Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Background: Operative treatment is indicated for unstable syndesmosis injuries, and approximately 20% of all ankle fractures require operative fixation for syndesmosis injuries.
Purpose: To perform a meta-analysis of randomized controlled trials evaluating clinical outcomes between suture button (SB) and syndesmotic screw (SS) fixation techniques for syndesmosis injuries of the ankle.
Study Design: Meta-analysis.
Methods: A literature search was performed according to the PRISMA guidelines to identify randomized controlled trials comparing the SB and SS techniques for syndesmosis injuries. Level of evidence was assessed per the criteria of the Oxford Centre for Evidence-Based Medicine. Statistical analysis was performed with RevMan, and a value ≤.05 was considered statistically significant.
Results: Five clinical studies were identified, allowing comparison of 143 patients in the SB group with 142 patients in the SS group. Patients treated with the SB technique had a higher postoperative American Orthopaedic Foot & Ankle Society score at a mean 20.8 months (95.3 vs 86.7, < .001). The SB group resulted in a lower rate of broken implants (0.0% vs 25.4%, < .001), implant removal (6.0% vs 22.4%, = .01), and joint malreduction (0.8% vs 11.5%, = .05) as compared with the SS group.
Conclusion: The SB technique results in improved functional outcomes as well as lower rates of broken implant and joint malreduction. Based on the findings of this meta-analysis, the SB technique warrants a grade A recommendation by comparison with the SS technique for the treatment of syndesmosis injuries.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1177/0363546518804804 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Efficacy and safety of different fixation methods for acute syndesmosis injuries: protocol for a network meta-analysis of randomised and observational studies.
BMJ Open
August 2025
Orthopedics Center of PLA, The 940th Hospital of Joint Logistics Support Force Army of PLA, Lanzhou, Gansu, China
Introduction: Acute unstable syndesmosis injuries require accurate reduction and stable fixation to improve short-term and long-term outcomes. Several different fixation methods have been established for acute syndesmosis injuries, each with pros and cons. Although some meta-analyses have reported better outcomes with suture-buttons than screws, the optimal fixation method remains uncertain because of heterogeneous study results and limited comparisons of emerging techniques.
View Article and Find Full Text PDFEvaluation of the clinical and radiological outcomes of syndesmotic screws not parallel to the ankle joint.
J Foot Ankle Surg
August 2025
Department of Orthopaedics and Traumatology, Baltalimani Metin Sabanci Bone Diseases Training and Research Hospital, Istanbul, Turkey. Electronic address:
Purpose: This study aimed to evaluate the clinical and radiological outcomes of parallel and non-parallel placements of a single syndesmotic screw relative to the ankle joint line in the coronal plane used to enhance tibiofibular stability after syndesmosis injuries in ankle trauma surgery.
Methods: Eighty-nine patients with isolated Weber B and C fractures treated from January 2021 to December 2024 were evaluated. They were divided into two groups based on the angulation of the syndesmotic screw: Group 1 (49 patients) had screws angled between -3° and +3° (parallel), while Group 2 (40 patients) had nonparallel screws.
Deltoid and Syndesmotic Ligaments, Part 2. The Value of Ligament Repair and Augmentation in Restoring Biomechanical Rotational Ankle Stability.
Am J Sports Med
September 2025
Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich, (MUM), University Hospital, LMU Munich, Munich, Bavaria, Germany.
Background: Despite studies on syndesmotic and deltoid ligament (DL) repair, the biomechanical role of (partial or full) ligament repair and bracing in unstable ankles to regain rotational stability remains unclear.
Purpose: To determine the ability of surgical intervention on syndesmosis and SLs with suture repair and ligament bracing to restore intact external rotation ankle stability.
Study Design: Controlled laboratory study.
Deltoid and Syndesmotic Ligaments, Part 1. The Role of Injury on Biomechanical Rotational Ankle Instability.
Am J Sports Med
September 2025
Orthopedic Foot and Ankle Department, DrNasef OrthoClinic, Cairo, Egypt.
Background: The syndesmotic and deltoid ligament (DL) complex contributes to ankle stability. However, the biomechanical role of (partial or complete) ligamentous injuries on external rotation instability remains unclear.
Purpose: To determine the contribution of syndesmosis and DL injuries to external rotation instability compared with the intact ankle.
Development of a deep learning algorithm for radiographic detection of syndesmotic instability in ankle fractures with intraoperative validation.
Sci Rep
August 2025
Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Maximiliansplatz 3, 91054, Erlangen, Germany.
Identifying syndesmotic instability in ankle fractures using conventional radiographs is still a major challenge. In this study we trained a convolutional neural network (CNN) to classify the fracture utilizing the AO-classification (AO-44 A/B/C) and to simultaneously detect syndesmosis instability in the conventional radiograph by leveraging the intraoperative stress testing as the gold standard. In this retrospective exploratory study we identified 700 patients with rotational ankle fractures at a university hospital from 2019 to 2024, from whom 1588 digital radiographs were extracted to train, validate, and test a CNN.
View Article and Find Full Text PDF