[Fixation of syndesmotic disruption using bioresorbable screws].
OBJECTIVE
Fixation of syndesmotic disruption using bioresorbable screws to avoid secondary surgery for removal of the positioning screw.


METHODS
Syndesmotic ligament disruption, i.e., associated with ankle fractures (AO type B and C injuries).


METHODS
Allergies to bioresorbable materials such as sutures containing polylactic acids. Open fractures with severe comminution or bone loss. Successful conservative management in older patients. Nonambulatory patients.


METHODS
In case of a syndesmotic disruption, one or two cannulated bioresorbable positioning screws are placed bicortically under image intensifier control to allow healing of the distal ligamentous junction between the fibula and tibia. Screws must be placed proximal to the cartilaginous part of the tibiofibular joint to avoid uneventful cartilage damage and arthrosis.


METHODS
Postoperatively, most patients are treated with a non-weight-bearing cast for 6 weeks. Casts are changed after 1 and 2 weeks postoperatively. After 6 weeks, weight bearing is initiated. Return to physically demanding work and sports is allowed after 10-12 weeks.


RESULTS
Eight patients with a 6- to 12-month follow-up period showed good clinical and radiologic results.
van der Elst
Maarten
M
Department of Surgery and Trauma, Reinier de Graaf Hospital, Delft, Niederlande. elst@rdgg.nl
Coster
Erwin
E
Dekker
Maarten
M
D020341:Absorbable Implants; D016512:Ankle Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D001863:Bone Screws; D001864:Bone Wires; D005360:Fibula / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D005471:Fluoroscopy; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D008022:Ligaments / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D011182:Postoperative Care; D011183:Postoperative Complications / Q000209:etiology; D012307:Risk Factors; D012421:Rupture; D013525:Surgical Instruments