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Screw versus suture button in treatment of syndesmosis instability: Comparison using weightbearing CT scan
Mohamed Abdelaziz Elghazy1, Noortje C Hagemeijer2, Daniel Guss3
1Department of Orthopedic Surgery, Faculty of Medicine, Mansoura University, 12 El-Gomhoriya Street, Mansoura University Hospital, Mansoura, Dakahliya 35516, Egypt; Foot and Ankle Research and Innovation Laboratory, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA.
Background:
The superiority of screw or suture button fixation for syndesmotic instability remains debatable. Our aim is to compare radiographic outcomes of screw and suture button fixation of syndesmotic instability using weight bearing CT scan (WBCT).
Methods:
Twenty patients with fixation of unilateral syndesmotic instability were recruited and divided among two groups (screw = 10, suture button = 10). All patients had WBCT of both ankles ≥12 months postoperatively.
Results:
In suture button group, injured side measurements were significantly different from normal side for syndesmotic area (P = 0.003), fibular rotation (P = 0.004), anterior difference (P = 0.025) and direct anterior difference (P = 0.035). In screw group, syndesmotic area was the only significantly different measurement (P = 0.006).
Conclusion:
While both screw and suture button didn't completely restore the syndesmotic area as compared to the contralateral uninjured ankle, external malrotation of the fibula was uniquely associated with suture button fixation.
Level Of Evidence:
III Retrospective Cohort Study.
