Background: Currently, the metallic syndesmotic screw is the gold
standard in the treatment of syndesmotic disruption. Whether or not this
screw needs to be removed remains debatable. The aim of the current
study was to determine the complications which occur following routine
removal of the syndesmotic screw following operative treatment of
unstable ankle fractures. Methods: This was a retrospective study with
consecutive cases in a Level-2 Trauma center. All patients with routine
removal of a syndesmotic screw, following the treatment of an unstable
ankle fracture, between January 1, 2004 and November 30, 2010 were
included. Complications recorded were: 1) minor or major wound infection
following removal of the syndesmotic screw, 2) recurrent syndesmotic
diastasis, and 3) unnecessary removal of a broken screw, not recognized
during preoperative planning prior to surgery. Results: A total of 76
patients were included. A wound infection occurred in 9.2% (N=7) of
which 2.6% (N=2) were deep infections requiring reoperation. Recurrent
syndesmotic diastasis was found in 6.6% (N=5) of patients, and in 6.6%
(N=5) screws were broken at the time of implant removal. In the group
with recurrent diastasis the screws were removed significantly earlier
compared with the group without recurrent diastasis (Mann- Whitney
U-test; p = 0.011) and the group with screw breakage had their screws
significantly longer in place compared with the group without breakage
(p = 0.038). Conclusion: A total of 22.4% complications occurred upon
routine removal of the syndesmotic screw. Removal might therefore be
considered only in selected cases with complaints, after a minimum of
eight to twelve weeks and using antibiotic prophylaxis during removal.
Copyright.
http://repub.eur.nl/res/pub/30956/41_Schepers%20et%20al_Foot%20Ankle%20In%202011_32%2811%29_1040-1044AAM.pdf
http://repub.eur.nl/res/pub/30956/41_Schepers%20et%20al_Foot%20Ankle%20In%202011_32%2811%29_1040-1044AAM.pdf
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