Dynamic Fixation versus Static Screw Fixation for Syndesmosis Injuries in Pronation External Rotation Ankle Fractures: A Retrospective Case Control Study
https://doi.org/10.5704/MOJ.2311.008
- Author:
Lim CM
1
;
Choi SW
1
;
Kim BS
1
;
Lee SJ
1
;
Kang HS
1
Author Information
1. Department of Orthopaedic Surgery, Jeju National University Hospital, Jeju, South Korea
- Publication Type:Journal Article
- Keywords:
ankle, syndesmosis injury, dynamic fixation, screw fixation
- From:Malaysian Orthopaedic Journal
2023;17(No.3):48-58
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: The current standard treatment for ankle
syndesmosis injury is static screw fixation. Dynamic fixation
was developed to restore the dynamic function of the
syndesmosis. The purpose of this study was to determine that
which of static screw fixation and dynamic fixation is better
for treatment of ankle syndesmosis injury in pronationexternal rotation fractures.
Materials and methods: Thirty patients were treated with
dynamic fixation (DF group) and 28 patients with static
screw fixation (SF group). The primary outcome was
Olerud–Molander Ankle Outcome Score. The secondary
outcome were Visual Analogue Scale score and American
Orthopedic Foot and Ankle Society score, radiographic
outcomes, complications and cost effectiveness. To evaluate
the radiographic outcome, the tibiofibular clear space,
tibiofibular overlap, and medial clear space were compared
using the pre-operative and last follow-up plain radiographs.
To evaluate the cost effectiveness, the total hospital cost was
compared between the two groups
Results: There was no significant difference in primary
outcome. Moreover, there were no significant difference in
secondary outcome including Visual Analogue Scale score
and American Orthopedic Foot and Ankle Society score and
radiographic outcome. Two cases of reduction loss and four
cases of screw breakage were observed in the SF group. No
complication in the DF group was observed. Dynamic
fixation was more cost effective than static screw fixation
with respect to the total hospital cost.
Conclusion: Although dynamic fixation provided similar
clinical and radiologic outcome, dynamic fixation is more
cost effective with fewer complications than static screw
fixation in ankle syndesmosis injury of pronation-external
rotation fractures.
- Full text:16.2023my1333.pdf
