G.V. BOGATSKIY¹, A.M. FAYN¹, A.YU. VAZA¹, S.F. GNETETSKIY¹, A. GRANDELIS², YU.A. BOGOLYUBSKIY¹, R.S. TITOV¹, A.YU. SERGEEV¹, K.I. SKURATOVSKAYA¹, V.B. BONDAREV¹

 ¹Scientific-Research Institute for Emergency Medical Care named after N.V. Sklifosofskiy, Moscow

²ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy

Contact details:

Bogatskiy G.V. — doctor of the Department of Emergency Traumatology

Address: 3 Bolshaya Sukharevskaya square, Moscow, Russian Federation, 129090, tel.: +7-910-400-9780, e-mail: b.gregori@yandex.ru

 For fixing tibiofibular syndesmosis, a full-threaded cortical screw ø 3.5 mm, or a Tight Rope system is often used. Fixing with a screw restricts the amplitude of movements of the foot. A fracture or loosening of the screw before the onset of fusion of the ligaments of tibiofibular syndesmosis is possible. The screw must be removed to avoid the formation of persistent limitations of the function of the ankle joint. The Tight Rope dynamically fixes the syndesmosis, does not limit the amplitude of movements and does not require removal, but its efficiency is insufficiently proven.

The purpose — to study the physiological mobility in the tibiofibular syndesmosis for the subsequent more accurate choice of the fixation method.

Material and methods. On 5 cadaver samples, 10 studies of fibular mobility were performed with intact ligaments of tibiofibular syndesmosis and after their dissection under conditions of fixation with a full-threaded screw ø 3.5 mm, a partial-threaded screw ø 4.0 mm, and a Tight Rope system.

Results. The amplitudes of mobility in the tibiofibular syndesmosis were determined in an intact state and in a state of fixation with different implants; the best fixator and the technique of its installation were determined.

Conclusion. During the experiment, the assumption was confirmed that a partial-threaded screw installed without the effect of tightening does not limit the volume of movements in the tibiofibular syndesmosis, which allows starting early functional rehabilitation and excludes the need for a staged removal of the screw.

Key words: rapture of tibiofibular syndesmosis, fixation of tibiofibular syndesmosis, partial-threaded screw, positioning screw.

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