Suture-button syndesmosis fixation: accelerated rehabilitation and improved outcomes

Syndesmosis screws have significant problems including loosening, breakage, the need for removal, and late diastasis. A new technique of syndesmosis fixation is proposed in this study, in which a heavy suture is placed across the syndesmosis, which has been looped and tightened through cortical butt...

Full description

Saved in:
Bibliographic Details
Published inClinical orthopaedics and related research no. 431; p. 207
Main Authors Thornes, Brian, Shannon, Fintan, Guiney, Anne-Marie, Hession, Paul, Masterson, Eric
Format Journal Article
LanguageEnglish
Published United States 01.02.2005
Subjects
Adult
Aged
Ankle Injuries - diagnostic imaging
Ankle Injuries - surgery
Bone Screws
Female
Fracture Fixation, Internal
Fractures, Bone - diagnostic imaging
Fractures, Bone - surgery
Humans
Male
Middle Aged
Patient Satisfaction
Prospective Studies
Sutures
Tomography, X-Ray Computed
Treatment Outcome
Online AccessGet more information

Cover

More Information
Summary:Syndesmosis screws have significant problems including loosening, breakage, the need for removal, and late diastasis. A new technique of syndesmosis fixation is proposed in this study, in which a heavy suture is placed across the syndesmosis, which has been looped and tightened through cortical button anchors on either side of the ankle. Indirect placement of the medial button avoids a medial incision. Sixteen patients had this suture-button fixation in a prospective clinical study. Mean American Orthopaedic Foot and Ankle Society ankle scores were significantly better in patients who had suture-button fixation than in a comparative group of 16 patients who had syndesmosis screw fixation at 3 months (91 versus 80, respectively) and at 12 months postoperatively (93 versus 83, respectively). Return to work was faster (2.8 months in patients who had suture-button fixation versus 4.6 months who had syndesmosis screw fixation), and no patients who had suture-buttons required secondary surgery for implant removal. Axial computed tomography scanning at 3 months showed maintenance of reduction. Suture-button fixation is simple, safe, and effective. Patients have had improved outcomes and faster rehabilitation, without needing routine implant removal. It may become the treatment of choice in patients with a syndesmosis injury.
ISSN:0009-921X
DOI:10.1097/01.blo.0000151845.75230.a0