Tightrope fixation of syndesmotic injuries in Weber C ankle fractures: a multicentre case series
Background No general consensus has yet been established for the gold standard treatment of ankle syndesmotic complex injuries. Recent literature has documented the success of ankle tightrope fixation for heterogeneous ankle fracture patterns, resulting in syndesmotic complex injuries. We present a...
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| Veröffentlicht in: | European journal of orthopaedic surgery & traumatology 2017-05, Vol.27 (4), p.461-467 |
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| creator | Anand, Amarjit Wei, Ran Patel, Akash Vedi, Vikas Allardice, Garth Anand, Bobby Singh |
| description | Background
No general consensus has yet been established for the gold standard treatment of ankle syndesmotic complex injuries. Recent literature has documented the success of ankle tightrope fixation for heterogeneous ankle fracture patterns, resulting in syndesmotic complex injuries. We present a multicentre case series assessing the clinical, radiological and functional outcomes of patients with Weber C ankle fractures treated with the Arthrex TightRope
®
fixation system.
Method
We performed a retrospective analysis of all adult patients with Weber C ankle fractures who were treated with the Arthrex TightRope
®
fixation system at four centres over a 3-year period. All patients were followed up for a mean of 14 months (range 12–26). Outcomes measures were assessed subjectively using functional scores (AOFAS and Olerud and Molander) and objectively using radiological measurements, complication rates and revision surgery rates.
Results
Thirty-six patients met our eligibility criteria. The mean age at operation was 31 years (range 18–65). There were 20 males and 16 females. No patients were lost to follow-up. The ankle tightrope maintained satisfactory reduction in the ankle mortise in 97% of cases. Of these 35 successfully treated cases, no evidence of re-displacement on follow-up radiographs of the syndesmotic complex was observed at an average of 10.8 months (range 6–12). Post-operative mean medial clear space was 3.1 mm, and mean tibio-fibular overlap was 10.1 mm. The mean American Orthopaedic Foot and Ankle Society (AOFAS) score was 88.8 (range 67–98) at a mean follow-up of 14 months (range 12–26). The overall complication rate was 6% (one failure requiring revision surgery and one medial sided skin irritation requiring removal of suture button). No infections or wound complications occurred.
Conclusion
Tightrope fixation is a safe alternative to screw fixation for syndesmotic complex injuries in Weber C ankle fractures. We have shown that it has low complication rates and a high patient satisfaction. |
| doi_str_mv | 10.1007/s00590-016-1882-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1857752528</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2837228985</sourcerecordid><originalsourceid>FETCH-LOGICAL-c2878-2863746a4050c15670bbf59270f9a1c9ee622c49c4ee7f002bfa0c0ea3961ddd3</originalsourceid><addsrcrecordid>eNp1kMtKxDAUhoMoOl4ewI0E3LipnqTNpe5k8AYDbkZcxjQ9HTv2MiYt6NubYbyA4CoHzvf_OXyEHDM4ZwDqIgCIHBJgMmFa80RvkQnLUp4wkHo7zjJNEw1S7JH9EJYATORM7JI9rkFlKbAJeZ7Xi5fB9yukVf1uh7rvaF_R8NGVGNp-qB2tu-XoawxxoE9YoKdTarvXJia8dcPoMVxSS9uxiTR2g0fqbEAacJ06JDuVbQIefb0H5PHmej69S2YPt_fTq1niuFY64VqmKpM2AwGOCamgKCqRcwVVbpnLESXnLstdhqgqAF5UFhygTXPJyrJMD8jZpnfl-7cRw2DaOjhsGtthPwbDtFBKcMF1RE__oMt-9F28zsSt4lznWkSKbSjn-xA8Vmbl69b6D8PArPWbjX4T9Zu1frNuPvlqHosWy5_Et-8I8A0Q4qpboP_9-v_WT9ihj20</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2837228985</pqid></control><display><type>article</type><title>Tightrope fixation of syndesmotic injuries in Weber C ankle fractures: a multicentre case series</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Anand, Amarjit ; Wei, Ran ; Patel, Akash ; Vedi, Vikas ; Allardice, Garth ; Anand, Bobby Singh</creator><creatorcontrib>Anand, Amarjit ; Wei, Ran ; Patel, Akash ; Vedi, Vikas ; Allardice, Garth ; Anand, Bobby Singh</creatorcontrib><description>Background
No general consensus has yet been established for the gold standard treatment of ankle syndesmotic complex injuries. Recent literature has documented the success of ankle tightrope fixation for heterogeneous ankle fracture patterns, resulting in syndesmotic complex injuries. We present a multicentre case series assessing the clinical, radiological and functional outcomes of patients with Weber C ankle fractures treated with the Arthrex TightRope
®
fixation system.
