Original ResearchComplications of Distal Tibiofibular Syndesmotic Screw Stabilization: Analysis of 236 Patients
Section snippets
Patients and Methods
Using a comprehensive, prospectively collected, fracture database, created in the framework of the Association for Osteosynthesis documentation, we analyzed the data from adult patients who had undergone syndesmotic screw stabilization from January 1979 to December 2000 at our level I academic trauma center. The patients were treated by experienced orthopedic surgeons and trauma surgeons or by residents under their supervision. All were familiar with the Association for
Results
After reviewing the prospectively collected data in the fracture database, we identified 236 consecutive patients with distal tibiofibular syndesmotic screw stabilization. This group included 152 male and 84 female patients. Of the 236 patients, 36 had a Weber B fracture, 88 a Weber C fracture in the distal third of the fibula, 28 a Weber C fracture in the middle part of the fibula, and 84 a Weber C or Maisonneuve fracture in the proximal third of the fibula. In 109 ankles (2 Weber B
Discussion
Internal fixation of ankle fractures with a syndesmotic screw requires strict awareness of the potential harm that can be inflicted on the tibiotalar and tibiofibular joint and a proper understanding of the biomechanics of the ankle joint structures (24). The question of whether it is harmful to insert a screw from the fibula into the tibia just above the syndesmosis has been asked by several investigators 4, 25, 26.
Although the present study included a large group of patients, the study did
Recommendations for Clinical Practice
- 1.
Removal of a synostosis is only advisable in young active patients after maturation of the synostosis
- 2.
Protected weightbearing in a plaster cast during the period of syndesmotic screw stabilization is safe postoperatively
- 3.
The use of 3.5-mm screws and screws penetrating 2 tibial cortices have a greater risk of breakage
- 4.
Removing the proximal part of the broken screw will be sufficient to avoid late pain and functional complaints
- 5.
Because of the low complication rate and the much more difficult
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Cited by (38)
Center-Center Surgical Technique With Dynamic Syndesmosis Fixation: A Cadaveric Pilot Study
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2021, Journal of Foot and Ankle SurgerySupination‐external rotation ankle fractures: analysis of clinical results after syndesmotic screw removal
2017, Revista Brasileira de OrtopediaBiomechanical Analysis of a Novel Syndesmotic Plate Compared With Traditional Screw and Suture Button Fixation
2020, Journal of Foot and Ankle Surgery
Financial Disclosure: None reported.
Conflict of Interest: None reported.