The Committee noted that suture fixation of acute disruption of the distal tibiofibular syndesmosis may be followed less frequently by reoperation for device removal compared with fixation by screws. It was also advised that there is a theoretical advantage with the less‑rigid fixation provided by sutures, which may allow some normal movement of the fibula.
The Committee was advised that there are significant differences between the suture and screw fixation techniques, and that using a precise suture knotting technique is particularly important in avoiding subsequent problems.
The Committee noted the paucity of long‑term follow‑up data but it was advised that these data would be difficult to collect and it perceived no special long‑term safety concerns. Nevertheless, it recognised that publication of long‑term outcomes (of at least 5 years) could guide future use of this procedure.