| Autor: |
Hosin S; Department of Orthopedics, 'Victor Babes' University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania., Vermesan D; Department of Orthopedics, 'Victor Babes' University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania., Prejbeanu R; Department of Orthopedics, 'Victor Babes' University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania., Crisan D; Department of Orthopedics, 'Victor Babes' University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania., Al-Qatawneh M; Department of Orthopedics, 'Victor Babes' University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania., Pop D; Department of Orthopedics, 'Victor Babes' University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania., Mioc M; Department of Orthopedics, 'Victor Babes' University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania., Bratosin F; Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania., Feciche B; Department of Urology, Satu-Mare County Emergency Hospital, Strada Ravensburg 2, 440192 Satu-Mare, Romania., Hemaswini K; Malla Reddy Institute of Medical Sciences, Suraram Main Road 138, Hyderabad 500055, India., Moise ML; Department of Radiology, 'Premiere' Hospital-'Regina Maria', Calea Aradului 113, 300643 Timisoara, Romania., Dumitru C; Department of Obstetrics and Gynecology, 'Premiere' Hospital-'Regina Maria', Calea Aradului 113, 300643 Timisoara, Romania., Bloanca V; Department of Plastic Surgery, 'Victor Babes' University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania., Pilut CN; Multidisciplinary Research Center on Antimicrobial Resistance (MULTI-REZ), Microbiology Department, 'Victor Babes' University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania. |
| Abstrakt: |
There is still no general agreement about the most effective form of syndesmosis fixation with syndesmotic screws for patients affected by ankle fractures that are accompanied by syndesmotic injuries. In the same manner, no consensus has been reached yet on whether or not the tibiofibular syndesmotic screw is more beneficial if removed or not, as well as the exact timing of removal if this proves superiority. The purpose of this research was to verify whether or not removing syndesmotic screws reduces the risk of developing a diastasis and compare outcomes in patients whose syndesmotic screw was or was not removed at all. A retrospective observational study was carried out to cover a period of five years and a computed sample size of almost 300 cases. Patients were included in the current study if their history was positive for ankle fracture with distal tibiofibular diastasis repair with syndesmotic screws. Loss of reduction was more frequent after screw removal (8.5% vs. 2.1%), although the quality of reduction was generally excellent in both groups. The mean AOFAS score was significantly better in patients who had their tibiofibular screw removed (92.6 vs. 88.4), but the tibiofibular clear space and incisura fibularis depth widened more following the second intervention (3.8 mm vs. 3.6 mm, and, respectively, 4.3 vs. 4.1). Lastly, the same patients with tibiofibular screw removal had a significantly higher cost of total interventions and more days of medical leave (21 vs. 15 days on average). It seems that a strong conclusion in favor of removing or not removing syndesmotic screws after distal tibiofibular diastasis repair cannot be given. However, several radiographic findings lean toward the benefit of those patients whose tibiofibular screws were not removed, although mobility was notably better after the screw was removed. Furthermore, treatment expenses are greatly lowered if a subsequent operation for screw removal is avoided, as well as if individuals who have a single surgery take a shorter medical leave. |
