Advertisement
Tips, Quips, and Pearls| Volume 56, ISSUE 5, P1087-1090, September 2017

An Alternative Strategy for Treatment of Distal Tibiofibular Syndesmotic Disruption: A Technical Note

      Abstract

      Metal screws are the most widely used in treating syndesmotic injuries; however, failure and the rigidity of the screws can threaten the success of the treatment and increase the cost of care. We performed open reduction and internal fixation of a fibula fracture followed by fixation of the tibiofibular joint with an olive wire and one half of an external fixator. We present a review of 1 patient treated with this material. We believe this method to be a physiologic fixation system with the advantage of being safe, inexpensive, adjustable, and effective; however, further clinical investigation and comparison to other methods is needed in order to better understand it clinical utility.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The Journal of Foot and Ankle Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Dattani R.
        • Patnaik S.
        • Kantak A.
        • Srikanth B.
        • Selvan T.P.
        Injuries to the tibiofibular syndesmosis.
        J Bone Joint Surg Br. 2008; 90: 405-410
        • Bava E.
        • Charlton T.
        • Thordarson D.
        Ankle fracture syndesmosis fixation and management: the current practice of orthopedic surgeons.
        Am J Orthop (Belle Mead NJ). 2010; 39: 242-246
        • Marqueen T.
        • Owen J.
        • Nicandri G.
        • Wayne J.
        • Carr J.
        Comparison of the syndesmotic staple to the transsyndesmotic screw: a biomechanical study.
        Foot Ankle Int. 2005; 26: 224-230
        • Sun H.
        • Luo C.F.
        • Zhong B.
        • Shi H.P.
        • Zhang C.Q.
        • Zeng B.F.
        A prospective, randomised trial comparing the use of absorbable and metallic screws in the fixation of distal tibiofibular syndesmosis injuries: mid-term follow-up.
        Bone Joint J. 2014; 96-B: 548-554
        • Schepers T.
        Acute distal tibiofibular syndesmosis injury: a systematic review of suture-button versus syndesmotic screw repair.
        Int Orthop. 2012; 36: 1199-1206
        • Olerud C.
        • Molander H.
        A scoring scale for symptom evaluation after ankle fracture.
        Arch Orthop Trauma Surg. 1984; 103: 190-194
        • Seyhan M.
        • Donmez F.
        • Mahirogullari M.
        • Cakmak S.
        • Mutlu S.
        • Guler O.
        Comparison of screw fixation with elastic fixation methods in the treatment of syndesmosis injuries in ankle fractures.
        Injury. 2015; 46: S19-S23
        • Kortekangas T.
        • Savola O.
        • Flinkkilä T.
        • Lepojärvi S.
        • Nortunen S.
        • Ohtonen P.
        • Katisko J.
        • Pakarinen H.
        A prospective randomised study comparing TightRope and syndesmotic screw fixation for accuracy and maintenance of syndesmotic reduction assessed with bilateral computed tomography.
        Injury. 2015; 46: 1119-1126
        • Gessmann J.
        • Jettkant B.
        • Schildhauer T.A.
        • Seybold D.
        Mechanical stress on tensioned wires at direct and indirect loading: a biomechanical study on the Ilizarov external fixator.
        Injury. 2011; 42: 1107-1111
        • Fleming B.
        • Paley D.
        • Kristiansen T.
        • Pope M.
        A biomechanical analysis of the Ilizarov external fixator.
        Clin Orthop Relat Res. 1989; : 95-105
        • Manjoo A.
        • Sanders D.W.
        • Tieszer C.
        • MacLeod M.D.
        Functional and radiographic results of patients with syndesmotic screw fixation: implications for screw removal.
        J Orthop Trauma. 2010; 24: 2-6
        • Naqvi G.A.
        • Shafqat A.
        • Awan N.
        Tightrope fixation of ankle syndesmosis injuries: clinical outcome, complications and technique modification.
        Injury. 2012; 43: 838-842
        • Sagi H.C.
        • Shah A.R.
        • Sanders R.W.
        The functional consequence of syndesmotic joint malreduction at a minimum 2-year follow-up.
        J Orthop Trauma. 2012; 26: 439-443
        • Naqvi G.A.
        • Cunningham P.
        • Lynch B.
        • Galvin R.
        • Awan N.
        Fixation of ankle syndesmotic injuries: comparison of tightrope fixation and syndesmotic screw fixation for accuracy of syndesmotic reduction.
        Am J Sports Med. 2012; 40: 2828-2835