Kyle S Peterson1, W Drew Chapman2, Christopher F Hyer3, Gregory C Berlet3. 1. Suburban Orthopaedics, Bartlett, IL, USA ofacresearch@orthofootankle.com. 2. Harvard Foot and Ankle, Hollywood, FL, USA. 3. Orthopedic Foot and Ankle Center, Westerville, OH, USA.
Abstract
BACKGROUND: Malreduction of the syndesmosis can lead to increased peak pressures and subsequent arthritis. The purpose of this study was to evaluate the initial syndesmotic reduction and radiographic maintenance when using a knotless suture button fixation device for treatment of syndesmotic injury. METHODS: A retrospective chart and radiographic review was performed to identify patients who underwent open reduction internal fixation of ankle syndesmosis ruptures treated with a knotless, suture button fixation system. Radiographic measurements included medial clear space, tibiofibular overlap, tibiofibular clear space, and the distance between buttons. Fifty-six patients underwent repair of an ankle fracture with syndesmotic rupture over a 3-year period, with a mean follow-up of 160.9 days. RESULTS: The tibiofibular clear space and tibiofibular overlap significantly improved from pre- to first postoperative, but also demonstrated some loss of fixation at final follow-up (P < .001). The distance between the buttons increased on average 1.1 mm from immediate postoperative to final follow-up, demonstrating some postoperative creep and loss of fixation in the system. A low complication rate and need for a revision operation was found in our patient cohort. Some loss of reduction did occur postoperatively, although this did not correlate to adverse patient outcomes. CONCLUSION: Syndesmotic stabilization, using a knotless suture button fixation device demonstrated adequate initial syndesmotic reduction, but also exhibited an increase in the tibiofibular clear space and tibiofibular overlap, relative to initial postfixation position, at short-term follow-up. LEVEL OF EVIDENCE: Level IV, retrospective case series.
BACKGROUND: Malreduction of the syndesmosis can lead to increased peak pressures and subsequent arthritis. The purpose of this study was to evaluate the initial syndesmotic reduction and radiographic maintenance when using a knotless suture button fixation device for treatment of syndesmotic injury. METHODS: A retrospective chart and radiographic review was performed to identify patients who underwent open reduction internal fixation of ankle syndesmosis ruptures treated with a knotless, suture button fixation system. Radiographic measurements included medial clear space, tibiofibular overlap, tibiofibular clear space, and the distance between buttons. Fifty-six patients underwent repair of an ankle fracture with syndesmotic rupture over a 3-year period, with a mean follow-up of 160.9 days. RESULTS: The tibiofibular clear space and tibiofibular overlap significantly improved from pre- to first postoperative, but also demonstrated some loss of fixation at final follow-up (P < .001). The distance between the buttons increased on average 1.1 mm from immediate postoperative to final follow-up, demonstrating some postoperative creep and loss of fixation in the system. A low complication rate and need for a revision operation was found in our patient cohort. Some loss of reduction did occur postoperatively, although this did not correlate to adverse patient outcomes. CONCLUSION: Syndesmotic stabilization, using a knotless suture button fixation device demonstrated adequate initial syndesmotic reduction, but also exhibited an increase in the tibiofibular clear space and tibiofibular overlap, relative to initial postfixation position, at short-term follow-up. LEVEL OF EVIDENCE: Level IV, retrospective case series.
Authors: Christopher T Cosgrove; Sara M Putnam; Steven M Cherney; William M Ricci; Amanda Spraggs-Hughes; Christopher M McAndrew; Michael J Gardner Journal: J Orthop Trauma Date: 2017-08 Impact factor: 2.512
Authors: Paul F Förschner; Knut Beitzel; Andreas B Imhoff; Stefan Buchmann; Georg Feuerriegel; Felix Hofmann; Dimitrios C Karampinos; Pia Jungmann; Jonas Pogorzelski Journal: Orthop J Sports Med Date: 2017-04-27
Authors: Neel K Patel; Conor I Murphy; Thomas R Pfeiffer; Jan-Hendrik Naendrup; Jason P Zlotnicki; Richard E Debski; MaCalus V Hogan; Volker Musahl Journal: J Exp Orthop Date: 2020-03-30