• J Orthop Trauma · Jan 2010

    Clinical Trial

    Functional outcomes after syndesmotic screw fixation and removal.

    • Anna N Miller, Omesh Paul, Sreevathsa Boraiah, Robert J Parker, David L Helfet, and Dean G Lorich.
    • Orthopaedic Trauma Service, Hospital for Special Surgery, New York, NY 10021, USA. millera@hss.edu
    • J Orthop Trauma. 2010 Jan 1;24(1):12-6.

    ObjectivesAnkle 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.DesignLevel IV--case series.SettingLevel I--trauma center.Patients/ParticipantsTwenty-five consecutive patients with unstable ankle fractures and syndesmotic injury confirmed on magnetic resonance imaging.InterventionLocked syndesmotic screws and plates were removed; functional outcomes and range of motion were measured before and after screw removal.Main Outcome MeasurementsFoot and Ankle Outcome Score, Olerud and Molander Ankle Score, and physical examinationResultsThere 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.ConclusionsLocked screw and plate removal improved function both subjectively and objectively. Transsyndesmotic implant removal seems to assist improvements in the speed of rehabilitation.

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