Tightrope surgery is a technique used to stabilize the ankle after an injury, specifically a high ankle sprain or a fracture of the fibula. It involves using a device called the TightRope, which is made up of a braided polyethylene cord secured between two metallic buttons. The TightRope system anchors the ends of the tibia and fibula together with the cord, rather than with a rigid surgical screw, to restore the original position of the bones and to allow for proper healing. The fixation is flexible, which allows for natural motion between the tibia and fibula, and eliminates the need for a second surgery to remove the screws. Tightrope surgery is an attractive option for athletes as it can shorten rehabilitation times and allow them to return to sport more quickly.
After a syndesmotic injury is diagnosed, a decision on surgery is made with the patient. Sometimes, these injuries can be treated nonoperatively with an extended period of limited weight-bearing immobilization in a cast or a boot. Oftentimes, surgery is recommended for athletes in an effort to shorten the rehab and return to play timeline. Tightrope surgery has become more popular in recent years due to some cases of famous athletes having the procedure and subsequent features on ESPN.
