The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons
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Comparative Study
Distal tibiofibular syndesmosis fixation: a cadaveric, simulated fracture stabilization study comparing bioabsorbable and metallic single screw fixation.
Metal screws that are used for ruptured tibiofibular syndesmosis repair are often removed within 3 months of placement, suggesting the utility of bioabsorbable screws. A biomechanical study was performed to compare fixation of a simulated syndesmosis separation with a 5-mm oriented copolymer bioabsorbable (82:18 poly-L-lactic acid/poly-glycolic acid) versus a stainless steel screw. Eight pairs of cadaveric lower-leg specimens were cleaned and a pronation external rotation-type injury was created in each. ⋯ Application of 1000 cycles of axial load (90 to 900 N) resulted in a significant decrease ( P < .0001) in axial stiffness for each fixation method, but the relative decrease was equivalent for both ( P = .211). Failure torque (17.8 +/- 8.3 N.m copolymer, 21.0 +/- 11.5 N.m stainless steel; P = .238) and angle of rotation at failure (47.9 +/- 13.6 degrees copolymer, 42.0 +/- 11.5 degrees stainless steel; P = .199) were also nearly equivalent. It appears that the 5.0-mm diameter copolymer screw is biomechanically equivalent to the 5.0-mm diameter stainless steel screw for repair of syndesmosis disruption.