Use of a Suture Button Device to Correct Syndesmotic Malreduction Caused by a Trans-Syndesmotic Screw.

Ankle syndesmosis malreduction is a common problem that leads to significantly worse functional outcomes. This report describes the replacement of a rigid syndesmotic screw with a flexible suture button fixation device to correct fibular translation and tibiotalar malalignment related to screw contact with other tibial implants. Suture button devices, although more expensive, can result in less postoperative malreduction and lead to better functional outcomes. As seen in these cases, careful attention should be given to syndesmotic or tibiotalar reduction after screw placement around other tibial implants, and the screw can be exchanged to a suture button device to address malreduction, if needed. [Orthopedics. 2019; 42(5):e480-e484.].