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Archives of Orthopaedic and Trauma Surgery
Published in: Archives of Orthopaedic and Trauma Surgery 7/2011

Open Access 01-07-2011 | Orthopaedic Surgery

To retain or remove the syndesmotic screw: a review of literature

Author: T. Schepers

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 7/2011

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Abstract

Introduction

Syndesmotic positioning screws are frequently placed in unstable ankle fractures. Many facets of adequate placement techniques have been the subject of various studies. Whether or not the syndesmosis screw should be removed prior to weight-bearing is still debated. In this study, the recent literature is reviewed concerning the need for removal of the syndesmotic screw.

Materials and methods

A comprehensive literature search was conducted in the electronic databases of the Cochrane Library, Pubmed Medline and EMbase from January 2000 to October 2010.

Results

A total of seven studies were identified in the literature. Most studies found no difference in outcome between retained or removed screws. Patients with screws that were broken, or showed loosening, had similar or improved outcome compared to patients with removed screws. Removal of the syndesmotic screws, when deemed necessary, is usually not performed before 8–12 weeks.

Conclusion

There is paucity in randomized controlled trials on the absolute need for removal of the syndesmotic screw. However, current literature suggests that it might be reserved for intact screws that cause hardware irritation or reduced range of motion after 4–6 months.
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Metadata
Title
To retain or remove the syndesmotic screw: a review of literature
Author
T. Schepers
Publication date
01-07-2011
Publisher
Springer-Verlag
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 7/2011
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-010-1225-x

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