Comparison of screw fixation with elastic fixation methods in the treatment of syndesmosis injuries in ankle fractures

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

“…At the sixth postoperative week, full weight bearing was allowedShort leg splints for 3 weeks,after splint removal, partial weight bearing was allowed. At the sixth postoperative week, full weight bearing was allowedNRAlthough the functional outcomes were similar, the restoration of the fibular rotation in the treatment of syndesmotic injuries by screw fixation was troublesome and the volume of the distal tibiofibular space increased with thesuture-button fixation technique.Kim et al 2016 [2]A below-the-knee cast for 1 week, partial weightbearing at 6weeks postoperativelyA below-the-knee cast for 1 week, partial weightbearing 6 to 8 weeks postoperativelyNRBoth suture-button and metal screw fixation are effective treatment methods for an ankle fracture accompanied by syndesmotic injury.Seyhan 2015 [17]Plaster-splint for twoWeeks and then pressure-socks for 4 weeksPartial weight bearing using double crutches and then complete weight bearing at the end of the 3rd monthPlaster-splint for twoWeeks and then pressure-socks for 4 weeksPartial weight bearing using double crutches and then complete weight bearing at the end of the 3rd month (after screw removal)NRElastic fixation is as functional as screw fixation in the treatment of ankle syndesmosis injuries. The unnecessary need of a second surgical intervention for removal of the fixation material is another advantageous aspect of this method of fixation.Kortekangas 2015 [8]A below-the-knee cast with the ankle joint at a 90° for 6 weeks with partial weight bearing.…”

“…Seyhan et al [17] performed a retrospective comparative study, including 7 Weber B fractures and 25 Weber C fractures with syndesmosis injury, of which 15 patients were treated with the TightRope system and 17 patients with the cortical screw system. No statistically significant difference was found between the two techniques according to AOFAS scores at the 3rd, 6th and 12th months.…”

Suture-button devices are at least as effective as screws for fixation of acute syndesmotic injuries: a systematic review

“…Only Naqvi et al 34 did not present such data. SB patients presented a complication rate of 3.8%–8.3%, mostly related to low-grade/superficial infections, and a removal rate due to knot irritation of up to 40% 35. Although no reports of infection were found in the screw group, complications related to screw breakage or loosening range from 3.8% to 84.2% and removal up to 75% 31…”

Injuries of the Sternoclavicular Joint - An Innovative Approach in the Management of a Rare Injury: Tight Rope Fixation of the Costo-Clavicular Ligament

“…An interaction of intricately arranged ligaments, a very elastic joint capsule and an intraarticular discus mediate the enormous degrees of freedom of movement of this joint. On the other hand, the most powerful of the ligaments, the CCL counteracts an overstraining of the SCL by keeping the medial clavicle firmly in spatial relation to the first rib (20,21,22).…”