Metallic and bioabsorbable screws for distal tibiofibular syndesmosis injury: a prospective randomized comparative study / 中华创伤杂志

ABSTRACT

Objective To evaluate the effect and potential risks of two types of materials ( taitanum versus polylevolactic acid,PLLA) screws on fixation of distal tibiofibular syndesmosis by a prospective randomized comparative clinical study.Methods From January 2007 to May 2008,48 patients with ankle fractures combined with a verified syndesmotic rupture were randomly allocated to receive either bioabsorbable PLLA (n =28 ) or titanium (n =20) screw fixation.The patients were assessed in aspects of radiography,function recovery and complication during follow-up.Results The total followup rate was 98％.The demographic information of the two groups showed no statistical difference ( P ＞0.05).After 1-2 years of follow-up,the indexes including Baird score,total score,and Baird grade were not statistically different between the two groups ( P ＞ 0.05).At the end of follow-up,there was significant difference in regard of joint motion between the injured and uninjured ankle in both groups ( P ＜0.05).Moderate rejection occurred in two patients and tibiofibular heterotopic ossification in two in PLLA group.Conclusions There is no significant difference between the bioabsorbable and metallic screws with regard to ankle function recovery,but the bioabsorbable screw fixation can avoid a second operation for taking out the screw.However,the complication risk of the bioabsorbable screws should not be ignored,such as rejection reaction,heterotopic ossification.