| Objectives Through the retrospective comparative analysis of the treatment of two different internal fixation materials,to evaluate the effect of Endobutton fixation in the treatment of ankle fracture with tibiofibular syndesmosis injury.Methods Patients with ankle fracture complicated with tibiofibular syndesmosis injury treated with Endobutton fixation and screw in Tangshan second Hospital from January2017 to September 2020 were studied,and the inclusion criteria and exclusion criteria were set.A total of 57 patients were selected for the study.The collected data included age,sex,cause of injury and type of fracture.The collected data were retrospectively analyzed using Excel2016 file statistics.According to the difference of internal fixation,57 patients were divided into two groups: the control group was fixed with screw and the experimental group was fixed with Endobutton fixation.There were 34 cases in the control group,male /female 17/17 cases,left / right 19/15 cases,average age 39.15±11.78 years old.There were11 cases of double malleolus fracture and 23 cases of trimalleolar fracture.The time from injury to operation was 8.1±5.7 days.According to Lauge-Hanse classification,there were3 cases of supination-external rotation III degree,12 cases of supination-external rotation IV degree,8 cases of pronation-external rotation III degree and 11 cases of pronationexternal rotation IV degree.Type of injury: 29 cases of sprain,3 cases of traffic injury,1case of high fall and 1 case of smashing injury.There were 23 cases in the experimental group,male / female: 8/15 cases,left / right: 12/11 cases,average age 38.22±10.10 years old.There were 8 cases of double malleolus fracture and 15 cases of trimalleolar fracture.The time from injury to operation was 9.4±5.6 days.According to Lauge-Hanse classification,there were 4 cases of supination-external rotation III degree,5 cases of supination-external rotation IV degree,4 cases of pronation-external rotation III degree,and 10 cases of pronation-external rotation IV degree.Type of injury: 16 cases of sprain,2cases of traffic injury,2 case of high fall and 3 case of smashing injury.First of all,the baseline data of patients in the two groups were compared,and after determining the comparability,the data of complications,operation time,inferior tibiofibular space(TBCS),inferior tibiofibular overlap(TBOL),medial malleolus space(MCS),AOFAS score and ankle dorsal extension angle at 3 months,6 months and 12 months after operation were summarized.Statistical software was used to compare the clinical efficacy of Endobutton fixation and screw in the treatment of ankle fracture with tibiofibular syndesmosis injury.Results Patients in both groups were followed up for 12 to 18 months.The operation time was 65(55,85)min in the control group and 80(70,95)min in the experimental group,the difference was statistically significant(P<0.05).There was no complication in the experimental group,but there was 1 case of broken nail and 1 case of reduction failure in the control group,and there was no significant difference between the two groups(P>0.05).On the first day after surgery,the MCS of the control group was 2.95±0.95 mm,and the MCS of the experimental group was 2.41±0.86 mm,the difference was statistically significant(P<0.05),but there was no significant difference in TBOL and TBCS(P>0.05).There was no significant difference in TBOL,TFCS and MCS between the two groups at 3months,6 months and 12 months after surgery(P>0.05).The AOFAS score was 65.0±15.2in the control group and 72.0±11.0 in the experimental group at 3 months after surgery,and there was significant difference between the two groups(P<0.05).At 6 months and 12 months after surgery,it was 86.7±6.5 and 93.5±4.6 in the control group,and 88.3±8.5 and94.2±4.9 in the experimental group,with no statistical difference(P>0.05).In terms of ankle dorsiflexion angle,the ankle dorsal extension angle was 10.3°±1.4° in the control group and 11.5°±1.6° in the experimental group at 3 months after surgery,with significant difference(P<0.05).At 6 months and 12 months after surgery,17.1°±1.6° and 21.0°±1.6°in the control group,17.7°±1.7° and 21.1°±1.9° in the experimental group.The differences were not statistically significant(P>0.05).Conclusions For the treatment of ankle fracture with tibiofibular syndesmosis injury,there was no significant difference in imaging between the Endobutton fixation group and the screw group.The operation time of the Endobutton fixation group was longer,but the incidence of complications was lower than that of the screw group.The Endobutton fixation group does not need to be removed by second operation to reduce the pain and economic burden of the patients.And the short-term ankle function recovery effect is significantly better than the screw group.There is no significant difference in functional recovery between the two groups half a year after surgery,which is an effective way to treat ankle fracture with tibiofibular syndesmosis injury.Figure 6;Table 11;Reference 118... |
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