scholarly journals Comparison of Time-dependent Changes in Syndesmotic Reduction Between Suture-button and Screw Fixation for Ankle Malleolar Fractures with Tibiofibular Diastasis

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0029
Author(s):  
Seiji Kimura ◽  
Satoshi Yamaguchi
Keyword(s):  
Fracture Fixation ◽  
Screw Fixation ◽  
Time Dependent ◽  
Fixation Method ◽  
Suture Button ◽  
Malleolar Fractures ◽  
Fixation Group ◽  
Postoperative Changes ◽  
Group B ◽  
Over Time

Category: Trauma Introduction/Purpose: Reduction of the tibiofibular syndesmosis is one of the most important factors that affect the clinical outcome after ankle malleolar fractures with syndesmotic diastasis. Recent studies have shown that suture-button fixation can yield better syndesmotic reduction than screw fixation immediately after surgery. However, the time-dependent change in the reduction for each fixation method has not been well studied. The purpose of this study was to compare the postoperative changes in the syndesmotic reduction after surgical treatment of ankle malleolar fractures between suture-button fixation and screw fixation using bilateral computed tomography. Methods: Patients who sustained ankle malleolar fractures with tibiofibular diastasis and underwent tibiofibular fixation were included. Suture-button fixation (Group B; n=14; age, 39 years) was used between 2015 and 2016, and syndesmotic screw fixation (Group S; n=20; age, 35 years) was used between 2012 and 2014. The syndesmotic screws were routinely removed. Patients underwent CT scanning of the bilateral ankles at 2 time points: at 2 weeks and 1 year after fracture fixation. Side-to-side differences in the anterior and posterior tibiofibular distances, and anteroposterior fibular translation were measured. Syndesmotic melreduction was defined as a side-to-side difference?2 mm in either of the measurements. The changes in each measurement and incidence of malreduction for each group were assessed using the Wilcoxon signed-ranks test and McNemar’s test. Differences between the two groups at each time point were also compared. Results: At 2 weeks after fracture fixation, the side-to-side difference in anterior tibiofibular distance was significantly wider in Group B (1.9 mm) than in Group S (0.7 mm) (p=0.03). Additionally, the fibulas were more translated posteriorly in Group B (1.5 mm) than in Group S (0.2 mm). At 1 year, the anterior tibiofibular distance decreased to 0.8 mm in Group B (p=0.09). On the contrary, it significantly increased to 1.9 mm in Group S (p=0.002). In Group B, the incidences of malreduction were 4/14 and 2/14 at 2 weeks and 1 year, respectively (p=0.74). Two ankles, which were malreduced at 2 weeks, changed to a reduced syndesmosis at 1 year. In Group S, the incidences were 8/20 and 9/20 at 2 weeks and 1 year, respectively (p=0.35). Conclusion: Syndesmotic alignment changed over time in both fixation methods, however, the patterns of change were different. Using suture-button fixation, the anterior tibiofibular distance decreased over time. As a result, the widened syndesmoses at 2 weeks changed to reduced syndesmoses at 1 year. On the contrary, using tibiofibular screw fixation, the anterior tibiofibular distance widened after screw removal. Our result suggests that the flexible suture-button fixation allows the fibula to move to the optimal location over time.

scholarly journals Comparison Between With Kirschner-wires Only And Combined Screw Fixation in Proximal Reverse Chevron osteotomy(PCMO) For Hallux Valgus Deformity

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Hwa Jun Kang ◽  
Hong-Geun Jung ◽  
Jong-Soo Lee ◽  
Sungwook Kim ◽  
Mao Yuan Sun
Keyword(s):  
Hallux Valgus ◽  
Screw Fixation ◽  
Fixation Method ◽  
Kirschner Wires ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Severe Hallux Valgus

