Massimiliano Carrozzo1, Giovanni Vicenti2, Vito Pesce2, Giuseppe Solarino2, Francesco Rifino2, Antonio Spinarelli2, Caterina Campagna3, Davide Bizzoca2, Biagio Moretti2. 1. School of Medicine, University of Bari "Aldo Moro", AOU Policlinico Consorziale, Department of Basic Medical Sciences, Neuroscience and Sense Organs, Orthopaedic &Trauma Unit, Bari, Italy. Electronic address: doc.mcarrozzo@gmail.com. 2. School of Medicine, University of Bari "Aldo Moro", AOU Policlinico Consorziale, Department of Basic Medical Sciences, Neuroscience and Sense Organs, Orthopaedic &Trauma Unit, Bari, Italy. 3. Unit of Radiology Faculty of Medicine and Surgery, University of Bari, General Hospital, Bari, Italy.
Abstract
BACKGROUND: This study compared clinical and radiographic results of patients who underwent stabilization of syndesmosis with one tricortical syndesmotic screw divided into three different groups: Group A without preoperative fractured ankle computedtomography (CT) scan, Group B with preoperative fractured CT scan, and Group C with preoperative bilateral ankle CT analysis. METHODS:Between June 2016 and May 2017, fifty-one patients with fracture type AO/OTA 44 B and C were analyzed. Of those, 14 (27.45%) were assigned to Group A, 19 (37.25%) to Group B, and 18 (35.30%) to Group C. Clinical outcomes with AOFAS score at 3, 6 and 12 months were recorded. Seven measurements on axial CT scan images were confronted between the injured and uninjured ankle to check the accuracy of reduction. RESULTS: At three months of follow up the median AOFAS score was 70.86 ± 2.98 with no significative difference between groups (p = 0.105). At 12 months of follow up the median AOFAS score was higher in group C (93.44 ± 3.01) compared to Group B and Group C. The seven variables measured at the CT scan after syndesmotic reduction were statistically different between groups. We found a better restoration of the tibiofibular distances and the correct ankle anatomy in Group C respect to Group A and Group B. CONCLUSIONS: Use of the pre-operative CT scan of the injured and uninjured ankle give to the surgeons the more and accurate information for the reduction and help him intraoperative in the correct maneuvers. The accuracy of the syndesmosis reduction determines better clinical outcomes.
RCT Entities:
BACKGROUND: This study compared clinical and radiographic results of patients who underwent stabilization of syndesmosis with one tricortical syndesmotic screw divided into three different groups: Group A without preoperative fractured ankle computed tomography (CT) scan, Group B with preoperative fractured CT scan, and Group C with preoperative bilateral ankle CT analysis. METHODS: Between June 2016 and May 2017, fifty-one patients with fracture type AO/OTA 44 B and C were analyzed. Of those, 14 (27.45%) were assigned to Group A, 19 (37.25%) to Group B, and 18 (35.30%) to Group C. Clinical outcomes with AOFAS score at 3, 6 and 12 months were recorded. Seven measurements on axial CT scan images were confronted between the injured and uninjured ankle to check the accuracy of reduction. RESULTS: At three months of follow up the median AOFAS score was 70.86 ± 2.98 with no significative difference between groups (p = 0.105). At 12 months of follow up the median AOFAS score was higher in group C (93.44 ± 3.01) compared to Group B and Group C. The seven variables measured at the CT scan after syndesmotic reduction were statistically different between groups. We found a better restoration of the tibiofibular distances and the correct ankle anatomy in Group C respect to Group A and Group B. CONCLUSIONS: Use of the pre-operative CT scan of the injured and uninjured ankle give to the surgeons the more and accurate information for the reduction and help him intraoperative in the correct maneuvers. The accuracy of the syndesmosis reduction determines better clinical outcomes.
Authors: Francesco Pogliacomi; Massimo De Filippo; Daniele Casalini; Alberto Longhi; Fabrizio Tacci; Rocco Perotta; Francesco Pagnini; Silvio Tocco; Francesco Ceccarelli Journal: World J Orthop Date: 2021-05-18