{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T21:40:16Z","timestamp":1783028416315,"version":"3.54.6"},"reference-count":46,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2016,10,13]],"date-time":"2016-10-13T00:00:00Z","timestamp":1476316800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot Ankle Int."],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Historically, syndesmosis injuries have been repaired with screw fixation; however, some suggest that suture-button constructs may provide a more accurate anatomic and physiologic reduction. The purpose of this study was to compare changes in the volume of the syndesmotic space following screw or suture-button fixation using a preinjury and postoperative 3-D computed tomography (CT) model. The null hypothesis was that no difference would be observed among repair techniques.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Twelve pairs of cadaveric specimens were dissected to identify the syndesmotic ligaments. Specimens were imaged with CT prior to the creation of a complete syndesmosis injury and were subsequently repaired using 1 of 3 randomly assigned techniques: (a) one 3.5-mm cortical screw, (b) 1 suture-button, and (c) 2 suture-buttons. Specimens were imaged postoperatively with CT. 3-D models of all scans and tibiofibular joint space volumes were calculated to assess restoration of the native syndesmosis. Analysis of variance and Tukey\u2019s method were used to compare least squares mean differences from the intact syndesmosis among repair techniques.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      For each of the 3 fixation methods, the total postoperative syndesmosis volume was significantly decreased relative to the intact state. The total mean decreases in volume compared with the intact state for the 1-suture-button construct, 2-suture-button construct, and syndesmotic screw were \u2212561 mm\n                      <jats:sup>3<\/jats:sup>\n                      (95% CI, \u2212878 to \u2212244), \u2212964 mm\n                      <jats:sup>3<\/jats:sup>\n                      (95% CI, \u22121281 to \u2212647) and \u2212377 mm\n                      <jats:sup>3<\/jats:sup>\n                      (95% CI, \u2212694 to \u221260), respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>All repairs notably reduced the volume of the syndesmosis beyond the intact state. Fixation with 1 suture-button was not significantly different from screw or 2-suture-button fixation; however, fixation with 2 suture-buttons resulted in significantly decreased volume compared with screw fixation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance:<\/jats:title>\n                    <jats:p>The results of this study suggest that the 1-suture-button repair technique and the screw fixation repair technique were comparable for reduction of syndesmosis injuries, although both may overcompress the syndesmosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1071100716673590","type":"journal-article","created":{"date-parts":[[2016,10,12]],"date-time":"2016-10-12T20:28:46Z","timestamp":1476304126000},"page":"208-214","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":38,"title":["A 3-D CT Analysis of Screw and Suture-Button Fixation of the Syndesmosis"],"prefix":"10.1177","volume":"38","author":[{"given":"Jason M.","family":"Schon","sequence":"first","affiliation":[{"name":"Steadman Philippon Research Institute, Vail, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brady T.","family":"Williams","sequence":"additional","affiliation":[{"name":"Steadman Philippon Research Institute, Vail, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie B.","family":"Venderley","sequence":"additional","affiliation":[{"name":"Steadman Philippon Research Institute, Vail, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grant J.","family":"Dornan","sequence":"additional","affiliation":[{"name":"Steadman Philippon Research Institute, Vail, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathon D.","family":"Backus","sequence":"additional","affiliation":[{"name":"Steadman Philippon Research Institute, Vail, CO, 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