{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T15:06:49Z","timestamp":1789139209037,"version":"build-2803163510"},"reference-count":51,"publisher":"Scientific Scholar","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Orthopaedics"],"published-print":{"date-parts":[[2026,3]]},"DOI":"10.1016\/j.jor.2025.12.035","type":"journal-article","created":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T07:14:12Z","timestamp":1765782852000},"page":"283-295","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":1,"special_numbering":"C","title":["A systematic review comparing the outcomes of utilizing a tricortical screw, quadricortical screw, or suture button for syndesmotic fixation"],"prefix":"10.25259","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-7872-6796","authenticated-orcid":false,"given":"Brent A.","family":"Prenger","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Casey","family":"Uffelmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0862-995X","authenticated-orcid":false,"given":"James L.","family":"Cook","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6848-1670","authenticated-orcid":false,"given":"Kyle M.","family":"Schweser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","reference":[{"key":"10.1016\/j.jor.2025.12.035_bib1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12891-017-1645-7","article-title":"A systematic review of suture-button versus syndesmotic screw in the treatment of distal tibiofibular syndesmosis injury","volume":"18","author":"Zhang","year":"2017","journal-title":"BMC Musculoskelet Disord"},{"key":"10.1016\/j.jor.2025.12.035_bib2","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.ijsu.2018.11.007","article-title":"Comparison of suture button fixation and syndesmotic screw fixation in the treatment of distal tibiofibular syndesmosis injury: a systematic review and meta-analysis","volume":"60","author":"Xie","year":"2018","journal-title":"Int J Surg"},{"key":"10.1016\/j.jor.2025.12.035_bib3","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1053\/j.jfas.2020.08.005","article-title":"Comparison of suture-button versus syndesmotic screw in the treatment of distal tibiofibular syndesmosis injury: a meta-analysis","volume":"60","author":"Xu","year":"2021","journal-title":"J Foot Ankle Surg"},{"key":"10.1016\/j.jor.2025.12.035_bib4","doi-asserted-by":"crossref","first-page":"2764","DOI":"10.1177\/0363546518804804","article-title":"Suture button versus syndesmotic screw for syndesmosis injuries: a meta-analysis of randomized controlled trials","volume":"47","author":"Shimozono","year":"2019","journal-title":"Am J Sports Med"},{"key":"10.1016\/j.jor.2025.12.035_bib5","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1053\/j.jfas.2020.09.021","article-title":"Syndesmotic stabilization: syndesmotic screw versus flexible fixation: a systematic review","volume":"60","author":"Elabd","year":"2021","journal-title":"J Foot Ankle Surg"},{"key":"10.1016\/j.jor.2025.12.035_bib6","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1080\/17453674.2020.1818175","article-title":"Randomized trial comparing suture button with single 3.5 mm syndesmotic screw for ankle syndesmosis injury: similar results at 2 years","volume":"91","author":"R\u00e6der","year":"2020","journal-title":"Acta Orthop"},{"key":"10.1016\/j.jor.2025.12.035_bib7","doi-asserted-by":"crossref","first-page":"3143","DOI":"10.1016\/j.injury.2021.06.025","article-title":"Suture button versus syndesmosis screw fixation in pronation-external rotation ankle fractures: a minimum 6-year follow-up of a randomised controlled trial","volume":"52","author":"Lehtola","year":"2021","journal-title":"Injury"},{"key":"10.1016\/j.jor.2025.12.035_bib8","doi-asserted-by":"crossref","first-page":"3156","DOI":"10.1007\/s00167-017-4820-3","article-title":"Lower complication rate and faster return to sports in patients with acute syndesmotic rupture treated with a new knotless suture button device","volume":"26","author":"Colcuc","year":"2018","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"10.1016\/j.jor.2025.12.035_bib9","doi-asserted-by":"crossref","first-page":"2","DOI":"10.2106\/JBJS.16.01011","article-title":"Randomized trial comparing suture button with single syndesmotic screw for syndesmosis injury","volume":"100","author":"Andersen","year":"2018","journal-title":"J Bone Joint Surg Am"},{"key":"10.1016\/j.jor.2025.12.035_bib10","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1097\/BOT.0000000000000245","article-title":"A prospective randomized multicenter trial comparing clinical outcomes of patients treated surgically with a static or dynamic implant for acute ankle syndesmosis rupture","volume":"29","author":"Laflamme","year":"2015","journal-title":"J Orthop Trauma"},{"key":"10.1016\/j.jor.2025.12.035_bib11","first-page":"32","article-title":"Treatment of syndesmoses disruptions: a prospective, randomized study comparing conventional