Cost-Effectiveness of Suture Button Versus Screw Fixation for Syndesmotic Injuries .

A cost-utility analysis was conducted to look at whether suture button fixation offers better value than syndesmotic screws for stabilizing acute syndesmotic injuries. Using quality-adjusted life years (QALYs) as the metric of effectiveness, the study examines how factors like device cost, implant removal rates, and revision surgeries influence the economic value of each approach. Sensitivity analyses provide a nuanced understanding of when suture button fixation may—or may not—offer greater value. Even when the screw-removal rate was set to its lowest reported value, suture buttons still offered better economic value. Cost-effectiveness shifted only when the suture button removal rate rose above around 17%, at which point screws became the more efficient option.