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syndesmotic screw removal

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https://www.readbyqxmd.com/read/29661674/evaluation-of-transsyndesmotic-fixation-and-primary-deltoid-ligament-repair-in-ankle-fractures-with-suspected-combined-deltoid-ligament-injury
#1
Kai Wu, Jian Lin, Jianhua Huang, Qiugen Wang
The present prospective study examined the utility of the intraoperative tap test/technique for distal tibiofibular syndesmosis in the diagnosis of deltoid ligament rupture and compared the outcomes of transsyndesmotic fixation to deltoid ligament repair with suture anchor. This diagnostic technique was performed in 59 ankle fractures with suspected deltoid ligament injury. The width of the medial clear space of 59 cases was evaluated to assess the sensitivity and specificity. Those with deltoid ligament rupture were randomly assigned to 2 groups and treated with deltoid ligament repair with a suture anchor or with syndesmosis screw fixation...
April 13, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29536695/-classification-and-treatment-of-syndesmotic-injury
#2
REVIEW
Zhi-Peng Wu, Peng-Tao Chen, Jin-Shan He, Jing-Cheng Wang
The distal tibiofibular syndesmosis is a critical structure in maintaining the ankle stability. Syndesmotic injuries are usually associated with ankle fractures and high fibula fractures. Non-isolated and partially isolated syndesmotic injuries are involved in unstable injuries, which need to operative treatment. Partially isolated syndesmotic injuries belong to stable injuries, which should be treated with non-operative management. It is becoming clear that early fixation and stabilization for unstable injuries are probably better than non-treatment or delayed treatment...
February 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29521685/cost-effectiveness-analysis-of-syndesmotic-screw-versus-suture-button-fixation-in-tibiofibular-syndesmotic-injuries
#3
Duncan C Ramsey, Darin M Friess
OBJECTIVES: To evaluate the cost-effectiveness of suture buttons compared to syndesmotic screws for repair of tibiofibular syndesmotic injuries. METHODS: A decision-tree model was constructed to describe outcomes after syndesmosis repair using suture buttons and syndesmotic screws from the perspective of a capitated healthcare system. Outcomes were uneventful healing, removal of symptomatic implants, deep infection, and persistent diastasis requiring revision. Weighted literature averages were used to estimate variables for a baseline model...
February 20, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29496318/technical-tip-removal-of-a-broken-tri-cortical-syndesmotic-screw-using-a-perfect-circle-technique
#4
Matthew D Riedel, Jorge Briceno, Christopher P Miller, John Y Kwon
While broken or loose syndesmotic screws are typically of no clinical consequence, occasionally breakage can result in pain, metal fretting, or bony erosion. Despite quad-cortical syndesmotic screws being relatively easy to remove due to the prominent screw tip penetrating the medial tibial cortex, removal of a broken tri-cortical screw can be technically challenging. The purpose of this manuscript is to describe a safe technique for removing the buried, broken tri-cortical screw fragment via a minimally invasive medial tibial approach by verifying the screw location using intra-operative fluoroscopy...
February 26, 2018: Injury
https://www.readbyqxmd.com/read/29409288/ankle-fractures-with-syndesmotic-stabilisation-are-associated-with-a-high-rate-of-secondary-osteoarthritis
#5
Robbie Ray, Nina Koohnejad, Nick D Clement, Gary F Keenan
BACKGROUND: The primary aim of this study was to present the incidence of clinically significant end stage osteoarthritis (cOA) after syndesmotic fixation of ankle fractures. The secondary aim was to and identify independent predictors of cOA. METHODS: A retrospective review of consecutive patients presenting to a single University affiliated institution between March 2008 and May 2010 was undertaken. Inclusion criteria were ankle fractures with syndesmotic stabilisation...
