Suture-button fixation and screw fixation for the treatment of distal tibiofibular syndesmosis injury: A meta-analysis
10.3969/j.issn.2095-4344.1950
- Author:
Chenyang TIAN
1
Author Information
1. Department of Orthopedics, Second Hospital of Shanxi Medical University
- Publication Type:Journal Article
- Keywords:
Button-sewing cable system;
Distal tibiofibular syndesmosis;
Elastic fixation;
Internal fixation;
Meta-analysis;
Screw;
Suture-Button
- From:
Chinese Journal of Tissue Engineering Research
2020;24(3):485-492
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND: In the clinical treatment of distal tibiofibular syndesmosis injury, Suture-Button fixation technique can achieve similar results to, even better results than, those of screws, but it cannot fully recover the anatomical reduction and activity to those before injury. However, the optimal treatment of distal tibiofibular syndesmosis injury is still controversial. OBJECTIVE: To systematically evaluate Suture-Button fixation and screw fixation for the treatment of distal tibiofibular syndesmosis injury. METHODS: EMBASE, Cochrane database, PubMed database, Wanfang database, and CNKI were searched to retrieve randomized or non-randomized controlled trials regarding Suture-Button fixation and screw fixation for the treatment of distal tibiofibular syndesmosis injury published from January 2005 to January 2019. The quality of the included studies was strictly evaluated. Relevant data were extracted. A meta-analysis of all outcome measures was performed using RevMan 5. 3 software. RESULTS AND CONCLUSION: (1) Twelve studies were included, including 4 randomized controlled trials and 8 cohort studies, involving 564 patients. (2) Meta-analysis results showed that Suture-Button fixation had shorter full weight-bearing time [WMD=-1. 50, 95%CI(-2. 08, -0. 92), P < 0. 05] than screw fixation method. Suture-Button fixation resulted in better AOFAS scores than screw fixation at 3, 6, 12, and 24 months after surgery [WMD=6. 50，95%CI(3. 41, 9. 58), P < 0. 05; WMD=2. 87, 95%CI(0. 75, 4. 98), P < 0. 05; WMD=2. 67, 95%CI(0. 09, 5. 24), P < 0. 05; WMD=5. 79, 95%CI(1. 41, 10. 18), P < 0. 05]. There were no significant differences in operation time, tibiofibular overlap at the last follow-up, tibiofibular clear space at the last follow-up, and the incidence of total postoperative complications after surgery between two fixation methods (P > 0. 05). (3) These findings suggest that compared with screw fixation, Suture-Button fixation for the treatment of distal tibiofibular syndesmosis injury leads to better recovery of ankle joint function and an earlier time point for full weight bearing and does not need to consider the risk of screw fracture during the surgery. In addition to screw fixation, Suture-Button fixation is an effective way to treat distal tibiofibular syndesmosis injury.
