Functional Outcomes After Syndesmotic Screw Fixation and Removal

Abstract

Ankle fractures with a syndesmotic injury have historically been treated with syndesmotic screw fixation. We compared range of motion and functional outcomes' scores to assess patient benefit from syndesmotic screw and plate removal. Level IV--case series. Level I--trauma center. Twenty-five consecutive patients with unstable ankle fractures and syndesmotic injury confirmed on magnetic resonance imaging. Locked syndesmotic screws and plates were removed; functional outcomes and range of motion were measured before and after screw removal. Foot and Ankle Outcome Score, Olerud and Molander Ankle Score, and physical examination There was a significant improvement in range of motion, Foot and Ankle Outcome, and Olerud and Molander Ankle scores at the immediate postoperative visit. This was not significantly changed at longer follow-up. There were no adverse events or complications in these patients. No patient had radiographic loss of syndesmotic reduction after screw removal. Locked screw and plate removal improved function both subjectively and objectively. Transsyndesmotic implant removal seems to assist improvements in the speed of rehabilitation.