# An Unusual Outcome Using the TightRope® System in Syndesmotic Injury Management: A Case Report

## TL;DR

This case report discusses complications from using the TightRope® system for ankle injury repair, highlighting its limitations compared to traditional methods.

## Contribution

The paper presents a rare case of complications with the TightRope® system in syndesmotic injury management.

## Key findings

- The TightRope® system can lead to complications requiring further surgical intervention.
- Dynamic fixation may not always provide the expected stability in syndesmotic injuries.
- This case emphasizes the need for careful patient selection and monitoring when using the TightRope® system.

## Abstract

Syndesmotic injuries of the ankle are critical for maintaining joint stability and function, especially during weight-bearing activities. While traditional management involves rigid fixation with trans-syndesmotic screws, limitations such as restricted micromovement, potential screw breakage, and the need for secondary procedures have spurred the adoption of dynamic fixation methods like the TightRope® system (Arthrex, Naples, Florida, US). This report presents a case of a 54-year-old female with complications related to TightRope fixation following open reduction and internal fixation (ORIF) of a bimalleolar fracture. The case highlights the clinical course, surgical management, and outcomes, providing valuable insights into the limitations and potential complications of this technique.