Removal of Hardware After Syndesmotic Screw Fixation: A Systematic Literature Review

Walley, Kempland C.; Hofmann, Kurt J.; Velasco, Brian; Kwon, John Y.

doi:10.1177/1938640016685153

Cited by 63 publications

(40 citation statements)

References 31 publications

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“…[ 29 ] The removal of syndesmotic screws is advisable mainly in cases of patient complaints related to the other implanted perimalleolar hardware or malreduction of the syndesmosis after at least eight weeks postoperatively. [ 30 ] In the current study, 58.8% of the respondents reported routine removal of the syndesmotic screw. This is the lowest rate in the survey literature, and over the years, this is one of the most dramatically changed surgeon preferences in ankle fracture management surveys.…”

Section: Discussionmentioning

confidence: 66%

Is there any change in surgeon’s attitude to the management of ankle fractures accompanying syndesmotic injury? A nationwide survey

et al. 2020

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Section: Discussionmentioning

confidence: 66%

Is there any change in surgeon’s attitude to the management of ankle fractures accompanying syndesmotic injury? A nationwide survey

et al. 2020

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“… 3 There is no definitive evidence for the need for screw removal after syndesmotic fixation. 26 , 27 …”

Section: Managementmentioning

confidence: 99%

Management of syndesmotic injuries of the ankle

Romero

Alvarez²,

Sanchez

et al. 2017

EFORT Open Reviews

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Injuries to the tibioperoneal syndesmosis are more frequent than previously thought and their treatment is essential for the stability of the ankle mortise.Recognition of these lesions is essential to avoid long-term morbidity.Diagnosis often requires complete history, physical examination, weight-bearing radiographs and MRI.Treatment-oriented classification is mandatory.It is recommended that acute stable injuries are treated conservatively and unstable injuries surgically by syndesmotic screw fixation, suture-button dynamic fixation or direct repair of the anterior inferior tibiofibular ligament.Subacute injuries may require ligamentoplasty and chronic lesions are best treated by syndesmotic fusion.However, knowledge about syndesmotic injuries is still limited as recommendations for surgical treatment are only based on level IV and V evidence.Cite this article: EFORT Open Rev 2017;2:403–409. DOI: 10.1302/2058-5241.2.160084

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“…While screw fixation is proven to be more rigid [ 12 ], dynamic fixation with suture buttons allows for an earlier ankle mobility and weight bearing while maintaining the required reduction [ 11 ]. Furthermore, the need for early screw removal prior to weight bearing postoperatively, can lead to loss of reduction and remaining tibio-fibular diastasis [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Does the choice of syndesmotic screw versus suture button in ankle surgery has a silver lining? – a technical note

D’Hooghe

Salameh

2020

J EXP ORTOP

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Purpose Unstable ankle fractures with associated syndesmotic injury are of considerable morbidity in the professional athlete population. The use of dynamic suture button versus static syndesmotic screws fixation, rehabilitation protocols and timing to return to play are still areas of debate. We report the use of novel algorithm of sequential static and dynamic syndesmotic fixation in an elite football player with Weber C ankle fracture. Methods The patient underwent open reduction and internal fixation for a weber C ankle fracture with associated syndesmotic and deltoid ligament injury. The osteosynthesis included lateral malleolus neutralizing plate, two syndesmotic screws and deltoid anchor repair. At 6 weeks post-operative both syndesmotic screws were removed and one suture button was implanted in the proximal screw hole. After the second operation the patient was allowed full weight bearing and range of motion in all direction with accelerated rehabilitation protocol. Results The technique provided satisfactory results. At 4 month the player participated in a 90 min official football match. The fracture healed uneventfully with no recurrent syndesmotic diastasis. Conclusion The presented technique of sequential dynamic and static fixation of associated syndesmotic injuries combined advantages of both syndesmotic screws and suture button implants. In an aim to allow earlier return to play in an elite football player. This opens the way for higher level of evidence clinical trials.

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Removal of Hardware After Syndesmotic Screw Fixation: A Systematic Literature Review

Abstract: Level IV: Systematic review.

Cited by 63 publications

References 31 publications

Is there any change in surgeon’s attitude to the management of ankle fractures accompanying syndesmotic injury? A nationwide survey

Is there any change in surgeon’s attitude to the management of ankle fractures accompanying syndesmotic injury? A nationwide survey

Management of syndesmotic injuries of the ankle

Does the choice of syndesmotic screw versus suture button in ankle surgery has a silver lining? – a technical note

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