Abstract
Introduction: Syndesmosis lesions are common in ankle trauma. They can be treated with screws (rigid fixation) or endobuttons (elastic fixation). When rigid fixation is chosen, the problem arises as to how long it should be removed, since according to some authors, prolonged retention of the screw can impair ankle biomechanics and lead to osteoarthritis in the long term. In our study, for various reasons, this screw was either removed at different times or remained in place. The aim of this study was to assess the impact of the time taken to remove the syndesmosis screw on the outcome of the ankle. Materials and method: We carried out a cross-sectional, analytical study with a retrospective and a prospective phase. Patients presenting with ankle trauma with syndesmostic lesion, without risk factors for osteoarthritis were included. Parameters such as age, sex, radiological analysis postoperatively and at the last follow-up, time to removal of the syndesmosis screw and AOFAS score for functional assessment. Data were analyzed using CS Pro7.5 software. Results: Eighty-one patients participated in the study. Mean age was 47.21 ±16.88. The majority were men, with a sex ratio of 1.38. All patients underwent surgical treatment with screw fixation of the syndesmosis. According to the time of screw removal, 02 were removed before 8 weeks, 20 between 8-12 weeks and 49 after 12 weeks. Assessment using the AOFAS score showed excellent results in 17 patients (21%), good results in 28 patients (35%), fair results in 27 patients (33%) and poor results in 9 patients (11%). The analysis between the time of screw removal and the onset of osteoarthritis showed signs of osteoarthritis beyond 12 weeks, with a rate of 44.4%. Conclusion: A syndesmosis screw left in place for more than 12 weeks increases the risk of osteoarthritis.
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