X-RAY ASSESSMENT OF THE EFFICIENCY OF HYBRID STABLE-ELASTIC FIXATION UNSTABLE ANKLE FRACTURES

Abstract

The level of complications after treatment of patients with bone fractures stays high 22–60 %. Understanding ankle-foot joint biomechanics is critical for choosing trendy methods hybrid fixation or the traditional fixation of the fibula plate and positional screw for distal syndesmosis. Objective. To analyze the effectiveness of surgical treatment of patients with unstable trans- and suprasyndesmosis fractures with hybrid stable-elastic fixation (HSEF) in comparison with the traditional method of fixation with a bone plate with a positioning screw according to X-ray morphometric parameters. Methods. 82 patients with unstable trans- and suprasyndesmotic fractures of the fibula. The main (I group) of the study consisted of 18 (21,95 %) patients with an average age of (41,6 ± 15,5) years who operated with hybrid stable-elastic fixation, and the control (II group) — 64 (78.05 %) patients with an average age of (52,4 ± 15,7) years, who operated with a bone plate with a positioning screw. Results. The TTA was 0.63 times lower than in patients after traditional fixation. For type C fractures in patients after HSEF, the value of TTA was also 0.78 times (p = 0.0005). Conclusions. The analysis of X-ray morphometric parameters of the angle of inclination of the talus bone and the talus-tibia angle confirms the advantage of hybrid stable-elastic fixation in trans- or supra-syndesmotic fractures of the fibula with damage to the distal inter-tibial syndesmosis. According to the value of the index of the angle of inclination of the talus in patients after hybrid stable-elastic fixation, lower risks of ankle-foot joint instability in the p/o period were found than in patients after traditional osteosynthesis. Median values of the talus-tibia angle indicated a tendency to shorten the fibula in patients after traditional osteosynthesis.