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Acute Disruption of Ankle SyndesmosisNCT04972578

Comparison of Gait in Syndesmosis Injuries Treated With Screw Fixation vs Suture Button

A study testing Suture Button vs Screw Fixation in people with Acute Disruption of Ankle Syndesmosis, run by University of Nebraska at 3 sites in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

Injuries to the distal tibiofibular syndesmosis are common and occur in an estimated 25% of all rotational ankle fractures. Anatomic reduction of the syndesmosis has been associated with improved functional outcome as well as decreased rates of posttraumatic arthritis. Read more about this study

Who is it for?
Ages 19 years and olderHealthy volunteers can take part
Conditions the study is for
Acute Disruption of Ankle Syndesmosis
What is being tested?
Suture Button vs Screw Fixation
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
21 participants
Where
3 sitesUnited States
Study dates
1 Oct 2021to 9 Jan 2026
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 19 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • 19 years of age and older
  • Isolated rotational ankle injury
  • Syndesmotic instability (determined either pre- or intra-operatively)
  • Length-stable fibula fracture pattern

Who cannot join

  • Open fracture
  • Length-unstable fracture pattern (including Maisonneuve fracture pattern)
  • Syndesmotic stability (determined either pre- or intra-operatively)
  • Lower extremity neuropathy
  • History of prior trauma or surgery to injured ankle
  • Non-ambulatory
  • Use of ambulatory assistive device prior to injury

Trial locations and contacts

3 sites in 1 country.

United States3 sites
  • Nebraska Medicine, Bellevue Health Center

    Bellevue, Nebraska, 68123

  • Lauritzen Outpatient Center

    Omaha, Nebraska, 68105

  • Village Point Outpatient Center

    Omaha, Nebraska, 68118

Other trials in United States

About this study

Injuries to the distal tibiofibular syndesmosis are common and occur in an estimated 25% of all rotational ankle fractures. Anatomic reduction of the syndesmosis has been associated with improved functional outcome as well as decreased rates of posttraumatic arthritis. Both screw fixation and suture fixation have become accepted standards of care for treatment of syndesmotic injuries. Recent literature would suggest trends favoring suture fixation over screw fixation with improved quality of syndesmotic reduction, postoperative range of motion, and improved maintenance of syndesmotic reduction. However, the evidence remains heterogeneous, and patient reported outcomes have failed to show a superiority of one method over the other. Additionally, there have been no studies that demonstrate objective gait outcomes comparing screw versus suture fixation for syndesmotic injuries.

Read the detailed description

This will be a prospective randomized study. Patients with isolated rotational ankle injuries with syndesmotic instability will be randomized to either screw fixation or suture fixation for treatment of their syndesmotic injury. Patients will be followed postoperatively for one year following surgery with documentation of both clinical outcomes and subjective patient reported outcomes. Additionally, postoperative gait patterns will be measured and compared between patients who had syndesmotic injuries treated with screw fixation versus suture fixation

Being tested
Suture Button vs Screw Fixation

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Suture Button vs Screw FixationDevice

    Syndesmotic fixation utilizing suture button fixation versus Screw Fixation (placing one or two screws across the syndesmosis)

Study groups in NCT04972578
Study groupRoleWhat they receive
Screw FixationActive comparatorTraditional fixation method of placing one or two screws across the syndesmosis.
Receives: Device: Suture Button vs Screw Fixation
Suture ButtonActive comparatorSuture button implants which use a suture and anchor to repair the syndesmosis
Receives: Device: Suture Button vs Screw Fixation

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Gait parameter - Step length

    Step length will be measured in meters. Participants will walk down the length of a gait mat and back (20 feet in length, one-way). Five passes will be completed and the results averaged. Data will be collected on the Zeno Walkway using PKMAS software.

    Measured: 3 months

  2. Gait parameter - Step length

    Step length will be measured in meters. Participants will walk down the length of a gait mat and back (20 feet in length, one-way). Five passes will be completed and the results averaged. Data will be collected on the Zeno Walkway using PKMAS software.

    Measured: 6 months

  3. Gait parameter - Step length

    Step length will be measured in meters. Participants will walk down the length of a gait mat and back (20 feet in length, one-way). Five passes will be completed and the results averaged. Data will be collected on the Zeno Walkway using PKMAS software.

