$Suture button versus syndesmotic screw in ankle fractures - evaluation with 3D imaging-based measurements$
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Suture button versus syndesmotic screw in ankle fractures - evaluation with 3D imaging-based measurements

Abstract Background Inadequate reduction of syndesmotic injuries can result in disabling clinical outcomes. The aim of the study was to compare syndesmosis congruity after fixation by syndesmotic screws (SYS) or a suture button system (SBS) using three-dimensional (3D) computed imaging techniques. M...

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Autores principales:	Robert Hennings, Firas Souleiman, Martin Heilemann, Mareike Hennings, Alexis Klengel, Georg Osterhoff, Pierre Hepp, Annette B. Ahrberg
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Syndesmosis Tibio-fibular Syndesmotic screw Suture button 3D imaging 3D measurement Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/d3da20af9534420bbff9e1b09b3231b4
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spelling	oai:doaj.org-article:d3da20af9534420bbff9e1b09b3231b42021-11-28T12:24:34ZSuture button versus syndesmotic screw in ankle fractures - evaluation with 3D imaging-based measurements10.1186/s12891-021-04834-01471-2474https://doaj.org/article/d3da20af9534420bbff9e1b09b3231b42021-11-01T00:00:00Zhttps://doi.org/10.1186/s12891-021-04834-0https://doaj.org/toc/1471-2474Abstract Background Inadequate reduction of syndesmotic injuries can result in disabling clinical outcomes. The aim of the study was to compare syndesmosis congruity after fixation by syndesmotic screws (SYS) or a suture button system (SBS) using three-dimensional (3D) computed imaging techniques. Methods In a retrospective single-center study, patients with unilateral stabilization of an ankle fracture with a syndesmotic injury and post-operative bilateral CT scans were analyzed using a recently established 3D method. The side-to-side differences were compared for tibio-fibular clear space (∆CS), translation angle (∆α), and vertical offset (∆z) among patients stabilized with syndesmotic screws or suture button system. Syndesmotic malreduction was defined for ∆CS > 2 mm and for \|∆α\| > 5°. ∆CS and ∆α were correlated with two-dimensional (2D) measurements. Results Eighteen patients stabilized with a syndesmosis screw and 29 stabilized with a suture button system were analyzed. After stabilization, both groups revealed mild diastasis (SYS: mean ∆CS 0.3 mm, SD 1.1 mm vs SBS: mean ∆CS 0.2 mm, SD 1.2 mm, p = 0.710). In addition, both stabilization methods showed slight dorsalization of the fibula (SYS: mean ∆α 0.5°, SD 4.6° vs SBS: mean ∆α 2.1°, SD 3.7°, p = 0.192). Also, restoration of the fibula-to-tibia length ratio also did not differ between the two groups (SYS: mean Δz of 0.5 mm, SD 2.4 mm vs SBS: mean Δz of 0 mm, SD 1.2 mm; p = 0.477). Malreduction according to high ∆α was most common (26% of cases), with equal distribution between the groups (p = 0.234). ∆CS and ∆α showed good correlation with 2D measurements (ρ = 0.567; ρ = 0.671). Conclusion This in vivo analysis of post-operative 3D models showed no differences in immediate post-operative alignment after syndesmotic screws or suture button system. Special attention should be paid to syndesmotic malreduction in the sagittal orientation of the fibula in relation to the tibia in radiological control of the syndesmotic congruity as well as intra-operatively.Robert HenningsFiras SouleimanMartin HeilemannMareike HenningsAlexis KlengelGeorg OsterhoffPierre HeppAnnette B. AhrbergBMCarticleSyndesmosisTibio-fibularSyndesmotic screwSuture button3D imaging3D measurementDiseases of the musculoskeletal systemRC925-935ENBMC Musculoskeletal Disorders, Vol 22, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Syndesmosis Tibio-fibular Syndesmotic screw Suture button 3D imaging 3D measurement Diseases of the musculoskeletal system RC925-935