Method
We performed a retrospective analysis of all adult patients with Weber C ankle fractures who were treated with the Arthrex TightRope
®
fixation system at four centres over a 3-year period. All patients were followed up for a mean of 14 months (range 12–26). Outcomes measures were assessed subjectively using functional scores (AOFAS and Olerud and Molander) and objectively using radiological measurements, complication rates and revision surgery rates.
Results
Thirty-six patients met our eligibility criteria. The mean age at operation was 31 years (range 18–65). There were 20 males and 16 females. No patients were lost to follow-up. The ankle tightrope maintained satisfactory reduction in the ankle mortise in 97% of cases. Of these 35 successfully treated cases, no evidence of re-displacement on follow-up radiographs of the syndesmotic complex was observed at an average of 10.8 months (range 6–12). Post-operative mean medial clear space was 3.1 mm, and mean tibio-fibular overlap was 10.1 mm. The mean American Orthopaedic Foot and Ankle Society (AOFAS) score was 88.8 (range 67–98) at a mean follow-up of 14 months (range 12–26). The overall complication rate was 6% (one failure requiring revision surgery and one medial sided skin irritation requiring removal of suture button). No infections or wound complications occurred.
Conclusion
Tightrope fixation is a safe alternative to screw fixation for syndesmotic complex injuries in Weber C ankle fractures. We have shown that it has low complication rates and a high patient satisfaction.</description><identifier>ISSN: 1633-8065</identifier><identifier>EISSN: 1432-1068</identifier><identifier>DOI: 10.1007/s00590-016-1882-8</identifier><identifier>PMID: 28074301</identifier><language>eng</language><publisher>Paris: Springer Paris</publisher><subject>Adolescent ; Adult ; Aged ; Ankle ; Ankle Fractures - diagnostic imaging ; Ankle Fractures - surgery ; Ankle Injuries - diagnostic imaging ; Ankle Injuries - surgery ; Bone Plates ; Cohort Studies ; Female ; Fracture Fixation, Internal - instrumentation ; Fracture Fixation, Internal - methods ; Fracture Fixation, Internal - rehabilitation ; Fracture Healing - physiology ; Humans ; Injury Severity Score ; Joint Instability - prevention & control ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Original Article • ANKLE - FRACTURES ; Patient Positioning ; Patient satisfaction ; Range of Motion, Articular - physiology ; Recovery of Function ; Retrospective Studies ; Supine Position ; Surgical Orthopedics ; Traumatic Surgery ; Treatment Outcome ; Young Adult</subject><ispartof>European journal of orthopaedic surgery & traumatology, 2017-05, Vol.27 (4), p.461-467</ispartof><rights>Springer-Verlag France 2017</rights><rights>Springer-Verlag France 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2878-2863746a4050c15670bbf59270f9a1c9ee622c49c4ee7f002bfa0c0ea3961ddd3</citedby><cites>FETCH-LOGICAL-c2878-2863746a4050c15670bbf59270f9a1c9ee622c49c4ee7f002bfa0c0ea3961ddd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00590-016-1882-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00590-016-1882-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28074301$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Anand, Amarjit</creatorcontrib><creatorcontrib>Wei, Ran</creatorcontrib><creatorcontrib>Patel, Akash</creatorcontrib><creatorcontrib>Vedi, Vikas</creatorcontrib><creatorcontrib>Allardice, Garth</creatorcontrib><creatorcontrib>Anand, Bobby Singh</creatorcontrib><title>Tightrope fixation of syndesmotic injuries in Weber C ankle fractures: a multicentre case series</title><title>European journal of orthopaedic surgery & traumatology</title><addtitle>Eur J Orthop Surg Traumatol</addtitle><addtitle>Eur J Orthop Surg Traumatol</addtitle><description>Background
No general consensus has yet been established for the gold standard treatment of ankle syndesmotic complex injuries. Recent literature has documented the success of ankle tightrope fixation for heterogeneous ankle fracture patterns, resulting in syndesmotic complex injuries. We present a multicentre case series assessing the clinical, radiological and functional outcomes of patients with Weber C ankle fractures treated with the Arthrex TightRope
®
fixation system.
Method
We performed a retrospective analysis of all adult patients with Weber C ankle fractures who were treated with the Arthrex TightRope
®
fixation system at four centres over a 3-year period. All patients were followed up for a mean of 14 months (range 12–26). Outcomes measures were assessed subjectively using functional scores (AOFAS and Olerud and Molander) and objectively using radiological measurements, complication rates and revision surgery rates.