    Measured: 1 year

  4. Gait parameter - Step width

    Step width will be measured in meters. Participants will walk down the length of a gait mat and back (20 feet in length, one-way). Five passes will be completed and the results averaged. Data will be collected on the Zeno Walkway using PKMAS software.

    Measured: 3 months

  5. Gait parameter - Step width

    Step width will be measured in meters. Participants will walk down the length of a gait mat and back (20 feet in length, one-way). Five passes will be completed and the results averaged. Data will be collected on the Zeno Walkway using PKMAS software.

    Measured: 6 months

  6. Gait parameter - Step width

    Step width will be measured in meters. Participants will walk down the length of a gait mat and back (20 feet in length, one-way). Five passes will be completed and the results averaged. Data will be collected on the Zeno Walkway using PKMAS software.

    Measured: 1 Year

  7. Gait parameter - Step time

    Step time will be measured in seconds. Participants will walk down the length of a gait mat and back (20 feet in length, one-way). Five passes will be completed and the results averaged. Data will be collected on the Zeno Walkway using PKMAS software.

    Measured: 3 months

  8. Gait parameter - Step time

    Step time will be measured in seconds. Participants will walk down the length of a gait mat and back (20 feet in length, one-way). Five passes will be completed and the results averaged. Data will be collected on the Zeno Walkway using PKMAS software.

    Measured: 6 months

  9. Gait parameter - Step time

    Step time will be measured in seconds. Participants will walk down the length of a gait mat and back (20 feet in length, one-way). Five passes will be completed and the results averaged. Data will be collected on the Zeno Walkway using PKMAS software.

    Measured: 1 year

  10. Gait parameter - Swing time

    Swing time will be measured in seconds. Participants will walk down the length of a gait mat and back (20 feet in length, one-way). Five passes will be completed and the results averaged. Data will be collected on the Zeno Walkway using PKMAS software.

    Measured: 3 months

  11. Gait parameter - Swing time

    Swing time will be measured in seconds. Participants will walk down the length of a gait mat and back (20 feet in length, one-way). Five passes will be completed and the results averaged. Data will be collected on the Zeno Walkway using PKMAS software.

    Measured: 6 months

  12. Gait parameter - Swing time

    Swing time will be measured in seconds. Participants will walk down the length of a gait mat and back (20 feet in length, one-way). Five passes will be completed and the results averaged. Data will be collected on the Zeno Walkway using PKMAS software.

    Measured: 1 year

  13. Gait parameter - Stance time

    Stance time will be measured in seconds. Participants will walk down the length of a gait mat and back (20 feet in length, one-way). Five passes will be completed and the results averaged. Data will be collected on the Zeno Walkway using PKMAS software.

    Measured: 3 months

  14. Gait parameter - Stance time

    Stance time will be measured in seconds. Participants will walk down the length of a gait mat and back (20 feet in length, one-way). Five passes will be completed and the results averaged. Data will be collected on the Zeno Walkway using PKMAS software.

    Measured: 6 months

  15. Gait parameter - Stance time

    Stance time will be measured in seconds. Participants will walk down the length of a gait mat and back (20 feet in length, one-way). Five passes will be completed and the results averaged. Data will be collected on the Zeno Walkway using PKMAS software.

    Measured: 1 year

  16. Gait parameter - Double support time

    Double support time will be measured in seconds. Participants will walk down the length of a gait mat and back (20 feet in length, one-way). Five passes will be completed and the results averaged. Data will be collected on the Zeno Walkway using PKMAS software.

    Measured: 3 months

  17. Gait parameter - Double support time

    Double support time will be measured in seconds. Participants will walk down the length of a gait mat and back (20 feet in length, one-way). Five passes will be completed and the results averaged. Data will be collected on the Zeno Walkway using PKMAS software.

    Measured: 6 months

  18. Gait parameter - Double support time

    Double support time will be measured in seconds. Participants will walk down the length of a gait mat and back (20 feet in length, one-way). Five passes will be completed and the results averaged. Data will be collected on the Zeno Walkway using PKMAS software.