screw fixation vs TightRope fiber wire fixation - medium term results","volume":"8","author":"Coetzee","year":"2009","journal-title":"SA Orthop J"},{"key":"10.1016\/j.jor.2025.12.035_bib12","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1016\/j.injury.2015.02.004","article-title":"A prospective randomised study comparing TightRope and syndesmotic screw fixation for accuracy and maintenance of syndesmotic reduction assessed with bilateral computed tomography","volume":"46","author":"Kortekangas","year":"2015","journal-title":"Injury"},{"key":"10.1016\/j.jor.2025.12.035_bib13","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1097\/BOT.0000000000002267","article-title":"In vivo syndesmotic motion after rigid and flexible fixation using 4-dimensional computerized tomography","volume":"36","author":"Wong","year":"2022","journal-title":"J Orthop Trauma"},{"key":"10.1016\/j.jor.2025.12.035_bib14","article-title":"Suture-button versus syndesmotic screw fixation of ankle fractures: a comparative retrospective review over one year","volume":"13","author":"Yawar","year":"2021","journal-title":"Cureus"},{"key":"10.1016\/j.jor.2025.12.035_bib15","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/j.fas.2021.01.001","article-title":"Screw versus suture button in treatment of syndesmosis instability: Comparison using weightbearing CT scan","volume":"27","author":"Elghazy","year":"2021","journal-title":"Foot Ankle Surg"},{"key":"10.1016\/j.jor.2025.12.035_bib16","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1053\/j.jfas.2021.07.009","article-title":"The clinical efficacy of suture-button fixation and trans-syndesmotic screw fixation in the treatment of ankle fracture combined with distal tibiofibular syndesmosis injury: a retrospective study","volume":"61","author":"Xu","year":"2022","journal-title":"J Foot Ankle Surg"},{"key":"10.1016\/j.jor.2025.12.035_bib17","doi-asserted-by":"crossref","first-page":"900","DOI":"10.14744\/tjtes.2024.20094","article-title":"Comparison of screw fixation and dynamic fixation in the treatment of ankle fractures with syndesmotic ruptures","volume":"30","author":"G\u00fcng\u00f6r","year":"2024","journal-title":"Ulus Travma Acil Cerrahi Derg"},{"key":"10.1016\/j.jor.2025.12.035_bib18","doi-asserted-by":"crossref","first-page":"6331","DOI":"10.3390\/jcm11216331","article-title":"Radiographic assessment of tibiofibular syndesmosis injury with different durations and types of fixation","volume":"11","author":"Klepacki","year":"2022","journal-title":"J Clin Med"},{"key":"10.1016\/j.jor.2025.12.035_bib19","doi-asserted-by":"crossref","first-page":"2524","DOI":"10.3390\/jcm11092524","article-title":"A 10-year follow-up of ankle syndesmotic injuries: prospective comparison of knotless suture-button fixation and syndesmotic screw fixation","volume":"11","author":"Altmeppen","year":"2022","journal-title":"J Clin Med"},{"key":"10.1016\/j.jor.2025.12.035_bib20","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/j.fas.2021.03.014","article-title":"Syndesmosis fixation in supination-external rotation ankle fractures. long-term results of a prospective randomised study","volume":"28","author":"Lehtola","year":"2022","journal-title":"Foot Ankle Surg"},{"key":"10.1016\/j.jor.2025.12.035_bib21","first-page":"702","article-title":"Comparative CT study on syndesmosis mobility after static or dynamic fixation for ankle fractures with syndesmotic rupture: a pilot study","volume":"10","author":"Aitor","year":"2022","journal-title":"Arch Bone Jt Surg"},{"key":"10.1016\/j.jor.2025.12.035_bib22","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1186\/s12893-023-01982-z","article-title":"Comparison the treatment of anterior inferior tibiofibular ligament anatomical repair and syndesmosis screw fixation for syndesmotic injuries in ankle fracture","volume":"23","author":"Lin","year":"2023","journal-title":"BMC Surg"},{"key":"10.1016\/j.jor.2025.12.035_bib23","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1097\/01.blo.0000151845.75230.a0","article-title":"Suture-button syndesmosis fixation: accelerated rehabilitation and improved outcomes","volume":"431","author":"Thornes","year":"2005","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.jor.2025.12.035_bib24","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000025328","article-title":"A comparison of double single suture-button fixation, suture-button fixation, and screw fixation for ankle syndesmosis injury","volume":"100","author":"Kurtoglu","year":"2021","journal-title":"Medicine (Baltim)"},{"key":"10.1016\/j.jor.2025.12.035_bib25","article-title":"Radiographic evaluation of syndesmosis stabilisation using the TightRope system versus syndesmotic screw fixation for the management of ankle fractures with a syndesmotic injury","volume":"15","author":"Saraglis","year":"2023","journal-title":"Cureus"},{"key":"10.1016\/j.jor.2025.12.035_bib26","doi-asserted-by":"crossref","first-page":"S19","DOI":"10.1016\/j.injury.2015.05.027","article-title":"Comparison