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Acta Ortopédica Mexicana

ISSN 2992-8036 (Electronic)
ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología
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2017, Number 6

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Acta Ortop Mex 2017; 31 (6)

Functionality and stability of the treatment of Weber B ankle fractures with syndesmotic injury depending on the placement level of the screw (2.0 versus 3.5 cm)

Sierra-Martínez O, Saucedo-Valencia J, Saldívar-Moreno A
Full text How to cite this article

Language: Spanish
References: 6
Page: 264-268
PDF size: 219.11 Kb.


Key words:

Ankle, fracture, syndesmosis, screw, lesion.

ABSTRACT

Background: Ankle fractures are one of the most frequent lesions of the musculoskeletal system; there are studies that report an increase in the incidence of these fractures starting in the 1970s, associated with the increased media outreach of sporting activities. Supra- and transyndesmal fractures often lead to injury of the syndesmosis, which, if not treated properly, will leave joint instability. The most common treatment is the placement of a transyndesmal screw; there is controversy on the height in which it should be located with regard to the distal tibial joint line. Material and method: A descriptive, observational, retrospective and transversal study with clinical and radiographic records of patients operated on bimalleolar fractures; they were divided into two groups: those with the transyndesmal screw at 2 or 2.5 cm and those with the screw at 3.5 cm or more proximal. There was a total of 34 cases (group A: 16 patients; group B: 18), 22 male and 12 female, aged between 19 and 45 years. Results: We applied the Olerud-Molander ankle score for the clinical evaluation and measured the radiographic medial space of the ankle to consider the degree of reduction. The results in both groups were compared. Discussion: The location of the screw at 2.0 cm presented a percentage of 75% of joint stability and 25% of joint instability, the joint functionality was relatively smaller in comparison to the placement of the screw at 3.5 cm, with which we achieved a joint stability of 83.3% and 16.3% of joint instability.


REFERENCES

  1. Jensen SL, Andresen BK, Mencke S, Nielsen PT: Epidemiology of ankle fractures. A prospective population-based study of 212 cases in Aalborg, Denmark. Acta Orthop Scand. 1998; 69(1): 48-50.

  2. Zalavras Ch, Thordarson D: Lesiones sindesmales de tobillo. J Am Acad Orthop Surg (Ed Esp). 2007; 6(5): 296-305.

  3. Yamaguchi K, Martin CH, Boden SD, Labropoulos PA: Operative treatment of syndesmotic disruptions without use of a syndesmotic screw: a prospective clinical study. Foot Ankle Int. 1994; 15(8): 407-14.

  4. McBryde A, Chiasson B, Wilhelm A, Donovan F, Ray T, Bacilla P: Syndesmotic screw placement: a biomechanical analysis. Foot Ankle Int. 1997; 18(5): 262-6.

  5. Kukreti S, Faraj A, Miles JN: Does position of syndesmotic screw affect functional and radiological outcome in ankle fractures? Injury. 2005; 36(9): 1121-4.

  6. Wang C, Ma X, Wang X, Huang J, Zhang C, Chen L. Internal fixation of distal tibiofibular syndesmotic injuries: a systematic review with meta-analysis. Int Orthop. 2013; 37(9): 1755-63.




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Acta Ortop Mex. 2017 Nov-Dic;31