October 28, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29409203/intramedullary-fixation-of-lateral-malleolus-using-fibula-rod-system-in-ankle-fractures-in-the-elderly
#6
Sudhakar Rao Challagundla, Sandeep Shewale, Calum Cree, Amanda Hawkins
BACKGROUND: Operative management of ever increasing ankle fractures in the elderly need a reliable system of internal fixation. We present results of one such fixation, Fibula Rod System. METHODS: Patients who underwent Fibula Rod System were included. Fracture union rate, complications, time to weight bearing and patient satisfaction using FAAM score were studied. RESULTS: The mean age of the fifteen patients included was 74 years. Satisfactory reduction was achieved and maintained in all...
April 27, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29386053/routine-versus-on-demand-removal-of-the-syndesmotic-screw-a-protocol-for-an-international-randomised-controlled-trial-rodeo-trial
#7
S A Dingemans, M F N Birnie, F R K Sanders, M P J van den Bekerom, M Backes, E van Beeck, F W Bloemers, B van Dijkman, E Flikweert, D Haverkamp, H R Holtslag, J M Hoogendoorn, P Joosse, M Parkkinen, G Roukema, N Sosef, B A Twigt, R N van Veen, A H van der Veen, J Vermeulen, J Winkelhagen, B C van der Zwaard, S van Dieren, J C Goslings, T Schepers
BACKGROUND: Syndesmotic injuries are common and their incidence is rising. In case of surgical fixation of the syndesmosis a metal syndesmotic screw is used most often. It is however unclear whether this screw needs to be removed routinely after the syndesmosis has healed. Traditionally the screw is removed after six to 12 weeks as it is thought to hamper ankle functional and to be a source of pain. Some studies however suggest this is only the case in a minority of patients. We therefore aim to investigate the effect of retaining the syndesmotic screw on functional outcome...
January 31, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29298255/randomized-trial-comparing-suture-button-with-single-syndesmotic-screw-for-syndesmosis-injury
#8
Mette Renate Andersen, Frede Frihagen, Johan Castberg Hellund, Jan Erik Madsen, Wender Figved
BACKGROUND: This study compared clinical and radiographic results between patients who underwent stabilization of an acutely injured syndesmosis with a suture button (SB) and those treated with 1 quadricortical syndesmotic screw (SS). METHODS: Ninety-seven patients, 18 to 70 years old, with an ankle injury that included the syndesmosis were randomized to 2 groups: SB (48 patients) and SS (49). The main outcome measure was the score on the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scale...
January 3, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29273186/operative-management-of-ao-type-44-ankle-fractures-determinants-of-outcome
#9
Jos Velleman, Stefaan Nijs, Harm Hoekstra
The consequences of inadequate treatment of ankle fractures can be disastrous. We assessed the radiologic and functional outcomes, postoperative quality of life (QOL), and its determinants for patients treated operatively for AO type 44 ankle fractures. Evidence is lacking concerning the management of posterior malleolus fractures and syndesmotic injuries. Our retrospective adult cohort study included 432 AO/OTA type 44 ankle fractures (431 patients). The median follow-up period was 52 months. Outcomes were assessed from the medical records, radiographs, American Orthopaedic Foot and Ankle Society (AOFAS) ankle scale (functional outcome), and EuroQol EQ-5D questionnaires...
March 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29234648/supination-external-rotation-ankle-fractures-analysis-of-clinical-results-after-syndesmotic-screw-removal
#10
João Mendonça de Lima Heck, Rosalino Guareschi Junior, Luiz Carlos Almeida da Silva, Marcelo Teodoro Ezequiel Guerra
Objective: To evaluate the postoperative results of patients with supination-external rotation ankle fractures who underwent syndesmotic screw (SS) removal. Methods: Retrospective cohort study assessing the late postoperative results of 35 patients operated from January 2013 to June 2015. Patients undergoing treatment of rupture of the distal tibiofibular syndesmosis with SS fixation and who did not have any concomitant surgical injuries in sites other than the ankle were included...
