{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T06:44:33Z","timestamp":1791787473405,"version":"4.3.4"},"reference-count":17,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T00:00:00Z","timestamp":1791676800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T00:00:00Z","timestamp":1791676800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["arthroscopyjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["arthrosc. tech."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Syndesmotic malreduction remains a major contributor to poor outcomes after ankle injuries, yet conventional fixation methods rely primarily on fluoroscopic assessment and may not fully reveal rotational or subtle translational malalignment. Needle arthroscopy offers direct visualization of the distal tibiofibular interval, enabling precise assessment of the injury and real\u2010time confirmation of reduction. This surgical technique describes a fully arthroscopic approach to anatomic reduction and dynamic stabilization of the syndesmosis using a suture button device. After arthroscopic identification of the pathological widening, a four\u2010cortex trans\u2010syndesmotic tunnel is created under fluoroscopic control, the medial button is deployed, and final reduction is achieved through symmetric tensioning while monitoring the syndesmosis with needle arthroscopy. This method allows accurate restoration of the fibular position within the incisura with minimal soft\u2010tissue disruption and may reduce the risk of malreduction associated with traditional techniques.<\/jats:p>","DOI":"10.1002\/atn2.70332","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T05:44:50Z","timestamp":1791783890000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Needle Arthroscopy\u2010Guided Anatomic Reduction and Suture Button Fixation of the Distal Tibiofibular Syndesmosis"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7801-0676","authenticated-orcid":false,"given":"B\u0142a\u017cej Grzegorz","family":"W\u00f3jtowicz","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Trauma Medical University of Lodz, University Hospital of Lodz No 2  Lodz Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bartosz","family":"Chlebanowski","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma Medical University of Lodz, University Hospital of Lodz No 2  Lodz Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grzegorz","family":"Taborski","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma Medical University of Lodz, University Hospital of Lodz No 2  Lodz Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6127-0639","authenticated-orcid":false,"given":"Grzegorz","family":"Ka\u0142u\u017cy\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma Medical University of Lodz, University Hospital of Lodz No 2  Lodz Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcin","family":"Dom\u017calski","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma Medical University of Lodz, University Hospital of Lodz No 2  Lodz Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jedrzej","family":"Lesman","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma Medical University of Lodz, University Hospital of Lodz No 2  Lodz Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,11]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1007\/s00167-016-4017-1","article-title":"Conservative and surgical management of acute isolated syndesmotic injuries: ESSKA\u2010AFAS consensus and guidelines","volume":"24","author":"van Dijk CN","year":"2016","journal-title":"Knee Surg Sports Traumatol Arthrosc."},{"key":"e_1_2_5_3_1","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1302\/0301-620X.85B3.13174","article-title":"Diagnosis of a tear of the tibiofibular syndesmosis: The role of arthroscopy of the ankle","volume":"85","author":"Takao M","year":"2003","journal-title":"J Bone Joint Surg Br."},{"key":"e_1_2_5_4_1","doi-asserted-by":"crossref","first-page":"102901","DOI":"10.1016\/j.eats.2023.102901","article-title":"Wide\u2010awake needle arthroscopy of the anterior ankle: A standardized approach","volume":"13","author":"Stornebrink T","year":"2024","journal-title":"Arthrosc Tech."},{"key":"e_1_2_5_5_1","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1097\/BOT.0b013e31822a526a","article-title":"The functional consequence of syndesmotic joint malreduction at a minimum 2\u2010year follow\u2010up","volume":"26","author":"Sagi HC","year":"2012","journal-title":"J Orthop Trauma."