J Korean Foot Ankle Soc.  2016 Dec;20(4):176-181. 10.14193/jkfas.2016.20.4.176.

Short-Term Results of Surgical Treatment Using TightRopeâ„¢ for Acute Ankle Syndesmosis Injury

• Kim DY
• Lee JH
• Park JH
• Cho J

• KMID: 2362766
• DOI: http://doi.org/10.14193/jkfas.2016.20.4.176

Abstract

PURPOSE
The purpose of this study was to evaluate the clinical and radiologic outcome of syndesmosis fixation using TightRopeâ„¢ (Arthrex, Naples, FL, USA) in acute syndesmosis injuries.
MATERIALS AND METHODS
Twenty-five consecutive patients with acute syndesmosis injuries, treated using TightRopeâ„¢, were reviewed. Patients were evaluated preoperatively and at the last follow-up (at least 12 months postoperatively). Clinical outcomes were assessed using American Orthopaedics Foot and Ankle Society (AOFAS) ankle-hindfoot score and self-subjective satisfaction survey. Three radiologic parameters were evaluated two times at the preoperative and final follow up from the nonweightbearing ankle anteroposterior radiographs.
RESULTS
The mean AOFAS ankle-hindfoot score was 95.5 at the final follow-up. According to the satisfaction survey, 21 patients chose excellent, and four patients chose good. All radiologic parameters, including the mean tibiofibular clear space, mean tibiofibular overlap, and mean medial clear space on nonweightbearing ankle anteroposterior view, significantly improved after surgery. Complications occurred in only one patient who experienced knot irritation with infection.
CONCLUSION
The short-term surgical results of syndesmosis fixation using TightRopeâ„¢ were good to excellent, both clinically and radiographically. These results suggest that the fixation using TightRopeâ„¢ is a valid option for acute syndesmosis injury.

Keyword

Ankle fractures; Ankle syndesmosis; Orthopedic fixation devices

MeSH Terms

Ankle Fractures
Ankle Joint*
Ankle*
Follow-Up Studies
Foot
Humans
Orthopedic Fixation Devices

Figure

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  Figure 1. (A) Preoperative nonweightbearing anteroposterior radiograph of a right ankle demonstrates supination-external rotation type ankle fracture. (B) Final non-weightbearing anteroposterior radiograph show no evidence of syndesmosis widening.

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  Figure 2. Three radiographic parameters were measured from non-weightbearing anteroposterior (AP) radiographs. Tibiofibular clear space (TFCS, α) is distance between the medial border of the fibula and the lateral border of the tibia. The TFCS is measured 1 cm proximal to the plafond. Tibiofibular overlap (β) is the overlap of the lateral malleolus and the anterior tibial tubercle measured 1 cm proximal to the plafond. Medial clear space (γ) is distance between the articular surfaces of the talus and the medial malleolus.

• 

  Figure 3. (A) Preoperative anteroposterior radiograph of a right ankle demonstrates pronation-external rotation type ankle fracture. (B) Open reduction and internal fixation with syndesmosis fixation was performed. (C) All implants were removed at 4 months due to soft tissue irritation and deep infection. (D) At one-year follow up after implant removal, radiograph show complete bone union and adequately maintained ankle mortise.

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