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A Prospective, Randomized Suture-button vs Screw Syndesmotic Fixation
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...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8696533/ http://dx.doi.org/10.1177/2473011419S00185 |
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author | Giza, Eric Oliver, Todd Kreulen, Christopher Sathy, Ashoke Faerber, Wade Lin, Johnny Stannard, James Barousse, Patrick Allen, Tyler |
author_facet | Giza, Eric Oliver, Todd Kreulen, Christopher Sathy, Ashoke Faerber, Wade Lin, Johnny Stannard, James Barousse, Patrick Allen, Tyler |
author_sort | Giza, Eric |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-8696533 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-86965332022-01-28 A Prospective, Randomized Suture-button vs Screw Syndesmotic Fixation Giza, Eric Oliver, Todd Kreulen, Christopher Sathy, Ashoke Faerber, Wade Lin, Johnny Stannard, James Barousse, Patrick Allen, Tyler Foot Ankle Orthop Article 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. SAGE Publications 2019-10-28 /pmc/articles/PMC8696533/ http://dx.doi.org/10.1177/2473011419S00185 Text en © The Author(s) 2019 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Article Giza, Eric Oliver, Todd Kreulen, Christopher Sathy, Ashoke Faerber, Wade Lin, Johnny Stannard, James Barousse, Patrick Allen, Tyler A Prospective, Randomized Suture-button vs Screw Syndesmotic Fixation |
title | A Prospective, Randomized Suture-button vs Screw Syndesmotic Fixation |
title_full | A Prospective, Randomized Suture-button vs Screw Syndesmotic Fixation |
title_fullStr | A Prospective, Randomized Suture-button vs Screw Syndesmotic Fixation |
title_full_unstemmed | A Prospective, Randomized Suture-button vs Screw Syndesmotic Fixation |
title_short | A Prospective, Randomized Suture-button vs Screw Syndesmotic Fixation |
title_sort | prospective, randomized suture-button vs screw syndesmotic fixation |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8696533/ http://dx.doi.org/10.1177/2473011419S00185 |
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