Abstract
Rigid syndesmosis fixation using a transfixation screw inevitably leads to either implant loosening or implant breakage. TightRope™ suture-button fixation allows physiological micromotion while resisting diastasis and may be more preferable than a rigid screw. It may be used on its own or in combination with fibular fracture plate fixation. Biomechanical testing and early clinical results using the TightRope™ have shown this new technique to be simple, safe, and effective. Rehabilitation is faster, an obvious advantage to the professional athlete, but also benefits the average patient, who will be able to return to the workplace sooner. A second operation for routine removal of the implant is not required; therefore, the complication of a late diastasis may be lessened. Syndesmosis fixation using the TightRope™ may become the new standard when treating these injuries.
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