Acute syndesmotic injuries were usually treated with trans-syndesmotic screw fixation. However, screw fixation is too strong compared with the physiologic ankle joint movement. In addition, it needs removal and leads to delayed rehabilitation. We propose the reconstruction of the anterior inferior tibiofibular ligament (AITFL) using suture anchors to substitute trans-syndesmotic screw fixation.
Materials and methods
We compared the results after trans-syndesmotic screw fixation and AITFL suture anchor fixation in syndesmotic injuries with or without ankle fracture. Consecutively, the trans-syndesmotic screw (group I) was conducted between June 2011 and June 2013, and since July 2013, suture anchor fixation was performed (group II). Reductions in quality, the American Orthopedic Foot and Ankle Society (AOFAS) score, and the Olerud–Molander ankle score (OMAS) were evaluated.
Results
The final AOFAS score and OMAS in both groups were not significantly different (p = 0.98, 0.67). Tibiofibular overlapping, tibiofibular space, and tibiofibular overlapping ratio to the tibial width in both groups had satisfactory reduction from the standards. Computed tomographic (CT) evaluation also confirmed that both groups had been anatomically reduced in standard. Anteroposterior axis reduction in CT was more accurate in group II. Nonclinically related complications were three broken screws in final follow-up in group I.
Conclusion
Both trans-syndesmotic screws and suture anchor fixation have satisfactory clinical outcomes. The suture anchor fixation for syndesmotic injury does not need removal and is less complicated compared with the trans-syndesmotic screw fixation.
How to cite this article
Kim JS. Anterior Inferior Tibiofibular Ligament Reconstruction with Anchor Sutures compared with Trans-syndesmotic Screw Fixation for Ankle Syndesmotic Injuries. J Foot Ankle Surg (Asia-Pacific) 2017;4(2):57-62.
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