Stabilization of Ankle Syndesmosis Injuries With a Syndesmosis Screw

A retrospective review was made of 30 patients who had disruption of the ankle syndesmosis that was treated at Santa Clara Valley Medical Center with a transfixation screw. Follow-up ranged from 3 months to 3 years. There were 21 pronation external rotation injuries and 9 Maison-neuve fractures. Screw size ranged from 3.5 cortical to 6.5 cancellous Synthes screws. Most were placed trans-versely from 1.5 to 3.5 cm above the joint line. Intraoper-ative difficulties with screw placement occurred in 2 pa-tients, resulting in one bent screw and one screw placed directly into the ankle joint. Most patients were mobilized prior to screw removal; lucent lines developed around the syndesmosis screw before it was removed in two-thirds of the patients. No screw broke prior to removal. In