Syndesmotic Screw Fixation Versus Suture Button Versus Tibiotalocalcaneal Nail Treatment in Syndesmotic Ankle Fractures: A Meta-Analysis.
Thomas Cho, Helen R Yan, Michael Uematsu et al.
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In 30 seconds
This meta-analysis compared syndesmotic screw fixation (SS), suture button fixation (SB), and tibiotalocalcaneal nailing (TTC) for syndesmotic ankle fractures. It included 18 comparative studies with 1,040 patients, identified through searches of PubMed and Embase through June 2024. SB was associated with higher Olerud-Molander Ankle Scores at 1 and 2 years and lower reoperation rates than SS, as well as higher scores and lower infection rates than TTC. The authors concluded that SB had the strongest overall results, with TTC a possible alternative.
Key findings
- SB had significantly higher OMAS at 1- and 2-year follow-up than both SS and TTC.
- SB had a significantly lower reoperation rate than SS.
- SB had a significantly lower infection rate than TTC; TTC had a significantly lower infection rate than SS.
- SS had significantly higher 2-year OMAS than TTC.
Why it matters
The comparison highlights differences in reported function and complications among three surgical approaches for syndesmotic ankle fractures. These outcomes can inform discussion of treatment options, while the evidence remains based on comparative studies pooled in a meta-analysis rather than a reported randomised trial.
What to keep in mind
The meta-analysis included comparative studies, and the abstract does not report quantitative effect estimates or details of study-level risk of bias.