Dual Suture Button Fixation With Buttress Plate for Ankle Syndesmotic Injury

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Anatomy

Background:

• Syndesmotic injuries are common in athletes, particularly those participating in high-impact sports.
• Purely ligamentous syndesmotic injuries require precise reduction and stable fixation for optimal outcomes.
• Current treatment strategies may vary, highlighting the need for innovative approaches.

Purpose of the Study:

• To present a unique surgical technique for managing purely ligamentous syndesmotic injuries.
• To detail the methods for achieving and validating syndesmotic reduction.
• To describe a fixation strategy using suture buttons and a buttress plate.

Main Methods:

• A large clamp was employed for syndesmotic reduction.
• Fibular positioning was validated against contralateral ankle fluoroscopy.
• Fixation involved dual suture button devices and a buttress plate.
• A medial incision protected the saphenous neurovascular bundle during device placement.

Main Results:

• Successful syndesmotic reduction was achieved and validated.
• The described fixation technique provided stability.
• The surgical approach minimized risk to neurovascular structures.

Conclusions:

• This technique offers a viable solution for purely ligamentous syndesmotic injuries.
• The combination of clamp reduction, fluoroscopic validation, and dual suture button fixation is effective.
• Careful surgical technique, including protecting neurovascular structures, is crucial for successful outcomes.