Fate of the syndesmotic screw—Search for a prudent solution

Kaftandziev, Igor; Spasov, Marko; Trpeski, Simon; Zafirova-Ivanovska, Beti; Bakota, Bore

doi:10.1016/j.injury.2015.10.062

Cited by 39 publications

(51 citation statements)

References 22 publications

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“…syndesmotic screws had poorer functional outcomes, suggesting the necessity for the removal of intact syndesmotic screws. Kaftandziev et al 45 also recently reported that patients with broken screws showed better clinical outcomes than those with intact screws. Moreover, one study showed that complications related to syndesmotic screw removal occurred in approximately 20% of patients who had undergone removal.…”

Section: Discussionmentioning

confidence: 95%

Reduction and fixation of anterior inferior tibiofibular ligament avulsion fracture without syndesmotic screw fixation in rotational ankle fracture

et al. 2019

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Objective We aimed to present the radiographic and functional outcomes of anatomical reduction and fixation of anterior inferior tibiofibular ligament (AITFL) avulsion fracture without syndesmotic screw fixation in rotational ankle fracture. Methods We retrospectively reviewed 66 consecutive patients with displaced malleolar fracture combined with AITFL avulsion fracture. We performed reduction and fixation for the AITFL avulsion fracture when syndesmotic instability was present after malleolar fracture fixation. A syndesmotic screw was inserted only when residual syndesmotic instability was present even after AITFL avulsion fracture fixation. The radiographic parameters were compared with those of the contralateral uninjured ankles. The American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores were assessed 1 year postoperatively. Results Fifty-four patients showed syndesmotic instability after malleolar fracture fixation and underwent reduction and fixation for AITFL avulsion fracture. Among them, 45 (83.3%) patients achieved syndesmotic stability, while 9 (16.7%) patients with residual syndesmotic instability needed additional syndesmotic screw fixation. The postoperative radiographic parameters were not significantly different from those of the uninjured ankles. The mean AOFAS score was 94. Conclusion Reduction and fixation of AITFL avulsion fracture obviated the need for syndesmotic screw fixation in more than 80% of patients with AITFL avulsion fracture and syndesmotic instability.

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Section: Discussionmentioning

confidence: 95%

Reduction and fixation of anterior inferior tibiofibular ligament avulsion fracture without syndesmotic screw fixation in rotational ankle fracture

et al. 2019

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“…The literature search strategy identi ed 2026 potential articles. According to the inclusion and exclusion criteria, a total of 8 articles were nally included in the meta-analysis [5][6][7][8][9][10][11][12]. A owchart of the literature search is shown in Fig.…”

Section: Literature Characteristicsmentioning

confidence: 99%

Should syndesmotic screws be removed or retained? A meta-analysis

Qin

Yang

et al. 2020

Preprint

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Background The aim of this study was to evaluate the different clinical outcomes after removing or retaining syndesmotic screws, and the difference in clinical outcomes after retaining broken or loose syndesmotic screws was also evaluated.Methods A systematic literature search was performed using PubMed, Web of Science, EMBASE and the Cochrane Central Register of Controlled Trials. In this meta-analysis, we conducted online searches using the search terms “syndesmotic diastasis”, “syndesmotic injury”, “syndesmotic screw”, “syndesmotic fixation”, and “tibiofibular syndesmosis”. The analysis was performed on data from all the studies that met the selection criteria. Clinical outcomes were expressed as standard mean differences for continuous outcomes with 95 % confidence intervals. Heterogeneity was assessed using the Chi2 test and the I2 statistic.Results There were 2 randomized controlled trials (RCTs) and 6 observational articles included in this analysis. In the comparison between retained and removed screws and the comparison between broken or loose and removed screws, no significant difference was found in terms of visual analogue scale (VAS), Olerud-Molander Ankle Score (OMAS) and American Orthopaedic Foot and Ankle Society (AOFAS) ankle/hindfoot score. Broken or loose screws were associated with better AOFAS scores compared with removed or intact screws, and no significant difference was found in terms of VAS and OMAS scores.Conclusions According to our analysis, there was no significant difference in clinical outcomes between removed and retained screws. Broken or loose screws were not associated with bad functional outcomes and may even lead to better function compared with removed or retained screws.

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“…The literature search strategy identified 225 potential articles. According to the inclusion and exclusion criteria, a total of 8 articles were finally included in the meta-analysis [11][12][13][14][15][16][17][18]. A flowchart of the literature search is shown in Fig.…”

Section: Literature Characteristicsmentioning

confidence: 99%

Should syndesmotic screws be removed or retained? A meta-analysis

Qin

Yang

et al. 2020

Preprint

View full text Add to dashboard Cite

Background The aim of this study was to evaluate the different clinical outcomes after removing or retaining syndesmotic screws, and the difference in clinical outcomes after retaining broken or loose syndesmotic screws was also evaluated. Methods A systematic literature search was performed using PubMed, Web of Science, EMBASE and the Cochrane Central Register of Controlled Trials. In this meta-analysis, we conducted online searches using the search terms “syndesmotic diastasis”, “syndesmotic injury”, “syndesmotic screw”, “syndesmotic fixation”, and “tibiofibular syndesmosis”. The analysis was performed on individual patient data from all the studies that met the selection criteria. Clinical outcomes were expressed as standard mean differences for continuous outcomes with 95% confidence intervals. Heterogeneity was assessed using the Chi 2 test and the I 2 statistic. Results There were 2 randomized controlled trials (RCTs) and 6 observational articles included in this analysis. In the comparison between retained and removed screws and the comparison between broken or loose and removed screws, no significant difference was found in terms of visual analogue scale (VAS), Olerud-Molander Ankle Score (OMAS) and American Orthopaedic Foot and Ankle Society (AOFAS) ankle/hindfoot score. Broken or loose screws were associated with better AOFAS scores compared with removed or intact screws, and no significant difference was found in terms of VAS and OMAS scores. Conclusions According to our analysis, there was no significant difference in clinical outcomes between removed and retained screws. Broken or loose screws were not associated with bad functional outcomes and may even lead to better function compared with removed or retained screws.

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Fate of the syndesmotic screw—Search for a prudent solution

Cited by 39 publications

References 22 publications

Reduction and fixation of anterior inferior tibiofibular ligament avulsion fracture without syndesmotic screw fixation in rotational ankle fracture

Reduction and fixation of anterior inferior tibiofibular ligament avulsion fracture without syndesmotic screw fixation in rotational ankle fracture

Should syndesmotic screws be removed or retained? A meta-analysis

Should syndesmotic screws be removed or retained? A meta-analysis

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