Outcomes of the Routine Removal of the Syndesmotic Screw

Abstract

Background Ankle joint stabilization with fixation following an injury has been the practice for ankle injuries requiring stabilization. When syndesmotic screws are used to stabilize the ankle joint, the current practice encourages the removal of these screws. However, this study was performed to evaluate the outcomes of patients treated with these screws, with the view to challenging routine screw removal. Methodology This was a retrospective study analyzing the records of 52 patients who had been treated with the syndesmotic screw over a two-year span. Results Of the 26 patients who did not retain the screw, 84.6% (n = 22) had it removed based on the advice of the surgeon as per the current practice. In total, 19 (73.1%) of these patients had suffered at least one complication over the two procedures. Conversely, of the 23 patients who had retained the screw through one procedure, 14 (60.7%) had at least one complication. Conclusions Routine syndesmotic screw removal is associated with increased risks of complications compared to retaining the screws, in addition to not producing a superior outcome for the patients.

Keywords: complication; surgeon preference; syndesmotic screw; weber b; weber c.

Figure 1. Documented reason for screw removal.

SP: surgeon’s preference; MWI: metalwork issues; TfC: treatment for complications; PC: patient’s choice

Figure 2. Complications following initial and subsequent procedures.

SR Total: total number of patients who did not have the screw retained; C 1: number of patients who had complications following screw fixation; C 2: number of patients who had complications following screw removal

Figure 3. Complications for patients who had the screw retained.

SNR: total number of patients who had syndesmotic screw retained; C: number of patients who had complications following screw retention