November 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28676078/a-systematic-review-of-suture-button-versus-syndesmotic-screw-in-the-treatment-of-distal-tibiofibular-syndesmosis-injury
#11
REVIEW
Pei Zhang, Yuan Liang, Jinshan He, Yongchao Fang, Pengtao Chen, Jingcheng Wang
BACKGROUND: Now, using a suture-button device to treat distal tibiofibular syndesmotic injuries is overwhelming due to its advantages over screw fixation. Current systematic review was conducted to make a comparison between suture-button fixation and traditionally screw fixation in the treatment of syndesmotic injuries. The outcomes included functional outcomes, implant removal, implant failure, malreduction, post-operative complications (except implant failure and malreduction), and cost-effectiveness aspects...
July 4, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28416851/-one-of-the-pitfalls-in-the-surgical-treatment-of-maisonneuve-fractures-a-case-report
#12
H Q Ji, F Zhou, Y Tian, Z S Zhang, Y Guo, Y Lv, Z W Yang, G J Hou
There exist controversies in the surgical treatment of maisonneuve injury with regard to reduction and fixation of syndesmosis and management of proximal fibular fracture. It is very important for the orthopaedic surgeons to learn more techniques and avoid pitfalls from clinical practice. We summarized the clinical data of 1 failed case, a 20-year-old girl with big body weight who underwent a primary surgery for the treatment of maisonneuve fracture with minimally invasive reduction and fixation of ankle syndesmosis and posterior malleolus and open reduction and internal fixation of medial malleolus, then a revision surgery for the treatment of iatrogenic syndesmotic malreduction with open reduction and re-stabilization of ankle syndesmosis supplemented with open reduction and internal fixation of proximal fibular facture...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28390687/overtightening-of-the-syndesmosis-revisited-and-the-effect-of-syndesmotic-malreduction-on-ankle-dorsiflexion
#13
Tyler Gonzalez, Jonathan Egan, Mohammad Ghorbanhoseini, Micah Blais, Aron Lechtig, Brian Velasco, Ara Nazarian, John Y Kwon
BACKGROUND: Ankle syndesmotic injuries are a significant source of morbidity and require anatomic reduction to optimize outcomes. Although a previous study concluded that maximal dorsiflexion during syndesmotic fixation was not required, methodologic weaknesses existed and several studies have demonstrated improved ankle dorsiflexion after removal of syndesmotic screws. The purposes of the current investigation are: (1) To assess the effect of compressive syndesmotic screw fixation on ankle dorsiflexion utilizing a controlled load and instrumentation allowing for precise measurement of motion...
June 2017: Injury
https://www.readbyqxmd.com/read/28142266/inflammatory-microenvironment-persists-after-bone-healing-in-intra-articular-ankle-fractures
#14
Samuel B Adams, Elizabeth M Leimer, Lori A Setton, Richard D Bell, Mark E Easley, Janet L Huebner, Thomas V Stabler, Virginia B Kraus, Steven A Olson, Dana L Nettles
BACKGROUND: Post-traumatic osteoarthritis (PTOA) is responsible for the majority of cases of ankle arthritis. While acute and end-stage intra-articular inflammation has previously been described, the state of the joint between fracture healing and end-stage PTOA remains undefined. This study characterized synovial fluid (SF) composition of ankles after bone healing of an intra-articular fracture to identify factors that may contribute to the development of PTOA. METHODS: Of an original 21 patients whose SF was characterized acutely following intra-articular ankle fractures, 7 returned for planned hardware (syndesmotic screw) removal after bone healing (approximately 6 months) and consented to a second bilateral SF collection...
May 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28074301/tightrope-fixation-of-syndesmotic-injuries-in-weber-c-ankle-fractures-a-multicentre-case-series
#15
Amarjit Anand, Ran Wei, Akash Patel, Vikas Vedi, Garth Allardice, Bobby Singh Anand
BACKGROUND: No general consensus has yet been established for the gold standard treatment of ankle syndesmotic complex injuries. Recent literature has documented the success of ankle tightrope fixation for heterogeneous ankle fracture patterns, resulting in syndesmotic complex injuries. We present a multicentre case series assessing the clinical, radiological and functional outcomes of patients with Weber C ankle fractures treated with the Arthrex TightRope(®) fixation system. METHOD: We performed a retrospective analysis of all adult patients with Weber C ankle fractures who were treated with the Arthrex TightRope(®) fixation system at four centres over a 3-year period...