of screw fixation with elastic fixation methods in the treatment of syndesmosis injuries in ankle fractures","volume":"46","author":"Seyhan","year":"2015","journal-title":"Injury"},{"key":"10.1016\/j.jor.2025.12.035_bib27","doi-asserted-by":"crossref","first-page":"988","DOI":"10.1177\/1071100714540894","article-title":"Syndesmotic fixation in supination-external rotation ankle fractures: a prospective randomized study","volume":"35","author":"Kortekangas","year":"2014","journal-title":"Foot Ankle Int"},{"key":"10.1016\/j.jor.2025.12.035_bib28","doi-asserted-by":"crossref","first-page":"2828","DOI":"10.1177\/0363546512461480","article-title":"Fixation of ankle syndesmotic injuries: comparison of TightRope fixation and syndesmotic screw fixation for accuracy of syndesmotic reduction","volume":"40","author":"Naqvi","year":"2012","journal-title":"Am J Sports Med"},{"key":"10.1016\/j.jor.2025.12.035_bib29","doi-asserted-by":"crossref","first-page":"4609","DOI":"10.3390\/jcm11154609","article-title":"The effect of stabilization procedures on sports discipline and performance level in non-elite athletes after acute syndesmotic injury: a prospective randomized trial","volume":"11","author":"Colcuc","year":"2022","journal-title":"J Clin Med"},{"key":"10.1016\/j.jor.2025.12.035_bib30","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1097\/00005131-200407000-00001","article-title":"Tricortical versus quadricortical syndesmosis fixation in ankle fractures: a prospective, randomized study comparing two methods of syndesmosis fixation","volume":"18","author":"H\u00f8iness","year":"2004","journal-title":"J Orthop Trauma"},{"key":"10.1016\/j.jor.2025.12.035_bib31","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1097\/BOT.0b013e3181bedca1","article-title":"No difference in functional and radiographic results 8.4 years after quadricortical compared with tricortical syndesmosis fixation in ankle fractures","volume":"24","author":"Wiker\u00f8y","year":"2010","journal-title":"J Orthop Trauma"},{"key":"10.1016\/j.jor.2025.12.035_bib32","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1053\/j.jfas.2024.07.011","article-title":"Post-treatment functional outcomes of distal tibiofibular syndesmosis injuries with varying duration and method of stabilization","volume":"63","author":"Klepacki","year":"2024","journal-title":"J Foot Ankle Surg"},{"issue":"7","key":"10.1016\/j.jor.2025.12.035_bib33","first-page":"820","article-title":"Effectiveness comparison of flexible fixation and rigid fixation in treatment of ankle pronation-external rotation fractures with distal tibiofibular syndesmosis","volume":"31","author":"Li","year":"2017","journal-title":"Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi"},{"key":"10.1016\/j.jor.2025.12.035_bib34","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1097\/BOT.0000000000001559","article-title":"Canadian orthopaedic Trauma society; improved reduction of the tibiofibular syndesmosis with TightRope compared with screw fixation: results of a randomized controlled study","volume":"33","author":"Sanders","year":"2019","journal-title":"J Orthop Trauma"},{"key":"10.1016\/j.jor.2025.12.035_bib35","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1186\/s13018-023-03579-x","article-title":"A new type of elastic fixation, using an encircling and binding technique, for tibiofibular syndesmosis stabilization: comparison to traditional cortical screw fixation","volume":"18","author":"Zhu","year":"2023","journal-title":"J Orthop Surg Res"},{"key":"10.1016\/j.jor.2025.12.035_bib36","doi-asserted-by":"crossref","first-page":"48","DOI":"10.5704\/MOJ.2311.008","article-title":"Dynamic fixation versus static screw fixation for syndesmosis injuries in pronation external rotation ankle fractures: a retrospective case control study","volume":"17","author":"Cm","year":"2023","journal-title":"Malays Orthop J"},{"key":"10.1016\/j.jor.2025.12.035_bib37","doi-asserted-by":"crossref","first-page":"2649","DOI":"10.1007\/s00264-022-05550-7","article-title":"\u201cFlexible nature of fixation\u201d in syndesmotic stabilization of the inferior tibiofibular joint affects the radiological reduction outcome","volume":"46","author":"Hennings","year":"2022","journal-title":"Int Orthop"},{"key":"10.1016\/j.jor.2025.12.035_bib38","first-page":"T73","article-title":"[Translated article] A randomised clinical trial comparing screws and the TighRope\u00ae knotless system in the treatment of acute injuries of syndesmosis","volume":"66","author":"Morales Mu\u00f1oz","year":"2022","journal-title":"Rev Esp Cir Ortop Traumatol"},{"key":"10.1016\/j.jor.2025.12.035_bib39","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1302\/0301-620X.102B2.BJJ-2019-0692.R2","article-title":"Better outcome for suture button compared with single syndesmotic screw for syndesmosis injury: five-year results of a randomized controlled