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Evidence. Clarity. Practice.

© 2026 OrthoVellum. For educational purposes only.

Not medical advice. Verify clinically important information against current local guidance.

Back to Research
Level IIHigh YieldFoot & AnkleRetrospective Cohort

Evidence brief

Syndesmosis Fixation

Syndesmotic Injuries: Fixation and Outcomes

Authors
Naqvi GA, Cunningham P, Lynch B, et al
Journal
J Bone Joint Surg Br
Year
2012

Key Findings

  • 1

    Suture button devices allow dynamic fixation

  • 2

    Screw fixation: malreduction in up to 50%

  • 3

    Intraoperative 3D imaging improves reduction accuracy

  • 4

    Removal of syndesmotic screws often needed

  • 5

    Flexible fixation may have biomechanical advantages

Clinical Implications

Syndesmotic fixation technique continues to evolve. Both screws and suture buttons are effective; accurate reduction is more important than fixation type.

Teaching Note

Understand syndesmosis anatomy (AITFL, PITFL, interosseous membrane, TFL). Diagnosis: external rotation stress test, squeeze test, imaging. Fixation: 1-2 screws (3.5-4.5mm, tricortical or quadricortical) vs suture button. Position: foot in maximal dorsiflexion. Screw removal controversial.

Citation

Naqvi GA et al. Fixation of ankle syndesmosis injuries: comparison of tightrope fixation and syndesmotic screw fixation for accuracy of syndesmotic reduction. Am J Sports Med. 2012;40(12):2828-2835.

PubMed

Evidence Level

II

Level II

Lesser quality RCT or prospective comparative study

Topics

syndesmosisankleTightRopescrew fixation

Related Topics

  • Syndesmotic Injury
  • Ankle Fractures
  • High Ankle Sprain

External Links

View on PubMed

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