Dunking the Knot in Suture Button Fixation for Distal Tibiofibular Syndesmosis Injury: Technique Tip

Watson, Dylan J.; Weatherby, Brian; Womack, John W.

doi:10.3113/fai.2012.0686

Cited by 3 publications

(2 citation statements)

References 6 publications

(4 reference statements)

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“…Most complications identified within the published data with respect to the suture button have addressed the potential for recurrence of syndesmotic diastasis and lateral wound complications (13)(14)(15)(16)(17)(18)(19)(20)(21). Several studies have demonstrated osteolysis associated with aseptic loosening, resulting in suture button subsidence and lateral knot irritation (13,14,(16)(17)(18).…”

mentioning

confidence: 95%

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

Pirozzi¹,

Creech

Meyr

2015

The Journal of Foot and Ankle Surgery

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mentioning

confidence: 95%

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

Pirozzi¹,

Creech

Meyr

2015

The Journal of Foot and Ankle Surgery

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“…The suture button technique provides effective stability by virtue of its good biocompatibility and nonabsorbability. Similar button plate suture devices have been successfully used in the treatment of anterior cruciate ligament reconstruction, syndesmotic injuries, and acromioclavicular joint dislocation [23][24][25] . However, clinical follow-up observations have shown that over time, the button device gradually becomes unstable due to the small size of the thread, leading to instability of the joint surface with increased load.…”

Section: Discussionmentioning

confidence: 99%

InternalBrace Fixation Technique for Lisfranc Injury:A Retrospective Study

Zeng,

Huang,

Cai

et al. 2023

Preprint

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Background Lisfranc ligament is an important structure to maintain the transverse and longitudinal arch of the foot, due to the inherent fretting between the medial cuneiform bone and the base of the 2nd metatarsal bone, the current preferred fixation method remains controversial. Our study aimed to evaluate the InternalBrace fixation technique for Lisfranc injury. Methods A total of 58 patients who underwent InternalBrace fixation technique for Lisfranc injury from January 2019 to September 2022 through a retrospective study. Preoperative classification was performed according to Myerson classification system with imaging data. Postoperative follow-up was performed according to fracture healing time, visual analog scores(VAS), the American Orthopedic Foot and Ankle Society (AOFAS), Tegner scores and complications. Results All cases completed the operation successfully and obtained follow-up. The patients age ranged from 19 to 62 years (34.6 ± 9.4 years on average). The postoperative follow-up time was 12–24 months (16.9 ± 3.0 months on average). During the follow up period, no recurrence of lisfranc fracture-dislocations. The VAS, AOFAS and Tegner scores significantly improved as time went postoperatively, which proved statistically significant (P < 0.01), and the good rates of AOFAS was 91.4%. The postoperative complications were 1 case of traumatic arthritis, 1 case of incision infection and 1 case of temporary dorsal foot numbness. Conclusions InternalBrace fixation technique for Lisfranc injury that is benifical to restore lisfranc joint stability and function, allow earlier return to activities with fewer surgical complications.

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Continuous Loop Double Cortical Button Technique for Distal Tibiofibular Syndesmosis Stabilization: A Technical Note and Case Series

Wolfson¹,

Struhl²

2020

Techniques in Foot &Amp; Ankle Surgery

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Injury to the distal tibiofibular syndesmosis is common and failure to correct instability may lead to inferior outcomes. Recently, suture-button devices have garnered increasing attention for dynamic syndesmotic fixation. However, current constructs and techniques have been consistently associated with complications such as lateral knot irritation and wound breakdown. In addition, knot slippage, loosening, and osteolysis have been described leading to recurrent syndesmotic diastasis. To address these shortcomings, a continuous loop double cortical button technique has been developed for dynamic syndesmotic stabilization. The continuous loop double cortical button technique has been utilized for coracoclavicular ligament stabilization for both acromioclavicular joint dislocation and distal clavicle fractures with excellent clinical outcomes. This procedure has been adapted for fixation of the distal tibiofibular syndesmosis. The technique utilizes 2 cortical buttons linked by a continuous loop of ultra-high molecular weight polyethylene suture for dynamic knotless syndesmotic fixation. The continuous loop double cortical button technique was performed on 4 consecutive cases of distal tibiofibular syndesmosis diastasis. Accurate, stable fixation was achieved in all cases without loosening or diastasis. At the final follow-up, no evidence of button-related osteolysis or migration was observed. One patient with prominent lateral hardware developed a wound infection requiring reoperation for hardware removal and debridement. Otherwise, no complications related to syndesmotic hardware were observed. The continuous loop double cortical button technique is a reproducible and reliable procedure for fixation of the distal tibiofibular syndesmosis. The construct allows for accurate restoration of the dynamic syndesmotic complex without compromising stability. Knot-related complications are minimized. As with all systems, limiting lateral hardware prominence appears to reduce the risk of wound-related complications. Level of Evidence: Diagnostic Level IV—case series. See Instructions for Authors for a complete description of levels of evidence.

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Dunking the Knot in Suture Button Fixation for Distal Tibiofibular Syndesmosis Injury: Technique Tip

Cited by 3 publications

References 6 publications

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

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

InternalBrace Fixation Technique for Lisfranc Injury:A Retrospective Study

Continuous Loop Double Cortical Button Technique for Distal Tibiofibular Syndesmosis Stabilization: A Technical Note and Case Series

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