Does the choice of syndesmotic screw versus suture button in ankle surgery has a silver lining? – a technical note

Journal of Experimental Orthopaedics

Pieter D’Hooghe¹  Motasem Salameh² 

[1] Department of Orthopaedic Surgery, Aspetar Orthopaedic and Sports Medical Hospital, P.O. Box 29222, Sports City Street 1, Doha, Qatar;Department of Orthopaedic Surgery, Hamad General Hospital, Doha, Qatar;

关键词: Ankle fracture;    Athlete;    Football;    Return to play;    Screw;    Suture button;    Syndesmosis;   

DOI  :  10.1186/s40634-020-00279-x

来源: Springer

【 摘 要 】

PurposeUnstable ankle fractures with associated syndesmotic injury are of considerable morbidity in the professional athlete population. The use of dynamic suture button versus static syndesmotic screws fixation, rehabilitation protocols and timing to return to play are still areas of debate. We report the use of novel algorithm of sequential static and dynamic syndesmotic fixation in an elite football player with Weber C ankle fracture.MethodsThe patient underwent open reduction and internal fixation for a weber C ankle fracture with associated syndesmotic and deltoid ligament injury. The osteosynthesis included lateral malleolus neutralizing plate, two syndesmotic screws and deltoid anchor repair. At 6 weeks post-operative both syndesmotic screws were removed and one suture button was implanted in the proximal screw hole. After the second operation the patient was allowed full weight bearing and range of motion in all direction with accelerated rehabilitation protocol.ResultsThe technique provided satisfactory results. At 4 month the player participated in a 90 min official football match. The fracture healed uneventfully with no recurrent syndesmotic diastasis.ConclusionThe presented technique of sequential dynamic and static fixation of associated syndesmotic injuries combined advantages of both syndesmotic screws and suture button implants. In an aim to allow earlier return to play in an elite football player. This opens the way for higher level of evidence clinical trials.

【 授权许可】

CC BY