The Effect of Varying Tension of a Suture Button Construct in Fixation of the Tibiofibular Syndesmosis—Evaluation Using Stress Computed Tomography

Morellato, John; Louati, Hakim; Bodrogi, Andrew; Stewart, Andrew D.; Papp, Steven; Liew, Allan; Gofton, Wade

doi:10.1097/bot.0000000000000737

Cited by 8 publications

(10 citation statements)

References 32 publications

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“…Previous studies have shown increased posterior translation of the fibula with SB constructs compared to screw constructs, 6 and excessive sagittal plane motion has remained a primary concern with the use of SB in syndesmosis repair. 17,21,26,33,34 This study demonstrates a lack of excessive sagittal plane motion under simulated physiologic, lower torque conditions in an isolated syndesmotic injury model.…”

Section: Discussionmentioning

confidence: 64%

Anterior Inferior Tibiofibular Ligament Suture Tape Augmentation for Isolated Syndesmotic Injuries

et al. 2022

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Background: The best operative construct and technique for treatment of isolated syndesmotic injuries is highly debated. The purpose of this study was to determine whether the addition of anterior inferior tibiofibular ligament (AITFL) suture repair or suture tape (ST) augmentation provides any biomechanical advantage to the operative repair of an isolated syndesmotic injury. Methods: Twelve lower leg specimens underwent biomechanical testing in 6 states: (1) intact, (2) AITFL suture repair, (3) AITFL suture repair + transsyndesmotic suture button (SB), (4) AITFL suture repair + ST augmentation + SB, (5) AITFL suture repair + ST augmentation, and (6) complete syndesmotic injury. The ankle joint was subjected to 6 cycles of 5 Nm internal and external rotation torque under a constant axial load. The spatial relationship between the tibia, fibula, and talus was continuously recorded with a 5-camera motion capture system. Results: AITFL suture repair and AITFL suture repair + ST augmentation showed no statistically significant change in fibula kinematics compared to the intact state. Compared to native, AITFL suture repair + SB showed increased fibular external rotation (+2.32 degrees, P < .001), and decreased tibiofibular gap (overtightening) (–0.72 mm, P = .007). AITFL suture repair + ST augmentation + SB also showed increased fibular external rotation (+1.46 degrees, P = .013). Sagittal plane motion of the fibula was not significantly different between any states. None of the repairs restored intact state talus rotation; however, the repairs that used ST augmentation reduced the talus external rotation laxity compared to the complete syndesmotic injury. Conclusion: AITFL suture repair and AITFL ST augmentation best restored the rotational kinematics and stability of the fibula and ankle joint in an isolated syndesmotic injury model. Clinical Relevance: AITFL suture repair with or without ST augmentation may be a good operative addition or alternative to SB fixation for isolated syndesmotic disruptions.

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Section: Discussionmentioning

confidence: 64%

Anterior Inferior Tibiofibular Ligament Suture Tape Augmentation for Isolated Syndesmotic Injuries

et al. 2022

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“…Overcompression of the syndesmosis has been demonstrated in multiple cadaveric studies, 16,39,40 as well as in vivo. 41 This is facilitated by the large mechanical advantage produced by the reduction forceps, especially when larger pelvic reduction forceps are utilized.…”

Section: Discussionmentioning

confidence: 94%

A Novel Indirect Reduction Technique in Ankle Syndesmotic Injuries: A Cadaveric Study

Cosgrove

Spraggs-Hughes

Putnam

et al. 2018

Journal of Orthopaedic Trauma

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“…O uso de TC vem se destacando em vários estudos como os de Fitzpatrick et al (11) , Morellato et al (12) e Elgafy et al (13) , os quais demonstraram que a análise de tomografias computadorizadas é um fator importante para verificação de resultados ineficientes na redução e estabilização de uma lesão da sindesmose.…”

Section: Discussionunclassified

Rate of unsatisfactory syndesmotic reduction by means of a postoperative tomographic study

et al. 2018

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Objective: To analyse the rate of unsatisfactory reduction in syndesmosis injuries by means of a postoperative tomographic study. Methods: This was a prospective study conducted from March to December 2017. Thirty patients with syndesmosis injury were selected, and ankle tomography was performed during the first postoperative period. A form developed for the study was used to collect demographic data (sex and age in years) and postoperative data (operated side, Weber classification, computed tomography results and need for surgical reoperation). The images were evaluated using tomographic criteria. The intraoperative analysis was performed through radioscopy and by direct visualization of the syndesmosis. Results: The majority of the patients were male (56.7%), ranging in age from 17 to 51 years; 53.3% of the patients were operated on the left side; 66.7% were classified as type C; and 66.7% did not undergo reoperation. Regarding the rate of unsatisfactory syndesmosis reduction, it was foundthat 25.9% of the analyses of the established variables presented unsatisfactory results. It was observed that 74.1% of the criteria presented satisfactory results; however, criterion B presented a significant rate (37%) of unsatisfactory results. Conclusion: Based on the computed tomographic scans, there was a high percentage of unsatisfactory reductions in syndesmosis injuries. Thus, it was concluded that, even using the correct fixation techniques and adequate intraoperative scopic monitoring, distal tibiofibular joint incongruence can still be observed when investigated using postoperative tomography. Level of Evidence II; Diagnostic Studies.

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The Effect of Varying Tension of a Suture Button Construct in Fixation of the Tibiofibular Syndesmosis—Evaluation Using Stress Computed Tomography

Cited by 8 publications

References 32 publications

Anterior Inferior Tibiofibular Ligament Suture Tape Augmentation for Isolated Syndesmotic Injuries

Anterior Inferior Tibiofibular Ligament Suture Tape Augmentation for Isolated Syndesmotic Injuries

A Novel Indirect Reduction Technique in Ankle Syndesmotic Injuries: A Cadaveric Study

Rate of unsatisfactory syndesmotic reduction by means of a postoperative tomographic study

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