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Портал Begell Электронная Бибилиотека e-Книги Журналы Справочники и Сборники статей Коллекции
Journal of Long-Term Effects of Medical Implants
SJR: 0.133 SNIP: 0.491 CiteScore™: 0.89

ISSN Печать: 1050-6934
ISSN Онлайн: 1940-4379

Выпуски:
Том 29, 2019 Том 28, 2018 Том 27, 2017 Том 26, 2016 Том 25, 2015 Том 24, 2014 Том 23, 2013 Том 22, 2012 Том 21, 2011 Том 20, 2010 Том 19, 2009 Том 18, 2008 Том 17, 2007 Том 16, 2006 Том 15, 2005 Том 14, 2004 Том 13, 2003 Том 12, 2002 Том 11, 2001 Том 10, 2000

Journal of Long-Term Effects of Medical Implants

DOI: 10.1615/JLongTermEffMedImplants.2016016538
pages 161-165

Strength of Syndesmosis Fixation: Two TightRope versus One TightRope with Plate-and-Screw Construct

Justin Tsai
Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Medical Center/University Hospital Brooklyn, Brooklyn, NY
Robert Pivec
Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Medical Center/University Hospital Brooklyn, Brooklyn, NY
Julio J. Jauregui
Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland; Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Medical Center/University Hospital Brooklyn, Brooklyn, NY
Westley T. Hayes
Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Medical Center/University Hospital Brooklyn, Brooklyn, NY
Marlon McLeold
Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Medical Center/University Hospital Brooklyn, Brooklyn, NY
Qais Naziri
Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Reconstruction, Sinai Hospital of Baltimore, Baltimore, Maryland; Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Medical Center/University Hospital Brooklyn, Brooklyn, NY
Bhaveen V. Kapadia
Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Medical Center/University Hospital Brooklyn, Brooklyn, NY
Subrata Saha
Affiliate Professor, Department of Restorative Dentistry Affiliate Instructor, Department of Oral and Maxillofacial Surgery School of Dentistry, University of Washington, Seattle, Washington 98195-6365, USA; Courtesy Professor, Department of Biomedical Engineering, Florida International University, Miami, Florida 33174, USA
Jaime A. Uribe
Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Medical Center/University Hospital Brooklyn, Brooklyn, NY

Краткое описание

Injuries involving the distal tibiofibular syndesmosis can lead to critical destabilization of the ankle mortise. Although specific indications for operative fixation remain unclear, accurate reduction of the syndesmosis has been correlated with the best functional outcomes. The purpose of this study was to evaluate the maximum torque and rotation to failure after fixation with a novel construct. Seven pairs (14 ankles) of embalmed cadaveric lower legs, disarticulated at the knee, were obtained. Each pair was randomly assigned to receive either two TightRopes (Arthrex) or a plate-and-screw construct with one TightRope. All samples were mechanically tested in torsion to determine peak torque, torsional stiffness, and the maximum rotation angle at which failure occurred. Differences between the groups were compared using paired Student's t test. The maximum torque to failure after fixation was not significantly different between the two TightRopes (28.8 N*m; range, 7.3–49.7 N*m) and the one TightRope group (29.5 N*m; range, 9.2–44.9 N*m; p = 0.92). The maximum rotation to fracture after fixation was not significantly different between the two TightRopes (33.3 degrees; range, 21.6–57.0 degrees) and one TightRope group (38.6 degrees; range, 23.0–73.9 degrees). All specimens failed with the fracture of the fibula at the level of the inferior syndesmotic screw. The similar load to failure of the two TightRope and the one TightRope and plate-and-screw plate suggested similar stiffness between the two constructs. The addition of the plate may improve distribution of forces at the level of syndesmosis, reducing stress risers and decreasing the risk of failure, as demonstrated by a lower rotation to failure of the one TightRope with plate-and-screw construct. In addition, this construct is not likely to not be associated with any substantial cost increase. Further clinical studies may further elucidate the role of plate and/or TightRope augmentation to syndesmosis fixation.

Ключевые слова: ankle, syndesmosis, fixation, TightRope, plate, ankle fracture, torsion