Category: Bunion Introduction/Purpose: Kirschner-wires fixation, sometimes we have encountered pin irritation or pull-out. This is the reason why we consider additional fixation. Moreover, there are few reports according to comparison of fixation method, and Most of them focused on comparison K-wires or screw fixation only. Purpose of study is to compare clinical and radiographic outcome between Kirschner-wires only and combined screw fixation. Methods: The study included two different groups according to fixation methods. One with Kirschner-wires fixation (KW group) included 117 feet(of 98 patients), the other with combined screw fixation (KWS group) 56 feet (of 40 patients) with moderate to severe hallux valgus. Clinically, the preoperative and final follow-up visual analog scale (VAS) pain scores, the preoperative and final follow-up American Orthopaedic Foot & Ankle Society (AOFAS) hallux metatarsophalangeal (MTP)-interphalangeal (IP) scores, and patient satisfaction after the surgery were evaluated. Radiographically, the hallux valgus angle (HVA), intermetatarsal angle (IMA), medial sesamoid position (MSP), and first to fifth metatarsal width (1-5MTW) were analyzed before and after surgery. Results: The mean AOFAS score improved preoperative 65.5 to 95.3 at final follow up in group A, while preoperative 56.5 to 88.6 at final follow up. Pain VAS decreased from 5.7 to 0.5 in group A, whereas from 6.2 to 1.6 in group B. The mean HVA all improved from preoperative 38.5 to 9.3 at final follow up in group A and 34.7 to 9.1 in group B. The mean IMA and MSP also improved significantly at final follow up. In comparative analysis, the IMA did not show significant difference between postoperative and final state in group A, while showed significant increase in group B. Conclusion: We achieved favorable clinical and radiographic outcomes with minimal complications in patient with moderate to severe hallux valgus in both groups. However, this study shows no statistically significant difference in IMA during follow-up period and lower recurrence rate. Therefore we need to consider combined fixation method to provide better stability and can expect lower recurrence rate.

Evaluation of Reduction Accuracy of Suture-Button and Screw Fixation Techniques for Syndesmotic Injuries

2016 ◽  
Vol 37 (12) ◽  
pp. 1317-1325 ◽  
Author(s):  
Onur Kocadal ◽  
Mehmet Yucel ◽  
Murad Pepe ◽  
Ertugrul Aksahin ◽  
Cem Nuri Aktekin
Keyword(s):  
Screw Fixation ◽  
Ct Scans ◽  
Functional Evaluation ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Suture Button ◽  
Fixation Group ◽  
Significant Difference ◽  
The Mean

Background: Among the most important predictors of functional results of treatment of syndesmotic injuries is the accurate restoration of the syndesmotic space. The purpose of this study was to investigate the reduction performance of screw fixation and suture-button techniques using images obtained from computed tomography (CT) scans. Methods: Patients at or below 65 years who were treated with screw or suture-button fixation for syndesmotic injuries accompanying ankle fractures between January 2012 and March 2015 were retrospectively reviewed in our regional trauma unit. A total of 52 patients were included in the present study. Fixation was performed with syndesmotic screws in 26 patients and suture-button fixation in 26 patients. The patients were divided into 2 groups according to the fixation methods. Postoperative CT scans were used for radiologic evaluation. Four parameters (anteroposterior reduction, rotational reduction, the cross-sectional syndesmotic area, and the distal tibiofibular volumes) were taken into consideration for the radiologic assessment. Functional evaluation of patients was done using the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scale at the final follow-up. The mean follow-up period was 16.7 ± 11.0 months, and the mean age was 44.1 ± 13.2. Results: There was a statistically significant decrease in the degree of fibular rotation ( P = .03) and an increase in the upper syndesmotic area ( P = .006) compared with the contralateral limb in the screw fixation group. In the suture-button fixation group, there was a statistically significant increase in the lower syndesmotic area ( P = .02) and distal tibiofibular volumes ( P = .04) compared with the contralateral limbs. The mean AOFAS scores were 88.4 ± 9.2 and 86.1 ± 14.0 in the suture-button fixation and screw fixation group, respectively. There was no statistically significant difference in the functional ankle joint scores between the groups. Conclusion: Although the functional outcomes were similar, the restoration of the fibular rotation in the treatment of syndesmotic injuries by screw fixation was troublesome and the volume of the distal tibiofibular space increased with the suture-button fixation technique. Level of Evidence: Level III, retrospective comparative study.

scholarly journals A Prospective, Randomized Investigation of Syndesmosis Injury Fixation

