Looks like there is a new proceedure for High Ankle Sprain Surgery

[smgortho.com]
What Is a High Ankle Sprain?
“Sprain” is the medical term for an injured ligament, which is a tough, fibrous piece of tissue that connects bones to other bones. A high ankle sprain usually happens in a similar manner as a common ankle sprain: Rolling the ankle. Rolling the ankle means that the inside of the foot turns up and the outside points to the ground. It often happens when running or playing sports.

A high ankle sprain is very similar to a regular (lateral) ankle sprain. The biggest difference is the ligaments involved. In a normal ankle sprain, it is usually one or more of the three ligaments of the lateral ligament complex that are damaged. These ligaments connect the fibula (calf bones) to the talus and the calcaneus (heel bone).

In a high ankle sprain, the ligament that is damaged is called the syndesmosis, which connects the fibula and the tibia (shin bone). For this reason, high ankle sprains are also known as syndesmotic ankle sprains or syndesmosis sprains.

TightRope Advantages for Treating High Ankle Sprains
What makes a high ankle sprain so difficult to recover from is that the fibula and tibia must be held together and allowed to heal in the correct position. Until recently, this was accomplished using internal fixation. However, this method has various drawbacks.

“Sometimes the screws don’t do a good job of holding the bones in place, and sometimes the screws break,” says Stephanie Adam, DO, one of Summit Medical Group’s foot and ankle orthopedic specialists. “There are even cases where the fibula and tibia drift apart after the screws are inserted.”

Instead of surgical screws, the TightRope procedure fixes the fibula and tibia in place with stainless steel buttons on the bones connected with a flexible polyethylene rope. This method of repair is known as dynamic fixation. A 2015 study suggests dynamic fixation via TightRope produces better clinical outcomes than traditional screws, while a 2012 study suggests faster recovery time.

[www.ncbi.nlm.nih.gov]
Lower complication rate and faster return to sports in patients with acute syndesmotic rupture treated with a new knotless suture button device.
Colcuc C1,2, Blank M3, Stein T4,5, Raimann F6, Weber-Spickschen S7, Fischer S8, Hoffmann R3.

Abstract
PURPOSE:
Suture button devices for tibiofibular syndesmosis injuries provide semirigid dynamic stabilization, but complications including knot irritation have been reported. No randomized trials of the new knotless suture button devices have been performed. We hypothesized that knotless suture button devices eliminate knot irritation and facilitate quicker return to sports. This study was performed to compare the clinical outcomes, complication rates, and time to return to sports between a new knotless suture button device and syndesmotic screw fixation.

METHODS:
This study included 54 patients treated for ankle syndesmotic injury from 2012 to 2014 with a knotless suture button device or syndesmotic screw fixation. Clinical outcomes were measured using the American Orthopaedics Foot and Ankle Society score, Foot and Ankle Disability Index, Olerud and Molander score, and visual analog scale for pain and function. Secondary outcome measures were the complication rate and time required to return to sports. Patients underwent clinical and radiological evaluations preoperatively and three times during the 1-year postoperative follow-up.

RESULTS:
54 of 62 eligible patients were analyzed, median age 37 (18-60) and underwent the 1-year follow-up. The screw fixation and knotless suture button groups comprised 26 and 28 patients, respectively. The complication rate was significantly lower (p = 0.03) and time to return to sports was significantly shorter in the knotless suture button than screw fixation group (average, 14 versus 19 weeks, respectively; p = 0.006). No significant differences were identified in clinical outcomes or visual analog scale scores for pain and function between the groups. Age, injury mechanism, and body mass index did not significantly affect the time required to return to sports activities. The type of fixation was the only independent variable that reached statistical significance (p = 0.006).

CONCLUSION:
Syndesmotic screw fixation and the new knotless suture button device both resulted in good clinical results. Lower complication rate and the earlier time to return to sports make the new knotless suture button device recommendable especially for highly active patients.

LEVEL OF EVIDENCE:
Randomized controlled trial, Level I.

KEYWORDS:
Ankle syndesmosis; Complication rate; Functional outcome; Knotless suture button device; Syndesmotic screw; Time to return to sports

Author information
1
Department of Trauma and Orthopaedic Surgery, Evangelical Hospital Bethel, Bielefeld, Germany. ChrisCol@gmx.de.
2
Department for Trauma and Orthopaedic Surgery, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Frankfurt, Germany. ChrisCol@gmx.de.
3
Department for Trauma and Orthopaedic Surgery, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Frankfurt, Germany.
4
Department of Sporttraumatology - Knee- and Shoulder-Surgery, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Frankfurt, Germany.
5
Department of Sports Science, University of Bielefeld, Bielefeld, Germany.
6
University Hospital Frankfurt am Main, Frankfurt, Germany.
7
Institute of Sports Medicine and Trauma Department, Hannover Medical School, Hannover, Germany.
8
Department of Foot and Ankle Surgery, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Frankfurt, Germany.



Edited 1 time(s). Last edit at 01/05/2020 01:50PM by Rams Junkie.