Syndesmotic Injuries Treated With an Aperture Fixation Device

Abstract

Syndesmotic injuries commonly occur in rotation injuries to the ankle. Suspensory suture button devices have become commonplace but are known to have several drawbacks. The aperture fixation device composed of a threaded tibia anchor, fixed length suture bridge, and telescoping fibular anchor. It preserves the concept of retaining physiological motion of the syndesmosis but provides several potential advantages over suspensory suture button devices. The most important and unique is it provides aperture fixation. This concept is significant in that it provides more strength and stiffness and less stretch and creep compared with suspensory suture button devices. It eliminates the issue of suture-tibial tunnel widening and toggling, promotes more secure fixation of the syndesmosis, allows treatment of axially unstable fractures (Maisonneuve), prevents suture creep that may lead to syndesmosis widening, and has no medial soft tissue or neurovascular risk. A 14-patient case series with promising short-term data is presented. Level of Evidence: Diagnostic Level IV (eg, 1, 2, 3…). See Instructions for Authors for a complete description of levels of evidence.