title: Functional outcomes after syndesmotic screw fixation and removal.
abstract: 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.
authors.affiliation: Orthopaedic Trauma Service, Hospital for Special Surgery, New York, NY 10021, USA. millera@hss.edu
authors.forename: Anna N
authors.initials: AN
authors.lastname: Miller
authors.forename: Omesh
authors.initials: O
authors.lastname: Paul
authors.forename: Sreevathsa
authors.initials: S
authors.lastname: Boraiah
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Parker
authors.forename: David L
authors.initials: DL
authors.lastname: Helfet
authors.forename: Dean G
authors.initials: DG
authors.lastname: Lorich
mesh_terms: 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