Surgical treatment of syndesmotic diastasis: emphasis on effect of syndesmotic screw on ankle function

Hsu, Yi-Ton; Wu, Chi‐Chuan; Lee, Wei-Cheun; Fan, Kuo-Feng; Tseng, I-Chuan; Lee, Po-Cheng

doi:10.1007/s00264-010-1147-9

Cited by 73 publications

(69 citation statements)

References 20 publications

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“…2 Only one, recent, study on the occurrence of recurrent diastasis following syndesmotic screw removal is available. 10 Herein, three groups who had their syndesmotic screw removed at different time intervals (6 weeks, 3 months and 9 months) were compared.…”

Section: Discussionmentioning

confidence: 99%

“…Recurrent diastasis was defined as widening of the syndesmosis of more than 2 mm compared with radiographs taken shortly after the first operation, in which the fracture was fixed, or a widening of the medial clear space of more than 2 mm compared with the distance between the tibia plafond (pilon) and talus. 4,10,15 Infectious wound complications were divided into superficial or minor and deep or major infectious complications by applying the criteria of the Centers for Disease Control and Prevention (CDC) for defining a surgical site infection. 11,19 Minor complications were defined as a superficial infection treatable with conservative management like oral antibiotics only, without the need for intervention or re-admission.…”

Section: Allmentioning

confidence: 99%

“…2 To date, considering complications after syndesmotic screw removal, there is only information on recurrent diastasis. 5,10,21 Routine removal of syndesmotic screws following operative treatment of unstable ankle fractures is currently standard practice in the Netherlands. The aim of the current study was to determine complications which accompany routine screw removal.…”

Section: Introductionmentioning

confidence: 99%

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Complications of Syndesmotic Screw Removal

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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. Level of Evidence: IV, Retrospective Case Study

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Section: Discussionmentioning

confidence: 99%

Section: Allmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Complications of Syndesmotic Screw Removal

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“…Dear Editor, With great interest we read the article of Hsu et al entitled "Surgical treatment of syndesmotic diastasis: emphasis on effect of syndesmotic screw on ankle function" [1]. The authors report on screw fixation in patients with syndesmotic diastasis.…”

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Comments on Hsu et al.: Surgical treatment of syndesmotic diastasis: emphasis on effect of syndesmotic screw on ankle function

Zuuren

Willems

Bekerom

2011

International Orthopaedics (SICOT)

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“…On behalf of all the authors, we are thankful for the interest and comments by van Zuuren et al [1] on our study [2]. In the literature, primary osteoarthritis (OA) of the ankle is uncommon [3].…”

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confidence: 99%

Reply to the comments on Hsu et al.: Surgical treatment of syndesmotic diastasis: emphasis on effect of syndesmotic screw on ankle function

Hsu

Lee

et al. 2011

International Orthopaedics (SICOT)

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Surgical treatment of syndesmotic diastasis: emphasis on effect of syndesmotic screw on ankle function

Abstract: Fifty-two consecutive adult patients with syndesmotic diastasis (SD) were treated with closed anatomical reduction and stable fixation by a trans-syndesmotic cancellous screw. A short leg splint was prescribed for a six week postoperative period.

Cited by 73 publications

References 20 publications

Complications of Syndesmotic Screw Removal

Complications of Syndesmotic Screw Removal

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