Suture-Button versus Syndesmotic Screw in the Treatment of Distal Tibiofibular Syndesmosis Injury

Abstract

Ankle fractures are one of the most common types of fractures, comprising 18% of all skeletal injuries annually. These fractures frequently involve the distal tibiofibular syndesmosis. The syndesmosis is vital in stabilizing the ankle mortise and transmitting load during weight bearing. It consists of the interosseous Tibiofibuar ligament (IL), the anterior Tibiofibular ligament (ATiFL), and the posterior Tibiofibular ligament (PTiFL) with the transverse ligament (TL). Inadequate reduction of syndesmosis can lead to arthrosis and instability that is equal to poor subjective and objective outcomes. During external rotation of the foot the fibula is translated posterioly and rolated externally, which result in high tension of ATiFL this may attribute to isolated rupture of ATiFL, Rupture of ATiFL in its turn, and cause instability of the ankle mortise. Following the injury of syndesmosis, pain during activity, a feeling of instability and weakness of the ankle are also commonly experienced symptoms.