Tightrope fixation of ankle syndesmosis injuries: Clinical outcome, complications and technique modification

Naqvi, Gohar A.; Shafqat, Aseer; Awan, Nasir

doi:10.1016/j.injury.2011.10.002

Cited by 140 publications

(128 citation statements)

References 15 publications

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“…The suture-button technique is relatively new and it provides dynamic fixation of the distal syndesmosis [16,46]. The physiologic micromotion could be more preserved than traditional rigid fixation.…”

Section: Discussionmentioning

confidence: 99%

“…Theoretically, routine removal of suturebutton was not necessary. But recent literature has reported about local soft tissue irritation of suture-button, and Naqvi et al [46] had recommended hardware removal. The present review only found one local irritation and one superficial The better results of the suture-button technique in shortand intermediate-term followup has made it a promising way for syndesmotic injury treatment.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Internal fixation of distal tibiofibular syndesmotic injuries: a systematic review with meta-analysis

Wang

et al. 2013

International Orthopaedics (SICOT)

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No consensus had been reached about the optimal method for syndesmotic fixation. The present study analysed syndesmotic fixation based on the highest level of clinical evidence in order to obtain more reliable results. Medline, Embase and Cochrane database were searched through the OVID retrieval engine. Manual searching was undertaken afterward to identify additional studies. Only randomized controlled trials (RCT) and prospective comparative studies were selected for final inclusion. Study screening and data extraction were completed independently by two reviewers. All study characteristics were summarized into a table. The extracted data were used for data analysis. Twelve studies were finally included: six of them were RCTs, two were quasi-randomized studies and four were prospective comparative studies. Four comparisons with traditional metallic screw were identified in terms of bioabsorbable screws, tricortical fixation method, suture-button device as well as non-fixation choice in low syndesmotic injuries. Both absorbable screws and the tricortical fixation method showed almost no better results than traditional quadricortical metallic screw (p>0.05). Additionally, existing studies could not illustrate their efficiency of reducing hardware removal rate. The suture button technique had significantly better functional score (p=0.003), ankle motion (p=0.02), time to full weightbearing (p<0.0001) and much less complications (p=0.0008) based on short and intermediate term follow-up data. Transfixation in low syndesmotic injuries showed poorer results than the non fixed group in all outcome measurements, but didn't reach a significant level (p>0.05). The present evidence still couldn't find superior performance of the bioabsorbable screw and tricortical fixation method. Their true effects in decreasing second operation rate need further specific studies. Better results of the suturebutton made it a promising technique, but it still needs long-term testing and cost-efficiency studies. The patients with low syndemotic injuries should be well assessed before fixation determination and the indication of screw placement in such conditions needs to be further defined.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Internal fixation of distal tibiofibular syndesmotic injuries: a systematic review with meta-analysis

Wang

et al. 2013

International Orthopaedics (SICOT)

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“…[130][131][132][133][134][135][136][137][138][139][140][141][142][143][144] A hole is drilled through the fibula and tibia, and then a suture is passed through and secured on both ends via a metallic button. Systematic reviews of low levels of clinical evidence have demonstrated similar functional outcomes, with quicker return to work and less frequent need for implant removal.…”

Section: Dynamic Fixationmentioning

confidence: 99%

Acute and Chronic Injuries to the Syndesmosis

Switaj

Mendoza

Kadakia

2015

Clinics in Sports Medicine

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“…12,[25][26][27] For chronic medial ankle instability, a skin incision measuring about 4 cm was made from the medial malleolus to the navicular bone, followed by incision of the crural fascia in the same direction as the skin incision to expose the tibionavicular band. The end of the band was cut off at a point approximately 2 to 3 mm from the medial malleolus.…”

Section: Surgical Proceduresmentioning

confidence: 99%

Concomitant Syndesmotic Instability and Medial Ankle Instability Are Risk Factors for Unsatisfactory Outcomes in Patients With Chronic Ankle Instability

Kim

Young

Cho

et al. 2015

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Tightrope fixation of ankle syndesmosis injuries: Clinical outcome, complications and technique modification

Cited by 140 publications

References 15 publications

Internal fixation of distal tibiofibular syndesmotic injuries: a systematic review with meta-analysis

Internal fixation of distal tibiofibular syndesmotic injuries: a systematic review with meta-analysis

Acute and Chronic Injuries to the Syndesmosis

Concomitant Syndesmotic Instability and Medial Ankle Instability Are Risk Factors for Unsatisfactory Outcomes in Patients With Chronic Ankle Instability

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