Comparison of a Novel FiberWire-Button Construct versus Metallic Screw Fixation in a Syndesmotic Injury Model

Forsythe, Kevin; Freedman, Kevin B.; Stover, Michael D.; Patwardhan, Avinash G.

doi:10.3113/fai.2008.0049

Cited by 109 publications

(85 citation statements)

References 35 publications

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“…The more recent development is the Endobutton fixation and its use is rapidly increasing; potentially, this technique has the following advantages: allows physiologic micromotion at the syndesmosis and thus an earlier return to weightbearing was possible, lessens the risk of hardware pain and the implant removal will not be necessary, without the risk of screw breakage and subsequent recurrent syndesmotic diastasis [15,[23][24][25]. However, this method still has some defects such as the suture loop may relax under weightbearing conditions, local irritation, osteolysis of the bone and subsidence of the device into the bone (as was occasionally observed), and its relatively high cost and complexity [17,26]. The bionic fixation construct we described in the present study was developed with the goal of more accurately recreating the native anatomy.…”

Section: Discussionmentioning

confidence: 89%

“…More recently, flexible fixation using the suture button device has been applied, which allows physiologic motion in the tibiofibular joint and, meanwhile, maintains the reduction of the ankle [14][15][16]. However, this method still has some drawbacks such as the suture between buttons can gradually relax under weightbearing conditions [17], and it has a relatively high cost and complexity.…”

Section: Introductionmentioning

confidence: 99%

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Biomechanical comparison of bionic, screw and Endobutton fixation in the treatment of tibiofibular syndesmosis injuries

Wang

et al. 2015

International Orthopaedics (SICOT)

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Section: Discussionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Biomechanical comparison of bionic, screw and Endobutton fixation in the treatment of tibiofibular syndesmosis injuries

Wang

et al. 2015

International Orthopaedics (SICOT)

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“…Inadequate fixation and foreign-body reactions from the suture-button placement have been reported. 10,16,25,32 Fracture of the index metacarpal has also been reported following SBS. 15,36 Since those reports, the Arthrex secondgeneration Mini TightRope kit includes a 1.1-mm guidewire to drill the metacarpal instead of the 2.7-mm drill used in the earlier systems.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical Comparison of Suture-Button Suspensionplasty and LRTI for Basilar Thumb Arthritis

Desai

Brogan

Richard

et al. 2016

Hand (New York, N,Y.)

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Surgery ArticleOsteoarthritis (OA) at the base of the thumb can cause severe pain, weakness, and deformity and can result in marked disability. 14 The unique anatomy of the thumb carpometacarpal (CMC) joint predisposes it to degenerative arthritis. 5,27 Specifically, the degree of weakening of the palmar beak ligament has been correlated with degenerative processes in the joint and is the target of ligament reconstruction for symptomatic arthritis. 7 Degenerative OA at the thumb CMC joint is treated initially with activity modification, splinting, medication, and intra-articular corticosteroid injections. 34 For advanced disease, or when nonoperative treatments have failed, surgical intervention can be considered. Surgical options include volar ligament reconstruction, 11 first metacarpal osteotomy, 13 CMC joint arthrodesis, 12 total joint arthroplasty, 1 and trapeziectomy with or without ligament reconstruction and tendon interposition (LRTI). 3,9 Comparative studies have shown no significant long-term difference in outcomes among these techniques, 18,[29][30][31] aside from a lower complication rate 30,31 and shorter operative time with trapeziectomy alone. 20 The use of a suture-button suspensionplasty (SBS) with trapeziectomy has grown in popularity. 6,24,35,36 Advocates of this technique cite safety, ease of use, early mobilization, and good early results. 35,36 However, it is not known how effectively the SBS withstands metacarpal subsidence under loaded conditions. The purpose of this study was to biomechanically compare the more widely adopted LRTI procedure with SBS using a cadaveric model. We hypothesize that the SBS will result in a biomechanically stronger construct with immediate loading. Demonstration of an enhanced ability to withstand early active pinch while preventing metacarpal subsidence may support early motion rehabilitation protocols. Abstract Background: The purpose of this study was to compare the initial biomechanical strength of trapeziectomy and suturebutton suspensionplasty (SBS) with ligament reconstruction and tendon interposition (LRTI) for thumb carpometacarpal (CMC) arthritis in a cadaveric model. Methods: Eight matched pairs of below-elbow cadaveric arms were used for this study. Each specimen was randomly assigned to either receive a trapeziectomy and LRTI (LRTI group) or trapeziectomy and SBS (SBS group). Using previously described and validated testing protocols, physiological key pinch was simulated. The thumb metacarpal was then incrementally loaded from 5 to 20 lbs, using 5-lb increments. Metacarpal subsidence during physiological key pinch and incremental loading was determined using radiographic measurements of trapezial space height. Results: The average pretesting trapezial space height did not differ significantly between the LRTI (11.9 mm) and SBS (13.7 mm) groups. After simulated physiological key pinch, the SBS group had significantly greater average trapezial space height compared with the LRTI group (8.0 mm vs 5.5 mm). For each incremental metacarpal load from 5...

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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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Comparison of a Novel FiberWire-Button Construct versus Metallic Screw Fixation in a Syndesmotic Injury Model

Abstract: The FiberWire-button implant may not maintain adequate ankle syndesmotic reduction in the immediate post-operative period relative to a metallic screw.

Cited by 109 publications

References 35 publications

Biomechanical comparison of bionic, screw and Endobutton fixation in the treatment of tibiofibular syndesmosis injuries

Biomechanical comparison of bionic, screw and Endobutton fixation in the treatment of tibiofibular syndesmosis injuries

Biomechanical Comparison of Suture-Button Suspensionplasty and LRTI for Basilar Thumb Arthritis

Acute and Chronic Injuries to the Syndesmosis

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