The use of suspensory fixation for ankle syndesmotic injuries: A modified technique

Background: Ankle injuries are a common presentation to the orthopedic clinic and can be just isolated sprains or associated with ankle fractures; most of these involve distal tibiofibular syndesmotic disruptions. Bony or deltoid ligament injuries can critically destabilize the ankle and affect its function. Suspensory repair is a relatively new and accepted surgical treatment for acute ankle syndesmotic injuries. Objective: This study was conducted to evaluate the results of the use of suspensory fixation by modified TightRope (hand-made suture-button system) after acute ankle syndesmotic injury in adults. The American Orthopedic Foot and Ankle Society (AOFAS) score was used as a functional result in this study. Patients and Methods: This prospective study included 20 patients (mean age, 29.5 ± 9.7 years) with acute syndesmotic injuries treated with a suspensory fixation system between the period of January 2017 and December 2017, with a mean follow-up (FU) of 2 years. Variables recorded and analyzed were the age, sex, fracture type, mechanism of injury, associated injuries, FU, complications, and final outcomes. Results: As regarded twenty patients in this study, the median AOFAS score was 97 (range, 90–100). One patient needed implant removal as a result of persistent skin irritation. Conclusion: A modified technique of suture-button fixation is an alternative optimal treatment for acute syndesmotic injuries, resulting in stable functional ankles with less costs. Level IV: Level II.