Assessment of Anatomic Risk During Syndesmotic Stabilization With the Suture Button Technique

Pirozzi, Kelly M.; Creech, Corine L.; Meyr, Andrew J.

doi:10.1053/j.jfas.2015.04.005

Cited by 23 publications

(32 citation statements)

References 26 publications

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“…Degroot et al 19 reported 4 cases of osteolysis (17%) with SB subsidence of 2 to 4 mm into the fibula or tibia when used without plate fixation in a series of 24 patients as compared with no cases of osteolysis or subsidence into the fibula when a plate was used. Although there are multiple studies assessing the risk of medial structure entrapment during SB placement, 16,20 we are unaware of any reports of intraoperative fibular cortical compromise or techniques to avoid the known complication of fibular button pull-through as shown in the case example. We believe that this may be an underreported technical error encountered by surgeons during placement of SB devices independent of fibular plating.…”

Section: Discussionmentioning

confidence: 99%

“…including tunnel widening, saphenous nerve injury, suture failure, and lateral button pull-through. [15][16][17][18][19] The surgical technique of placing a SB device without a fibular plate can be technically challenging. This is particularly true when performed via a small incision as is typical for pure syndesmotic injuries.…”

Section: Getting the Starting Point Rightmentioning

confidence: 99%

“…5,12,13 Based on these and other findings, some surgeons have adopted the SB, and it is an increasingly popular construct in the treatment of syndesmotic ankle injuries. 14 Whereas screws are more frequently removed and may cause postoperative pain and discomfort, 5,7,[15][16][17][18]…”

Section: Introductionmentioning

confidence: 99%

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Getting the Starting Point Right: Prevention of Skiving and Fibular Cortical Breach During Suture Button Placement for Syndesmotic Ankle Injuries

Kaiser

Cronin

Stenquist

et al. 2020

Foot & Ankle Specialist

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The use of suture button (SB) devices in the treatment of syndesmotic ankle injuries is increasing. These constructs have demonstrated better syndesmotic reduction, improved clinical outcomes, and lower rates of hardware removal compared with screw fixation. However, placing a SB device without a fibular plate can be technically challenging. In this technique tip, we use an illustrative case to demonstrate a technique tip that minimizes the risk of anterior or posterior cortical breach of the fibula and helps facilitate more accurate placement of a SB device. Levels of Evidence: Level V: Expert opinion

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Section: Discussionmentioning

confidence: 99%

Section: Getting the Starting Point Rightmentioning

confidence: 99%

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Getting the Starting Point Right: Prevention of Skiving and Fibular Cortical Breach During Suture Button Placement for Syndesmotic Ankle Injuries

Kaiser

Cronin

Stenquist

et al. 2020

Foot & Ankle Specialist

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show abstract

“…• Lesión de estructuras mediales. Pirozzi (26) alerta de la posibilidad de lesión de la vena y/o el nervio safenos en la cara medial del tobillo hasta en un 20% de los casos, recomendando realizar una mini-incisión medial que nos asegure que estas estructuras no quedan atrapadas por el botón metálico.…”

unclassified

Sistemas de estabilización de la sindesmosis

Herrera-Pérez¹,

Rendón-Díaz²,

Ramírez-de-Paz³

2019

MACT

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“…The distal tibiofibular syndesmosis is essential for weightbearing activities. The suture-button (SB) technique has increased in popularity for the management of syndesmotic injuries because it allows for physiologic movement of the distal tibiofibular joint (1)(2)(3)(4)(5). Nevertheless, in developing countries, the increased expenses of the commercial construct have been a burden on already limited funds.…”

mentioning

confidence: 99%

A 24-Month Follow-Up of a Custom-Made Suture-Button Assembly for Syndesmotic Injuries of the Ankle

Imam

Matthana

Kim

et al. 2017

The Journal of Foot and Ankle Surgery

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In the present retrospective analysis, we introduce a custom suture-button fixation device for acute ankle syndesmotic injuries that allows for early weightbearing without another planned operation for hardware removal. We evaluated 87 consecutive ankles in 87 patients (49 males [56.32%] and 38 females [43.68%]). Of the 87 patients, 15 (17.24%) withdrew or were lost to follow-up, leaving 72 patients (82.76%) in the present study. Their mean age was 35.2 (range 17 to 67) years. Nineteen patients (26.39%) presented with a pure syndesmotic disruption, and 53 (73.61%) had associated malleolar fractures. The American Orthopaedic Foot and Ankle Society scale score improved significantly from 31.2 ± 4.2 preoperatively to 88.5 ± 5.3 at an average of 24 months postoperatively (p < .0043). Revision was undertaken because of implant failure in 4 ankles (5.56%). Two revisions (2.78%) were performed in 2 ankles because of early weightbearing in the first 2 weeks after surgery. The third patient (1.39%) underwent revision at 5 weeks postoperatively. This syndesmotic reduction failure was attributed to failure of the threads, which was noted at the second surgery. The fourth patient (1.39%), a 66-year-old male, underwent revision at 5 months postoperatively because of persistent infection. An 18-month postoperative radiograph was available for all patients. The medial clear space had significantly decreased, from 8.2 ± 3.1 mm preoperatively to 3.5 ± 2.2 mm at 18 months postoperatively (p < .0344). Likewise, the tibiofibular clear space had decreased significantly, from a mean of 8.8 ± 3.7 mm preoperatively to a mean of 3.7 ± 2.2 mm at 18 months postoperatively (p < .0322). In conclusion, suture-button fixation described in the present report delivered satisfactory functional outcomes and anatomic reduction at minimum of 18 months after surgery.

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Assessment of Anatomic Risk During Syndesmotic Stabilization With the Suture Button Technique

Cited by 23 publications

References 26 publications

Getting the Starting Point Right: Prevention of Skiving and Fibular Cortical Breach During Suture Button Placement for Syndesmotic Ankle Injuries

Getting the Starting Point Right: Prevention of Skiving and Fibular Cortical Breach During Suture Button Placement for Syndesmotic Ankle Injuries

Sistemas de estabilización de la sindesmosis

A 24-Month Follow-Up of a Custom-Made Suture-Button Assembly for Syndesmotic Injuries of the Ankle

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