Comparison of elastic fixation and rigid fixation in the treatment of distal tibiofibular syndesmosis injury.

Abstract

Compare clinical outcomes of elastic (Rigidloop) vs. rigid (screw) fixation for distal tibiofibular syndesmosis injury. Eighty-eight patients were divided into an elastic fixation group (n=43) and a rigid fixation group (n=45) groups, with the elastic fixation group undergoing Rigidloop fixation and the rigid fixation group undergoing screw fixation. Clinical data (operation time, blood loss, weight-bearing/fracture healing time), radiographic parameters (talocalcaneal fusion site [TFCS], tibiofibular overlap [TFO], medial clear space [MCS]), American Orthopaedic Foot and Ankle Society (AOFAS) scores, plantar flexion range, and complications were analyzed. Preoperative and 12-month TFCS, TFO, and MCS were comparable (P >0.05). The elastic fixation group had shorter operation time (60.23±11.67 vs. 66.32 ± 12.28 min), reduced blood loss (151.05 ± 21.04 vs. 159.47 ± 22.11 mL), earlier weight-bearing (6.12 ± 1.06 vs. 7.75 ± 1.36 weeks), and faster wound/fracture healing compared with the rigid fixation group(P <0.05). At 3 months, the elastic fixation group showed superior plantar flexion (42.68 ± 4.00 vs. 40.18 ± 4.08°) and AOFAS scores (81.30 ± 5.23 vs. 77.98 ± 5.70 points, P <0.05), but both groups tended to be consistent by 12 months (P >0.05). Complications of the elastic fixation group (loosening, infection, re-separation) were lower (9.3% vs. 24.4%, P <0.05); satisfaction rates were similar (P >0.05). Rigidloop fixation is as effective as screw fixation in stabilizing syndesmosis injuries, and the Rigidloop system has the advantages of faster recovery, fewer complications, and early functional benefits, making it superior to screw fixation.