A Prospective Randomized Multicenter Trial Comparing Clinical Outcomes of Patients Treated Surgically With a Static or Dynamic Implant for Acute Ankle Syndesmosis Rupture

Abstract

Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

Bioabsorbable Versus Metallic Screw Fixation for Tibiofibular Syndesmotic Ruptures: A Meta-Analysis

“…The use of these devices was not evaluated in our meta-analysis; however, this is an interesting topic for future research (25).…”

Acute and Chronic Injuries to the Syndesmosis

“…A prospective, randomized control trial demonstrated better clinical and radiographic outcomes with a dynamic device, with improved maintenance of reduction and lower reoperation rate. 131 Despite the increased cost of the implant, the decreased need for hardware removal may confer cost-effectiveness to this technique. Lastly, one can consider hybrid fixation with a screw and suture button construct for severe diastasis or large athletes.…”

“…The literature on dynamic fixation is evolving, with the recent high-level literature suggesting improved outcomes without the need for hardware removal. 131 The most pertinent, technical aspect of surgical treatment is the accuracy of the reduction. This aspect has been shown to be the most important independent predictor of clinical outcomes and vital in avoiding posttraumatic arthrosis.…”

“…[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.…”

Current trends in the diagnosis and management of syndesmotic injury

“…Some limited investigations have attempted to compare dynamic suture button fixation with syndesmotic screw fixation [54,[57][58][59][60][61][62]. Westermann et al performed a cadaveric study to see if there was a difference in the malreduction of syndesmotic injuries when comparing screw fixation with tightrope fixation [58].…”