Syndesmotic Screw Vs Suture Button in Ankle Syndesmotic Diastasis

NCT ID: NCT06856980

Last Updated: 2025-03-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

42 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-03-15

Study Completion Date

2026-01-01

Brief Summary

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The aim of this study is to compare suture-button versus syndesmotic screw in the treatment of distal tibiofibular syndesmotic injury.

Detailed Description

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The term syndesmotic injury is used to describe a lesion of the ligaments that connect the distal fibula and the tibial notch surrounded on both sides by the anterior and posterior tibial tubercles, with or without an associated injury of the deltoid ligament.

Accuracy and maintenance of syndesmosis reduction are considered the key elements in the treatment of ankle fractures. Screw fixation is considered the gold standard treatment for an unstable syndesmosis injury.

Button and suture construction with a medial-lateral metallic button and suture system offers an alternative method for repairing the distal tibio-fibular joint. Suture-button design has been shown to maintain the reduction, facilitating physiologic stability of the ankle mortise. This may allow early physiological motion, leading to earlier ligament healing and potentially earlier loading, which may produce better clinical results. However, this system is more expensive than the screw method and it may gradually relax under weightbearing conditions. Therefore, whether this device is a suitable alternative, and how many devices are needed for adequate stability are not yet known.

Conditions

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Syndesmotic Screw Suture Button Fixation Ankle Syndesmotic Diastasis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Suture button fixation

Patients undergoing suture button fixation of syndesmosis injury

Group Type EXPERIMENTAL

Suture button fixation

Intervention Type PROCEDURE

Patients undergoing suture button fixation of syndesmosis injury.

Syndesmotic screw fixation

Patients undergoing syndesmotic screw fixation of syndesmosis injury

Group Type EXPERIMENTAL

Syndesmotic screw fixation

Intervention Type PROCEDURE

Patients undergoing syndesmotic screw fixation of syndesmosis injury.

Interventions

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Suture button fixation

Patients undergoing suture button fixation of syndesmosis injury.

Intervention Type PROCEDURE

Syndesmotic screw fixation

Patients undergoing syndesmotic screw fixation of syndesmosis injury.

Intervention Type PROCEDURE

Other Intervention Names

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Group A Group B

Eligibility Criteria

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Inclusion Criteria

\- Unstable unilateral syndesmotic injuries that was considered by the attending staff surgeon to require surgical fixation, including:

* Age : 18 - 60 years old.
* Closed or grade I open fractures are included.
* Isolated syndesmotic injury.
* associated lateral malleolus fracture with talar shift.
* Associated with Bimalleolar fractures.
* Associated with Trimalleolar fractures that did not require posterior fragment fixation (typically \<25% of articular surface).

Exclusion Criteria

Patient-related exclusion factors included:

* Skeletal immaturity.
* Previous ipsilateral ankle surgery.
* Non-ambulatory status before injury.
* Inability to comply with postoperative protocol (i.e., advanced dementia).
* Medical unfit patients for surgery.
* Uncontrolled diabetes mellitus with charcot joint or peripheral neuropathy.
* Polytrauma patients.

Injury-related exclusion factors included:

* Grade II or III open fractures
* Tibial plafond fractures
* Posterior malleolar fractures requiring fixation (typically \>25% articular surface involved).
Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Tanta University

OTHER

Sponsor Role lead

Responsible Party

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El-Sayed Sherif Soliman El-Gamasy

Resident of Orthopedic Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt.

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Tanta University

Tanta, El-Gharbia, Egypt

Site Status

Countries

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Egypt

Central Contacts

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El-Sayed S El-Gamasy, MBBCh

Role: CONTACT

002 01206220396

Other Identifiers

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36264MS76/6/23

Identifier Type: -

Identifier Source: org_study_id

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