Functional outcomes after syndesmotic screw fixation and removal.
OBJECTIVE
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.


METHODS
Level IV--case series.


METHODS
Level I--trauma center.


METHODS
Twenty-five consecutive patients with unstable ankle fractures and syndesmotic injury confirmed on magnetic resonance imaging.


METHODS
Locked syndesmotic screws and plates were removed; functional outcomes and range of motion were measured before and after screw removal.


METHODS
Foot and Ankle Outcome Score, Olerud and Molander Ankle Score, and physical examination


RESULTS
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.


CONCLUSIONS
Locked screw and plate removal improved function both subjectively and objectively. Transsyndesmotic implant removal seems to assist improvements in the speed of rehabilitation.
Miller
Anna N
AN
Orthopaedic Trauma Service, Hospital for Special Surgery, New York, NY 10021, USA. millera@hss.edu
Paul
Omesh
O
Boraiah
Sreevathsa
S
Parker
Robert J
RJ
Helfet
David L
DL
Lorich
Dean G
DG
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016512:Ankle Injuries / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D001863:Bone Screws; D020878:Device Removal; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D050723:Fractures, Bone / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007593:Joint Instability / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D016059:Range of Motion, Articular; D020127:Recovery of Function; D016896:Treatment Outcome; D055815:Young Adult