{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T03:27:12Z","timestamp":1789442832024,"version":"build-2803163510"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JBJS Essential Surgical Techniques"],"abstract":"<jats:p>A suture button device provides fixation of syndesmosis injuries of the ankle with or without concomitant malleolar fracture. The suture button device consists of a fiber thread attached between 2 small metal buttons. The buttons are placed on the cortical bone on the medial and lateral sides of the ankle, and the fiber thread is tightened to stabilize the syndesmosis. The suture button device offers stable yet dynamic fixation of the injured syndesmosis. The major steps of the procedure are (1) lateral skin incision straight to the bone; (2) open reduction and plate fixation of the fibular fracture if one is present; (3) reduction of the syndesmosis and temporary stabilization with a pin or clamp; (4) use of an appropriate burr to make a hole through 4 cortices at the level of the inferior tibiofibular joint, approximately 1.5 cm proximal to the ankle joint line and at a 20\u00b0 to 30\u00b0 lateral-to-anteromedial angle; (5) pulling the needle attached to the suture button device through the drill-hole from lateral to medial and flipping the small plate on the cortical bone of the medial cortex of the medial malleolus; (6) tightening the device by pulling the 2 threads on the lateral side with care taken to remove all of the slack from the system; and (7) checking placement and fixation with fluoroscopy, cutting the threads, and skin closure. Use of a walker boot or cast is decided on the basis of the fracture fixation. Partial weight-bearing is allowed for the first 6 weeks, after which full weight-bearing is permitted as pain allows. Routine removal of the suture button device is not required.<\/jats:p>","DOI":"10.2106\/jbjs.st.17.00050","type":"journal-article","created":{"date-parts":[[2018,5,8]],"date-time":"2018-05-08T23:46:13Z","timestamp":1525823173000},"page":"e13","source":"Crossref","is-referenced-by-count":13,"title":["Use of Suture Button in the Treatment of Syndesmosis Injuries"],"prefix":"10.2106","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1917-8565","authenticated-orcid":false,"given":"Mette Renate","family":"Andersen","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Baerum Hospital, Vestre Viken Health Trust (M.R.A. and W.F.), and the Institute of Clinical Medicine, University of Oslo (M.R.A.), Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8201-9818","authenticated-orcid":false,"given":"Wender","family":"Figved","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Baerum Hospital, Vestre Viken Health Trust (M.R.A. and W.F.), and the Institute of Clinical Medicine, University of Oslo (M.R.A.), Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2018,6,27]]},"reference":[{"key":"bib1-20230812","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3109\/ort.1981.52.suppl-189.01","article-title":"Operative treatment of ankle fractures","volume":"189","author":"Lindsj\u00f6","year":"1981","journal-title":"Acta Orthop Scand Suppl."},{"issue":"1","key":"bib2-20230812","doi-asserted-by":"crossref","first-page":"43","DOI":"10.3109\/17453679809002355","article-title":"Adult ankle fractures\u2014an increasing problem?","volume":"69","author":"Court-Brown","year":"1998","journal-title":"Acta Orthop Scand."},{"issue":"4","key":"bib3-20230812","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1016\/j.arthro.2015.10.003","article-title":"Stable versus unstable grade II high ankle sprains: a prospective study predicting the need for surgical stabilization and time to return to sports","volume":"32","author":"Calder","year":"2016","journal-title":"Arthroscopy."},{"issue":"4","key":"bib4-20230812","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-AFAS consensus and guidelines","volume":"24","author":"van Dijk","year":"2016","journal-title":"Knee Surg Sports Traumatol Arthrosc."},{"issue":"11","key":"bib6-20230812","doi-asserted-by":"crossref","first-page":"2283","DOI":"10.1016\/j.injury.2015.08.021","article-title":"High complication rate after syndesmotic screw removal","volume":"46","author":"Andersen","year":"2015","journal-title":"Injury."},{"issue":"11","key":"bib7-20230812","doi-asserted-by":"crossref","first-page":"1040","DOI":"10.3113\/FAI.2011.1040","article-title":"Complications of syndesmotic screw removal","volume":"32","author":"Schepers","year":"2011","journal-title":"Foot Ankle Int."},{"issue":"6","key":"bib8-20230812","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1007\/s00068-014-0466-8","article-title":"An update on the evaluation and treatment of syndesmotic injuries","volume":"41","author":"Rammelt","year":"2015","journal-title":"Eur J Trauma Emerg Surg."},{"issue":"1","key":"bib9-20230812","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":"South Afr Orthop J."},{"issue":"5","key":"bib10-20230812","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."}],"container-title":["JBJS Essential Surgical Techniques"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/01709766-201808020-00003","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:43:10Z","timestamp":1787751790000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/01709766-201808020-00003"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,5,9]]},"references-count":9,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2018]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.st.17.00050","relation":{},"ISSN":["2160-2204"],"issn-type":[{"value":"2160-2204","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,5,9]]}}}