2020 ◽  
Vol 5 (2) ◽  
pp. 2473011420S0000
Author(s):  
Eric Giza ◽  
Todd Oliver ◽  
Patrick S. Barousse ◽  
Tyler Allen ◽  
Trevor Shelton ◽  
...  
Keyword(s):  
Adverse Events ◽  
Clinical Outcomes ◽  
Screw Fixation ◽  
Syndesmotic Injury ◽  
Short Term ◽  
Suture Button ◽  
Syndesmotic Screw ◽  
Fixation Group ◽  
Significant Difference ◽  
Vas Scores

Category: Ankle; Trauma Introduction/Purpose: Syndesmotic disruption occurs in 10 to 13% of all ankle fractures. It is present in 15 cases per 100,000 of the general population. There has been debate on the best treatment for syndesmotic injuries. The typical surgical treatments include fixation with either screws or suture button devices. The purpose of this study is to compare clinical outcomes of syndesmotic injuries treated surgically with either screws or suture button devices. It was hypothesized that suture button fixation would provide equal clinical results with less need for hardware removal. Methods: This was a multi-center, randomized, prospective clinical trial comparing two surgical interventions for treatment of acute syndesmotic injury. Subjects were placed into either screw fixation or the Suture-button device group. Subjects with clinical signs or radiographic evidence of syndesmotic injury were asked to participate in this study. Inclusion criteria was ages 18 to 65 years old with confirmed syndesmotic instability. The primary outcomes of the study were VAS scores (activity, pain, satisfaction) and FFI scores (pain, disability, activity) which were collected at preoperative state, 6 weeks, and 12 months postoperatively. Results: Sixty-five subjects were enrolled in this study. Thirty-two subjects received Suture-button fixation (49%) and 33 received screw fixation (51%). VAS scores and FFI scores for subjects treated with the Suture-button device or screw fixation comparing preoperative, six-week, and 12-month scores all showed clinical improvement. There was no significant difference between the two treatment groups (p >0.05).Nine subjects (27%) in the syndesmotic screw fixation group experienced adverse events, and only one subject (3%) in the suture-button group had adverse event. Conclusion: The short-term clinical outcomes suggest that both syndesmotic screws and suture-button devices are effective treatment options to address acute syndesmotic injuries. In the short-term (12-months), suture-button fixation resulted in significantly less adverse events compared to syndesmotic screw fixation group.

scholarly journals A Prospective, Randomized Suture-button vs Screw Syndesmotic Fixation

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0018
Author(s):  
Eric Giza ◽  
Todd Oliver ◽  
Christopher Kreulen ◽  
Ashoke Sathy ◽  
Wade Faerber ◽  
...  
Keyword(s):  
Adverse Events ◽  
Clinical Outcomes ◽  
Screw Fixation ◽  
Hardware Removal ◽  
Syndesmotic Injury ◽  
Short Term ◽  
Suture Button ◽  
Syndesmotic Screw ◽  
Fixation Group ◽  
Vas Scores

Category: Ankle, Arthroscopy, Sports Introduction/Purpose: Syndesmotic disruption occurs in 10 to 13% of all ankle fractures. It is present in 15 cases per 100,000 of the general population. There has been debate on the best treatment for syndesmotic injuries. The typical surgical treatments include fixation with either screws or suture button devices. The purpose of this study is to compare clinical outcomes of syndesmotic injuries treated surgically with either screws or suture button devices. It was hypothesized that suture button fixation would provide equal clinical results with less need for hardware removal. Methods: This was a multi-center, randomized, prospective clinical trial comparing two surgical interventions for treatment of acute syndesmotic injury. At the time of surgical intervention, subjects were placed into either the screw fixation or the Suture-button device group by opening a randomized envelope in the operating room. Subjects with clinical signs or radiographic evidence of syndesmotic injury were asked to participate in this study. Inclusion criteria was ages 18 to 65 years old with confirmed syndesmotic instability. The primary outcomes of thestudy were VAS scores (activity, pain, satisfaction) and FFI scores (pain, disability, activity) which were collected at preoperative state, 6 weeks, and 12 months postoperatively. Results: Sixty-five subjects were enrolled in this study. Thirty-two subjects received Suture-button fixation (49%) and 33 received screw fixation (51%). VAS scores and FFI scores for subjects treated with the Suture-button device or screw fixation comparing preoperative, six-week, and 12-month scores all showed clinical improvement. There was no significant difference between the two treatment groups (p >0.05). Nine subjects (27%) in the syndesmotic screw fixation group experienced adverse events; four required repeat surgery for symptomatic syndesmotic screw removal, one for revision fixation, and four did not return to surgery despite hardware failure. One subject(3%) in the suture-button group required hardware removal. Conclusion: The short-term clinical outcomes suggest that both syndesmotic screws and suture-button devices are effective treatment options to address acute syndesmotic injuries. In the short-term (12-months), suture-button fixation resulted in significantly less adverse events compared to syndesmotic screw fixation group.

