Ræder BW, et al. - A randomized controlled trial was designed to compare clinical and radiological outcomes for these treatment groups after five years. A sum of 97 individuals with acute syndesmotic injury were assigned randomly to syndesmotic screw (SS) or suture button (SB). The five-year follow-up rate was 81 individuals (84%). In this study, the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle Hindfoot Scale were the primary endpoints. The Olerud-Molander Ankle (OMA) score, visual analogue scale (VAS), EuroQol five-dimension questionnaire (EQ-5D), range of movement, complications, reoperations, and radiological results were considered as secondary endpoints. The results showed that five years after syndesmotic injury treated with either SB or SS, researchers observed better AOFAS and OMA scores, and lower incidence of ankle OA, in the SB group. When treating an acute syndesmotic injury, these long-term outcomes prefer the use of SB.