Biomechanical comparison of suture-button, bioabsorbable screw, and metal screw for ankle syndesmotic repair: A meta-analysis

2020 ◽  
Author(s):  
Joseph S. Lee ◽  
Bryan Curnutte ◽  
Karen Pan ◽  
Jiayong Liu ◽  
Nabil A. Ebraheim
Keyword(s):  
Meta Analysis ◽  
Bioabsorbable Screw ◽  
Suture Button ◽  
Biomechanical Comparison

Suture Button Versus Syndesmotic Screw for Syndesmosis Injuries: A Meta-analysis of Randomized Controlled Trials

2018 ◽  
Vol 47 (11) ◽  
pp. 2764-2771 ◽  
Author(s):  
Yoshiharu Shimozono ◽  
Eoghan T. Hurley ◽  
C. Lucas Myerson ◽  
Christopher D. Murawski ◽  
John G. Kennedy
Keyword(s):  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
P Value ◽  
Controlled Trials ◽  
Level Of Evidence ◽  
Suture Button ◽  
Randomized Controlled ◽  
Syndesmotic Screw ◽  
Fixation Techniques ◽  
American Orthopaedic

Background: Operative treatment is indicated for unstable syndesmosis injuries, and approximately 20% of all ankle fractures require operative fixation for syndesmosis injuries. Purpose: To perform a meta-analysis of randomized controlled trials evaluating clinical outcomes between suture button (SB) and syndesmotic screw (SS) fixation techniques for syndesmosis injuries of the ankle. Study Design: Meta-analysis. Methods: A literature search was performed according to the PRISMA guidelines to identify randomized controlled trials comparing the SB and SS techniques for syndesmosis injuries. Level of evidence was assessed per the criteria of the Oxford Centre for Evidence-Based Medicine. Statistical analysis was performed with RevMan, and a P value ≤.05 was considered statistically significant. Results: Five clinical studies were identified, allowing comparison of 143 patients in the SB group with 142 patients in the SS group. Patients treated with the SB technique had a higher postoperative American Orthopaedic Foot & Ankle Society score at a mean 20.8 months (95.3 vs 86.7, P < .001). The SB group resulted in a lower rate of broken implants (0.0% vs 25.4%, P < .001), implant removal (6.0% vs 22.4%, P = .01), and joint malreduction (0.8% vs 11.5%, P = .05) as compared with the SS group. Conclusion: The SB technique results in improved functional outcomes as well as lower rates of broken implant and joint malreduction. Based on the findings of this meta-analysis, the SB technique warrants a grade A recommendation by comparison with the SS technique for the treatment of syndesmosis injuries.

scholarly journals Biomechanical Comparison of 3 Syndesmosis Repair Techniques With Suture Button Implants

2018 ◽  
Vol 6 (10) ◽  
pp. 232596711880420 ◽  
Author(s):  
Andrew S. Parker ◽  
David P. Beason ◽  
Jonathan S. Slowik ◽  
Jefferson B. Sabatini ◽  
Norman E. Waldrop
Keyword(s):  
Suture Button ◽  
Biomechanical Comparison ◽  
Repair Techniques

Cortical suture button fixation vs. bicortical screw fixation in the Latarjet procedure: a biomechanical comparison

2020 ◽  
Vol 29 (7) ◽  
pp. 1470-1478 ◽  
Author(s):  
Robert C. Williams ◽  
Randal P. Morris ◽  
Marc El Beaino ◽  
Nicholas H. Maassen
Keyword(s):  
Screw Fixation ◽  
Latarjet Procedure ◽  
Suture Button ◽  
Biomechanical Comparison ◽  
Bicortical Screw

Suture-Button versus Screw Fixation in a Syndesmosis Rupture Model: A Biomechanical Comparison

2009 ◽  
Vol 30 (4) ◽  
pp. 346-352 ◽  
Author(s):  
Sandeep P. Soin ◽  
Trevor A. Knight ◽  
A. Feroz Dinah ◽  
Simon C. Mears ◽  
Bart A. Swierstra ◽  
...  
Keyword(s):  
Screw Fixation ◽  
Suture Button ◽  
Rupture Model ◽  
Biomechanical Comparison

scholarly journals Comparison of Outcomes Between Suture Button Technique and Screw Fixation Technique in Patients With Acute Syndesmotic Diastasis: A Meta-analysis of Randomized Controlled Trials

