Hong-Yun Li1, Ru-Shou Zhou2, Zi-Ying Wu1, Yutong Zhao3, Shi-Yi Chen1, Ying-Hui Hua4. 1. Sports Medicine Center of Fudan University, Department of Sports Medicine and Arthroscopy Surgery, Huashan Hospital, Fudan University, No. 12 Urumq Middle Road, Shanghai, 200040, China. 2. Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, 650027, Yunnan, China. 3. Dunn School, Los Olivos, CA, USA. 4. Sports Medicine Center of Fudan University, Department of Sports Medicine and Arthroscopy Surgery, Huashan Hospital, Fudan University, No. 12 Urumq Middle Road, Shanghai, 200040, China. hua023@hotmail.com.
Abstract
PURPOSE: To compare the biomechanical characteristics of suture-button fixation versus ligament reconstruction using semitendinosus tendon autograft in treatment of syndesmotic injury in cadaver biomechanical study. METHODS: Eight matched pairs of human cadaveric lower-extremities were measured intact, then following simulated syndesmosis injury by cutting the anterior tibiofibular ligament (AITFL), the distal 15 cm of the interosseous membrane (IO), and the deltoid ligament. Thereafter, the syndesmotic injury was treated by suture-button fixation or ligament reconstruction. The semitendinosus tendon was harvested as a graft. Biomechanical testing was performed after the surgical fixation. The foot underwent rotation from neutral position to an external rotation at a rate of 5°/s to 12.5 Nm. The three-dimensional syndesmotic diastasis readings, final rotation torque, and rotational angle were recorded. RESULTS: No difference was found in fibular displacements between two groups. Moreover, no significant difference was found in final rotation torque (11.95 ± 1.03 VS 11.66 ± 1.18 Nm, P = 0.62) and rotation angle (43.61° ± 14.77° VS 40.93° ± 10.94°, P = 0.56) in the suture-button group and ligament reconstruction group. CONCLUSION: The stability of the suture-button fixation was equivalent to ligament reconstruction using semitendinosus tendon autograft in treatment of syndesmotic injury as determined with biomechanical testing. However, this study does not prove that one is advantageous over the other.
PURPOSE: To compare the biomechanical characteristics of suture-button fixation versus ligament reconstruction using semitendinosus tendon autograft in treatment of syndesmotic injury in cadaver biomechanical study. METHODS: Eight matched pairs of human cadaveric lower-extremities were measured intact, then following simulated syndesmosis injury by cutting the anterior tibiofibular ligament (AITFL), the distal 15 cm of the interosseous membrane (IO), and the deltoid ligament. Thereafter, the syndesmotic injury was treated by suture-button fixation or ligament reconstruction. The semitendinosus tendon was harvested as a graft. Biomechanical testing was performed after the surgical fixation. The foot underwent rotation from neutral position to an external rotation at a rate of 5°/s to 12.5 Nm. The three-dimensional syndesmotic diastasis readings, final rotation torque, and rotational angle were recorded. RESULTS: No difference was found in fibular displacements between two groups. Moreover, no significant difference was found in final rotation torque (11.95 ± 1.03 VS 11.66 ± 1.18 Nm, P = 0.62) and rotation angle (43.61° ± 14.77° VS 40.93° ± 10.94°, P = 0.56) in the suture-button group and ligament reconstruction group. CONCLUSION: The stability of the suture-button fixation was equivalent to ligament reconstruction using semitendinosus tendon autograft in treatment of syndesmotic injury as determined with biomechanical testing. However, this study does not prove that one is advantageous over the other.
Authors: Jason M Schon; Brady T Williams; Melanie B Venderley; Grant J Dornan; Jonathon D Backus; Travis Lee Turnbull; Robert F LaPrade; Thomas O Clanton Journal: Foot Ankle Int Date: 2016-10-13 Impact factor: 2.827
Authors: George Parlamas; Charles P Hannon; Christopher D Murawski; Niall A Smyth; Yan Ma; Gino M Kerkhoffs; C Niek van Dijk; Jon Karlsson; John G Kennedy Journal: Knee Surg Sports Traumatol Arthrosc Date: 2013-04-26 Impact factor: 4.342
Authors: Sandeep P Soin; Trevor A Knight; A Feroz Dinah; Simon C Mears; Bart A Swierstra; Stephen M Belkoff Journal: Foot Ankle Int Date: 2009-04 Impact factor: 2.827