A Prospective Study on Fixation of Syndesmotic Ankle Injury: Tight Rope Versus Screw Fixation.

Autor:	Shevate I; Orthopaedics, Dr. D. Y. Patil Medical College, Hospital and Research Center, Pune, IND., Salunkhe R; Orthopaedics, Dr. D. Y. Patil Medical College, Hospital and Research Center, Pune, IND., Pervez F; Orthopaedics, Dr. D. Y. Patil Medical College, Hospital and Research Center, Pune, IND., Pawar P; Orthopaedics, Dr. D. Y. Patil Medical College, Hospital and Research Center, Pune, IND.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Aug 19; Vol. 16 (8), pp. e67172. Date of Electronic Publication: 2024 Aug 19 (Print Publication: 2024).
DOI:	10.7759/cureus.67172
Abstrakt:	Background Syndesmotic injury can result in significant instability and long-term complications if not treated correctly. Traditional management has involved transyndesmotic screw fixation, but a newer technique, the tight rope system, has been developed to mitigate some of the issues related to screw fixation, such as hardware discomfort and the necessity for hardware removal. Methods In this randomized, prospective study, 32 patients with ankle injuries requiring syndesmotic fixation were equally divided into two groups: one receiving the tight rope system (n=16) and the other undergoing screw fixation (n=16). The patients were monitored for six months following surgery. The study measured outcomes such as time to weight-bearing, range of motion, pain levels, functional outcomes using the American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot Scale, and complication rates. Results Both groups had comparable demographic and injury profiles. The tight rope group achieved weight-bearing significantly earlier (6.19 ± 0.9 weeks vs. 7.13 ± 0.95 weeks, p=0.008) and had better functional outcomes at six months (87.5% excellent AOFAS scores vs. 37.5%, p=0.003) compared to the screw fixation group. The range of motion and pain scores were similar between the groups. Different complications were observed: screw breakage was more common in the screw fixation group, while the tight rope group experienced more laxity. Overall complication rates were similar. Conclusion Both techniques were effective in reducing pain and maintaining range of motion. However, the tight rope system allowed for earlier weight-bearing and better functional outcomes at six months. These results indicate that the tight rope system may provide certain advantages in treating syndesmotic injuries, although the choice of technique should be tailored to the specific injury and patient factors. Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Dr. D. Y. Patil Medical College, Hospital, and Research Centre Institutional Ethics Committee issued approval IESC/PGS/2022/92. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Shevate et al.)
Databáze:	MEDLINE
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