COMPARISON OF FIXATION USING SCREWS AND SUTURE BUTTONS IN THE TREATMENT OF DISTAL TIBIOFIBULAR DIASTASIS ASSOCIATED WITH ANKLE FRACTURES

Purpose: We aimed to compare the treatment results of fixation using screws and a suture button when treating distal tibiofibular joint diastasis combined with ankle fractures Materials and Methods: A retrospective study was conducted on 30 patients with ankle fractures who were treated with screws and 34 patients who were treated with suture buttons for distal tibiofibular joint diastasis. Postoperative clinical outcomes were evaluated using the American Orthopedic Foot and Ankle Society (AOFAS) score, and radiologic outcomes were evaluated by measuring tibiofibular clear space, tibiofibular overlap, and medial clear space on pre- and post-operative radiographs. The average length of hospital stay, whether surgery was performed to remove the internal fixation, the time of weight bearing, and whether the internal fixation was damaged were investigated. Results: One year after surgery, the average AOFAS score showed no statistically significant difference between the screw surgery group and the suture button surgery group. The averages of tibiofibular clear space, tibiofibular overlap, and medial clear space measured immediately postoperatively did not show statistically significant differences between the screw surgery group and the suture button surgery group, but the measurements taken 1 year after surgery were significantly different statistically. Screw removal surgery was performed in all cases in the screw surgery group. In the screw surgery group, there were 3 cases of screw breakage and 3 cases of surgical wound infection, and the length of hospitalization and the postoperative weight-bearing start time in the screw surgery group were longer. Conclusion: When treating distal tibiofibular joint diastasis, the screw surgery group and the suture button surgery group showed no statistically significant difference in clinical outcomes measured by AOFAS 1 year after surgery, but the suture button surgery group had better results in radiological evaluation and in complication frequency.