Suture-Button Fixation And Screw Fixation For The Treatment Of Distal Tibiofibular Syndesmosis Injury:A Meta-analysis

Objective:In the clinical treatment of distal tibiofibular syndesmosis injury,Suture-Button fixation technique can achieve similar results to,even better results than,those of screws,but it cannot fully recover the anatomical reduction and activity to those before injury.However,the optimal treatment of distal tibiofibular syndesmosis injury is still controversial.To systemaatically evalute Suture-Button fixation for the treatment of distal tibiofibular syndesmosis injury Methods:EMBASE,Cochrane database,PubMed database,Wanfang database,CNKI China journal full-text database,and assisting with manual search and literature traceability related literature,the relevant public publications from January 2005 to January 2019 were collected.Suture-Button fixation and screw fixation for the treatment of tibiofibular syndesmosis injury.,rigorous evaluation of the quality of the literature included in the study and extraction of relevant data,Meta-analysis of all outcomes by RevMan 5.3 software.Results:(1)Twelve studies were included,including 4 randomized controlled trials and 8 cohort studies,involving 564 patients.(2)Meta-analysis results showed that Suture-Button fixation had shorter full weight-bearing time [WMD=-1.50,95%CI(-2.08,-0.92),P < 0.05] than screw fixation method.Suture-Button fixation resulted in better AOFAS scores than screw fixation at 3,6,12,and 24 months after surgery [WMD=6.50,95%CI(3.41,9.58),P < 0.05;WMD=2.87,95%CI(0.75,4.98),P < 0.05;WMD=2.67,95%CI(0.09,5.24),P < 0.05;WMD=5.79,95%CI(1.41,10.18),P < 0.05].There were no significant differences in operation time,tibiofibular overlap at the last follow-up,tibiofibular clear space at the last follow-up,and the incidence of total postoperative complications after surgery between two fixation methods(P > 0.05).Conclusion:Suture-Button fixation for the treatment of distal tibiofibular syndesmosis injury leads to better recovery of ankle joint function and an earlier time point for full weight bearing and does not need to consider the risk of screw fracture during the surgery.In addition to screw fixation,Suture-Button fixation is an effective way to treat distal tibiofibular syndesmosis injury...