title: A prospective, randomised trial comparing the use of absorbable and metallic screws in the fixation of distal tibiofibular syndesmosis injuries: mid-term follow-up.
abstract: Our aim was to compare polylevolactic acid screws with titanium screws when used for fixation of the distal tibiofibular syndesmosis at mid-term follow-up. A total of 168 patients, with a mean age of 38.5 years (18 to 72) who were randomly allocated to receive either polylevolactic acid (n = 86) or metallic (n = 82) screws were included. The Baird scoring system was used to assess the overall satisfaction and functional recovery post-operatively. The demographic details and characteristics of the injury were similar in the two groups. The mean follow-up was 55.8 months (48 to 66). The Baird scores were similar in the two groups at the final follow-up. Patients in the polylevolactic acid group had a greater mean dorsiflexion (p = 0.011) and plantar-flexion of the injured ankles (p < 0.001). In the same group, 18 patients had a mild and eight patients had a moderate foreign body reaction. In the metallic groups eight had mild and none had a moderate foreign body reaction (p < 0.001). In total, three patients in the polylevolactic acid group and none in the metallic group had heterotopic ossification (p = 0.246). We conclude that both screws provide adequate fixation and functional recovery, but polylevolactic acid screws are associated with a higher incidence of foreign body reactions.
authors.affiliation: Shanghai Jiao Tong University, Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 YiShan Road, Shanghai 200233, China.
authors.forename: H
authors.initials: H
authors.lastname: Sun
authors.forename: C F
authors.initials: CF
authors.lastname: Luo
authors.forename: B
authors.initials: B
authors.lastname: Zhong
authors.forename: H P
authors.initials: HP
authors.lastname: Shi
authors.forename: C Q
authors.initials: CQ
authors.lastname: Zhang
authors.forename: B F
authors.initials: BF
authors.lastname: Zeng
mesh_terms: D020341:Absorbable Implants / Q000009:adverse effects; D000293:Adolescent; D000328:Adult; D000368:Aged; D064386:Ankle Fractures; D016512:Ankle Injuries / Q000601:surgery*; D000843:Ankle Joint / Q000503:physiopathology; D001863:Bone Screws / Q000009:adverse effects; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D005549:Foreign-Body Reaction / Q000209:etiology; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D019344:Lactic Acid / Q000009:adverse effects / Q000031:analogs & derivatives; D008023:Ligaments, Articular / Q000293:injuries; D008297:Male; D008875:Middle Aged; D011108:Polymers / Q000009:adverse effects; D011446:Prospective Studies; D016059:Range of Motion, Articular; D014025:Titanium / Q000009:adverse effects; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D011108:Polymers; C445939:polylevolactic acid; D019344:Lactic Acid; D014025:Titanium
keywords: Prospective randomized study; Bioabsorbable; Polylevolactic acid; Distal tibiofibular syndesmosis