Clinical study of a steel cable fixation for distal tibiofibular syndesmosis injury

BACKGROUND: In order to overcome the shortcomings of common surgical fixation methods for Distal Tibiofibular Syndesmosis (DTS) injuries, which include the inability to exercise early, significant surgical trauma, and the risk of loosening and breakage of implants, we have designed and implemented a new technique using steel cable fixation to treat DTS injuries. METHODS: Twenty-six patients treated with steel cable fixation for DTS injury between March 2013 and March 2019 in the Second Hospital of Tangshan City trauma department were followed up to monitor the efficacy of treatment. There were 16 males and 10 females between the ages of 19 and 64, with a mean age of 41.81 ± 9.54 years. All patients were examined by X-ray and CT for 3 days before and after surgery. The patients were then reexamined by X-ray 6 and 9 weeks postoperatively, and by CT 1 year later. The treatment results were evaluated by comparing the distal tibiofibular anterior, middle, and posterior gap changes and the Baird-Jackson score. RESULTS: The 26 patients attained good postoperative repositioning, with a fracture healing time of 2.5 to 3 months. and the Baird-Jackson score was 96 ± 2.78. After surgery, the DTS gaps observed in the CT scans taken 3 days and 1 year postoperatively in all patients were significantly reduced compared to the preoperative measurements, with statistical significance (P < .05). However, when comparing the CT scans taken 1 year postoperatively to those at 3 days postoperatively, there was no significant change in the anterior gap. The middle and posterior gaps of DTS showed a slight increase with statistical significance (P < .05), but all measurements remained within the normal range CONCLUSION: Steel cable fixation for DTS injury has the advantages of reliable fixation, early functional exercise, and reduction in the number of operations, and no adverse effects or complications were found.