Resumé
Ankle fractures accompanied by syndesmotic rupture are a complex challenge for orthopedic surgeons. Sufficient reduction and stabilization of the syndesmosis are important to prevent early degeneration of the ankle joint and to optimize clinical outcomes. The purpose of the study was to systematically review the literature comparing the suture-button fixation method with the cortical screw fixation method when treating syndesmotic rupture. For this, a systematic review of the literature was performed that included Cochrane, PubMed, and Embase. The following search terms were used: ankle fractures, syndesmosis rupture, tibiofibular syndesmosis injury, ankle joint, tightrope, and suture button. Inclusion criteria were comparison studies, acute ankle fractures with syndesmotic rupture, adult patients, and Coleman score >60. Cadaveric studies, chronic instability, open fractures, polytrauma, and arthropathies were exclusion criteria. Two investigators independently reviewed titles and relevant abstracts. Reoperation and malreduction rates were compared in a meta-analysis. Six studies with 275 patients were included: 2 randomized controlled trials and 2 prospective and 2 retrospective cohort studies. All studies used similar surgical techniques. Functional outcomes (American Orthopedic Foot and Ankle Society scale and the Olerud-Molander score) were not quantitatively comparable. No significantly less number of malreduction events were detected in the suture-button group (risk ratio = 0.19, 95% confidence interval 0.03 to 1.04, p = .06). Significantly lower reoperation rate was detected in the suture-button group (risk ratio = 0.21, 95% confidence interval 0.06 to 0.69, p = .01). We conclude that the suture-button technique showed a significantly lower reoperation rate and tendency toward less malreduction and better American Orthopedic Foot and Ankle Society scale scores. This finding is clinically relevant; however, this conclusion is primarily based on 2 studies, and therefore the interest for further research increases.
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | Journal of Foot and Ankle Surgery |
| Vol/bind | 58 |
| Udgave nummer | 5 |
| Sider (fra-til) | 946-953 |
| ISSN | 1067-2516 |
| DOI | |
| Status | Udgivet - 1. sep. 2019 |
Fingeraftryk
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A Systematic Review and Meta-Analysis on Treatment of Ankle Fractures With Syndesmotic Rupture : Suture-Button Fixation Versus Cortical Screw Fixation. / McKenzie, Alexandra C.; Hesselholt, Kristian E.; Larsen, Morten S.; Schmal, Hagen.
I: Journal of Foot and Ankle Surgery, Bind 58, Nr. 5, 01.09.2019, s. 946-953.Publikation: Bidrag til tidsskrift › Review › Forskning › peer review
TY - JOUR
T1 - A Systematic Review and Meta-Analysis on Treatment of Ankle Fractures With Syndesmotic Rupture
T2 - Suture-Button Fixation Versus Cortical Screw Fixation
AU - McKenzie, Alexandra C.
AU - Hesselholt, Kristian E.
AU - Larsen, Morten S.
AU - Schmal, Hagen
PY - 2019/9/1
Y1 - 2019/9/1
N2 - Ankle fractures accompanied by syndesmotic rupture are a complex challenge for orthopedic surgeons. Sufficient reduction and stabilization of the syndesmosis are important to prevent early degeneration of the ankle joint and to optimize clinical outcomes. The purpose of the study was to systematically review the literature comparing the suture-button fixation method with the cortical screw fixation method when treating syndesmotic rupture. For this, a systematic review of the literature was performed that included Cochrane, PubMed, and Embase. The following search terms were used: ankle fractures, syndesmosis rupture, tibiofibular syndesmosis injury, ankle joint, tightrope, and suture button. Inclusion criteria were comparison studies, acute ankle fractures with syndesmotic rupture, adult patients, and Coleman score >60. Cadaveric studies, chronic instability, open fractures, polytrauma, and arthropathies were exclusion criteria. Two investigators independently reviewed titles and relevant abstracts. Reoperation and malreduction rates were compared in a meta-analysis. Six studies with 275 patients were included: 2 randomized controlled trials and 2 prospective and 2 retrospective cohort studies. All studies used similar surgical techniques. Functional outcomes (American Orthopedic Foot and Ankle Society scale and the Olerud-Molander score) were not quantitatively comparable. No significantly less number of malreduction events were detected in the suture-button group (risk ratio = 0.19, 95% confidence interval 0.03 to 1.04, p = .06). Significantly lower reoperation rate was detected in the suture-button group (risk ratio = 0.21, 95% confidence interval 0.06 to 0.69, p = .01). We conclude that the suture-button technique showed a significantly lower reoperation rate and tendency toward less malreduction and better American Orthopedic Foot and Ankle Society scale scores. This finding is clinically relevant; however, this conclusion is primarily based on 2 studies, and therefore the interest for further research increases.
AB - Ankle fractures accompanied by syndesmotic rupture are a complex challenge for orthopedic surgeons. Sufficient reduction and stabilization of the syndesmosis are important to prevent early degeneration of the ankle joint and to optimize clinical outcomes. The purpose of the study was to systematically review the literature comparing the suture-button fixation method with the cortical screw fixation method when treating syndesmotic rupture. For this, a systematic review of the literature was performed that included Cochrane, PubMed, and Embase. The following search terms were used: ankle fractures, syndesmosis rupture, tibiofibular syndesmosis injury, ankle joint, tightrope, and suture button. Inclusion criteria were comparison studies, acute ankle fractures with syndesmotic rupture, adult patients, and Coleman score >60. Cadaveric studies, chronic instability, open fractures, polytrauma, and arthropathies were exclusion criteria. Two investigators independently reviewed titles and relevant abstracts. Reoperation and malreduction rates were compared in a meta-analysis. Six studies with 275 patients were included: 2 randomized controlled trials and 2 prospective and 2 retrospective cohort studies. All studies used similar surgical techniques. Functional outcomes (American Orthopedic Foot and Ankle Society scale and the Olerud-Molander score) were not quantitatively comparable. No significantly less number of malreduction events were detected in the suture-button group (risk ratio = 0.19, 95% confidence interval 0.03 to 1.04, p = .06). Significantly lower reoperation rate was detected in the suture-button group (risk ratio = 0.21, 95% confidence interval 0.06 to 0.69, p = .01). We conclude that the suture-button technique showed a significantly lower reoperation rate and tendency toward less malreduction and better American Orthopedic Foot and Ankle Society scale scores. This finding is clinically relevant; however, this conclusion is primarily based on 2 studies, and therefore the interest for further research increases.
KW - 1
KW - ankle joint
KW - meta-analysis
KW - screw
KW - suture-button
KW - syndesmosis injury
KW - syndesmotic rupture
KW - systematic review
KW - Bone Screws
KW - Ankle Fractures/surgery
KW - Humans
KW - Rupture
KW - Suture Techniques/instrumentation
KW - Sutures
KW - Fracture Fixation, Internal/instrumentation
U2 - 10.1053/j.jfas.2018.12.006
DO - 10.1053/j.jfas.2018.12.006
M3 - Review
C2 - 31474406
AN - SCOPUS:85071449918
VL - 58
SP - 946
EP - 953
JO - The Journal of Foot & Ankle Surgery
JF - The Journal of Foot & Ankle Surgery
SN - 1067-2516
IS - 5
ER -