Avoiding Suture Knot Prominence With Suture Button Along Distal Fibula: Technical Tip

Hodgson, P.; Thomas, Rhys

doi:10.3113/fai.2011.0908

Cited by 24 publications

(19 citation statements)

References 4 publications

(2 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In current review, the suture-button fixation group showed similar risk of post-operative complications with the screw fixation group. Regarding the suture-button fixation group, some literatures suggested some modifications in surgical procedure, such as a posterior short knot and/or reaming the posterior aspect of fibula which was useful to reduce the incidence rate of infection, irritation and discomfort [25, 30]. These complications existed as similar issues to the screw fixation group.…”

Section: Discussionmentioning

confidence: 99%

A systematic review of suture-button versus syndesmotic screw in the treatment of distal tibiofibular syndesmosis injury

Zhang

Liang

et al. 2017

BMC Musculoskelet Disord

119

123

View full text Add to dashboard Cite

BackgroundNow, using a suture-button device to treat distal tibiofibular syndesmotic injuries is overwhelming due to its advantages over screw fixation. Current systematic review was conducted to make a comparison between suture-button fixation and traditionally screw fixation in the treatment of syndesmotic injuries. The outcomes included functional outcomes, implant removal, implant failure, malreduction, post-operative complications (except implant failure and malreduction), and cost-effectiveness aspects.MethodA literature search in the electronic databases of Medline, Embase, the Cochrane Library, Web of Science was conducted to identify studies until March 2017. The references of the included articles were also checked for potentially relevant studies. Only English articles were included. We followed the Preferred Reporting Items for Systematics reviews and Meta-Analysis (PRISMA) guidelines in this review.ResultsFinally, 10 studies were identified, encompassing a total of 390 patients. The mean American Orthopaedic Foot and Ankle Society ankle score (AOFAS) score of 150 patients treated with the suture-button device was 91.06 points, with an average follow-up of 17.58 months, and the mean AOFAS score of 150 patients treated with syndesmotic screws was 87.78 points, with an average follow-up of 17.73 months. Implant removal was reported in 5 of 134 (3.7%) patients treated with the suture-button device, and in 54 of 134 (40.2%) patients treated with the syndesmotic screw. No patient in the suture-button fixation group had implant failure, however the rate of implant failure in the screw fixation group was 30.9%. Malreduction was reported in 1 of 93 (1.0%) patients treated with the suture-button device, and in 12 of 95 (12.6%) patients treated with the syndesmotic screw. The rate of post-operative complications in the suture-button fixation group was 12.0% and 16.4% in the screw fixation group. There was only one publication demonstrated about cost-effectiveness aspects, it showed that patients treated with the suture-button device spent on average $1482 less and had a higher quality of life by 0.058 quality-adjusted life-year compared with patients who received fixation with 2 syndesmotic screws in supination-external rotation type 4 injuries.ConclusionBased on our research, though the suture-button fixation group had similar functional outcome (measured on the AOFAS score) and post-operative complication rate compared with the syndesmotic screw fixation group, the suture-button device could lead to better objective range of motion (ROM) measurements and earlier return to work. Besides, the suture-button fixation group had lower rate of implant removal, implant failure, and malreduction. However, high-quality randomized controlled trials with more uniformity in outcome reporting are desirable to determine the long-term effects and cost-effectiveness of the suture-button device.

show abstract

Section: Discussionmentioning

confidence: 99%

A systematic review of suture-button versus syndesmotic screw in the treatment of distal tibiofibular syndesmosis injury

Zhang

Liang

et al. 2017

BMC Musculoskelet Disord

119

123

View full text Add to dashboard Cite

show abstract

“…In the current review it was 10% on average. Several authors have already made suggestions to lower the rate of implant irritation and subsequent removal [3, 21, 39]. In the literature on syndesmotic screw fixation this percentage is dependent on hospital protocol and is slightly over 50% on average.…”

Section: Discussionmentioning

confidence: 99%

Acute distal tibiofibular syndesmosis injury: a systematic review of suture-button versus syndesmotic screw repair

Schepers

2012

International Orthopaedics (SICOT)

167

106

View full text Add to dashboard Cite

Purpose Recently, a new suture-button fixation device has emerged for the treatment of acute distal tibiofibular syndesmotic injuries and its use is rapidly increasing. The current systematic review was undertaken to compare the biomechanical properties, functional outcome, need for implant removal, and the complication rate of syndesmotic disruptions treated with a suture-button device with the current 'gold standard', i.e. the syndesmotic screw.

show abstract

“…3 This latter complication is the most commonly cited and can be avoided by adopting a modified surgical technique. 34 Complication rates range from 8% to 25%. 3 35 36 What is not clear from previous work is when the complications were discovered, by whom and during what process, for example by the patient at work, by the physiotherapist during rehabilitation or by the surgeon on review.…”

Section: Discussionmentioning

confidence: 99%

Ankle syndesmosis repair and rehabilitation in professional rugby league players: a case series report

Latham

Goodwin

Stirling³

et al. 2017

BMJ Open Sport Exerc Med

View full text Add to dashboard Cite

Background/aimThe distal tibiofibular joint is described as a syndesmosis. Traditionally, severe syndesmotic injuries with diastasis have been treated surgically with screw fixation. This case series details an ankle syndesmosis tightrope repair and an accelerated rehabilitation protocol that reduces the amount of time to return to professional rugby league in the UK. The aim of this study was to describe players’ journey from injury, through diagnosis to surgery, rehabilitation and return to participation, detailing time scales and methods used at each stage to highlight the change in current practice.MethodsPlayers were identified via a single orthopaedic surgeon in the UK who specialises in ankle syndesmosis repair. Between January 2010 and September 2015, adult men playing full-time professional rugby league in the UK Super League with ankle syndesmosis injuries were identified.ResultsEighteen players from six different clubs were included. The most common mechanism of injury was forced dorsiflexion/eversion. The average return to participation was 64 days (SD 17.2, range 38–108). This compares favourably to reports of between 120 and 180 days following screw fixation.ConclusionAnkle syndesmosis tightrope repair and an accelerated rehabilitation protocol is as safe as traditional methods. The accelerated rehabilitation protocol promotes early weight-bearing and has shown to expedite the return to sport for professional Rugby League players. It is possible to return to sport 2 months after a tightrope repair and accelerated rehabilitation, compared with 3–6 months post screw fixation. This is extremely encouraging for the professional sporting population.

show abstract

Avoiding Suture Knot Prominence With Suture Button Along Distal Fibula: Technical Tip

Abstract: Level of Evidence: V, Expert Opinion

Cited by 24 publications

References 4 publications

A systematic review of suture-button versus syndesmotic screw in the treatment of distal tibiofibular syndesmosis injury

A systematic review of suture-button versus syndesmotic screw in the treatment of distal tibiofibular syndesmosis injury

Acute distal tibiofibular syndesmosis injury: a systematic review of suture-button versus syndesmotic screw repair

Ankle syndesmosis repair and rehabilitation in professional rugby league players: a case series report

Contact Info

Product

Resources

About