TightRope fixation system

Last revised by Ashesh Ishwarlal Ranchod on 21 Feb 2023

The TightRope fixation system (Arthrex, Germany) is a reconstruction technique most commonly used for fixation for distal tibiofibular syndesmotic injuries or acromioclavicular joint injuries.

This technique uses a non-absorbable fiber wire held between two or more metal cortical buttons at the opposite aspects of the joint. It may or may not be used in conjunction with other internal fixator plates and screws.

Radiographic features

Plain radiograph

Often seen as two or more small button like plates/fixators on either side of the bones (e.g. above the malleoli in the setting of syndesmosis fixation) and a faint radiolucent tract extending between them.

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