None listed
Conditions
Brief summary
Certain ankle fractures require surgical fixation, with a subset of these ankle fractures also requiring screw fixation of syndesmotic ligamentous injuries. Screw stabilisation of the disrupted ankle syndesmosis maintains reduction as healing of the distal tibiofibular ligaments occurs. It has previously been thought that syndesmosis screws may contribute to ankle dysfunction by restricting the normal motion between the tibia and fibula. Screw removal, breakage, or loosening may restore motion but can permit loss of reduction if these occur before complete ligamentous healing. In 2014, we published an article in the Bone and Joint Journal, demonstrating that there is no difference in removing or retaining ankle syndesmosis screws at one-year follow-up. At the time of publication, our study, entitled “Removal of the syndesmotic screw after the surgical treatment of a fracture of the ankle in adult patients does not affect one-year outcomes”, was voted by the American Academy of Orthopaedic Surgeons (AAOS) as one of the top 15 studies (from a cohort of 856 studies) most likely to impact Orthopaedic Surgeons’ practice in the world. One of the limitations in our initial study was the short duration of follow-up of one year. The aim of this current study is to review the patients who participated in the initial study and assess the medium-term outcomes in these patients. At the time of follow-up, we will have a minimum of five years follow-up results from this patient cohort.
Interventions
Our intervention group is of those patents who did not have a removal of ankle syndesmosis screws. We are reviewing their outcomes five years post surgery with their screw still in situ in a clinical setting where we will assess patients outcomes using various scoring systems and repeat xrays of their ankles as well as retrospective review their electronic hospital clinical notes and imaging over the past 5 years to determine any complications prior to our 5-year follow-up.
Sponsors
Middlemore Hospital
Eligibility
Sex/Gender
All
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
Patients will be identified from the previous study database from the original randomised control trial (Boyle, M, Gao, R, Frampton, C et al. Removal of the syndesmotic screw after the surgical treatment of a fracture of the ankle in adult patients does not affect one-year outcomes (2014) Bone and Joint Journal. 96 (12).) and invited by telephone to return for follow-up. Our original inclusion criteria were patients who were between the ages of 16 and 65 with a displaced fibular fracture with associated tibiofibular diastasis.
Exclusion criteria
Our original exclusion criteria was open fractures, preceding ankle abnormality, neurovascular injury, plafond injury or posterior maleollar fracture involving >10% of joint surface, polytrauma, diaphysial tibia fracture, pathological fracture, cognitive impairment or pregnancy.
Outcome results
None listed