trans-syndesmosis screw fixation technology are both effective treatments for syndesmotic injury.Elastic fixation technology can better restore the function of the ankle joint without secondary surgery to remove the trans-syndesmosis screw,which is worthy of clinical promotion.