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Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue 8, 1069-1073.
doi: 10.1302/0301-620X.91B8.22430  
Copyright © 2009 by British Editorial Society of Bone and Joint Surgery
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Outcome after fixation of ankle fractures with an injury to the syndesmosis

THE EFFECT OF THE SYNDESMOSIS SCREW

N. Hamid, MD, Orthopaedic Surgeon1; B. J. Loeffler, MD, Orthopaedic Surgeon1; W. Braddy, BS, Medical Student1; J. F. Kellam, MD, Orthopaedic Surgeon1; B. E. Cohen, MD, Orthopaedic Surgeon2; and M. J. Bosse, MD, Orthopaedic Surgeon1

1 Department of Orthopaedic Surgery, Carolinas Medical Center, 1714, Scott Avenue, P. O. Box 32861, Charlotte, North Carolina 28232, USA.
2 OrthoCarolina, 1025 Morehead Medical Drive, Suite 300, Charlotte, North Carolina 28204, USA.

Correspondence should be sent to Dr N. Hamid; e-mail: nady_hamid{at}hotmail.com

The purpose of this study was to compare the clinical and radiological outcome of patients with intact, broken and removed syndesmosis screws after Weber B or C ankle fracture with an associated injury to the syndesmosis. We hypothesised that there would be no difference. Of a possible 142 patients who fulfilled our inclusion criteria, 52 returned for clinical and radiological assessment at least one year after surgery. Of these, 27 had intact syndesmosis screws, ten had broken screws, and 15 had undergone elective removal of the screw. The mean American Orthopaedic Foot and Ankle Society ankle/hindfoot score was 83.07 (SD 13.59) in the intact screw group, 92.40 (SD 12.69) in the broken screw group, and 85.80 (SD 11.33) in the removed screw group (p = 0.0466).

There was no difference in clinical outcome of patients with intact or removed syndesmotic screws. Paradoxically, patients with a broken syndesmosis screw had the best clinical outcome. Our data do not support the removal of intact or broken syndesmosis screws, and we caution against attributing post-operative ankle pain to breakage of the syndesmosis screw.




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Outcome after fixation of ankle fractures with an injury to the syndesmosis
Samer S Morgan, et al.
J Bone Joint Surg Br Online, 11 Sep 2009 [Full text]

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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General