trial","volume":"102-B","author":"R\u00e6der","year":"2020","journal-title":"Bone Joint Lett J"},{"key":"10.1016\/j.jor.2025.12.035_bib40","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1302\/0301-620X.96B4.32171","article-title":"A prospective, randomised trial comparing the use of absorbable and metallic screws in the fixation of distal tibiofibular syndesmosis injuries: mid-term follow-up","volume":"96-B","author":"Sun","year":"2014","journal-title":"Bone Joint Lett J"},{"key":"10.1016\/j.jor.2025.12.035_bib41","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1097\/01.bot.0000155313.50627.f6","article-title":"Fixation of syndesmotic ruptures in 38 patients with a malleolar fracture: a randomized study comparing a metallic and a bioabsorbable screw","volume":"19","author":"Kaukonen","year":"2005","journal-title":"J Orthop Trauma"},{"key":"10.1016\/j.jor.2025.12.035_bib42","doi-asserted-by":"crossref","first-page":"1699","DOI":"10.1302\/0301-620X.96B12.34258","article-title":"Removal of the syndesmotic screw after the surgical treatment of a fracture of the ankle in adult patients does not affect one-year outcomes: a randomised controlled trial","volume":"96-B","author":"Boyle","year":"2014","journal-title":"Bone Joint Lett J"},{"key":"10.1016\/j.jor.2025.12.035_bib43","doi-asserted-by":"crossref","first-page":"1129","DOI":"10.1007\/s11999-009-1111-4","article-title":"Posterior malleolar stabilization of syndesmotic injuries is equivalent to screw fixation","volume":"468","author":"Miller","year":"2010","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.jor.2025.12.035_bib44","doi-asserted-by":"crossref","first-page":"1574","DOI":"10.1016\/j.injury.2016.04.014","volume":"47","author":"Zhan","year":"2016","journal-title":"Injury"},{"key":"10.1016\/j.jor.2025.12.035_bib45","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1177\/1071100716661221","article-title":"Evaluation of reduction accuracy of suture-button and screw fixation techniques for syndesmotic injuries","volume":"37","author":"Kocadal","year":"2016","journal-title":"Foot Ankle Int"},{"key":"10.1016\/j.jor.2025.12.035_bib46","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1053\/j.jfas.2017.08.007","article-title":"Novel elastic syndesmosis hook plate fixation versus routine screw fixation for syndesmosis injury","volume":"57","author":"Xian","year":"2018","journal-title":"J Foot Ankle Surg"},{"key":"10.1016\/j.jor.2025.12.035_bib47","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1177\/107110079301400308","article-title":"Tibiotalar joint dynamics: indications for the syndesmotic screw--a cadaver study","volume":"14","author":"Burns","year":"1993","journal-title":"Foot Ankle"},{"key":"10.1016\/j.jor.2025.12.035_bib48","first-page":"741","article-title":"The effects of fibular and talar displacement on joint contact areas about the ankle","volume":"21","author":"Moody","year":"1992","journal-title":"Orthop Rev"},{"key":"10.1016\/j.jor.2025.12.035_bib49","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-year follow-up","volume":"26","author":"Sagi","year":"2012","journal-title":"J Orthop Trauma"},{"key":"10.1016\/j.jor.2025.12.035_bib50","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1302\/2058-5241.1.000023","article-title":"Management of ankle fractures in the elderly","volume":"1","author":"Rammelt","year":"2016","journal-title":"EFORT Open Rev"},{"issue":"3","key":"10.1016\/j.jor.2025.12.035_bib51","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1053\/j.jfas.2024.11.002","article-title":"Radiographic outcomes of flexible and rigid fixation techniques of syndesmotic injuries across various body mass indices: a retrospective analysis","volume":"64","author":"Black","year":"2025","journal-title":"J Foot Ankle Surg"}],"container-title":["Journal of Orthopaedics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0972978X25005173?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0972978X25005173?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T14:08:59Z","timestamp":1789135739000},"score":1,"resource":{"primary":{"URL":"https:\/\/jortho.org\/a-systematic-review-comparing-the-outcomes-of-utilizing-a-tricortical-screw-quadricortical-screw-or-suture-button-for-syndesmotic-fixation\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":51,"alternative-id":["S0972978X25005173"],"URL":"https:\/\/doi.org\/10.1016\/j.jor.2025.12.035","relation":{},"ISSN":["0972-978X"],"issn-type":[{"value":"0972-978X","type":"print"}],"subject":[],"published":{"date-parts":[[2026,3]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"A systematic review comparing the outcomes of utilizing a tricortical screw, quadricortical screw, or suture button for syndesmotic fixation","name":"articletitle","label":"Article Title"},{"value":"Journal of Orthopaedics","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jor.2025.12.035","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}]}}