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원위 경비 인대 결합 손상을 동반한 족관절 골절에서 Knotless Tightrope®를 이용한 고정법과 인대 결합 나사 고정법의 임상적 수술적 결과 비교

Comparision between Syndesmotic Screw Fixation and Knotless Tightrope® Fixation on Ankle Fractures with Distal Tibiofibular Syndesmosis Injury

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초록

Purpose: A distal tibiofibular syndesmosis injury with an ankle fracture is usually fixed with syndesmotic screws. Knotless Tightrope® has been used as an alternative procedure because of the fewer reported complications. Therefore, this study compared the two surgeries. Materials and Methods: Forty-two patients, who underwent syndesmotic screw fixation, and 34 patients, who underwent Knotless Tightrope® fixation for distal tibiofibular syndesmosis injury from February 2014 to February 2016, were analyzed retrospectively. The visual analogue scale (VAS) score, American Orthopaedic Foot and Ankle Society (AOFAS) score, range of motion of ankle at 1 year after surgery, tibiofibular clear space, and tibiofibular interval at preoperative, postoperative and 1 year after surgery were investigated. Results: The VAS score, AOFAS score and radiographs were similar in the two groups. Knotless Tightrope® showed better results in complications and plantarflexion. Conclusion: Knotless Tightrope® fixation is a useful treatment that does not show a difference in fixation strength and clinical outcome. Knotless Tightrope® fixation also has an advantage in the range of motion and complications.

Abstract

Purpose: A distal tibiofibular syndesmosis injury with an ankle fracture is usually fixed with syndesmotic screws. Knotless Tightrope® has been used as an alternative procedure because of the fewer reported complications. Therefore, this study compared the two surgeries. Materials and Methods: Forty-two patients, who underwent syndesmotic screw fixation, and 34 patients, who underwent Knotless Tightrope® fixation for distal tibiofibular syndesmosis injury from February 2014 to February 2016, were analyzed retrospectively. The visual analogue scale (VAS) score, American Orthopaedic Foot and Ankle Society (AOFAS) score, range of motion of ankle at 1 year after surgery, tibiofibular clear space, and tibiofibular interval at preoperative, postoperative and 1 year after surgery were investigated. Results: The VAS score, AOFAS score and radiographs were similar in the two groups. Knotless Tightrope® showed better results in complications and plantarflexion. Conclusion: Knotless Tightrope® fixation is a useful treatment that does not show a difference in fixation strength and clinical outcome. Knotless Tightrope® fixation also has an advantage in the range of motion and complications.

참고문헌 (14)

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  4. Sman AD, "Diagnostic accuracy of clinical tests for diagnosis of ankle syndesmosis injury : a systematic review", Br J Sports Med, 47, pp.620~628 (2013)
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  6. Plessis GN, "Incidence of syndesmotic injuries in all different types of ankle fractures", SA Orthop J, 7, pp.28~32 (2008)
  7. Park JC, "Acute syndesmosis injuries associated with ankle fractures : current perspectives in management", Bull NYU Hosp Jt Dis, 67, pp.39~44 (2009)
  8. van den Bekerom MP, "Complications of distal tibiofibular syndesmotic screw stabilization : analysis of 236 patients", J Foot Ankle Surg, 52, pp.456~459 (2013)
  9. Naqvi GA, "Fixation of ankle syndesmotic injuries : comparison of tightrope fixation and syndesmotic screw fixation for accuracy of syndesmotic reduction", Am J Sports Med, 40, pp.2828~2835 (2012)
  10. Thornes B, "Sutureendobutton fixation of ankle tibio-fibular diastasis : a cadaver study", Foot Ankle Int, 24, pp.142~146 (2003)
  11. Coetzee JC, "Treatment of syndesmoses disruptions : a prospective, randomized study comparing conventional screw fixation vs TightRope® fiber wire fixation : medium term results", SA Orthop J, 8, pp.32~37 (2009)
  12. Storey P, "Complications of suture button ankle syndesmosis stabilization with modifications of surgical technique", Foot Ankle Int, 33, pp.717~721 (2012)
  13. Hong CC, "Osteomyelitis after TightRope(®)fixation of the ankle syndesmosis : a case report and review of the literature", J Foot Ankle Surg, 54, pp.130~134 (2015)
  14. Willmott HJ, "Outcome and complications of treatment of ankle diastasis with tightrope fixation", Injury, 40, pp.1204~1206 (2009)

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