Biomechanical Evaluation of Syndesmotic Screw Position

Verim, Ozgur; Er, Mehmet Serhan; Altınel, Levent; Taşgetiren, Süleyman

doi:10.1097/bot.0b013e3182a6df0a

Cited by 39 publications

(39 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In 2014, Verim et al performed a study of nite elemental analysis [39]. The syndesmotic screw was placed at six different altitudes above the plafond.…”

Section: Discussionmentioning

confidence: 99%

Favored location of a stabilizing screw for syndesmotic diastasis: Recommendation based on clinical and theoretical considerations

Yeh

Lee

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Although ankle injuries are common, combined malleolar fractures and syndesmotic diastasis (SD) are relatively fewer. The optimal technique for syndesmotic stabilization has yet achieved consensus. The favored location of a stabilizing screw for SD was investigated clinically and theoretically. Methods For the 10-year period, 63 consecutive adult patients with combined injuries were retrospectively studied. After malleolar fractures were internally stabilized with screws and plates, stress tests were performed to re-confirm syndesmotic instability. The diastatic syndesmosis was stabilized with cortical screws under image intensifier guidance. In the present study, only patients with one syndesmotic screw (55 patients) were enrolled and divided into the trans-syndesmotic (TR) or the supra-syndesmotic (SU) group. Clinical and functional outcomes between the two groups were compared. The favored location was speculated consequently.Results Forty-eight patients were followed for at least one year (average, 1.8 years; range, 1.0-7.0 years). The TR group included 31 patients and the SU group, 17 patients. All clinical and functional comparisons were not statistically significant (p > 0.05). Conclusions Although statistical comparison is insignificant, TR screw insertion possesses biomechanical and biological merits. Unable to reveal advantages of TR screw insertion in clinical and functional comparisons may be imputed to insufficient sample sizes and early screw removal. Practically, TR insertion of a screw with late removal (> 3 months) may be a better choice.

show abstract

“…In 2014, Verim et al performed a study of nite elemental analysis [39]. The syndesmotic screw was placed at six different altitudes above the plafond.…”

Section: Discussionmentioning

confidence: 99%

Favored location of a stabilizing screw for syndesmotic diastasis: Recommendation based on clinical and theoretical considerations

Yeh

Lee

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…One study showed that a screw placed 2.0 cm above the tibiotalar joint resulted in less syndesmotic widening than a screw placed 3.5 cm above the joint, 145 whereas another showed that fixation 3 to 4 cm above the joint may have biomechanical advantages. 146 Clinical evidence has not demonstrated significantly different radiographic or clinical outcomes in transsyndesmotic Acute and Chronic Injuries to the Syndesmosis or suprasyndesmotic fixation. 147 Screw placement more than 4.1 cm above the joint negatively influences patient outcomes, likely due to decreased stability at this level or by slight bending of the fibula on insertion, causing widening at the mortise.…”

Section: Implant Placementmentioning

confidence: 98%

Acute and Chronic Injuries to the Syndesmosis

Switaj

Mendoza

Kadakia

2015

Clinics in Sports Medicine

View full text Add to dashboard Cite

“…The authors of one study reported less syndesmotic widening with a screw at 2 cm than was seen when the screw was 3.5 cm above the plafond 65 ; another demonstrated increased fixation strength and less widening with fixation at 5 cm compared with when it was 2 cm above the plafond 66 . Finite element models have shown that 3.5-mm and 4.5-mm screws experience the lowest stress between 30 and 40 mm above the plafond whereas the least widening occurs with placement at 20 to 30 mm above the plafond 67 .…”

Section: Screw Positionmentioning

confidence: 99%