Results
Thirty-six patients met our eligibility criteria. The mean age at operation was 31 years (range 18–65). There were 20 males and 16 females. No patients were lost to follow-up. The ankle tightrope maintained satisfactory reduction in the ankle mortise in 97% of cases. Of these 35 successfully treated cases, no evidence of re-displacement on follow-up radiographs of the syndesmotic complex was observed at an average of 10.8 months (range 6–12). Post-operative mean medial clear space was 3.1 mm, and mean tibio-fibular overlap was 10.1 mm. The mean American Orthopaedic Foot and Ankle Society (AOFAS) score was 88.8 (range 67–98) at a mean follow-up of 14 months (range 12–26). The overall complication rate was 6% (one failure requiring revision surgery and one medial sided skin irritation requiring removal of suture button). No infections or wound complications occurred.
Conclusion
Tightrope fixation is a safe alternative to screw fixation for syndesmotic complex injuries in Weber C ankle fractures. We have shown that it has low complication rates and a high patient satisfaction.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Ankle</subject><subject>Ankle Fractures - diagnostic imaging</subject><subject>Ankle Fractures - surgery</subject><subject>Ankle Injuries - diagnostic imaging</subject><subject>Ankle Injuries - surgery</subject><subject>Bone Plates</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>Fracture Fixation, Internal - instrumentation</subject><subject>Fracture Fixation, Internal - methods</subject><subject>Fracture Fixation, Internal - rehabilitation</subject><subject>Fracture Healing - physiology</subject><subject>Humans</subject><subject>Injury Severity Score</subject><subject>Joint Instability - prevention & control</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Original Article • ANKLE - FRACTURES</subject><subject>Patient Positioning</subject><subject>Patient satisfaction</subject><subject>Range of Motion, Articular - physiology</subject><subject>Recovery of Function</subject><subject>Retrospective Studies</subject><subject>Supine Position</subject><subject>Surgical Orthopedics</subject><subject>Traumatic Surgery</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>1633-8065</issn><issn>1432-1068</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kMtKxDAUhoMoOl4ewI0E3LipnqTNpe5k8AYDbkZcxjQ9HTv2MiYt6NubYbyA4CoHzvf_OXyEHDM4ZwDqIgCIHBJgMmFa80RvkQnLUp4wkHo7zjJNEw1S7JH9EJYATORM7JI9rkFlKbAJeZ7Xi5fB9yukVf1uh7rvaF_R8NGVGNp-qB2tu-XoawxxoE9YoKdTarvXJia8dcPoMVxSS9uxiTR2g0fqbEAacJ06JDuVbQIefb0H5PHmej69S2YPt_fTq1niuFY64VqmKpM2AwGOCamgKCqRcwVVbpnLESXnLstdhqgqAF5UFhygTXPJyrJMD8jZpnfl-7cRw2DaOjhsGtthPwbDtFBKcMF1RE__oMt-9F28zsSt4lznWkSKbSjn-xA8Vmbl69b6D8PArPWbjX4T9Zu1frNuPvlqHosWy5_Et-8I8A0Q4qpboP_9-v_WT9ihj20</recordid><startdate>20170501</startdate><enddate>20170501</enddate><creator>Anand, Amarjit</creator><creator>Wei, Ran</creator><creator>Patel, Akash</creator><creator>Vedi, Vikas</creator><creator>Allardice, Garth</creator><creator>Anand, Bobby Singh</creator><general>Springer Paris</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20170501</creationdate><title>Tightrope fixation of syndesmotic injuries in Weber C ankle fractures: a multicentre case series</title><author>Anand, Amarjit ; Wei, Ran ; Patel, Akash ; Vedi, Vikas ; Allardice, Garth ; Anand, Bobby Singh</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2878-2863746a4050c15670bbf59270f9a1c9ee622c49c4ee7f002bfa0c0ea3961ddd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Ankle</topic><topic>Ankle Fractures - diagnostic imaging</topic><topic>Ankle Fractures - surgery</topic><topic>Ankle Injuries - diagnostic imaging</topic><topic>Ankle Injuries - surgery</topic><topic>Bone Plates</topic><topic>Cohort Studies</topic><topic>Female</topic><topic>Fracture Fixation, Internal - instrumentation</topic><topic>Fracture Fixation, Internal - methods</topic><topic>Fracture Fixation, Internal - rehabilitation</topic><topic>Fracture Healing - physiology</topic><topic>Humans</topic><topic>Injury Severity Score</topic><topic>Joint Instability - prevention & control</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Original Article • ANKLE - FRACTURES</topic><topic>Patient Positioning</topic><topic>Patient satisfaction</topic><topic>Range of Motion, Articular - physiology</topic><topic>Recovery of