},{"key":"e_1_2_5_6_1","doi-asserted-by":"crossref","first-page":"419","DOI":"10.3113\/FAI-2009-0419","article-title":"Direct visualization for syndesmotic stabilization of ankle fractures","volume":"30","author":"Miller AN","year":"2009","journal-title":"Foot Ankle Int."},{"key":"e_1_2_5_7_1","doi-asserted-by":"crossref","first-page":"1302","DOI":"10.1016\/j.arthro.2021.09.016","article-title":"In\u2010office needle arthroscopy for the treatment of anterior ankle impingement yields high patient satisfaction with high rates of return to work and sport","volume":"38","author":"Colasanti CA","year":"2022","journal-title":"Arthroscopy."},{"key":"e_1_2_5_8_1","doi-asserted-by":"crossref","first-page":"1129","DOI":"10.1016\/j.arthro.2023.01.005","article-title":"In\u2010office needle arthroscopy for the foot and ankle","volume":"39","author":"Duenes ML","year":"2023","journal-title":"Arthroscopy."},{"key":"e_1_2_5_9_1","doi-asserted-by":"crossref","first-page":"103035","DOI":"10.1016\/j.eats.2024.103035","article-title":"Stabilization of anterior aspect of distal tibiofibular syndesmosis: A fully arthroscopic technique","volume":"13","author":"Mioduszewski A","year":"2024","journal-title":"Arthrosc Tech."},{"key":"e_1_2_5_10_1","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1016\/j.fas.2024.05.005","article-title":"Comparison of visibility in needle arthroscopy of the ankle according to surgical experience: A cadaveric study","volume":"30","author":"Inoue J","year":"2024","journal-title":"Foot Ankle Surg."},{"key":"e_1_2_5_11_1","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1007\/s12178-022-09769-0","article-title":"Intraoperative assessment of reduction of the ankle syndesmosis","volume":"15","author":"Hao KA","year":"2022","journal-title":"Curr Rev Musculoskelet Med."},{"key":"e_1_2_5_12_1","doi-asserted-by":"crossref","first-page":"102255362311823","DOI":"10.1177\/10225536231182349","article-title":"Instability of the distal tibiofibular syndesmosis","volume":"31","author":"Vohra R","year":"2023","journal-title":"J Orthop Surg (Hong Kong)."},{"key":"e_1_2_5_13_1","doi-asserted-by":"crossref","first-page":"101227","DOI":"10.1016\/j.asmr.2025.101227","article-title":"Suture\u2010button repair improves outcomes in arthroscopically diagnosed chronic syndesmotic injury despite low imaging sensitivity","volume":"7","author":"Vinje T","year":"2025","journal-title":"Arthrosc Sports Med Rehabil."},{"key":"e_1_2_5_14_1","doi-asserted-by":"crossref","first-page":"103166","DOI":"10.1016\/j.eats.2024.103166","article-title":"Arthroscopic repair of the anterior inferior tibiofibular ligament","volume":"14","author":"Andersen MR","year":"2025","journal-title":"Arthrosc Tech."},{"key":"e_1_2_5_15_1","doi-asserted-by":"crossref","first-page":"820","DOI":"10.5312\/wjo.v15.i8.820","article-title":"Needle arthroscopic\u2010assisted repair of tibio\u2010fibular syndesmosis acute injury: A case report","volume":"15","author":"Wojtowicz BG","year":"2024","journal-title":"World J Orthop."},{"key":"e_1_2_5_16_1","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1016\/j.fcl.2025.07.013","article-title":"Needle arthroscopy: Current and future use in the ankle","volume":"30","author":"Tham A","year":"2025","journal-title":"Foot Ankle Clin."},{"key":"e_1_2_5_17_1","doi-asserted-by":"crossref","first-page":"250","DOI":"10.3113\/FAI.2011.0250","article-title":"Outcomes of suture button repair of the distal tibiofibular syndesmosis","volume":"32","author":"Degroot H","year":"2011","journal-title":"Foot Ankle Int."},{"key":"e_1_2_5_18_1","doi-asserted-by":"crossref","first-page":"101158","DOI":"10.1016\/j.asmr.2025.101158","article-title":"Only minor complications are reported after needle arthroscopy: A systematic review","volume":"7","author":"Walinga AB","year":"2025","journal-title":"Arthrosc Sports Med Rehabil."}],"container-title":["Arthroscopy Techniques"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/atn2.70332","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/atn2.70332","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/atn2.70332","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T05:44:53Z","timestamp":1791783893000},"score":1,"resource":{"primary":{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/10.1002\/atn2.70332"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,11]]},"references-count":17,"alternative-id":["10.1002\/atn2.70332"],"URL":"https:\/\/doi.org\/10.1002\/atn2.70332","archive":["Portico"],"relation":{},"ISSN":["2212-6287","2212-6287"],"issn-type":[{"value":"2212-6287","type":"print"},{"value":"2212-6287","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,11]]},"assertion":[{"value":"2026-02-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70332"}}