Suture Button Fixation for Treatment of Acute Distal Tibiofibular Syndesmotic Injury

Abstract

Introduction and Aim: Ankle fractures are common fractures encountered by the orthopedic surgeons in their daily clinical practice. The syndesmosis complex stabilizes the mortis by securing the fibula into the fibular notch. The current work aimed to evaluate the outcome of suture button fixation for treatment of distal tibiofibular syndesmotic injuries.

Patients and methods: This was a quasi-experimental study. It included twenty patients with distal tibiofibular syndesmotic injury. They were operated upon by suture button fixation at Al-Azhar University Hospital (New Damietta) and were assessed clinically and radiologically directly and followed up over four months after surgery.

Results: Patient’s age ranged from 25-54 years with the mean value of 39±7.3 years.  Female patients were 15 (75%). The left side was 14(70%) affected in patients, while the right 6 patients (30%). The functional outcomes were 95% excellent and 5% good. There was no post-operative complication except one case complicated with superficial infection and another case complicated with wound dehiscent. All cases were operated on the same day of fracture except two cases presented by severe edema and skin bullae and the operation was delay one week until the edema subsided. Time to full weight bearing ranged 5 to 6 weeks.

Conclusion: The suture button technique is considered a viable alternative option to replace screw fixation for syndesmosis injuries. It normalizes the distal tibiofibular syndesmosis that remains normal throughout the follow up duration.