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Journal of Orthopaedic Trauma:
doi: 10.1097/BOT.0b013e3181c6e199
Original Article

Functional Outcomes After Syndesmotic Screw Fixation and Removal

Miller, Anna N MD*; Paul, Omesh MD*; Boraiah, Sreevathsa MD†; Parker, Robert J BS*; Helfet, David L MD*; Lorich, Dean G MD*

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Objectives: Ankle fractures with a syndesmotic injury have historically been treated with syndesmotic screw fixation. We compared range of motion and functional outcomes' scores to assess patient benefit from syndesmotic screw and plate removal.

Design: Level IV-case series.

Setting: Level I-trauma center.

Patients/Participants: Twenty-five consecutive patients with unstable ankle fractures and syndesmotic injury confirmed on magnetic resonance imaging.

Intervention: Locked syndesmotic screws and plates were removed; functional outcomes and range of motion were measured before and after screw removal.

Main Outcome Measurements: Foot and Ankle Outcome Score, Olerud and Molander Ankle Score, and physical examination

Results: There was a significant improvement in range of motion, Foot and Ankle Outcome, and Olerud and Molander Ankle scores at the immediate postoperative visit. This was not significantly changed at longer follow-up. There were no adverse events or complications in these patients. No patient had radiographic loss of syndesmotic reduction after screw removal.

Conclusions: Locked screw and plate removal improved function both subjectively and objectively. Transsyndesmotic implant removal seems to assist improvements in the speed of rehabilitation.

© 2010 Lippincott Williams & Wilkins, Inc.

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