Comparison of Tightrope Fixation and Tricortical-Screw Fixation in Treatment of Ankle Syndesmosis Injuries

Ankle syndesmosis injury is among the common ankle injuries. This injury results in a long-term inability to perform physical activities. Various surgical techniques have been experimented that each accompanies with limitations, advantages, and disadvantages, and controversial outcomes have been presented. In the current study, two techniques of tightrope and tricortial-screw fixation were compared.

The current randomized clinical trial study was conducted on 30 patients with ankle syndesmosis injury in the Alzahra and Kashani hospitals, Isfahan, Iran, during the years 2014-17. The patients were randomly divided into two groups of tightrope and tricortical-screw treatments. The two groups were followed and compared considering the range of motion, American Orthopedic Foot and Ankle Society (AOFAS) score, required time for return to work, and need for reoperation within 6, 12, and 18 months.

Patients of the two groups were not different regarding age, gender, and body mass index (BMI) (P > 0.050); but the recovery time and need for reoperation were significantly less in tightrope group (P < 0.001). According to AOFAS score, tightrope group was better considering pain, activity limitation, maximum walk, and walk surface (P < 0.050); but they were not statistically different regarding plantar and dorsiflexion, gait, sagittal motion, hind foot motion, and function (P > 0.050).

 Based on the findings of the current study, tightrope fixation technique was accompanied with better outcomes in comparison to tricortical-screw fixation in ankle syndesmosis injury.