Relieve Health Group

Relieve Health Group

Syndesmotic injuries, which involve damage to the connective tissue between the two bones of the lower leg, the tibia and fibula, can significantly impact a person’s mobility and quality of life. The accurate restoration of the space between these two bones, known as the syndesmotic space, is a key factor in the successful treatment of these injuries. Two common techniques used to achieve this are screw fixation and suture-button fixation. This article delves into a study that compared the effectiveness of these two techniques in restoring the syndesmotic space.

The study retrospectively reviewed patients aged 65 or below who had undergone either screw or suture-button fixation for syndesmotic injuries accompanying ankle fractures between January 2012 and March 2015. A total of 52 patients were included, with 26 treated with syndesmotic screws and 26 with suture-button fixation. The patients were divided into two groups based on the fixation method used.

The researchers used postoperative computed tomography (CT) scans to evaluate the effectiveness of the two techniques. They considered four parameters: anteroposterior reduction (the decrease in size from front to back), rotational reduction (the decrease in rotation), the cross-sectional syndesmotic area (the area of the space between the tibia and fibula), and the distal tibiofibular volumes (the volume of the lower part of the space between the tibia and fibula).

The functional outcomes of the patients were evaluated using the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scale. This scale measures pain and function in the ankle and hindfoot, with higher scores indicating better function. The average follow-up period was around 16.7 months, and the average age of the patients was 44.1 years.

The results of the study showed some interesting differences between the two techniques. In the screw fixation group, there was a significant decrease in the degree of fibular rotation and an increase in the upper syndesmotic area compared with the contralateral limb (the corresponding limb on the other side of the body). In contrast, in the suture-button fixation group, there was a significant increase in the lower syndesmotic area and distal tibiofibular volumes compared with the contralateral limbs.

In terms of functional outcomes, the mean AOFAS scores were 88.4 and 86.1 in the suture-button fixation and screw fixation group, respectively. However, there was no statistically significant difference in the functional ankle joint scores between the groups. This suggests that both techniques are similarly effective in terms of improving function after syndesmotic injuries.

The study concluded that while the functional outcomes were similar for both techniques, there were some challenges with each. The restoration of fibular rotation in the treatment of syndesmotic injuries by screw fixation was found to be troublesome. On the other hand, the volume of the distal tibiofibular space increased with the suture-button fixation technique.

In summary, this study provides valuable insights into the effectiveness of screw fixation and suture-button fixation techniques in treating syndesmotic injuries. While both techniques appear to be similarly effective in terms of functional outcomes, each has its own challenges. These findings could help inform the choice of treatment for syndesmotic injuries in the future. However, as this was a retrospective study, further research is needed to confirm these findings.

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