[A prospective randomized trial of poly-DL-lactic acid absorbable and metallic screws for treatment of syndesmotic disruptions].
OBJECTIVE
To compare the clinical effect of poly-DL-lactic acid (PDLLA) absorbable screws and titanium metallic screws in the treatment of syndesmotic disruptions in ankle fractures.


METHODS
In this prospective, randomized clinical trial, 58 patients with or suspected of syndesmotic disruption associated with ankle fractures were randomly allocated to receive either bioabsorbable PDLLA or metallic titanium screwing fixation. Using preoperative radiography and intraoperative hook test, syndesmotic disruption was confirmed in 47 cases (25 with metallic screwing and 22 with PLLA screwing). Statistical analyses were performed at 6 months postoperatively to compare the AOFAS score, range of motion of the joint, TFCS width and TFO width on anteroposterior view radiographs, and inflammatory reactions between the two groups.


RESULTS
The PDLLA screws showed good therapeutic effect similar to that of titanium metallic screws in syndesmosis fixation in these patients. No significant differences were found in the AOFAS score, range of motion of the joint, or TFCS width or TFO width between two groups (P>0.05). One patient in PDLLA screw group showed inflammatory reactions to the implants.


CONCLUSIONS
PDLLA screws allow effective and reliable stabilization of syndesmotic disruptions without a second operation for screw removal.
Department of Trauma Surgery, Affiliated Hospital of Medical College, Qingdao University, Qingdao 266000, China. huyanlingqy@126.com
Yan-ling
YL
Hu
Wan-qing
WQ
Yuan
Lan-feng
LF
Wang
Hai-fei
HF
Liu
Dan
D
Jin
D020341:Absorbable Implants; D000328:Adult; D016512:Ankle Injuries / Q000601:surgery*; D001863:Bone Screws; D005260:Female; D005360:Fibula / Q000293:injuries; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D019344:Lactic Acid; D008297:Male; D008875:Middle Aged; D011091:Polyesters; D011108:Polymers; D011446:Prospective Studies; D013978:Tibial Fractures / Q000601:surgery; D014025:Titanium; D016896:Treatment Outcome
D011091:Polyesters; D011108:Polymers; D019344:Lactic Acid; C033616:poly(lactide); D014025:Titanium