Suture button versus syndesmotic screw in ankle fractures - evaluation with 3D imaging-based measurements

Autor:	Martin Heilemann, Robert Hennings, Annette B. Ahrberg, Georg Osterhoff, Firas Souleiman, Alexis Klengel, Mareike Hennings, Pierre Hepp
Rok vydání:	2021
Předmět:	medicine.medical_specialty Syndesmosis Bone Screws Diseases of the musculoskeletal system Ankle Fractures Fracture Fixation Internal Imaging Three-Dimensional Rheumatology 3D imaging Syndesmotic screw Medicine Humans Orthopedics and Sports Medicine Tibia Fixation (histology) Retrospective Studies 3D measurement Sutures business.industry Suture Techniques Suture button medicine.disease Sagittal plane Tibio-fibular medicine.anatomical_structure RC925-935 Orthopedic surgery Diastasis Ankle business Nuclear medicine Ankle Joint Research Article
Zdroj:	BMC Musculoskeletal Disorders BMC Musculoskeletal Disorders, Vol 22, Iss 1, Pp 1-8 (2021)
ISSN:	1471-2474
Popis:	Background Inadequate reduction of syndesmotic injuries can result in disabling clinical outcomes. The aim of the study was to compare syndesmosis congruity after fixation by syndesmotic screws (SYS) or a suture button system (SBS) using three-dimensional (3D) computed imaging techniques. Methods In a retrospective single-center study, patients with unilateral stabilization of an ankle fracture with a syndesmotic injury and post-operative bilateral CT scans were analyzed using a recently established 3D method. The side-to-side differences were compared for tibio-fibular clear space (∆CS), translation angle (∆α), and vertical offset (∆z) among patients stabilized with syndesmotic screws or suture button system. Syndesmotic malreduction was defined for ∆CS > 2 mm and for |∆α| > 5°. ∆CS and ∆α were correlated with two-dimensional (2D) measurements. Results Eighteen patients stabilized with a syndesmosis screw and 29 stabilized with a suture button system were analyzed. After stabilization, both groups revealed mild diastasis (SYS: mean ∆CS 0.3 mm, SD 1.1 mm vs SBS: mean ∆CS 0.2 mm, SD 1.2 mm, p = 0.710). In addition, both stabilization methods showed slight dorsalization of the fibula (SYS: mean ∆α 0.5°, SD 4.6° vs SBS: mean ∆α 2.1°, SD 3.7°, p = 0.192). Also, restoration of the fibula-to-tibia length ratio also did not differ between the two groups (SYS: mean Δz of 0.5 mm, SD 2.4 mm vs SBS: mean Δz of 0 mm, SD 1.2 mm; p = 0.477). Malreduction according to high ∆α was most common (26% of cases), with equal distribution between the groups (p = 0.234). ∆CS and ∆α showed good correlation with 2D measurements (ρ = 0.567; ρ = 0.671). Conclusion This in vivo analysis of post-operative 3D models showed no differences in immediate post-operative alignment after syndesmotic screws or suture button system. Special attention should be paid to syndesmotic malreduction in the sagittal orientation of the fibula in relation to the tibia in radiological control of the syndesmotic congruity as well as intra-operatively.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::bac640b507e2103c8f78a24316ec746b https://pubmed.ncbi.nlm.nih.gov/34809628 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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