scholarly journals An In Vivo Biomechanical Analysis of Syndesmotic Surgical Repair in Elite Athletes: Screw versus Suture Button Fixation

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0015
Author(s):  
Stephen P. Canton ◽  
Tom Gale ◽  
Dukens LaBaze ◽  
William Anderst ◽  
MaCalus V. Hogan
Keyword(s):  
Patient Reported Outcomes ◽  
Screw Fixation ◽  
Tracking System ◽  
Surgical Techniques ◽  
Biomechanical Analysis ◽  
Fixation Method ◽  
Patient Specific ◽  
Suture Button ◽  
Patient Reported

Category: Trauma; Basic Sciences/Biologics Introduction/Purpose: Syndesmotic injuries account for 1-11% of all ankle sprains and are the most predictive factor of chronic ankle dysfunction 6 months after injury. Common surgical techniques include screw fixation (the ‘gold standard’) and dynamic fixation with a suture button device, which may lead to better clinical outcomes than rigid screw. To date, there are no studies comparing the in vivo biomechanics of suture button and rigid screw syndesmotic fixation, and no report of the correlations between biomechanics and patient outcomes. The goal of this study is to characterize the biomechanics of the native ankle syndesmosis, rigid screw fixation, suture button fixation, along with associated patient-reported outcomes. This study will elucidate mechanisms for improved patient-reported outcomes based on the fixation method. Methods: 6 patients (average age:23.6, 4M/1F, 2 suture button, 2 screw fixation and 1 hybrid) consented to participate in this IRB-approved study. After being medically cleared to return to full athletic participation, each participant performed seven movements (two single leg hops (straight and lateral), two alternating single-leg push-offs (front-to-back and side-to-side), vertical jumping, running, and walking within a biplane radiographic system (Figure 1). A validated volumetric model-based tracking system matched patient-specific 3D bone models (obtained from CT) to the synchronized biplane radiographs (Figure 1). Six degree of freedom ankle kinematics were determined for each movement and for the repaired and contralateral ankle of each participant. Patient reported outcomes were also measured using the Foot and Ankle Ability Measure (FAAM) and a Visual Analogue Scale (VAS). Results: The results show that the screw fixation (-0.99 mm) has greater tibiotalar lateral-medial translation of the injured side relative contralateral healthy side compared to the tightrope fixation (-0.73 mm) and hybrid (.05 mm). For the syndesmosis translation, the screw fixation (2.00 mm) also exhibits greater total magnitude of translation compared to the tightrope ((-0.44 mm) and hybrid fixation (1.02 mm). Conclusion: This study shows that the screw fixation exhibits greater translation of the syndemosis and lateral/medial translation of the Talus. This may suggest that this method is inferior to the tight-rope and hybrtid. Future studies will include all the motions and more subjects.

scholarly journals Latarjet with cortical button fixation is associated with an increase of the risk of recurrent dislocation compared to screw fixation

2019 ◽  
Vol 28 (7) ◽  
pp. 2354-2360 ◽  
Author(s):  
Alexandre Hardy ◽  
◽  
Vincent Sabatier ◽  
Bradley Schoch ◽  
Marie Vigan ◽  
...  
Keyword(s):  
Screw Fixation ◽  
Cohort Analysis ◽  
Recurrent Dislocation ◽  
Latarjet Procedure ◽  
Fixation Group ◽  
Increased Risk ◽  
Cortical Button ◽  
Group A ◽  
Group B

