Suture Button装置修复下胫腓联合损伤的初步报告

Fixation of distal tibiofibular syndesmosis rupture with Suture Button device

[目的]探讨Suture Button装置治疗下胫腓联合损伤后的手术方法及临床效果。[方法]对截止于2007年9月利用Suture Button装置固定的下胫腓联合急、慢性损伤的13例病人进行连续随访观察,通过术后X线片数字化测量和标准的踝足功能评分,评估其疗效并探讨临床应用前景。[结果]除1例病人因术后短期再次创伤意外,行2次手术更换为传统螺钉内固定外,其余病人均在术后6周开始部分负重功能锻炼,术后第3个月功能平均评分达到满意,术后第6、12个月功能平均评分达到优良,X线片未发现内固定失效。[结论]Suture Button装置治疗下胫腓联合损伤具有技术简单、手术时间短、内固定器物理特性符合人体正常解剖生理、固定强度足够、无需2次手术取出等多项优势,可能成为下胫腓联合损伤新的治疗标准。

[Objective] To discuss the surgical treatment of distal tibiofibular syndesmosis rupture with TightropeTM Suture Button device and evaluate the clinical outcome. [ Method] A total of 13 patients with acute and chronic distal tibiofibular syndesmosis rupture treated with Suture Button device before September 2007 were followed up. According to patients＇pre/post-operative radiological measurement and Ankle-Hindfout function score,the clinical outcomes of this new syndesmosis fixation device were e- valuated. [ Result] Except one patient who had second traumatic injury shortly after her syndesmosis fixation with Suture Button device and accepted the traditional screw fixation instead of Suture Button device, all the other 12 patients began their partial weight-bearing practice at 6 weeks post-operatively. The average AOFAS Ankle-Hindfoot Score showed a fair resalt at 12 weeks,a good result at 6 months and all excellent resalt at 12 months post-operatively. The follow-up plain X-ray measurement showed no loosening or breakage hints of Suture Button device fixation. [ Conclusion] Fixation of acute and chronic distal tibiofihular syndesmosis rupture with Suture Button device may have several advantages including easier technique,shorter surgical time,more compatible to normal human tissue structure, enough strength and no need of removal. It is possible to be a new standard surgical treatment for distal tibiofibular syndesmosis rupture.