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Comparision between Syndesmotic Screw Fixation and Knotless Tightrope® Fixation on Ankle Fractures with Distal Tibiofibular Syndesmosis Injury
J Korean Foot Ankle Soc 2018;22:161-165
Published online December 15, 2018;
© 2018 Korean Foot and Ankle Society

Jun-Sik Park, Sung-Jin Lee, Sae-Hyun Kang, Gab-Lae Kim

Department of Orthopaedic Surgery, Kangdong Sacred Heart Hospital, Seoul, Korea
Correspondence to: Gab-Lae Kim
Department of Orthopaedic Surgery, Kangdong Sacred Heart Hospital, 150 Seongan-ro, Gangdong-gu, Seoul 05355, Korea
Tel: 82-2-2224-2230, Fax: 82-2-489-4391, E-mail:
Received July 30, 2018; Revised September 21, 2018; Accepted October 9, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Purpose: A distal tibiofibular syndesmosis injury with an ankle fracture is usually fixed with syndesmotic screws. Knotless Tightrope® has been used as an alternative procedure because of the fewer reported complications. Therefore, this study compared the two surgeries.
Materials and Methods: Forty-two patients, who underwent syndesmotic screw fixation, and 34 patients, who underwent Knotless Tightrope® fixation for distal tibiofibular syndesmosis injury from February 2014 to February 2016, were analyzed retrospectively. The visual analogue scale (VAS) score, American Orthopaedic Foot and Ankle Society (AOFAS) score, range of motion of ankle at 1 year after surgery, tibiofibular clear space, and tibiofibular interval at preoperative, postoperative and 1 year after surgery were investigated.
Results: The VAS score, AOFAS score and radiographs were similar in the two groups. Knotless Tightrope® showed better results in complications and plantarflexion.
Conclusion: Knotless Tightrope® fixation is a useful treatment that does not show a difference in fixation strength and clinical outcome. Knotless Tightrope® fixation also has an advantage in the range of motion and complications.
Keywords : Ankle fracture, Syndesmotic injuries, Bone screws, Suture anchors

June 2019, 23 (2)