Abstract Purpose The purpose of this study was to compare the clinical results of the Latarjet procedure using two cortical buttons vs two screws. It was hypothesized that cortical button would result in similar rates of recurrent dislocations, but a lower rate of reoperation compared to screw fixation. Methods A retrospective comparative case-cohort analysis was performed for all patients undergoing a Latarjet procedure for recurrent anterior glenohumeral instability. Patient demographics, number of dislocations prior surgery, arm dominance, shoulder hyperlaxity, level of sport, type of sport and ISIS score were collected. Shoulders were separated into two groups based on surgical fixation (screws vs cortical button). Postoperatively, shoulders were evaluated for recurrent dislocation, revision surgery, post-operative Walch–Duplay score, and the Simple shoulder test (SST). Two hundred and thirty-six patients were included in the screw fixation group (group A) and 72 in button fixation group (group B) and were evaluated at a mean follow-up of 3.4 ± 0.8 years. Demographics of the two groups were similar with the exception of operative side hand dominance, which was more common in group B [50 (69.4%) vs 128 (54.2%), p = 0.02]. Results Recurrent dislocation was significantly lower in Group A: 6 (2.5%) vs 6(8.3%) (p = 0.02). Reoperation was more common in group A [14 (5.9%) vs 0 (0%)]. At follow-up, Walch–Duplay scores and simple shoulder tests were similar in both groups. Conclusion Button fixation for Latarjet showed higher rates of recurrent dislocation compared to screw fixation. However, the increased stability afforded by screw fixation needs to be weighed against the increased risk of reoperation for hardware prominence. Level of evidence III.

scholarly journals Effect of Skeletal Maturity on Fixation Techniques for Tibial Eminence Fractures

2021 ◽  
Vol 9 (11) ◽  
pp. 232596712110494
Author(s):  
Andrew P. Thome ◽  
Ryan O’Donnell ◽  
Steven F. DeFroda ◽  
Brian H. Cohen ◽  
Aristides I. Cruz ◽  
...  
Keyword(s):  
Cyclic Loading ◽  
Screw Fixation ◽  
Skeletal Maturity ◽  
Suture Technique ◽  
Fixation Method ◽  
Suture Fixation ◽  
Skeletally Immature ◽  
Tibial Eminence ◽  
Fixation Group ◽  
Load To Failure

Background: Several fixation methods have been reported for the operative treatment of tibial eminence fractures. Previous biomechanical studies have demonstrated that suture fixation may be a stronger construct; however, the maturity status of these specimens was not scrutinized. Purpose: To examine if suture fixation remains a biomechanically superior fixation method to screw fixation in both skeletally mature and immature specimens. Study Design: Controlled laboratory study. Methods: Sixteen total matched porcine (Yorkshire) knees (8 skeletally immature knees and 8 skeletally mature knees) were procured, and a standardized tibial eminence fracture was created. In each age-matched group of knees, 4 knees underwent randomization to fixation with 2 screws while 4 knees were randomized to fixation using a dual-suture technique. Once fixation was complete, the specimens underwent cyclic loading (200 cycles) in the anteroposterior plane of the tibia and load-to-failure testing, both with the knee positioned at 30° of flexion. Relevant measurements were recorded, and data were analyzed. Results: Among mature specimens, load to failure was 1.9 times higher in the suture fixation group compared with the screw fixation group (1318.84 ± 305.55 vs 711.66 ± 279.95 N, respectively; P = .03). The load to failure was not significantly different between the groups in immature specimens (suture: 470.00 ± 161.91 N vs screw: 348.79 ± 102.46; P = .08). Conclusion: These findings suggest that suture fixation may represent a better construct choice for fixation of tibial eminence fractures in the skeletally mature population. However, in the skeletally immature population, fixation with screws or suture may be equivalent. Displacement after cyclic loading did not appear to differ by fixation method, nor did stiffness. Clinical Relevance: A stronger fixation construct may be beneficial and allow for earlier range of motion to help potentially decrease postoperative stiffness. Clinical studies are warranted to see if these results may be replicated in humans.

scholarly journals Fracture neck of femur treated with hemiarthroplasty and cannulated cancellous screw fixation: a comparative study

2017 ◽  
Vol 3 (4) ◽  
pp. 849
Author(s):  
S. K. Rai ◽  
Rohit Vikas ◽  
Vyom Sharma ◽  
S. S. Wani ◽  
Rohit Varma
Keyword(s):  
Fracture Fixation ◽  
Screw Fixation ◽  
Type I ◽  
Age Group ◽  
Cancellous Screw ◽  
Neck Of Femur ◽  
Non Union ◽  
Fracture Neck Of Femur ◽  
Group A ◽  
Group B

