Suture button fixation improved outcomes of syndesmosis injuries vs syndesmotic screw fixation
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Patients with syndesmosis injuries of the ankle who underwent suture button fixation had improved functional outcomes and lower rates of broken implant and joint malreduction compared with patient who had syndesmotic screw fixation, according to results of a meta-analysis.
John G. Kennedy, MD, MCh , MMSc , FFSEM, FRCS(Orth), and colleagues performed a meta-analysis that included five randomized controlled trials that compared suture button and syndesmotic screw fixation techniques for syndesmosis injuries. Overall, researchers compared 143 patients who underwent suture button fixation with 142 patients who underwent syndesmotic screw fixation.
Results showed a higher postoperative American Orthopaedic Foot & Ankle Society score and a more favorable Olerud-Molander score among patients in the suture button fixation group. Researchers also found a lower rate of broken implants, implant removal and joint malreduction among the suture button fixation group vs. the syndesmotic screw fixation group.
By preserving physiological ankle motion, Kennedy noted patients who undergo suture button technique may return to activities sooner.
“This meta-analysis is based on only level 1 evidence studies therefore, at this time, the suture-button technique warrants a grade A recommendation for syndesmosis injuries,” Kennedy, who is chief of the division of foot and ankle surgery in the department of orthopedic surgery at NYU Langone Health, told Healio.com/Orthopedics. “This is not a condemnation of screw fixation. However, based on the best available evidence to date, suture-button technique is recommended as a standard treatment for syndesmosis stabilization.” – by Casey Tingle
Disclosures: Kennedy reports he receives support from Ohnell Family Foundation and Mr. and Mrs. Michael J. Levitt. Please see the study for a list of all other authors’ relevant financial disclosures.
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