2021 ◽  
Vol 6 (4) ◽  
pp. 247301142110614
Author(s):  
Nikolai Ramadanov ◽  
Simon Bueschges ◽  
Dobromir Dimitrov
Keyword(s):  
Postoperative Complications ◽  
Randomized Controlled Trials ◽  
Functional Outcomes ◽  
Screw Fixation ◽  
Meta Analysis ◽  
Implant Failure ◽  
Controlled Trials ◽  
Suture Button ◽  
Randomized Controlled ◽  
Level I

Background: Our aim was to compare the outcome between suture button (SB) stabilization and syndesmotic screw fixation (SF) in patients with acute syndesmotic diastasis. Methods: A systematic literature search up to June 30, 2021, was performed to identify randomized controlled trials (RCTs) comparing outcomes of SB with SF techniques in patients with acute syndesmotic diastasis. We calculated mean differences for continuous outcomes, using the Hartung-Knapp-Sidik-Jonkman method, and odds ratio for dichotomous outcomes, using the Mantel-Haenszel method. Results: Eight RCTs involving 569 patients met the inclusion criteria, 1 RCT with level I evidence, and 7 RCTs with level II evidence. The meta-analysis showed that the SB technique had a higher AOFAS score <6 months and 12 months postoperatively (MD = 4.74, 95% CI 1.68-7.80, P = .01; and MD = 5.42, 95% CI 1.50-9.33, P = .02) and reduced the risk of implant irritation (OR = 0.31, 95% CI 0.11-0.89, P = .03), implant failure (OR = 0.06, 95% CI 0.02-0.23, P < .01), and reoperation (OR = 0.43, 95% CI 0.22-0.83, P = .01). The 2 approaches did not differ in further functional outcomes or postoperative complications. Conclusion: Because functional outcomes showed no relevant difference between both SB and SF, the advantage of SB appears to be in the lower risk for postoperative complications. The SB technique led to fewer cases of implant irritation, implant failure, and reoperation compared with SF. Level of Evidence: Level I, meta-analysis of RCTs.

scholarly journals Suture Button versus Syndesmotic Screw for Syndesmotic Injuries

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0044
Author(s):  
Yoshiharu Shimozono ◽  
Eoghan Hurley ◽  
John Kennedy
Keyword(s):  
Clinical Studies ◽  
Screw Fixation ◽  
Meta Analysis ◽  
Implant Removal ◽  
Implant Failure ◽  
Athletic Injury ◽  
P Value ◽  
Suture Button ◽  
Syndesmotic Screw ◽  
Significant Difference

Category: Trauma Introduction/Purpose: Syndesmotic injuries are a common athletic injury and involved in approximately 13% of ankle fractures. Screw fixation (SS) has been the most common fixation treatment for syndesmotic injury, however syndesmosis malreduction has been reported to occur up to more than 50% in syndesmotic screw fixation. Recently, suture-button fixation (SB) technique has been developed to restore anatomic function of the syndesmosis, with potential advantages of allowing physiological movement of syndesmosis, anatomic healing, avoidance of implant removal and earlier rehabilitation. However, optimal surgical treatment is still controversial to date. The purpose of this study was to compare the clinical outcomes of SB and SS fixation techniques for syndesmotic injuries with a meta-analysis of the clinical studies comparing SB and SS fixation for syndesmosis injuries. Methods: The literature search was performed according to the PRISMA guidelines to identify cohort studies comparing SB and SS fixation for syndesmosis injuries. The level of evidence (LOE) was assessed based on the criteria by the Oxford-Centre for Evidence Based Medicine. Statistical analysis was performed using RevMan, and a p-value of < 0.05 was considered to be statistically significant. Results: Ten clinical studies were identified comparing 222 patients with SB to 235 patients with SS fixation. Patients treated with SB had a higher postoperative AOFAS score at a mean of 17.2 months (90.9 vs 87.3, p = 0.002). SB resulted in a lower rate of implant failure (0.0% vs 27.1%, p < 0.0001), implant removal failure (4.0% vs 37.5%, p < 0.0001), and joint malreduction (0.8% vs 10.7%, p = 0.009). However, there was no significant difference in the rate of other complications with SB (4.2% vs 8.6%, p = 0.21). Conclusion: SB fixation results in improved functional outcomes, lower rates of implant failure, and joint malreduction. Based on the findings of this meta-analysis SB appears to be favorable to SS for treating syndesmotic injuries.

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