<p class="abstract"><strong>Background:</strong> Intracapsular fracture neck of femur has always presented great challenges to every Orthopaedic surgeons and it is remain a mystery whether to fix or to replace the fracture in the elderly. The aim of the study was to analyze the functional outcome of two widely used and accepted modalities of treatment in the age group 57-75 years, in Garden’s type I and II fractures, namely (a) cannulated cancellous screw fixation(internal fixation) and (b) modular bipolar prosthetic replacement of the femoral head (hemiarthroplasty).</p><p class="abstract"><strong>Methods:</strong> The total 110 patients were including in the study from age groups 57-75 (mean age 66). The Garden classification of fracture neck of femur was used to evaluate the displacement of femoral neck fractures. Only grade 1 and 2 was included in the study. 55 patients were included in each group A and B. Osteosynthesis (fracture fixation) was carried out by closed reduction and insertion of cannulated cancellous screw and in other group hemiarthroplasty was done.<strong></strong></p><p class="abstract"><strong>Results:</strong> In group A 55 patient with fracture neck of femur was treated by osteosynthesis i.e. fixation using 02 or 03 cannulated cancellous screw and in group B, 55 patients with fracture neck of femur was treated by modular bipolar replacement hemiarthroplasty. In Group A out of 55, 41 patients union was achieved between 08 to 14 months (mean 11.5 month), 09 patients developed non-union even after 16 months and 05 patients develop collapse of head with AVN with shortening at end of 02 year, however in Group B out of 55 patients 51 patients started walking after 2<sup>nd</sup> postoperative days, 02 patients developed infection, and 02 patients developed posterior dislocation.</p><p><strong>Conclusions:</strong> The fracture fixation may be tempting for fracture neck femur in age group 57-75 especially of Garden Type I but internal fixation put risk of non-union and AVN and second surgery may be required after few months or years  if patients survive. Based on results in our study we therefore can conclude that in Garden Type I and II femur neck fractures in the patients between 57-75 years of age, hemiarthroplasty is the better modality of treatment.</p>

Changes in the Syndesmotic Reduction After Syndesmotic Suture-Button Fixation for Ankle Malleolar Fractures: 1-Year Longitudinal Evaluations Using Computed Tomography

2021 ◽  
pp. 107110072110085
Author(s):  
Seiji Kimura ◽  
Satoshi Yamaguchi ◽  
Yoshimasa Ono ◽  
Shotaro Watanabe ◽  
Ryuichiro Akagi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Case Series ◽  
Level Of Evidence ◽  
Tomographic Images ◽  
Minimum Detectable Change ◽  
Suture Button ◽  
Malleolar Fractures ◽  
Dependent Change ◽  
Time Dependent Change ◽  
Over Time

Background: Evaluation over time is important in assessing the reduction of the syndesmosis after suture-button fixation for ankle malleolar fractures. The purposes of this study were to evaluate time-dependent change in the syndesmotic reduction immediately after suture-button fixation for ankle malleolus fractures and 1 year after surgery using computed tomography, and to investigate the reliability of the measurement values to evaluate the reduction of syndesmosis. Methods: We assessed 28 patients who underwent suture-button fixation for ankle fractures. Syndesmotic reduction was assessed within 2 weeks of the fracture surgery and 1 year after surgery using axial computer tomographic images. Side-to-side differences in the anterior, central, and posterior tibiofibular distances, anteroposterior fibular translation, fibular rotation, and syndesmosis area were measured. Results: The mean anterior tibiofibular distance and anteroposterior fibular translation were 1.8 mm and 1.5 mm, respectively, after syndesmotic fixation. They decreased to 1.2 mm and 0.6 mm, respectively, at 1 year after surgery ( P = .03 and P = .01, respectively). The other measurement values did not change over time. The minimum detectable change in the distance of measurements was 1 mm or less. Conclusion: The anterior tibiofibular distance and anteroposterior fibular translation had decreased 1 year after fixation in ankle malleolar fractures with syndesmotic suture button. Even if the fibula is posteriorly malreduced by the time computed tomography is performed immediately after surgery, the fibula may return to a good position 1 year after surgery. Level of Evidence: Level IV, case series.

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