Abstract:

BACKGROUND: Doornail, steel wire, polyester twin wire plus button have been used to treat lower tibiofibular ligament union. However, the fixation is not stable, with high incidence of re-separation.
OBJECTIVE: To compare the effects of new adjustable nested stud and common screw in curing the abruption of lower tibiofibular ligament union with ankle joint fracture. 
METHODS: A total of 113 patients with the abruption of lower tibiofibular ligament union and ankle joint fracture were selected from Department of Orthopedics, Nanjing First Hospital and Nantong First People’s Hospital between March 1988 and September 2008. All patients were treated with open reduction internal fixation, including 66 cases with the new adjustable nested stud and 47 with common screw. Excellent good rate of two methods was evaluated according to clinical standards.
RESULTS AND CONCLUSION: A total of 94 patients were followed-up for 8 months to 11 years. X-ray showed that bone fracture healed in all patients. Except for open wound, all wounds healed at the primary stage, with no bursitis or infection. Of patients treated with new adjustable nested stud, 49 (90.7%) were excellent, 4 (7.4%) good, 1 (1.9%) poor, with the excellent and good rate of 98% and high quality rate of 91%. Of patients treated with common screw, 30 (75%) were excellent, 6 (15%) good, and 4 (10%) poor, with the excellent and good rate of 90% and high quality rate of 75%. The new adjustable nested stud is simpler than the common screw to operate, fix firmly and reliably, with better recover normal dissection structure. It is an ideal treatment for the abruption of lower tibiofibular ligament union with ankle joint fracture.