Functional outcomes after syndesmotic screw fixation and removal

Objectives: Ankle fractures with a syndesmotic injury have historically been treated with syndesmotic screw fixation. We compared range of motion and functional outcomes' scores to assess patient benefit from syndesmotic screw and plate removal. Design: Level IV-case series. Setting: Level I-trauma center. Patients/Participants: Twenty-five consecutive patients with unstable ankle fractures and syndesmotic injury confirmed on magnetic resonance imaging. Intervention: Locked syndesmotic screws and plates were removed; functional outcomes and range of motion were measured before and after screw removal. Main Outcome Measurements: Foot and Ankle Outcome Score, Olerud and Molander Ankle Score, and physical examination Results: There was a significant improvement in range of motion, Foot and Ankle Outcome, and Olerud and Molander Ankle scores at the immediate postoperative visit. This was not significantly changed at longer follow-up. There were no adverse events or complications in these patients. No patient had radiographic loss of syndesmotic reduction after screw removal. Conclusions: Locked screw and plate removal improved function both subjectively and objectively. Transsyndesmotic implant removal seems to assist improvements in the speed of rehabilitation.