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Suture button fixation design kept syndesmotic reduction of most Weber C fractures

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CHICAGO — Researchers from the United Kingdom found the use of a novel suture button fixation design successfully maintained the reduced syndesmosis in 97% of patients with Weber C ankle fractures.

“Weber C ankle fractures with syndesmosis can be successfully treated using TightRope,” Amirjit Anand, MBBS, BSc, said during a presentation at the American Academy of Orthopaedic Surgeons Annual Meeting. “We had a low complication rate. We have to use a cautious approach in children.”

Anand mentioned that the Arthrex TightRope (Naples, Fla.) is a “relatively new design” that uses suture buttons and a No. 5 FiberWire (Arthrex) loop. He said that the design does not require removal of diastasis screws and allows for a more “physiological reconstruction.”

 

Amirjit Anand

Anand and colleagues performed a retrospective study of 36 patients with Weber C ankle fractures with syndesmosis. They excluded patients with peripheral vascular disease, neuropathy, open fractures or Weber B fractures. They treated 21 patients with a single TightRope and 15 patients with two TightRopes. The patients were not allowed weight-bearing for 8 weeks and each completed postoperative physiotherapy. The mean follow-up was 12 months. Outcome measures included the American Orthopaedic Foot and Ankle Society (AOFAS) and Olerud and Molander ankle scores.

The mean AOFAS score was 53.4 and the mean Olerud and Molander score was 90. One case failed at 2 weeks and needed revision.

“The use of TightRope is an acceptable and attractive alternative to the use of diastasis screws for well-selected cases,” the authors wrote in their study abstract. “Good surgical technique is required and care should be taken with the fibula-sided knot to ensure that it is well buried.”

Reference:

Anand A. Paper #22. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 19-23, 2013; Chicago.

Disclosure: Anand has no relevant financial disclosures.