Anterior Syndesmotic Augmentation Technique Using Nonabsorbable Suture-Tape for Acute and Chronic Syndesmotic Instability
John Y. Kwon, MD, Derek Stenquist, MD, Michael Ye, MBS, Caroline Williams, BA, Eric Giza, MD, Anish R. Kadakia, MD, Christopher Kreulen, MD, MS
Syndesmotic instability is a source of significant pain and disability. Both subtle instability and gross diastasis, whether acute or chronic, require stabilization and may benefit from reconstruction with ligamentous augmentation. The use of nonabsorbable suture-tape has emerged as a promising operative strategy, allowing surgeons to anatomically reconstruct the syndesmosis, in particular the anterior inferior tibiofibular ligament. The current work provides a detailed description of the technique and preliminary results of a patient cohort treated using nonabsorbable suture-tape for syndesmotic augmentation.
There has been a growing understanding of the syndesmosis and its associated injuries over the past decade. As Sports Medicine, Trauma, and Foot and Ankle surgeons all continue to treat syndesmotic injuries there is yet to be a consensus on the most effective stabilization technique. With the growing popularity of transyndesmotic flexible fixation, research on its biomechanics and clinical examples continue to push the treatment algorithm forward. This has led to the development of suture augmentation repair of the anterior inferior tibiofibular ligament (AITFL). Recent biomechanical data has suggested that anterior syndesmotic suture augmentation provides improved rotational and translational control of the fibula.
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