spellingShingle	Syndesmosis Tibio-fibular Syndesmotic screw Suture button 3D imaging 3D measurement Diseases of the musculoskeletal system RC925-935 Robert Hennings Firas Souleiman Martin Heilemann Mareike Hennings Alexis Klengel Georg Osterhoff Pierre Hepp Annette B. Ahrberg Suture button versus syndesmotic screw in ankle fractures - evaluation with 3D imaging-based measurements
description	Abstract Background Inadequate reduction of syndesmotic injuries can result in disabling clinical outcomes. The aim of the study was to compare syndesmosis congruity after fixation by syndesmotic screws (SYS) or a suture button system (SBS) using three-dimensional (3D) computed imaging techniques. Methods In a retrospective single-center study, patients with unilateral stabilization of an ankle fracture with a syndesmotic injury and post-operative bilateral CT scans were analyzed using a recently established 3D method. The side-to-side differences were compared for tibio-fibular clear space (∆CS), translation angle (∆α), and vertical offset (∆z) among patients stabilized with syndesmotic screws or suture button system. Syndesmotic malreduction was defined for ∆CS > 2 mm and for \|∆α\| > 5°. ∆CS and ∆α were correlated with two-dimensional (2D) measurements. Results Eighteen patients stabilized with a syndesmosis screw and 29 stabilized with a suture button system were analyzed. After stabilization, both groups revealed mild diastasis (SYS: mean ∆CS 0.3 mm, SD 1.1 mm vs SBS: mean ∆CS 0.2 mm, SD 1.2 mm, p = 0.710). In addition, both stabilization methods showed slight dorsalization of the fibula (SYS: mean ∆α 0.5°, SD 4.6° vs SBS: mean ∆α 2.1°, SD 3.7°, p = 0.192). Also, restoration of the fibula-to-tibia length ratio also did not differ between the two groups (SYS: mean Δz of 0.5 mm, SD 2.4 mm vs SBS: mean Δz of 0 mm, SD 1.2 mm; p = 0.477). Malreduction according to high ∆α was most common (26% of cases), with equal distribution between the groups (p = 0.234). ∆CS and ∆α showed good correlation with 2D measurements (ρ = 0.567; ρ = 0.671). Conclusion This in vivo analysis of post-operative 3D models showed no differences in immediate post-operative alignment after syndesmotic screws or suture button system. Special attention should be paid to syndesmotic malreduction in the sagittal orientation of the fibula in relation to the tibia in radiological control of the syndesmotic congruity as well as intra-operatively.
format	article
author	Robert Hennings Firas Souleiman Martin Heilemann Mareike Hennings Alexis Klengel Georg Osterhoff Pierre Hepp Annette B. Ahrberg
author_facet	Robert Hennings Firas Souleiman Martin Heilemann Mareike Hennings Alexis Klengel Georg Osterhoff Pierre Hepp Annette B. Ahrberg
author_sort	Robert Hennings
title	Suture button versus syndesmotic screw in ankle fractures - evaluation with 3D imaging-based measurements
title_short	Suture button versus syndesmotic screw in ankle fractures - evaluation with 3D imaging-based measurements
title_full	Suture button versus syndesmotic screw in ankle fractures - evaluation with 3D imaging-based measurements
title_fullStr	Suture button versus syndesmotic screw in ankle fractures - evaluation with 3D imaging-based measurements
title_full_unstemmed	Suture button versus syndesmotic screw in ankle fractures - evaluation with 3D imaging-based measurements
title_sort	suture button versus syndesmotic screw in ankle fractures - evaluation with 3d imaging-based measurements
publisher	BMC
publishDate	2021
url	https://doaj.org/article/d3da20af9534420bbff9e1b09b3231b4
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Suture button versus syndesmotic screw in ankle fractures - evaluation with 3D imaging-based measurements

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