    Measured: 1 year

  19. Gait parameter - Gait speed

    Gait speed will be measured in meters per second. Participants will walk down the length of a gait mat and back (20 feet in length, one-way). Five passes will be completed and the results averaged. Data will be collected on the Zeno Walkway using PKMAS software.

    Measured: 3 months

  20. Gait parameter - Gait speed

    Gait speed will be measured in meters per second. Participants will walk down the length of a gait mat and back (20 feet in length, one-way). Five passes will be completed and the results averaged. Data will be collected on the Zeno Walkway using PKMAS software.

    Measured: 6 months

  21. Gait parameter - Gait speed

    Gait speed will be measured in meters per second. Participants will walk down the length of a gait mat and back (20 feet in length, one-way). Five passes will be completed and the results averaged. Data will be collected on the Zeno Walkway using PKMAS software.

    Measured: 1 year

Secondary outcomes (9)
  1. Time to fracture union

    Time to fracture union will be obtained based upon radiographic analysis at routine clinical follow-up visits.

    Measured: 6 weeks, 3 months, 6 months, and 1 year

  2. Maintenance of syndesmotic reduction

    Maintenance or loss of syndesmotic reduction will be evaluated radiographically at routine clinical follow-up visits.

    Measured: 6 weeks, 3 months, 6 months, and 1 year

  3. Development of radiographic arthritis

    Presence or absence of new radiographic tibiotalar arthritis will be noted on radiographs obtained at routine clinical follow-up visits.

    Measured: 6 weeks, 3 months, 6 months, and 1 year

  4. Implant complications

    Presence or absence of implant-related complications will be assessed radiographically at routine clinical follow-up visits (defined as screw fracture, loss of fixation, osteolysis surrounding implant).

    Measured: 6 weeks, 3 months, 6 months, and 1 year

  5. Secondary procedures

    The need for secondary procedures will be recorded. Secondary procedures would include of return trips to the OR for infection, for implant removal, for revision reduction or fixation, as well as in-office procedures including implant removal

    Measured: 1 year

  6. Postoperative wound complications

    Presence or absence of wound complications will be evaluated on physical exam at routine clinical follow-up visits (defined as superficial or deep infection, delayed wound healing, wound dehiscence).

    Measured: 2 weeks, 6 weeks, 3 months, 6 months, and 1 year

  7. Ankle range of motion

    Ankle range of motion (tibiotalar dorsiflexion and plantarflexion) will be evaluated on physical exam at routine clinical follow-up visits (measured in degrees of dorsiflexion or plantarflexion from neutral).

    Measured: 2 weeks, 6 weeks, 3 months, 6 months, and 1 year

  8. Patient reported outcomes - PROMIS LE (Patient-Reported Outcomes Information System Lower Extremity)

    The PROMIS LE is a computer-adaptive test that reports a score of patient-perceived physical functioning (walking and mobility) specific to the lower extremity. Scores are reported as T scores, with a score of 50 equal to the mean of the general population. Higher scores indicate more favorable physical function. Theoretical maximum and minimum scores are 100 and 0, respectively.

    Measured: 3 months, 6 months, and 1 year

  9. Patient reported outcomes - Olerud-Molander Score

    The Olerud-Molander Score was designed to score patient-reported outcomes regarding symptoms after ankle fracture. Scale minimum and maximum are 0 and 100, respectively, with a higher score indicative of improved outcome.

    Measured: 3 months, 6 months, and 1 year

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted22 Jul 2021
  2. Study start1 Oct 2021
  3. Primary completion8 Jan 2026
  4. Study completion9 Jan 2026

Why it stopped: Follow-up and consent was difficult and accrual was not being met.

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
21 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04972578
Sponsor's protocol ID
0146-21-FB
Status last verified
Dec 2025
First submitted
23 Apr 2021
Last updated
13 Jan 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing Suture Button vs Screw Fixation in people with Acute Disruption of Ankle Syndesmosis, run by University of Nebraska at 3 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 13 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study was stopped early (reason given: Follow-up and consent was difficult and accrual was not being met.). Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Gait parameter - Step length (time frame: 3 months). The study lists 21 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 Jan 2026; AzTrials last refreshed its copy on 8 Nov 2026.

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