Immediate Improvement in Physical Function After Symptomatic Syndesmotic Screw Removal

Area of Science:

• Orthopedic surgery
• Biomechanics
• Patient outcomes

Background:

• Ankle fractures treated with open reduction and internal fixation (ORIF) with syndesmotic fixation may lead to functional limitations.
• Symptomatic syndesmotic screws can impede ankle range of motion (ROM) and physical function (PF).

Purpose of the Study:

• To evaluate the immediate impact of symptomatic syndesmotic screw removal (SSR) on PROMIS (Patient-Reported Outcomes Measurement Information System) PF and pain interference T-scores, and ankle ROM.
• To compare outcomes between patients undergoing SSR and those with ORIF without screw removal.

Main Methods:

• Prospective cohort study involving patients who underwent ORIF with syndesmotic fixation for ankle fractures.
• Fifty-eight patients underwent symptomatic SSR, while 71 served as a control group without screw removal.
• PROMIS PF and pain interference T-scores, and ankle ROM were measured before and after SSR.

Main Results:

• Patients undergoing SSR showed a statistically significant improvement in PF T-scores (44.5, P < 0.01) at a mean of 48 days post-removal.
• This improvement met the minimally clinically important difference.
• Ankle ROM improved by a mean of 17 degrees post-SSR (P < 0.01).

Conclusions:

• Symptomatic syndesmotic screw removal leads to immediate and significant improvements in physical function and ankle range of motion.
• SSR is an effective intervention for patients with functional limitations after ankle fracture ORIF with syndesmotic fixation.