ABSTRACT
Objective:To compare the clinical efficacy of anchor repair versus screw fixation in the treatment of posterior malleolar fracture with distal tibiofibular syndesmosis injury.Methods:PubMed, Medline, Web of Science, ScienceDirect, CNKI, Wanfang, and Chinese Medical Journal Full-text Database were searched for articles on anchor repair versus screw fixation in the treatment of posterior malleolar fracture with distal tibiofibular syndesmosis injury. The search time was from the establishment of each database to April 2023. Literature screening, data extraction and literature quality assessment were performed independently by two researchers according to the inclusion and exclusion criteria, and meta-analysis of the included literature was performed.Results:A total of 7 articles were included in the meta-analysis, including 3 randomized controlled trials and 4 case-control studies. There were 280 cases treated with anchor repair and 312 cases treated with screw fixation. The results of meta-analysis showed that the number of fluoroscopy [ MD=-5.08, 95% CI (-9.20, -0.96), P=0.020], postoperative anterior inferior tibiofibular space [ MD=-0.93, 95% CI (-1.06, -0.81), P<0.001] and incidence of malposition [ OR=0.21, 95% CI (0.10, 0.46), P<0.001] in the anchor repair group were smaller than that in the screw fixation group, while postoperative recovery time were earlier than that in the screw fixation group [ MD=-2.22, 95% CI (-2.68, -1.75), P<0.001], postoperative ankle plantarflexion angle [ MD=2.77, 95% CI (0.28, 5.25), P=0.030], and postoperative 6 months of American Orthopedic Foot and Ankle Society score [ MD=5.85, 95% CI (2.05, 9.64), P=0.003] were greater than those of the screw fixation group. The operation time [ MD=-10.45, 95% CI (-24.25, 3.35), P=0.140], the American Orthopaedic Foot and Ankle Society score at 6 months after operation [ MD=0.09, 95% CI (-0.94, 1.11), P=0.860] and the postoperative ankle dorsiflexion angle [ MD=0.66, 95% CI (-0.75, 2.88), P=0.360] were not statistically different. Conclusion:Compared with screw fixation, fixation of anterior inferior tibiofibular ligament with anchor fixation has the advantages of less fluoroscopy, faster recovery time, better reduction quality, and higher ankle function score.
ABSTRACT
Objective To compare the clinical results of anterior cruciate ligament(ACL)reconstruction using anterior tibial muscle tendons allograft and hamstring tendons autograft.Methods According to the graft used for ACL reconstruction,60 patients with chronic ruptures of ACL were divided into group A(30 patients,using anterior tibial muscle tendons allograft)and group B(30 patients,using semitendinosus and gracilis tendons autograft).The average follow-up periods after surgery were 29.4 and 31.6 months respectively.Lysholm,Tegner,IKDC clinical rating scales and KT2000 were used for evaluation pre-and post-operation.The muscle strength of the extension,flexion,internal rotation and external rotation of knees was evaluated by the isokinetic tester.Results There were statistically significant differences in Lysholm,Tegner,IKDC clinical rating scales and KT2000 results between pre-and postoperation(P0.05).The Isokinetic muscle strength tester showed that the knee muscle strength of the internal rotation and flexion were decreased post-operative in group B,rather than group A,which showed no significant differences between pre-and post.operation(P<0.05).Conclusion For ACL reconstruction under arthroscopy,anterior tibial muscle tendons allograft was a favorable substitute for autograft materials for its convenience,satisfactory clinical effect and less complications.