Evaluation of the Efficacy of Tightrope and Screw Fixation in the Treatment of Lower Tibiofibular Joint Injury based on CT Measurements

Objective: To evaluate the clinical efficacy of using Tightrope and screw fixation to treat lower tibiofibular syndesmosis injury based on postoperative CT measurements. Methods: A retrospective case-control study was conducted to analyze the clinical data of 41 patients with ankle joint fractures accompanied by lower tibiofibular joint injuries treated in our hospital from October 2017 to June 2023, including 24 males and 17 females, with an average age of 39 years. Among them, 16 patients were treated with Tightrope fixation (elastic fixation group), and 25 patients were treated with lower tibiofibular joint screw fixation (screw fixation group). Postoperative follow-up injured ankle CT scan was performed to measure the anterior and posterior spaces (a, b) of the tibiofibular joint, the shortest distance between the tibia and fibula (c), the shortest distance from the midpoint of the segment connected to the anterior and posterior tibial tuberosity to the anterior fibular vertex (d), the shortest distance from the midpoint of the segment connected to the anterior and posterior tibial tuberosity to the posterior fibular vertex (e), the sagittal displacement of the fibula (f), and the rotation angle of the fibula (θ) in both groups of patients. The AOFAS functional scores and postoperative complications for one year after surgery of the two groups of patients were recorrded and compared. Results: There were no significant statistical differences in the anterior space(a), posterior space(b), sagittal translation of the fibula(f), fibular rotation angle(θ) and the value of d/e between the two groups of patients after surgery. The shortest distance between the tibia and fibula (c) in the Tightrope fixation group was significantly higher than that in the screw fixation group, and the observed difference is statistically significant (P<0.05). The value of b-a in the elastic fixation group was lower than that in the screw fixation group, and the value of a/b was higher than that in the screw fixation group, with statistical significance (P<0.05). The AOFAS scores of patients in the Tightrope fixation group were statistically higher than those in the screw fixation group(P<0.05). During the follow-up period, neither group of patients experienced any complications. Conclusion: The use of elastic fixation for the treatment of tibiofibular joint injuries can achieve the same fixation effect as screw fixation and higher ankle joint function scores. CT has high value in evaluating the postoperative reduction effect of tibiofibular syndesmosis and is worthy of clinical promotion.