Outcome after fixation of ankle fractures with an injury to the syndesmosis: the effect of the syndesmosis screw.

@article{Hamid2009OutcomeAF,
  title={Outcome after fixation of ankle fractures with an injury to the syndesmosis: the effect of the syndesmosis screw.},
  author={Nady Hamid and Bryan J. Loeffler and W Braddy and James F. Kellam and Bruce E. Cohen and Michael J Bosse},
  journal={The Journal of bone and joint surgery. British volume},
  year={2009},
  volume={91 8},
  pages={
          1069-73
        }
}
The purpose of this study was to compare the clinical and radiological outcome of patients with intact, broken and removed syndesmosis screws after Weber B or C ankle fracture with an associated injury to the syndesmosis. We hypothesised that there would be no difference. Of a possible 142 patients who fulfilled our inclusion criteria, 52 returned for clinical and radiological assessment at least one year after surgery. Of these, 27 had intact syndesmosis screws, ten had broken screws, and 15… Expand
Removal of the syndesmotic screw after the surgical treatment of a fracture of the ankle in adult patients does not affect one-year outcomes: a randomised controlled trial.
TLDR
It is concluded that removal of a syndesmotic screw produces no significant functional, clinical or radiological benefit in adult patients who are treated surgically for a fracture of the ankle. Expand
FUNCTIONAL OUTCOMES FOLLOWING SYNDESMOTIC SCREW FIXATION- A COMPARISON OF SCREW REMOVAL VERSUS RETENTION.
BACKGROUND: - The incidence of distal tibiofibular syndesmotic injury in ankle fractures is about 13%. The integrity of syndesmosis is a critical factor which stabilizes ankle mortise duringExpand
Removal of Syndesmotic Screw After Fixation in Ankle Fractures: A Systematic Review
TLDR
Overall, the current literature provides no evidence to support routine removal of syndesmotic screws, and removal in the clinic, with the use of prophylactic antibiotics should be considered if indicated in cases with pain or loss of function. Expand
Fate of the syndesmotic screw--Search for a prudent solution.
TLDR
There were no statistically significant differences in clinical outcome between the group with the screw retained and the group in which the screw was removed; however, the groupWith broken screws had the best clinical outcome based on AOFAS score. Expand
Mid-term results of ankle fractures with and without syndesmotic rupture.
  • E. Veen, R. G. Zuurmond
  • Medicine
  • Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons
  • 2015
TLDR
Patients with ankle fractures using syndesmotic repair and screw removal after 8 weeks and operated patients without syndesmosis injury have comparable results after 6 years, as there still exists controversy on the duration of screw stabilization. Expand
Functional outcomes following syndesmotic fixation: A comparison of screws retained in situ versus routine removal - Is it really necessary?
TLDR
It is shown that retained-screw fixation does not significantly impair functional capacity, with additional cost-effectiveness, and that syndesmosis screws be left in situ and should only be removed in case of symptomatic implants beyond 6 months postoperatively. Expand
The management of syndesmotic screw in ankle fractures.
TLDR
Results observed suggest that syndesmotic screw removal is not necessary, and if surgeon decide to remove this device correct timing is mandatory in order to obtain satisfactory long-term results. Expand
Mid- to Long-term Outcomes After Weber B-type Ankle Fractures With and Without Syndesmotic Rupture
Background/Aim: The aim of the present study was to assess the impact of syndesmotic screw fixation on overall clinical outcomes following Weber B-type ankle fractures. Materials and Methods: A totalExpand
Randomized Trial Comparing Suture Button with Single Syndesmotic Screw for Syndesmosis Injury
TLDR
The patients treated with an SB had higher AOFAS scores, OMA scores, and EQ-5D Index scores as well as lower (better) VAS scores for pain during walking and pain during rest, and the SB group had less widening seen radiographically at 2 years than did the patients in the SS group. Expand
Should syndesmotic screws be removed after surgical fixation of unstable ankle fractures? a systematic review.
TLDR
The currently available literature does not support routine elective removal of syndesmotic screws, and in the absence of high quality evidence there appears to be little justification for routine removal. Expand
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References

SHOWING 1-10 OF 19 REFERENCES
Syndesmotic screw fixation in Weber C ankle injuries--should the screw be removed before weight bearing?
TLDR
Judicious fixation of Weber C type injuries with syndesmotic screw fixation allows for good functional outcome and retention of the syndesmosis screw on commencement of weight bearing seems to increase the risk of subsequent screw breakage. Expand
Stabilization of Ankle Syndesmosis Injuries With a Syndesmosis Screw
TLDR
It was found that transfixation screws provided satisfactory stability of the syndesmosis to permit stable healing of the interosseous membrane and distal ligaments after ankle fracture. Expand
Tricortical Versus Quadricortical Syndesmosis Fixation in Ankle Fractures: A Prospective, Randomized Study Comparing Two Methods of Syndesmosis Fixation
TLDR
Syndesmosis fixation with 2 tricortical screws is safe and improves early function and there were no significant differences between the 2 groups in functional score, pain, and dorsiflexion after 1 year. Expand
Treatment of Syndesmotic Disruptions of the Ankle with Bioabsorbable Screw Fixation
TLDR
Polylevolactic acid screws are effective in stabilizing disruption of the syndesmosis during healing of unstable ankle fractures and there was no need for a second operation to remove it in this small series. Expand
Effect of the syndesmotic screw on ankle motion.
TLDR
It was concluded that the syndesmotic screw should be removed prior to the return to full activity; leaving it in place will contribute to abnormal ankle motion; this may result in local discomfort and a possible fatigue fracture of the screw. Expand
Intraoperative Diagnosis of Syndesmosis Injuries in External Rotation Ankle Fractures
TLDR
Preoperative radiographs and biomechanical criteria are unable to routinely predict the presence or absence of syndesmotic instability in patients with external rotation type ankle fractures. Expand
[Malleolar fractures with ankle joint instability--experience with the positioning screw].
TLDR
The results of 135 patients treated with the so-called positioning screw show that positioning screws require early removal only if they fail to loosen or if a persistent limitation of dorsiflexion is still present after three months. Expand
Syndesmotic Screw Placement: A Biomechanical Analysis
TLDR
To demonstrate the optimal level of syndesmotic screw placement before creation of a Maisonneuve fracture, legs of 17 embalmed cadavers underwent knee disarticulation to expose the syndesmosis/interosseous membrane were tested. Expand
Screw fixation of the syndesmosis: a cadaver model comparing stainless steel and titanium screws and three and four cortical fixation.
TLDR
It is concluded that the syndesmotic set screw cannot prevent excessive Syndesmotic widening when loaded with a load comparable with body weight, and patients with a syndesmosis set screw in situ should not bear weight. Expand
Injuries to the Distal Lower Extremity Syndesmosis
  • T. Wuest
  • Medicine
  • The Journal of the American Academy of Orthopaedic Surgeons
  • 1997
TLDR
Current indications for syndesmosis fixation are based on tibiotalar joint mechanics as determined in cadaveric and biomechanical studies, as well as radiologic evaluation and an understanding of the pertinent anatomy and the etiology of these injuries, and data support the use of syndesmotic screws in selected fractures that include a disruption of the Syndesmosis. Expand
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