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Removal of broken syndesmotic screw with minimal bone defects in Korea: a case report

  • Min Gyu Kyung (Department of Orthopedic Surgery, Armed Forces Yangju Hospital) ;
  • Chulhee Park (Department of Orthopedic Surgery, Armed Forces Capital Hospital)
  • 투고 : 2022.10.27
  • 심사 : 2022.11.21
  • 발행 : 2023.09.30

초록

Ankle fractures with syndesmotic injuries often require fixation, where metal screw fixation is a popular method. However, as the patient begins weight-bearing, most syndesmotic screws tend to loosen or break, and removal of such screws has been challenging for the surgeons, as the available techniques require predrilling or trephination and are associated with risks of bone damage. This study presents a case with technical tip for the removal of broken tricortical-fixed non-cannulated syndesmotic screws. It implements the generation of a small cortical window in the medial distal tibia and the use of pliers to engage the screw tip and remove through the medial side. The technique presented in the current study overcomes these limitations and facilitates minimal bone damage and reduced exposure to radiation.

키워드

참고문헌

  1. Sugi MT, Ortega B, Shepherd L, Zalavras C. Syndesmotic screw removal in a clinic setting is safe and cost-effective. Foot Ankle Spec 2020;13:144-51.  https://doi.org/10.1177/1938640019843321
  2. Ibrahim IO, Velasco BT, Ye MY, Miller CP, Kwon JY. Syndesmotic screw breakage may be more problematic than previously reported: increased rates of hardware removal secondary to pain with intraosseous screw breakage. Foot Ankle Spec 2022;15:27-35.  https://doi.org/10.1177/1938640020932049
  3. Henley MB, Law MD Jr, Henry SL. Removal of broken syndesmotic screws: a technical tip. Orthopedics 1994;17:641-4.  https://doi.org/10.3928/0147-7447-19940701-17
  4. Melvin JS, Downing KL, Ogilvie CM. A technique for removal of broken cannulated tricortical syndesmotic screws. J Orthop Trauma 2008;22:648-51.  https://doi.org/10.1097/BOT.0b013e3181886f74
  5. Riedel MD, Briceno J, Miller CP, Kwon JY. Technical tip: removal of a broken tri-cortical syndesmotic screw using a "perfect circle" technique. Injury 2018;49:877-80.  https://doi.org/10.1016/j.injury.2018.02.022
  6. Citak M, Backhaus M, Muhr G, Kalicke T. Distal tibial fracture post syndesmotic screw removal: an adverse complication. Arch Orthop Trauma Surg 2011;131:1405-8.  https://doi.org/10.1007/s00402-011-1314-5
  7. Lee KB. Ankle syndesmotic injury. J Korean Fract Soc 2007;20:282-90.  https://doi.org/10.12671/jkfs.2007.20.3.282
  8. Schepers T, van der Linden H, van Lieshout EM, Niesten DD, van der Elst M. Technical aspects of the syndesmotic screw and their effect on functional outcome following acute distal tibiofibular syndesmosis injury. Injury 2014;45:775-9. https://doi.org/10.1016/j.injury.2013.09.035