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《The Journal of Traditional Chinese Orthopedics and Traumatology》 2015-11
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Internal fixation with cortical bone screws for the treatment of distal tibiofibular syndesmosis separation: a CT study of 32 patients

LU Jianzuo;LIN Yangyang;YANG Jie;DONG Xiaomin;The People's Hospital of Wenzhou city;  
Objective: To explore the effect of internal fixation with cortical bone screws on the distal tibiofibular syndesmosis.Methods: The clinical records of 32 patients who were treated with cortical bone screws internal fixation for distal tibiofibular syndesmosis were analyzed retrospectively. The patients consisted of 18 males and 14 females,and ranged in age from 28 to 64 years( Median =43. 5 yrs). The distal tibiofibular syndesmosis separation located in left leg for 14 cases and right leg for 18 cases. According to the Danis-Weber classification,the injuries belonged to types B( 12) and C( 20). Fibula fracture combined with posterior malleolus injury and medial malleolus injury or deltoid ligament injury were found in 11 patients,and fibula fracture combined with medial malleolus injury or deltoid ligament injury were found in 21 patients. Bilateral distal tibiofibular transverse CT films were taken in all patients. The tibiofibula congruence angle,fibular outward displacement and backward displacement relative to peroneal sinus of tibia were measured on the CT films and were analyzed. Results: The tibiofibula congruence angle and fibular outward displacement relative to peroneal sinus of tibia of affected side were less than those of uninjured side( 68. 66 + /- 9. 28 vs 79. 49 + /- 14. 66 degrees,t = 2. 998,P = 0. 025; 5. 65 + /- 1. 79 vs 7. 66 + /-2. 05 mm,t = 2. 131,P = 0. 012),while fibular backward displacement relative to peroneal sinus of tibia of affected side was greater than that of uninjured side( 4. 94 + /- 1. 49 vs 1. 90 + /- 3. 34 mm,t = 14. 089,P = 0. 002). Conclusion: After cortical bone screws internal fixation for the treatment of distal tibiofibular syndesmosis separation,there is a trend for anteromedial rotation of distal tibiofibular syndesmosis of affected side compared to uninjured side.
【CateGory Index】: R687.3
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