Clinical Efficacy Analysis Of Two Treatment For Ankle Fracture Combined With Distal Tibiofibular Syndesmosis Injury

Objective: To compare and analyze the effect of screw fixation and unscrew fixation on ankle fracture combined with distal tibiofibular syndesmodesis injury,and to provide reference for the clinical treatment of ankle fracture combined with distal tibiofibular syndesmodesis injury.Methods: Based on the affiliated Hospital of Yanbian University form March2017 to March 2021 admitted during the period of 47 cases of ankle joint fracture combined distal tibiofibular syndesmodesis injury patients were analyzed retrospectively,according to the distal tibiofibular syndesmodesis injury treatment is different,divided into observation group(fixed ankle fractures and distal tibiofibular syndesmodesis)and control group(only internal fixation of ankle fracture without screw fixation of distal tibiofibular syndesmodesis).There were 24 patients in the observation group(15 males and 9 females;8 cases on the left side,16 cases on the right side;aged 16 to 60 years,mean age was 38.04±14.15 years old).There were 23 patients in the control group(8 males and 15 females;13 cases on the left side,10 cases on the right side;aged 18 to 60 years,mean age was 40.83±12.54 years old).The general information,duration of surgery and hospital stay,fracture healing time,postoperative visual analogue scale(VAS)and preoperative data of patients in the two groups were compared The parameters of the tibiofibular clear space(TFCS)and the tibiofibular overlap(TFO)were used to evaluate the ankle function of the patients during the postoperative follow-up by the American Orthopaedic Foot and Ankle Society(AOFAS)scoring system.The data obtained were statistically analyzed to evaluate the therapeutic effect of the two surgical methods.Results: All the 47 patients collected were followed up for 12 to 16 months,with an average of(14.03±1.19 months).After statistical analysis,the VAS of 3 months and 1 year after surgery of the two groups in terms of the causes of injury on the affected side of gender and age,duration of surgery and length of hospitalization,duration of fracture healing In terms of TFCS 3 months and 1 year before and after surgery and TFO parameters comparison 3 months and 1 year after surgery,there was no significant statistical significance in the comparison of TFO parameters between the two groups(P>0.05).TFCS of the two groups 3 months and 1 year after surgery showed no significant statistical significance TFO parameters were statistically significant compared with those before surgery(P<0.05).TFCS TFO parameters of the two groups at 3 months and 1 year after surgery showed no significant statistical significance(P>0.05).When the ankle joint function was evaluated according to the AOFAS scoring system during the postoperative follow-up,the excellent and good rate was 91.7% in the observation group and 87.0% in the control group.There was no significant difference in the results between the two groups(P>0.05).Conclusion: 1.For patients with Denis-Weber ankle fracture type B and C,fixation of the distal tibiofibular syndesmodesis ligament is required if the intraoperative Hook test is positive.2.For patients with Denis-Weber ankle fracture type B and C,satisfactory clinical results can be achieved without the need to fix the distal tibiofibular syndesmodesis ligament when the intraoperative Hook test is negative.