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syndesmotic screw removal

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
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
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
Kaitlin C Neary, Matthew A Mormino, Hongmei Wang
BACKGROUND: In stress-positive, unstable supination-external rotation type 4 (SER IV) ankle fractures, implant selection for syndesmotic fixation is a debated topic. Among the available syndesmotic fixation methods, the metallic screw and the suture button have been routinely compared in the literature. In addition to strength of fixation and ability to anatomically restore the syndesmosis, costs associated with implant use have recently been called into question. PURPOSE: This study aimed to examine the cost-effectiveness of the suture button and determine whether suture button fixation is more cost-effective than two 3...
September 6, 2016: American Journal of Sports Medicine
Jun Endo, Satoshi Yamaguchi, Masahiko Saito, Tsuguo Morikawa, Ryuichiro Akagi, Takahisa Sasho
INTRODUCTION: To evaluate time-dependent changes in the syndesmotic reduction after syndesmotic screw fixation and one year after screw removal for ankle malleolar fractures, and to assess whether the incidence of syndesmotic malreduction changes depending on the measurement method. METHODS: We assessed twenty patients who underwent syndesmotic screw fixation for ankle fractures. The syndesmotic screws were removed after six weeks of the fracture surgery. Syndesmotic reduction was assessed within two weeks of the fracture surgery and one year after the screw removal using the axial computer tomographic images...
October 2016: Injury
S Jasqui-Remba, A Torres-Gómez, G A Salas-Morales, A Hernández-Martínez
The tibiofibular syndesmosis provides stability to the ankle mortise. The ankle syndesmosis is compromised in all Weber C type injuries. The radiographic method described by Merle DAubigné considers the bony relationships as a measure of syndesmotic widening. We sought to investigate whether the patients with a C type ankle fracture treated with ORIF and placement of a transyndesmal screw have an increment of the tibiofibular space and decrease of the tibiofibular overlap after the transyndesmal screw is removed...
November 2015: Acta Ortopédica Mexicana
Zackary A Johnson, Paul M Ryan, Claude D Anderson
Subtle syndesmotic instability not evident on radiography can result in chronic ankle pain. The diagnosis is uncommon, and arthroscopic evaluation remains the gold standard for diagnosis. Definitive surgical management can be performed at the time of diagnosis. Patients with 2 to 4 mm of diastasis of the syndesmosis or translation can be treated with debridement alone, and patients with 4 mm or more of diastasis or translation can be treated with arthroscopic debridement and reduction followed by percutaneous stabilization...
April 2016: Arthroscopy Techniques
Igor Kaftandziev, Marko Spasov, Simon Trpeski, Beti Zafirova-Ivanovska, Bore Bakota
INTRODUCTION: Ankle fractures are common injuries. Since the recognition of the importance of syndesmotic injury in ankle fractures, much of the scientific work has been focused on concomitant syndesmotic injury. Despite the invention of novel devices for restoration and maintenance of the congruent syndesmosis following syndesmotic injury, the metallic syndesmotic screw is still considered to be the "gold standard". The aim of this study was to compare the clinical results in patients who retained the syndesmosis screw with those in whom the screw was removed following open reduction and internal fixation of the malleolar fracture associated with syndesmosis disruption...
November 2015: Injury
Nicole van Vlijmen, Katharina Denk, Albert van Kampen, Ruurd L Jaarsma
Syndesmotic disruption occurs in more than 10% of ankle fractures. Operative treatment with syndesmosis screw fixation has been successfully performed for decades and is considered the gold standard of treatment. Few studies have reported the long-term outcomes of syndesmosis injuries. This study investigated long-term patient-reported, radiographic, and functional outcomes of syndesmosis injuries treated with screw fixation and subsequent timed screw removal. A retrospective cohort study was carried out at a Level I trauma center...
November 2015: Orthopedics
Mette Renate Andersen, Frede Frihagen, Jan Erik Madsen, Wender Figved
PURPOSE: The aim of this study was to determine the rate of complications after routine syndesmotic screw removal. MATERIALS AND METHODS: All patients who underwent syndesmotic screw removal at our hospital between 2007 and 2012 were included in the study. Patient demographics, surgical characteristics, radiographic evaluation and complications were recorded from the patients' charts. Questionnaires were sent by postal mail to all patients, to measure patient satisfaction and pain (VAS scales)...
November 2015: Injury
Elisabeth Gennis, Scott Koenig, Deirdre Rodericks, Peters Otlans, Paul Tornetta
BACKGROUND: A prior study demonstrated statistical widening of the syndesmosis within weeks of elective screw removal. However, no information is available as to the radiographic outcomes of screw retention. The aim of this study was to evaluate radiographic syndesmotic widening and talar shift over time in patients treated with syndesmotic screws and to compare screw removal with retention along with other potential risk factors that may have led to tibia-fibula diastasis after weightbearing...
