What does a syndesmosis screw do?
A syndesmotic screw designed to replace the inferior tibiofibular articulation that fix the tibia and fibula together at the lower joint, is 5–6 cm long and made of a stainless, solid metal. The screw may inhibit normal movement of the bones and, thereby, the corresponding joint(s).
Where do you put the syndesmosis screw?
Fixation of the syndesmotic complex Drill a 2.5 mm hole through the fibula and the lateral cortex of the tibia, just proximal to the inferior tibiofibular joint, 30 degrees from posterior to anterior, parallel to the tibial plafond, with the ankle joint in neutral position.
Do syndesmotic screws need to be removed?
Conclusion: Removal of syndesmotic screws is advisable mainly in cases of patient complaints related to the other implanted perimalleolar hardware or malreduction of the syndesmosis after at least 8 weeks postoperatively. Broken or loose screws should not be removed routinely unless causing symptoms.
When should syndesmotic screws be removed?
Some studies have shown that the removal of syndesmotic screws can be performed about 3 to 4 months after surgery, especially when patients have discomfort or limitation of ankle dorsiflexion due to these screws.
What happens if a syndesmotic screw breaks?
Syndesmotic Screw Breakage May Be More Problematic Than Previously Reported: Increased Rates of Hardware Removal Secondary to Pain With Intraosseous Screw Breakage.
How do you fix syndesmosis?
The syndesmosis cannot be simply repaired by suturing ligaments together, so instead, the two bones of the leg are stabilized together to allow the syndesmosis to heal in the proper alignment – either by using one or two screws that span the fibula and tibia completely (called syndesmosis screws), or alternatively, by …
How do you prevent ankle syndesmosis?
Recently, the most common operative method used to reduce the syndesmosis has involved placement of a pointed reduction clamp around the distal tibia and fibula to maintain reduction of the syndesmosis with fixation (9–13).
Why do syndesmotic screws break?
Background: The majority of retained syndesmotic screws will either loosen or break once the patient resumes weight-bearing. While evidence is limited, anecdotal experience suggests that intraosseous screw breakage may be problematic for some patients due to painful bony erosion.
What ligaments stabilize the ankle syndesmosis?
The ankle syndesmosis is a complex joint between the distal tibia and fibula. It is stabilized by the anterior inferior tibiofibular ligament (AiTFL), the posterior inferior tibiofibular ligament (PiTFL), the inferior transverse ligament (ITL), and the interosseous membrane (IOM).
What is an incomplete ligamentous injury to the syndesmosis?
Ligamentous injuries to the syndesmosis are commonly referred to as “high ankle sprains,” since they occur proximal to the more common inversion lateral ankle sprains. These injuries can be generally classified as incomplete ligamentous injuries (i.e., “sprain”) or complete ligamentous disruption.
What are the treatment options for syndesmosis and associated ligaments?
Aggressive rehabilitation with early range of motion and weight-bearing exercises allows patients to regain functional activity at the quickest rate. Mobility and strength-training exercises promote the natural healing process of the syndesmosis and associated ligaments, and thus accelerate return to previous levels of function.
Are syndesmosis injuries similar to lateral ankle sprains?
Since syndesmosis injuries often present with confounding symptoms similar to severe lateral ankle sprains, an understanding of the mechanism of injury is crucial.