Syndesmotic screw fixation in Weber C ankle injuries--should the screw be removed before weight bearing?

Injury
David Paul Bell, Merng Koon Wong

Abstract

To compare the outcomes of Weber C ankle fractures treated with syndesmotic screw fixation where the screw was removed prior to weight bearing against those where the screw was left in situ indefinitely. Retrospective observational analysis of a consecutive series. Acute tertiary hospital. Thirty-three patients with ankle fractures and syndesmotic disruption were treated with open reduction, internal fixation, and syndesmotic stabilisation with a syndesmotic screw. Three patients defaulted follow-up after 1-3 months. In the remaining 30, the syndesmotic screw was removed prior to weight bearing in 23 patients and was left in situ in 7 patients. Mean follow-up was 15 months. Assessment with subjective, objective, and radiographic criteria was used. Statistical analysis was performed with independent groups t-test and chi-square test. There was no statistically significant difference between ankle scores, functional outcome or range of motion between the two groups. However, there was a significantly higher incidence of syndesmotic screw breakage and osteolysis in the group where screws were retained. Judicious fixation of Weber C type injuries with syndesmotic screw fixation allows for good functional outcome. Retaining of the s...Continue Reading

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