The Effect of the Syndesmotic Screw on Ankle Motion

Acute and Chronic Injuries to the Syndesmosis

“…This nonphysiologic intervention, theoretically, may result in some degree of functional incapacity and abnormal ankle motion. 170,171 Syndesmotic screws are typically left in place 12 weeks to allow for ligamentous healing. 172,173 The authors prefer screw retention for 4.5 months to decrease the risk of syndesmotic failure after screw removal.…”

Ist eine routinemäßige Implantatentfernung nach unfallchirurgischen Eingriffen sinnvoll?

“…Die Ergebnisse biomechanischer Studien, welche eine Einschränkung der natürlichen Beweglichkeit im distalen Fibulo tibialgelenk durch Syndesmosenstellschrauben zeigten [9,14,40], implizieren die Notwendigkeit, diese nach Syndesmosenheilung zu entfernen [34].…”

Syndesmotic Injuries in Athletes

“…Syndesmotic fixation of the tibiofibular joint prevents its normal physiologic movement that occurs during normal weight bearing and ankle range of motion. Needleman et al [101] demonstrated that quadricortical fixation with a 4.5-mm screw decreases tibiotalar external rotation, and may result in fatigue fracture of the screw [102]. Three cortical fixation may decrease the rigidity of fixation and increase physiologic motion, but may also lead to hardware loosening [103].…”

“…This technique provides fixation at the posterior cortex of the fibula to the anterolateral edge of the tibia (FIGURE 13). Traditional, syndesmotic fixation has been performed with the ankle in maximum dorsiflexion [101,125]. This maneuver accounts for the narrower posterior talus engaging in the mortise during plantarflexion, which theoretically could cause overtightening of the mortise and prevent dorsiflexion when the wider anterior talus attempt to engage into the mortise.…”