Syndesmosis injuries

Summary

Three prognostic studies (class of evidence, CoE, III) examined the effect of syndesmotic screw status on outcomes following fixation of ankle fractures with an injury to the syndesmosis. Syndesmotic screws were categorized as intact or non-intact (broken or loosened and left in situ, or removed). Patient-reported functional outcomes were significantly better (85 versus 70, P = .01) and pain scores were also significantly better (0.74 versus 2.31, P = .02) in patients that have non-intact screws compared with patients that have intact screws. All three clinician-based outcomes were better in patients with non-intact screws compared with intact screws; however, only one (Olerud Molander score) reached statistical significance (64 versus 47, P = .04). Non-intact syndesmotic screws were associated with better functional outcomes and pain scores compared with intact syndesmotic screws.