Outcomes of the Routine Removal of the Syndesmotic Screw

Area of Science:

• Orthopedic Surgery
• Traumatology
• Biomedical Engineering

Background:

• Ankle stabilization following injury commonly involves fixation with syndesmotic screws.
• Current clinical practice generally recommends the routine removal of these syndesmotic screws post-fixation.
• This study questions the necessity of routine screw removal by evaluating patient outcomes.

Purpose of the Study:

• To evaluate the clinical outcomes of patients treated with syndesmotic screws.
• To compare complication rates between screw retention and removal groups.
• To challenge the standard practice of routine syndesmotic screw removal.

Main Methods:

• Retrospective analysis of 52 patients treated with syndesmotic screws over a two-year period.
• Categorization of patients into screw retention and screw removal groups.
• Review of medical records to identify complications and outcomes associated with each treatment approach.

Main Results:

• Of 26 patients with screw removal, 84.6% underwent the procedure as per standard practice, with 73.1% experiencing at least one complication.
• Of 23 patients who retained the screw, 60.7% experienced at least one complication.
• The group that retained the syndesmotic screw had a lower complication rate compared to the group that had the screw removed.

Conclusions:

• Routine syndesmotic screw removal is linked to a higher risk of complications.
• Retaining syndesmotic screws does not yield inferior patient outcomes compared to removal.
• The findings suggest reconsidering the routine removal of syndesmotic screws in ankle stabilization procedures.