Comparative Study Between Suture Button Versus Syndesmotic Screw Fixation in Acute Syndesmotic Ankle Injury

Abstract Aim: To evaluate the outcomes of the patients of all ages with ankle sprain treated with a suture button and compare it to patients with syndesmotic screw fixation and compare the radiologic and functional outcomes of patients treated with a suture button with syndesmotic screw fixation. Materials and Methods: This study adopts a prospective comparative design to assess the efficacy of two surgical interventions—suture button fixation and syndesmotic screw fixation in managing acute syndesmotic ankle injuries. Forty-two patients diagnosed with acute syndesmotic ankle injuries at Tezpur Medical College and Hospital participated in this study. The sample were selected consecutively from October 2022 to September 2023 based on predefined inclusion criteria. Randomisation was conducted using computer-generated lists to assign patients to either Group 1 (suture button fixation) or Group 2 (syndesmotic screw fixation). Results: The distribution of suture button fixation and syndesmotic screws across different age groups in this study highlights interesting trends and preferences in the treatment of syndesmotic injuries. Among patients aged 21–40 years, the majority received suture button fixation (66.7%), which might suggest a perceived advantage of this method in younger adults. The distribution of interventions for Weber B fractures in this study suggests a slight preference for syndesmotic screw fixation, with 57.1% of patients receiving screws and 42.9% treated with suture buttons. The higher mean American Orthopaedic Foot and Ankle Society (AOFAS) score of 91.2 in the suture button group compared to 87.5 in the syndesmotic screw group suggests that the treatment with suture button may result in better functional outcomes. Conclusion: Suture button fixation provides certain advantages over syndesmotic screws, including lower rates of implant failure and removal, as well as slightly better functional outcomes based on the AOFAS scores. These benefits highlight the potential of suture button fixation as a more reliable and effective treatment option for maintaining syndesmotic stability and facilitating patient recovery.