Functional outcomes after syndesmotic screw fixation and removal.

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.