A Comparison of Screw Fixation and Suture-Button Fixation in a Syndesmosis Injury in an Ankle Fracture

A systematic review of suture-button versus syndesmotic screw in the treatment of distal tibiofibular syndesmosis injury

“…After full texts assessed for eligibility, 1 article [14] was excluded, because the main topic of it was the introduction of TightRope fixation technique, besides, another publication [15] demonstrated a same research. Finally, a total number of 10 eligible articles [2, 4, 8, 9, 11, 12, 15–18] that are described in this systematic review. The suture-button fixation group included 196 participates, and 194 patients in the screw fixation group.…”

“…At the sixth postoperative week, full weight bearing was allowedShort leg splints for 3 weeks,after splint removal, partial weight bearing was allowed. At the sixth postoperative week, full weight bearing was allowedNRAlthough the functional outcomes were similar, the restoration of the fibular rotation in the treatment of syndesmotic injuries by screw fixation was troublesome and the volume of the distal tibiofibular space increased with thesuture-button fixation technique.Kim et al 2016 [2]A below-the-knee cast for 1 week, partial weightbearing at 6weeks postoperativelyA below-the-knee cast for 1 week, partial weightbearing 6 to 8 weeks postoperativelyNRBoth suture-button and metal screw fixation are effective treatment methods for an ankle fracture accompanied by syndesmotic injury.Seyhan 2015 [17]Plaster-splint for twoWeeks and then pressure-socks for 4 weeksPartial weight bearing using double crutches and then complete weight bearing at the end of the 3rd monthPlaster-splint for twoWeeks and then pressure-socks for 4 weeksPartial weight bearing using double crutches and then complete weight bearing at the end of the 3rd month (after screw removal)NRElastic fixation is as functional as screw fixation in the treatment of ankle syndesmosis injuries. The unnecessary need of a second surgical intervention for removal of the fixation material is another advantageous aspect of this method of fixation.Kortekangas 2015 [8]A below-the-knee cast with the ankle joint at a 90° for 6 weeks with partial weight bearing.…”

“…As persistent ankle pain, function disability, and early osteoarthritis are potential problems related to misdiagnosed or inadequate treatment of syndesmotic injuries [2, 3], thus, it is essential to acquire accuracy and maintenance of syndesmotic reduction when treating ankle fractures with concomitant syndesmotic injuries.…”

“…Anatomic reduction has been shown to be the most important predictor of clinical outcomes [11]. Optimal surgical management is still a subject of debate in the literature [2, 12]. Therefore, current systematic review was undertaken to make a comparison between suture-button fixation and screw fixation focusing on following outcomes: functional outcome, need for implant removal, implant failure, rate of malreduction, post-operative complications rate (except implant failure and malreduction), and cost-effectiveness aspects.…”

Akut ve kronik sindesmoz yaralanmaları

“…[70] Sindesmoz redük-siyonunun kalitesi göz önüne alındığında, düğme dikişlerdeki malredüksiyon oranı vidalarla eşdeğer ya da daha az görünmektedir. [70][71][72][73][74] Erken ya da geç dönem-de redüksiyon kaybı bildirilmemiştir. [75] Düğme dikiş-lere has bir komplikasyon, mediyaldeki düğmeye bağlı olarak tendon tuzaklanmasıdır.…”