The Impacts of Fixation Tightness and Duration on the Remnant Syndesmotic Widening and Clinical Symptom after Removal of Screws

Bae, Su Young; Sohn, Su Een; Seong, Min Kyu

Abstract

PURPOSE
We aimed to analyze the effect of fixation tightness of the syndesmotic screw and its indwelling period on the recurrence of the syndesmosis widening after screw removal and the clinical outcomes.
MATERIALS AND METHODS
Forty consecutive patients with acute syndesmotic injury were retrospectively reviewed. The tibiofibular clear space is measured by digitalized measurement tool on serial radiographs. We analyzed the effect of time from trauma to fixation, syndesmotic screw indwelling duration, and fixation methods. Residual symptoms at the last follow up were evaluated. The student t-test, correlation test, and chi-square test were used for statistical analysis.
RESULTS
Eighteen ankles (45%) had recurrent syndesmosis widening (greater than 5% compared to the contralateral side). Seven patients had pain and five had limitation of motion in the ankle joint. Fixation tightness had significant effect on reducing the recurrence while the severity of the initial widening, time to fixation, and duration of fixation did not affect the outcome.
CONCLUSION
Tight fixation of syndesmotic screw is essential for achieving final syndesmotic stability and reducing recurrence.