Tibiofibular syndesmosis reduction after screw fixation of ankle fracture evaluated by CT imaging

doi:10.3969/j.issn.2095-4344.2896

Abstract

Abstract:

BACKGROUND: Assessing tibiofibular ligament combined anatomical reduction is important for the surgical treatment of ankle fractures, and the large difference in the incidence of malreduction in the study may be due to inconsistent measurement and definition of malreduction.

OBJECTIVE: To observe the changes of tibiofibular joint reduction over time 1 year after tibiofibular joint screw fixation and screw removal for ankle fractures, and to evaluate the incidence of poor tibiofibular joint reduction.

METHODS: Twenty-nine patients with tibiofibular screw fixation for ankle fractures were evaluated. The lower tibiofibular joint screw was removed 6 weeks after fracture surgery. CT scan images were used to evaluate the reduction of the lower tibiofibular region within two weeks after fracture surgery and one year after screw removal. The differences of the anterior and posterior distances of the tibiofibula, anteroposterior fibula translation, and fibular rotation were measured.

RESULTS AND CONCLUSION: (1) The mean anterior tibiofibular distance after combined fixation was (0.8±1.4) mm, and increased to (1.8±1.1) mm within 1 year after screw removal (P=0.001). (2) After the combined fixation of the lower tibiofibular joint, the anterior tibiofibular distance of the ankle joint was maladjusted in four cases, among which three cases had the ankle joint widened and one case had the ankle joint too tight. In one year, there were eight cases of malreduction of the ankle joint and all of the ankle joints were enlarged. Other measurements did not change over time. (3) According to the definition of poor reduction, the incidence of poor reduction after lower tibiofibular joint fixation was 10%-51%, and the incidence of poor reduction was 20%-62% 1 year after screw removal. The difference in the incidence of poor reduction was statistically significant (P=0.01, 0.03). (4) It is indicated that within 1 year after removal of the tibiofibular screw, the anterior tibiofibular distance widened, but there was no significant difference in translation or rotation in other directions. The repeatability of measurement by different observers is good, and the incidence of malreduction varies with different measurement methods.

Key words: bone, ankle, joint, fracture, internal fixation, CT, tibiofibular syndesmosis, ligament

CLC Number:

Wang Dong, Zeng Debin, Lin Qiao, Liu Kehui. Tibiofibular syndesmosis reduction after screw fixation of ankle fracture evaluated by CT imaging[J]. Chinese Journal of Tissue Engineering Research, 2020, 24(33): 5349-5353.

Figures/Tables 6

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