2024, Vol. 28 ›› Issue (24): 3862-3866

A controlled trial of elastic fixation and absolute fixation for treatment of ankle fractures with lower tibiofibular instability

Zhang Guohui, Tian Weifeng, Li Hua, Wang Quan, Liu Yanhui, Guan Yulong, Xiao Chunlai   

Abstract: BACKGROUND: Although traditional screw fixation has been successful in treating ankle fractures, rigid fixation solutions tend to restrict ankle movement and delay fracture healing, whereas elastic fixation is more compatible with human mechanics and has unique advantages in patients with ankle fractures.
OBJECTIVE: To compare the clinical effectiveness of elastic fixation and absolute fixation in repairing ankle fractures in the elderly with lower tibiofibular instability.
METHODS: The clinical data of 108 elderly ankle fractures with lower tibiofibular instability in Hengshui People’s Hospital from August 2019 to August 2021 were retrospectively collected. They were divided into screw group and elastic fixation group (n=54 per group) according to the surgical protocol, and traditional screw internal fixation and elastic internal fixation were performed respectively. The perioperative indicators, surgical results, economic benefits, and American orthopedic foot and ankle society scores were collected and compared between the two groups. Serum tumor necrosis factor-α, interleukin-8 levels, ankle cavity width, depth, and lower tibiofibular space were compared before and after surgery.
RESULTS AND CONCLUSION: (1) The full weight-bearing time was shorter in the elastic fixation group than that in the screw group; the operating angle was greater in the elastic fixation group than that in the screw group, and the complication rate was lower in the elastic fixation group than that in the screw group (P < 0.05). (2) Serum tumor necrosis factor-α and interleukin-8 levels in the elastic fixation group were lower than those in the screw group 3 days after surgery (P < 0.05). (3) American orthopedic foot and ankle society scores in the two groups were higher than those before surgery at 6 and 12 months after surgery, and the depth and width of the inferior tibiofibular space and ankle cavity were lower than those before surgery (P < 0.05); but no significant difference was detected between the two groups (P > 0.05). (4) There was no significant difference in the excellent and good rate between the two groups at 12 months after surgery (P > 0.05). (5) There was no significant difference in the comparison of direct non-medical costs, direct medical costs, and total costs between the two groups (P > 0.05). (6) It is indicated that elastic fixation for the repair of ankle fractures with lower tibiofibular instability in the elderly can obtain effective outcomes, which can shorten the time of complete weight-bearing, diminish complications, and alleviate inflammatory stress.

Key words: elderly, ankle joint, lower tibiofibular instability, elastic fixation, screw, economics