The Fate of the Syndesmosis Screw in Syndesmotic Injuries

Abstract

Summary Introduction: Ankle fractures are common orthopedic injuries. Some ankle fractures are associated with syndesmosis injuries and surgical treatment is indicated. Screw fixation is the gold standard for fixation of sindesmotic rupture. However, there are different opinions in terms of implementation and follow-up. The current literature advocates that it should be removed in 6-8. weeks, some recent publications and surgeon opinions suggest that screws need not to be removed. The aim of this study was to compare the clinical results of patients with and without sindesmotic screw removal. Material and Methods: Thirty-one patients with sindesmosis fixation were retrospectively reviewed. The minimum follow-up period is 12 months. In the clinical evaluation, the Manchester Oxford Foot Questionnaire (MOXFQ) and the visual pain scale (VAS) were used. The final state of the screw (removed, fractured, intact) was evaluated with standard AP and lateral radiographs. Measurements of ankle joint motion were measured by goniometer Conclusion: A total of 33 patients were included in the study. Sindesmotic screw was removed in 39.4% (n = 13) of the cases and it was observed that 60.6% (n = 20) had not been removed. There were no statistically significant differences between the two groups. Discussion: There was no statistically significant difference between the two groups with and without sindesmotic screw removal. We believe that the removal of the syndesmotic screw should not be recommended considering our limited experience and current literature.