May 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28027655/removal-of-hardware-after-syndesmotic-screw-fixation-a-systematic-literature-review
#16
Kempland C Walley, Kurt J Hofmann, Brian T Velasco, John Y Kwon
BACKGROUND: While trans-syndesmotic fixation with metal screws is considered the gold standard in treating syndesmotic injuries, controversy exists regarding the need and timing of postoperative screw removal. Formal recommendations have not been well established in the literature and clinical practice is highly variable in this regard. The purpose of this systematic review is to critically examine the most recent literature regarding syndesmotic screw removal in order to provide surgeons an evidence-based approach to management of these injuries...
June 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28002322/the-effect-of-polydeoxyribonucleotide-prolotherapy-on-posterior-tibial-tendon-dysfunction-after-ankle-syndesmotic-surgery-a-case-report
#17
Tae-Ha Lim, Hyung Rae Cho, Keum Nae Kang, Chang Joon Rhyu, Sung Won Chon, Young Su Lim, Jee In Yoo, Jung-Won Kim, Young Uk Kim
RATIONALE: Ankle syndesmotic injuries occasionally require long-term therapy for recovery and can result in tendon injury. Posterior tibial tendon dysfunction (PTTD) is an acquired deformity that can cause flatfoot deformity. The current nonoperative management of PTTD includes nonsteroidal antiinflammatory drugs (NSAIDs), orthopedic devices. Although various treatment options have been attempted, optimal treatments for each stage of the condition are debated. Polydeoxyribonucleotide (PDRN) is effective in healing of chronic wounds associated with tissue damage by attracting tissue growth factors...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27900268/management-of-syndesmotic-injuries-what-is-the-evidence
#18
REVIEW
Marc Schnetzke, Sven Y Vetter, Nils Beisemann, Benedict Swartman, Paul A Grützner, Jochen Franke
Ankle fractures are accompanied by a syndesmotic injury in about 10% of operatively treated ankle fractures. Usually, the total rupture of the syndesmotic ligaments with an external rotation force is associated with a Weber type B or C fracture or a Maisonneuve fracture. The clinical assessment should consist of a comprehensive history including mechanism of injury followed by a specific physical examination. Radiographs, and if in doubt magnetic resonance imaging, are needed to ascertain the syndesmotic injury...
November 18, 2016: World Journal of Orthopedics
https://www.readbyqxmd.com/read/27810152/syndesmosis-reduction-by-computer-assisted-orthopaedic-surgery-with-navigation-feasibility-and-accuracy-in-a-cadaveric-study
#19
Victor Dubois-Ferrière, Axel Gamulin, Ashwin Chowdhary, Jean Fasel, Richard Stern, Mathieu Assal
INTRODUCTION: Syndesmotic disruption may be difficult to reduce and fix, and malreduction is associated with inferior outcomes. Intraoperative computed tomography (CT) can provide accurate assessment of syndesmotic reduction. We hypothesized that three-dimensional (3-D) computer-assisted orthopaedic surgery (CAOS) with navigation of syndesmotic reduction could avoid malreduction. Our goal was to assess feasibility and accuracy of such a technic in a cadaveric study. METHOD: Eleven through-the-knee cadaveric specimens were used...
December 2016: Injury
https://www.readbyqxmd.com/read/27803225/should-syndesmotic-screws-be-removed-after-surgical-fixation-of-unstable-ankle-fractures-a-systematic-review
#20
REVIEW
S A Dingemans, S Rammelt, T O White, J C Goslings, T Schepers
AIMS: In approximately 20% of patients with ankle fractures, there is an concomitant injury to the syndesmosis which requires stabilisation, usually with one or more syndesmotic screws. The aim of this review is to evaluate whether removal of the syndesmotic screw is required in order for the patient to obtain optimal functional recovery. MATERIALS AND METHODS: A literature search was conducted in Medline, Embase and the Cochrane Library for articles in which the syndesmotic screw was retained...
November 2016: Bone & Joint Journal
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