Suture-Button versus Screw Fixation in a Syndesmosis Rupture Model: A Biomechanical Comparison

Soin, Sandeep; Knight, Trevor A.; Dinah, A. Feroz; Mears, Simon C.; Swierstra, Bart A; Belkoff, Stephen M.

doi:10.3113/fai.2009.0346

Cited by 85 publications

(86 citation statements)

References 17 publications

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“…One potential mode of fixation for this pathologic entity is the suture button technique. Proponents of this method have described equivocal outcomes with a decreased risk of hardware failure compared with screw fixation, a reduced rate of required secondary surgery for hardware removal, and the allowance of some anatomic motion about the syndesmotic complex after insertion (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12).…”

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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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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“…They found similar results between groups in cyclic loading. Neither of the groups could not restore the native ankle motion [48].…”

Section: Suture Button Fixationmentioning

confidence: 79%

Suture Button Fixation for Syndesmosis Injuries: Review of the Literature

A¹

2014

Clin Res Foot Ankle

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Syndesmosis injuries -also known as high ankle sprains-have an increasing popularity because of an increased awareness of diagnosis. Different from lateral ankle sprains, mechanism of injury mostly involves external rotation, eversion and excessive dorsiflexion. Other mechanisms can also cause sydesmosis injuries. Because of high levels of missed injuries the real prevalence of syndesmosis injuries is underestimated. It is less frequently seen than lateral ankle injuries. For diagnosis, physical and radiological examination is essential.In radiological examination, associated injuries must be determined if present. Mostly seen associated injury is ankle fracture. Nonoperative treatment provides good results for syndesmosis injuries. Surgical treatment is indicated when syndesmosis injuries include frank diastasis. Arthroscopic view of syndesmotic instability is another indication. Failed conservative treatment may also be an indication. There are a lot of options for surgical fixation. Screws are the most popular among others but there are some complications about them. Alternatively, suture button fixation technique can be used. Suture button fixation is an implant with two metallic buttons surrounded with thick fiberwire sutures. Its stabilization mechanism depends on compression of two buttons to opposite sites by the help of fiberwire. It is designed to resist diastasis but allows small movement to other planes. It is very suitable for fixation of syndesmosis injuries and also to have less complication rates. Purpose of this study is to discuss the syndesmotic injuries and review the suture button fixation technique for the treatment.

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“…Contrario a los estudios antes mencionados, Soin y colaboradores en su estudio biomecánico que comparó TightRope® y tornillos, se evidenció que ambos grupos soportaron cargas similares y ninguno recuperó el rango normal de movimiento del tobillo previo a la fractura; asimismo, Degroot y colaboradores afirmaron que con TightRope® podría presentarse osteólisis cerca del botón por lo que se requeriría ingresar nuevamente a quirófano [17,18]. Sin embargo esta complicación puede evitarse con una adecuada técnica al momento de colocar el endobotón sobre la cortical ósea.…”

Section: Discussionunclassified

Caso Clínico: Fractura de Tobillo Weber B, Tratamiento Quirúrgico con Doble Sistema Tightrope®

Maldonado¹,

Dominguez²,

Galarza

et al. 2017

Rev. Méd. HJCA

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INTRODUCCIÓN:Las fracturas de tobillo representan un motivo frecuente de visita a los servicios de emergencias, constituyen el 25 % de las fracturas de miembro inferior. Al manejarse inadecuadamente pueden generar artrosis, por lo que adquiere importancia el manejo adecuado y oportuno que permita recuperar la movilidad temprana.CASO CLÍNICO: Paciente femenino de 17 años de edad, deportista (danza profesional), sin antecedentes patológicos de importancia, acudió al servicio de emergencias por sufrir caída de 2 metros de altura, mientras practicaba deporte, sufriendo trauma directo en miembro inferior izquierdo. Al examen físico el tobillo izquierdo se evidenció deformidad, dolor a la digitopresión, imposibilidad de apoyar el pie, inestabilidad de la articulación tibioperónea indicando lesión de la sindesmosis, tumefacción, equimosis, pulso pedio y tibial posterior presente, llenado capilar normal, y sensibilidad distal conservada. El diagnóstico fue fractura de tobillo tipo B de Weber. EVOLUCIÓN:Se realizó una reducción con osteosíntesis «tercio de caña» y fijación interna mediante doble sistema Tightrope®, luego del procedimiento permaneció 4 semanas con yeso cerrado, evidenciándose un adecuado proceso consolidativo en los controles radiográ-ficos posteriores. Luego de un mes de terapia física presentó recuperación de la movilidad y negó presentar dolor o sensación de disconfort; el resultado funcional fue satisfactorio y luego de dos meses retomó su actividad regular. CONCLUSIÓN:El manejo activo con cirugía y fijación mediante sistema Tightrope® en fracturas de tobillo constituye una opción de tratamiento alternativa y eficaz en lugar de clavos sindesmales. En pacientes deportistas o con alta demanda de actividad física evita una reintervención quirúrgica y permite un retorno precoz a las actividades habituales. *DESCRIPTORES DeCS

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Suture-Button versus Screw Fixation in a Syndesmosis Rupture Model: A Biomechanical Comparison

Abstract: It appears the suture-button behaves similarly to the syndesmotic screw in the syndesmotic rupture injury model tested. Clinical trials are needed to determine how the device performs in vivo.

Cited by 85 publications

References 17 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

Suture Button Fixation for Syndesmosis Injuries: Review of the Literature

Caso Clínico: Fractura de Tobillo Weber B, Tratamiento Quirúrgico con Doble Sistema Tightrope®

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