• Injury · Nov 2015

    High complication rate after syndesmotic screw removal.

    • Mette Renate Andersen, Frede Frihagen, Jan Erik Madsen, and Wender Figved.
    • Department of Orthopaedic Surgery, Baerum Hospital, Drammen, Norway. Electronic address: merean@vestreviken.no.
    • Injury. 2015 Nov 1; 46 (11): 2283-7.

    PurposeThe aim of this study was to determine the rate of complications after routine syndesmotic screw removal.Materials And MethodsAll patients who underwent syndesmotic screw removal at our hospital between 2007 and 2012 were included in the study. Patient demographics, surgical characteristics, radiographic evaluation and complications were recorded from the patients' charts. Questionnaires were sent by postal mail to all patients, to measure patient satisfaction and pain (VAS scales).Results161 patients were included in the trial. A wound infection was found in 8 (5%) patients. 3 were regarded as serious infections requiring hospitalisation and intravenous antibiotics, 2 of those required surgical revisions. 5 patients were treated by oral antibiotics. Staphylococcus aureus was identified as the causing organism in all (6/8) cases with a positive culture. The patients with postoperative infection reported more pain (5.3 vs. 2.3; p=0.02) and were less satisfied (4.7 vs. 7.6; p=0.014) with their ankle compared to those without infection (T-test for independent samples).ConclusionThere were 5% wound infections after routine syndesmotic screw removal. Routine antibiotic prophylaxis effective against S. aureus should be administered when removing syndesmotic screws. In our institution we now use one single dose Cefalotin of 2g intravenously 30-60min before screw removal.Copyright © 2015 Elsevier Ltd. All rights reserved.

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