The Fate of the Syndesmosis Screw in Syndesmotic Injuries


  • Emre Baca
  • Burak Belen

Received Date: 28.11.2018 Accepted Date: 18.01.2019 Med J Bakirkoy 2019;15(1):69-75


Ankle fractures are common orthopedic injuries. Some ankle fractures are associated with syndesmotic injuries and surgical treatment is indicated. Screw fixation is the gold standard in fixation of syndesmosis rupture. However, there are different opinions about this technique in terms of application and follow-up. The present literature suggests that it should be removed in 6-8th weeks, some recent publications and surgeon opinions suggest that screws need not be removed. The aim of this study was to compare the clinical results of patients with retained and removed syndesmosis screws.


Thirty-one patients with syndesmosis fixation were retrospectively reviewed. The minimum follow-up period was 12 months. In the clinical evaluation, Manchester Oxford Foot Questionnaire (MOXFQ) and visual pain scale (VAS) were used. The final state of the screw (removed, fractured, intact) was evaluated by standard AP and lateral radiographs. Ankle range of motion was measured by goniometer.


A total of 33 patients were included in the study. Syndesmosis screw was removed in 39.4% (n=13) of the cases and it was observed that 60.6% (n=20) had not been removed. There were no statistically significant differences between the two groups.


There was no statistically significant difference between the two groups with retained or removed syndesmosis screws. Given the cost and workload associated with secondary surgery, increased complication risk and loss of patient workforce, we do not recommend routine removal of the syndesmosis screw.

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