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. 2023 Dec 18;4(12):957-963.
doi: 10.1302/2633-1462.412.BJO-2023-0061.

Functional outcome of routine versus on-demand removal of the syndesmotic screw

Stein van den Heuvel  1 , Diederick Penning  1 , Fay Sanders  1 , Ruben van Veen  2 , Nico Sosef  3 , Bart van Dijkman  4 , Tim Schepers  1 ; RODEO Collaborator group
Affiliations

Functional outcome of routine versus on-demand removal of the syndesmotic screw

Stein van den Heuvel et al. Bone Jt Open. .

Abstract

Aims: The primary aim of this study was to present the mid-term follow-up of a multicentre randomized controlled trial (RCT) which compared the functional outcome following routine removal (RR) to the outcome following on-demand removal (ODR) of the syndesmotic screw (SS).

Methods: All patients included in the 'ROutine vs on DEmand removal Of the syndesmotic screw' (RODEO) trial received the Olerud-Molander Ankle Score (OMAS), American Orthopaedic Foot and Ankle Hindfoot Score (AOFAS), Foot and Ankle Outcome Score (FAOS), and EuroQol five-dimension questionnaire (EQ-5D). Out of the 152 patients, 109 (71.7%) completed the mid-term follow-up questionnaire and were included in this study (53 treated with RR and 56 with ODR). Median follow-up was 50 months (interquartile range 43.0 to 56.0) since the initial surgical treatment of the acute syndesmotic injury. The primary outcome of this study consisted of the OMAS scores of the two groups.

Results: The median OMAS score was 85.0 for patients treated with RR, and 90.0 for patients treated with ODR (p = 0.384), indicating no significant difference between ODR and RR. The secondary outcome measures included the AOFAS (88.0 in the RR group and 90.0 for ODR; p = 0.722), FAOS (87.5 in the RR group and 92.9 for ODR; p = 0.399), and EQ-5D (0.87 in the RR group and 0.96 for ODR; p = 0.092).

Conclusion: This study demonstrated no functional difference comparing ODR to RR in syndesmotic injuries at a four year follow-up period, which supports the results of the primary RODEO trial. ODR should be the standard practice after syndesmotic screw fixation.

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Conflict of interest statement

As per the funding information and open access funding, the authors disclose funding for the APC from ZonMW, under project number 843002705.

Figures

Fig. 1
Fig. 1
Olerud-Molander Ankle Scores clustered by per protocol groups.
See this image and copyright information in PMC

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