Comparison of elastic fixation and rigid fixation in the treatment of distal tibiofibular syndesmosis injury.

IF 1.3 4区医学 Q2 Medicine

Journal of Foot & Ankle Surgery Pub Date : 2025-09-27 DOI:10.1053/j.jfas.2025.09.003

Ke Chen, Qiang Zhu, Wenping Huo, Jian Zhang, Shitao Wang

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Abstract

Objective: Compare clinical outcomes of elastic (Rigidloop) vs. rigid (screw) fixation for distal tibiofibular syndesmosis injury.

Methods: Eighty-eight patients were divided into an elastic fixation group (n=43) and a rigid fixation group (n=45) groups, with the elastic fixation group undergoing Rigidloop fixation and the rigid fixation group undergoing screw fixation. Clinical data (operation time, blood loss, weight-bearing/fracture healing time), radiographic parameters (talocalcaneal fusion site [TFCS], tibiofibular overlap [TFO], medial clear space [MCS]), American Orthopaedic Foot and Ankle Society (AOFAS) scores, plantar flexion range, and complications were analyzed.

Results: Preoperative and 12-month TFCS, TFO, and MCS were comparable (P >0.05). The elastic fixation group had shorter operation time (60.23±11.67 vs. 66.32 ± 12.28 min), reduced blood loss (151.05 ± 21.04 vs. 159.47 ± 22.11 mL), earlier weight-bearing (6.12 ± 1.06 vs. 7.75 ± 1.36 weeks), and faster wound/fracture healing compared with the rigid fixation group(P <0.05). At 3 months, the elastic fixation group showed superior plantar flexion (42.68 ± 4.00 vs. 40.18 ± 4.08°) and AOFAS scores (81.30 ± 5.23 vs. 77.98 ± 5.70 points, P <0.05), but both groups tended to be consistent by 12 months (P >0.05). Complications of the elastic fixation group (loosening, infection, re-separation) were lower (9.3% vs. 24.4%, P <0.05); satisfaction rates were similar (P >0.05).

Conclusion: Rigidloop fixation is as effective as screw fixation in stabilizing syndesmosis injuries, and the Rigidloop system has the advantages of faster recovery, fewer complications, and early functional benefits, making it superior to screw fixation.

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弹性内固定与刚性内固定治疗胫腓骨远端联合损伤的比较。

目的：比较弹性（Rigidloop）与刚性（螺钉）固定治疗胫腓联合远端损伤的临床效果。方法：88例患者分为弹性固定组（n=43）和刚性固定组（n=45），弹性固定组采用Rigidloop固定，刚性固定组采用螺钉固定。分析临床资料（手术时间、出血量、负重/骨折愈合时间）、影像学参数（距跟骨融合部位[TFCS]、胫腓骨重叠部位[TFO]、内侧间隙[MCS]）、美国矫形足踝学会（AOFAS）评分、足底屈曲范围及并发症。结果：术前和12个月TFCS、TFO、MCS具有可比性（P < 0.05）。弹性内固定组手术时间短（60.23±11.67 vs 66.32±12.28 min），出血量少（151.05±21.04 vs 159.47±22.11 mL），负重早（6.12±1.06 vs 7.75±1.36周），创面/骨折愈合快（P < 0.05）。弹性固定组并发症（松动、感染、再分离）发生率较低（9.3%比24.4%,P < 0.05）。结论：在稳定韧带联合损伤方面，Rigidloop固定与螺钉固定一样有效，且Rigidloop系统具有恢复快、并发症少、早期功能获益等优点，优于螺钉固定。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Foot & Ankle Surgery ORTHOPEDICS-SURGERY

CiteScore

2.30

自引率

7.70%

发文量

234

审稿时长

29.8 weeks

期刊介绍： The Journal of Foot & Ankle Surgery is the leading source for original, clinically-focused articles on the surgical and medical management of the foot and ankle. Each bi-monthly, peer-reviewed issue addresses relevant topics to the profession, such as: adult reconstruction of the forefoot; adult reconstruction of the hindfoot and ankle; diabetes; medicine/rheumatology; pediatrics; research; sports medicine; trauma; and tumors.