Osteomyelitis After TightRope® Fixation of the Ankle Syndesmosis: A Case Report and Review of the Literature

Hong, Choon Chiet; Lee, Wei Ting; Tan, Ken Jin

doi:10.1053/j.jfas.2014.09.041

Cited by 20 publications

(13 citation statements)

References 12 publications

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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: 99%

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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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confidence: 99%

“…Treon et al (16) reported an overall complication rate of 44%, with 22% of suture buttons requiring removal secondary to wound complications and irritation. Osteomyelitis has also been a concern when associated with the presence of a wound and implant subsidence (19,20).…”

mentioning

confidence: 99%

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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“…Stitch infection, osteomyelitis, loosening, polyethylene-related osteolysis reactions, and failure of the construct have been reported previously (10,(13)(14)(15). Degroot et al (10) proposed cutting the suture component of the fixation device !1 cm beyond the knot, such that it rests flat on the fibula.…”

Section: Discussionmentioning

confidence: 98%

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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“…It remains equally unclear, however, if proper syndesmotic fixation benefits most from the rigid multiplanar fixation conferred by traditional screw and plate constructs. While some publications have documented excellent results using a form of suture button fixation, reports of superficial wound infection, chronic osteomyelitis, irritation from the suture knots, and creeping button migration/bony subsidence have been published using one version of this type of construct (Tightrope, Arthrex, Naples, FL) [51][52][53]. Both construct types seem equally prone to malreduction and technical limitation when there is lack of user familiarity.…”

Section: Operative Treatment For Isolated Syndesmotic Injuriesmentioning

confidence: 99%

Current trends in the diagnosis and management of syndesmotic injury

Vopat

Lubberts

et al. 2017

Curr Rev Musculoskelet Med

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Ideal management of the various presentations of syndesmotic injury remains controversial to this day. High quality evidentiary science on this topic is rare, and numerous existing studies continue to contradict one another. The primary reasons for these discrepancies are that previous studies have failed to (1) properly distinguish between isolated (nonfractured) and non-isolated injuries, (2) accurately define stable from unstable injuries, and (3) sufficiently differentiate between acute and chronic injuries. The purpose of this review is to summarize today's body of literature regarding diagnosis and management of syndesmotic injury and discuss current trends and important future directions to optimize care of this very heterogeneous population.

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Osteomyelitis After TightRope® Fixation of the Ankle Syndesmosis: A Case Report and Review of the Literature

Cited by 20 publications

References 12 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

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

Current trends in the diagnosis and management of syndesmotic injury

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