SynthesisKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2021
Static versus dynamic fixation of distal tibiofibular syndesmosis: a systematic review of overlapping meta-analyses.
Synthesis in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- Predictors of Increased Fragility Index Scores in Surgical Randomized Controlled Trials: An Umbrella Review.World journal of surgery · 2023Pooled it
- Return-to-Sport Outcomes After Suture Button Fixation for Syndesmotic Injury in Elite Athletes With Chronic Lateral Ankle Instability: A Prospective Case Series.Orthopaedic journal of sports medicine · 2026Article
- Dynamic Versus Stable Fixation of Distal Tibiofibular Joint Injuries: A Meta-Analysis Comparing Functional Outcomes.Cureus · 2026Review
- Biomechanical comparison of different fixation methods for tibiofibular syndesmosis injuries: a finite element analysis study.BMC musculoskeletal disorders · 2026Article
- Fixation height has a greater biomechanical effect than anterior tilt angle in syndesmotic fixation for weber B ankle fractures: a specific finite element study.Frontiers in surgery · 2026Article
- Effect of early weight bearing on rehabilitation in ankle fractures with syndesmotic injuries.Scientific reports · 2025Article
- Recurring low statistical robustness in orthopaedic surgery: A systematic review of 84 fragility index studies.Journal of experimental orthopaedics · 2025Review
- All-suture fixation of syndesmotic injuries: a case series.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Article
- A Modified Dynamic Fixation Technique for Acute Syndesmotic Injuries.Foot & ankle orthopaedics · 2024Article
- Safe drilling zones for anteriorly, central, and posteriorly angulated syndesmotic stabilization devices.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- A 10-Year Follow-Up of Ankle Syndesmotic Injuries: Prospective Comparison of Knotless Suture-Button Fixation and Syndesmotic Screw Fixation.Journal of clinical medicine · 2022Article
Corrections and comments
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Authors and funding
10 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeMultiple Level I meta-analyses were conducted comparing traditional static vs. more recently introduced dynamic strategies of fixation for injuries of the distal tibiofibular syndesmosis (TFS). The aim of this review was to assess their robustness and methodological quality, providing support in the choice of a treatment strategy in case of TFS injury using the highest level of evidence.
methodsIn this systematic review, conducted in accordance with the PRISMA guidelines, meta-analyses/systematic reviews comparing static and dynamic fixation methods after acute TFS injury were identified. The robustness of studies was evaluated using the fragility index (FI) for meta-analysis and the fragility quotient (FQ). The risk of bias was evaluated using the Assessment of Multiple Systematic Reviews (AMSTAR) instrument. Finally, the Jadad was applied to select the study which provided the highest quality of evidence to develop recommendations for the fixation strategy of these lesions.
resultsOut of 1.302 records, four Level I meta-analyses were included in this study. Analyzing the statistically significant dichotomous outcomes, the median FI was 3.5 (IQR, 2 to 5.5; range, 1 to 9), while the median FQ was 1.9% (IQR, 1 to 3.5; range 0.35 to 4.4). In total, 37% had an FI of 2 or less and 75% of outcomes had a FI of 4 or less. According to the AMSTAR score and Jadad algorithm, the largest meta-analysis was selected as the highest evidence provided so far.
conclusionThe meta-analyses with statistically significant dichotomous outcomes comparing dynamic and static fixation for treating injuries of the distal tibiofibular syndesmosis are fragile, with a change in less than four patients or less than 2% of the study population sufficient to reverse a significant outcome to nonsignificant. LEVEL OF EVIDENCE: Level I.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.