Function</topic><topic>Retrospective Studies</topic><topic>Supine Position</topic><topic>Surgical Orthopedics</topic><topic>Traumatic Surgery</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Anand, Amarjit</creatorcontrib><creatorcontrib>Wei, Ran</creatorcontrib><creatorcontrib>Patel, Akash</creatorcontrib><creatorcontrib>Vedi, Vikas</creatorcontrib><creatorcontrib>Allardice, Garth</creatorcontrib><creatorcontrib>Anand, Bobby Singh</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of orthopaedic surgery & traumatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Anand, Amarjit</au><au>Wei, Ran</au><au>Patel, Akash</au><au>Vedi, Vikas</au><au>Allardice, Garth</au><au>Anand, Bobby Singh</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Tightrope fixation of syndesmotic injuries in Weber C ankle fractures: a multicentre case series</atitle><jtitle>European journal of orthopaedic surgery & traumatology</jtitle><stitle>Eur J Orthop Surg Traumatol</stitle><addtitle>Eur J Orthop Surg Traumatol</addtitle><date>2017-05-01</date><risdate>2017</risdate><volume>27</volume><issue>4</issue><spage>461</spage><epage>467</epage><pages>461-467</pages><issn>1633-8065</issn><eissn>1432-1068</eissn><abstract>Background
No general consensus has yet been established for the gold standard treatment of ankle syndesmotic complex injuries. Recent literature has documented the success of ankle tightrope fixation for heterogeneous ankle fracture patterns, resulting in syndesmotic complex injuries. We present a multicentre case series assessing the clinical, radiological and functional outcomes of patients with Weber C ankle fractures treated with the Arthrex TightRope
®
fixation system.
Method
We performed a retrospective analysis of all adult patients with Weber C ankle fractures who were treated with the Arthrex TightRope
®
fixation system at four centres over a 3-year period. All patients were followed up for a mean of 14 months (range 12–26). Outcomes measures were assessed subjectively using functional scores (AOFAS and Olerud and Molander) and objectively using radiological measurements, complication rates and revision surgery rates.
Results
Thirty-six patients met our eligibility criteria. The mean age at operation was 31 years (range 18–65). There were 20 males and 16 females. No patients were lost to follow-up. The ankle tightrope maintained satisfactory reduction in the ankle mortise in 97% of cases. Of these 35 successfully treated cases, no evidence of re-displacement on follow-up radiographs of the syndesmotic complex was observed at an average of 10.8 months (range 6–12). Post-operative mean medial clear space was 3.1 mm, and mean tibio-fibular overlap was 10.1 mm. The mean American Orthopaedic Foot and Ankle Society (AOFAS) score was 88.8 (range 67–98) at a mean follow-up of 14 months (range 12–26). The overall complication rate was 6% (one failure requiring revision surgery and one medial sided skin irritation requiring removal of suture button). No infections or wound complications occurred.
Conclusion
Tightrope fixation is a safe alternative to screw fixation for syndesmotic complex injuries in Weber C ankle fractures. We have shown that it has low complication rates and a high patient satisfaction.</abstract><cop>Paris</cop><pub>Springer Paris</pub><pmid>28074301</pmid><doi>10.1007/s00590-016-1882-8</doi><tpages>7</tpages></addata></record> |
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| source | MEDLINE; SpringerLink Journals |
| subjects | Adolescent Adult Aged Ankle Ankle Fractures - diagnostic imaging Ankle Fractures - surgery Ankle Injuries - diagnostic imaging Ankle Injuries - surgery Bone Plates Cohort Studies Female Fracture Fixation, Internal - instrumentation Fracture Fixation, Internal - methods Fracture Fixation, Internal - rehabilitation Fracture Healing - physiology Humans Injury Severity Score Joint Instability - prevention & control Male Medicine Medicine & Public Health Middle Aged Original Article • ANKLE - FRACTURES Patient Positioning Patient satisfaction Range of Motion, Articular - physiology Recovery of Function Retrospective Studies Supine Position Surgical Orthopedics Traumatic Surgery Treatment Outcome Young Adult |
| title | Tightrope fixation of syndesmotic injuries in Weber C ankle fractures: a multicentre case series |
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