October 2015: Foot & Ankle International
S Rammelt, P Obruba
INTRODUCTION: Injuries to the distal tibiofibular syndesmosis are frequent and continue to generate controversy. METHODS: The majority of purely ligamentous injuries ("high ankle sprains") is not sassociated with a latent or frank tibiofibular diastasis and may be treated with an extended protocol of physical therapy. Relevant instability of the syndesmosis with diastasis results from rupture of two or more ligaments that require surgical stabilization. Syndesmosis disruptions are commonly associated with bony avulsions or malleolar fractures...
December 2015: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Dorien M van der Eng, Niels W L Schep, Tim Schepers
Ankle fractures with syndesmotic rupture require operative treatment. In most cases, this consists of fixation of the tibiofibular joint with 1 or more screws. Bioabsorbable screws are used for the same purpose but have the advantage that screw removal is unnecessary. The aim of the present study was to compare the results of bioabsorbable and metallic syndesmotic screws. A systematic search was performed in the Ovid MEDLINE electronic database and Google Scholar. Three randomized controlled trials and one comparison study, with 260 patients, were included...
July 2015: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Milton M T Little, Marschall B Berkes, Patrick C Schottel, Matthew R Garner, Lionel E Lazaro, Jacqueline F Birnbaum, David L Helfet, Dean G Lorich
OBJECTIVES: To compare radiographic and clinical outcomes of supination external rotation type IV equivalent (SER IV E) ankle fractures (AO/OTA classification 44-B2.1) treated with transsyndesmotic screw fixation with those treated with deltoid and posterior inferior tibiofibular ligament (PITFL) repair. DESIGN: Case series and single-surgeon retrospective analysis of a prospective database. SETTING: Academic level I trauma center. PATIENTS: Forty-five SER IV E ankle fractures fulfilled all inclusion/exclusion criteria with at least 12 months of radiographic follow-up...
May 2015: Journal of Orthopaedic Trauma
Egbert J D Veen, Rutger G Zuurmond
BACKGROUNDS: This study investigated the effect of short term removal of syndesmotic screws on the ankle function after 6 years, as there still exists controversy on the duration of screw stabilization. METHODS: Patients with an ankle fracture who received surgery between 1998 and 2004 were reviewed. One group was composed of patients with an ankle fracture needing a syndesmotic repair with screws. The second was composed of operated patients that did not need syndesmotic repair...
March 2015: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
S Weckbach, J Hahnhaussen, J T Losacco, F Gebhard, P F Stahel
BACKGROUND: Unstable ankle injuries with associated disruption of the distal-fibular syndesmosis are typically managed by adjunctive placement of temporary syndesmotic positioning screws. The widespread notion that positioning screws must be removed by default after healing of the syndesmosis remains a topic of debate which lacks scientific support. The present study was designed to test the hypothesis that syndesmotic positioning screws are safely retained per protocol in asymptomatic patients...
December 2014: Zeitschrift Für Orthopädie und Unfallchirurgie
M J Boyle, R Gao, C M A Frampton, B Coleman
Our aim was to compare the one-year post-operative outcomes following retention or removal of syndesmotic screws in adult patients with a fracture of the ankle that was treated surgically. A total of 51 patients (35 males, 16 females), with a mean age of 33.5 years (16 to 62), undergoing fibular osteosynthesis and syndesmotic screw fixation, were randomly allocated to retention of the syndesmotic screw or removal at three months post-operatively. The two groups were comparable at baseline. One year post-operatively, there was no significant difference in the mean Olerud-Molander ankle score (82...
December 2014: Bone & Joint Journal
Choon Chiet Hong, Wei Ting Lee, Ken Jin Tan
Fixation of ankle syndesmosis injuries using the Ankle TightRope(®) has been gaining popularity. It has been shown to produce good results, facilitate early weightbearing, reduce the need for implant removal, and allow an earlier return to work and, possibly, a more anatomic syndesmotic reduction compared with screw fixation. However, its usage has been associated with complications such as soft tissue irritation, infection and wound breakdown, suture-button subsidence, and pathologic fracture from the screw tract...
January 2015: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Qinghua Liu, Guanghui Zhao, Bin Yu, Jianbin Ma, Zhong Li, Kun Zhang
PURPOSE: Traditional studies of syndesmosis injury and screw stabilization have been conducted in cadaveric models, which cannot yield sufficient and exact biomechanical data about the interior of the ankle. The purpose of this study was to evaluate the effects of inferior tibiofibular syndesmosis injury (ITSI) and screw stabilization on the motion of the ankle with finite element analysis. METHODS: Three-dimensional models of the ankle complex were created with CT images of a volunteer's right ankle in three states: normal, post-ITSI, and stabilization with a screw 2...
April 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
D Camus, F Launay, J-M Guillaume, E Viehweger, G Bollini, J-L Jouve
INTRODUCTION: During tibial lengthening procedures, it is recommended to prevent fibular malleolus proximal migration using a distal tibiofibular syndesmotic screw, which is removed at 6 months. We have observed proximal migrations of the fibular malleolus despite placement of this syndesmotic screw. OBJECTIVE: The objective of this study was to demonstrate this migration and to study the influence of two factors that may favor its occurrence: positioning of the syndesmotic screw and union of the fibula at the time of removal...
October 2014: Orthopaedics & Traumatology, Surgery & Research: OTSR
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