Isolated syndesmotic injury: treatment with suture button system-retrospective cohort study

Ankle injuries, often involving the syndesmotic complex, are common and may lead to acute instability. The syndesmosis, comprising several key ligaments, provides critical support for ankle function. This study assesses the efficacy and safety of the suture button system for isolated syndesmotic injuries, a treatment method that is gaining popularity over traditional transsyndesmotic screws.

A retrospective review was conducted on patients treated surgically with the suture button system for isolated syndesmotic injuries from January 2018 to December 2023. Key outcomes measured included time to full weight-bearing, returning of daily activities, and complications. The study also compared these outcomes with historical data from screw fixation methods.

Thirty-two patients (20 men, 12 women; mean age 41.66 ± 16.57 years [range 16-72 years]) were analyzed over an average follow-up of 9.94 ± 5.49 months (range 3-28 months). Patients achieved full weight-bearing at 1.23 ± 0.31 months postoperatively, resumed daily activities with restrictions at 3 ± 1.09 months, and without restrictions at 6.67 ± 2.55 months. No major complications were reported; minor complications included implant removal due to irritation in two patients (6.25%) and minor wound issues in one patient (3.13%).

The suture button system demonstrated good outcomes in allowing physiological motion, low malreduction rates, and minimizing reoperation needs. The present results indicate a promising safety profile and functional recovery, despite limitations such as small sample size and lack of patient-reported outcome measures.