The application of suture anchor in the treatment of ankle fractures with deltoid ligament rupture / 中华骨科杂志

ABSTRACT

Objective To discuss the clinical efficacy of suture anchor associated with open reduction and internal fixation (ORIF) in the treatment of ankle fractures with deltoid ligament rupture.Methods To retrospectively analyze 32 patients' information admitted to Dalian Central Hospital from January 2010 to December 2015 treated by suture anchor associated with ORIF,there were 25 male,7 female,and the average age was 46.6 years old (ranged from 28 to 66 years old).14 cases lefi side and 18 cases right side.All cases were closed fractures with no combinedfractures elsewhere.The timing from injury to therapy was 2 to 8 days,4.8d on average.According to Lange-Hansen classification system,6 cases were supination-external rotation (SER),18 were pronation-external rotation (PER) and 8 cases were pronation-abduction (PA).All of 32 cases were treated by suture anchor technique,then evaluated its clinical efficacy on suture anchor technique by judging improvements on clinical syndromes and signs,and radiological examination.All patients were not provided with gypsum external fixation after operation,ankle functioning practice was allowed at early-stage and partially weight-bearing was permitted during the first 6 weeks of post-operation,and full weight -bearing on 12 weeks.The ankle foot function score was evaluated by American Orthopedic Foot and Ankle Society (AOFAS).Results All 32 cases were followed from 6 to 18 months,12 months on average.Fracture union time was 8 to 12 weeks,10 weeks on average.No infection,delayed union,nerve injury,screw loosening or osteomyelitis after surgery.1 case of wound partially split and part of titanium plate screws exposed,and it was recovered through debridement for 3 weeks.2 cases of traumatic arthritis with walking pain,1 of which was treated by joint fusion and recovered then and the other was lost in follow-up,because of medical expense.AOFAS evaluation16 cases were excellent,11 cases were good,3 cases were fair and 2 cases were poor.The excellent and good rate reached 84.4％ (27/32).X-ray measurement showed the medial malleolus space of pre-operation was (5.32±0.38) mm on the affected side,and (2.67±0.26) mm of post-operation,the difference was statistically significance.X-ray measurement showed the medial malleolus space was (2.78±0.23) mm on the affected side 8 months after operation,compared to the space (2.56±0.26) mm on unaffected side which indicated no statistically significance.Conclusion It shows promising clinical efficacy through suture anchor technique associated with ORIF in the treatment of ankle fractures with deltoid ligament rupture.