title: Bioabsorbable versus stainless steel screw fixation of the syndesmosis in pronation-lateral rotation ankle fractures: a prospective randomized trial.
abstract: Thirty-two patients who had pronation-lateral rotation (PLR) fractures occurring four centimeters or more proximal to the ankle joint or lower if the talus was displaced greater than one centimeter laterally were enrolled in this study. Seventeen patients were randomized to fibular plate fixation with a 4.5 ml polylactic acid (PLA) bioabsorbable syndesmotic screw, and fifteen patients randomized to fibular plate fixation with a 4.5 mm stainless steel syndesmotic screw. All thirty-two patients had uncomplicated healing of their fibular fracture without loss of reduction. There was neither evidence of osteolysis nor sterile effusion in the patients who were treated with the PLA screw. There were no wound complications in either group. No difference in range of motion or subjective complaints was noted in either group. Use of the PLA syndesmotic screw at short-term follow-up was well tolerated and avoided the need for subsequent screw removal.
authors.affiliation: University of Southern California Department of Orthopaedics, Los Angeles, USA. thordars@hsc.usc.edu
authors.forename: D B
authors.initials: DB
authors.lastname: Thordarson
authors.forename: M
authors.initials: M
authors.lastname: Samuelson
authors.forename: L E
authors.initials: LE
authors.lastname: Shepherd
authors.forename: P F
authors.initials: PF
authors.lastname: Merkle
authors.forename: J
authors.initials: J
authors.lastname: Lee
mesh_terms: D020341:Absorbable Implants / Q000009:adverse effects; D000328:Adult; D016512:Ankle Injuries / Q000503:physiopathology / Q000601:surgery*; D001863:Bone Screws / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D050723:Fractures, Bone / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D019344:Lactic Acid / Q000009:adverse effects; D008297:Male; D011091:Polyesters; D011108:Polymers / Q000009:adverse effects; D011403:Pronation; D011446:Prospective Studies; D012399:Rotation; D013193:Stainless Steel / Q000009:adverse effects
chemical_list: D011091:Polyesters; D011108:Polymers; D013193:Stainless Steel; D019344:Lactic Acid; C033616:poly(lactide)