Background: Open reduction and screw fixation is the current standard treatment for displaced injuries of the ankle syndesmosis. Despite reduction and stable internal fixation, however, these injuries do not uniformly have excellent outcomes. In addition, screw fixation has potential disadvantages.
Materials and methods: An ongoing prospective, randomized clinical trial comparing conventional screw fixation with TightRope® fiber wire fixation for syndesmosis injuries. The objective of this paper is also to provide an overview of the important anatomical and biomechanical issues relating to syndesmosis injuries.
Results: At medium term follow-up the TightRope® fiber wire fixation group had a statistically significant better range of motion compared to conventional screw fixation. The AOFAS ankle and hindfoot score did not show a significant difference between the two groups.