Comparing routine syndesmotic screws removal vs on-demand removal .
Syndesmotic screws, unscrew them, or leave them? A systematic review and meta-analysis of randomized controlled trials.
J Orthop . 2024 Mar 22:54:136-142. doi: 10.1016/j.jor.2024.03.012.Three randomized controlled trials with 267 patients who had acute ankle fractures or isolated syndesmotic injuries were included in this systematic review and meta-analysis comparing those undergoing routine removal of the screw and those receiving on-demand removal. Pooled outcomes included the Olerud-Molander Ankle Score (OMAS), American Orthopedic Foot and Ankle Hindfoot Score (AOFAS), dorsiflexion, pain scores, range of motion, and complication rates. The results showed no significant difference in OMAS, AOFAS, dorsiflexion, pain scores, or range of motion between groups at one year. However, routine removal was associated with a significantly higher complication rate.
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