Tips, Quips, and PearlsA Modified Technique for Fixation of Chronic Instability of the Distal Tibiofibular Syndesmosis Using a Wire and Button
Section snippets
Surgical Technique
The technical steps before insertion of the wire and button fixation device were similar to suture button fixation described by DeGroot et al (9). After reduction of the fracture, repair of the syndesmosis was initiated. For chronic instability of the distal tibiofibular syndesmosis, the fibrous scar and soft tissue in the distal syndesmosis can interfere with the reduction procedure and, therefore, should be trimmed thoroughly. The syndesmosis can then be reduced and maintained in position
Discussion
Distal tibiofibular syndesmosis injury can be classified as acute, subacute, and chronic (10). A chronic syndesmosis injury has been defined as persistent syndesmotic widening 3 months after the injury. At that point, the ruptured anterior tibiofibular ligament, posterior tibiofibular ligament, and interosseous tibiofibular ligament have either healed in an elongated position or formed fibrous scar tissue. The latter has been more commonly confirmed at surgery. Each of these ligaments
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Cited by (11)
Salvage of Chronic Syndesmosis Instability: A Retrospective Review With Mid-Term Follow-Up
2023, Journal of Foot and Ankle SurgeryA Novel Adjustable EndoButton Fixation Assisted by 3D Printing Technology for Tibiofibular Syndesmosis Injury: A Biomechanical Study
2022, Frontiers in Bioengineering and BiotechnologyComparison of elastic syndesmosis hook plate and suture-button technique in treatment of syndesmosis injury
2021, Chinese Journal of Orthopaedic TraumaReconstruction of Chronic Injured Distal Tibiofibular Syndesmosis with Autogenous Tendon Graft: A Systematic Review
2021, BioMed Research InternationalTitanium cable isotonic annular fixation system for the treatment of distal tibiofibular syndesmosis injury
2019, American Journal of Translational ResearchStrength of suture-button fixation versus ligament reconstruction in syndesmotic injury: a biomechanical study
2019, International Orthopaedics
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Conflict of Interest: None reported.