{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:42:11Z","timestamp":1787755331323,"version":"build-2784847793"},"reference-count":89,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>\u00bb Syndesmotic fixation has evolved from predominantly rigid screw-based techniques toward dynamic stabilization methods, including suture-button devices and anatomic augmentation of the anterior inferior tibiofibular ligament (AITFL), which aim to restore more physiologic ankle motion while maintaining stability.<\/jats:p>\n                    <jats:p>\u00bb Suture-button fixation demonstrates clinical advantages over traditional screw fixation, including lower rates of hardware removal and reoperation, earlier return to weight bearing, and reduced implant-related complications. However, infection and neurovascular injury during medial placement remain important device-specific risks.<\/jats:p>\n                    <jats:p>\u00bb AITFL augmentation using suture tape or anchors shows promise in restoring native ligament biomechanics and may be particularly beneficial for young, high-demand patients with isolated ligamentous injuries, although long-term randomized trials are needed to validate early favorable outcomes.<\/jats:p>\n                    <jats:p>\u00bb Despite growing evidence for dynamic and hybrid fixation strategies, high-quality comparative data remain limited, with most studies consisting of cadaveric biomechanical analyses, retrospective case series, and technique descriptions rather than prospective randomized controlled trials with long-term functional outcomes.<\/jats:p>\n                    <jats:p>\u00bb Future research should prioritize standardized outcome measures, patient-reported functional data, and multicenter comparative trials to determine which fixation strategies provide optimal long-term stability, functional recovery, and cost-effectiveness across different patient populations and injury patterns.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.rvw.26.00034","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T18:06:24Z","timestamp":1781546784000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Beyond the Screw: Mapping the Evidence Landscape of Modern Syndesmotic Fixation"],"prefix":"10.2106","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4083-2912","authenticated-orcid":false,"given":"Megna","family":"Panchbhavi","sequence":"first","affiliation":[{"name":"Baylor College of Medicine, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0061-7225","authenticated-orcid":false,"given":"Vishank","family":"Panchbhavi","sequence":"additional","affiliation":[{"name":"Emory University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8554-1011","authenticated-orcid":false,"given":"Richard","family":"Liu","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7760-6508","authenticated-orcid":false,"given":"Ryan","family":"Lam","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2814-6856","authenticated-orcid":false,"given":"William","family":"McGarvey","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, McGovern Medical School, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,6]]},"reference":[{"issue":"4","key":"r1-20260615","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/j.fas.2014.08.003","article-title":"Ligamentous advancement for the treatment of subacute syndesmotic injuries. 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