scholarly journals Complications of Syndesmotic Screw Removal

2011 ◽  
Vol 32 (11) ◽  
pp. 1040-1044 ◽  
Author(s):  
Tim Schepers ◽  
Esther M.M. Van Lieshout ◽  
Mark R. de Vries ◽  
Maarten Van der Elst

Background: Currently, the metallic syndesmotic screw is the gold standard in the treatment of syndesmotic disruption. Whether or not this screw needs to be removed remains debatable. The aim of the current study was to determine the complications which occur following routine removal of the syndesmotic screw following operative treatment of unstable ankle fractures. Methods: This was a retrospective study with consecutive cases in a Level-2 Trauma center. All patients with routine removal of a syndesmotic screw, following the treatment of an unstable ankle fracture, between January 1, 2004 and November 30, 2010 were included. Complications recorded were: 1) minor or major wound infection following removal of the syndesmotic screw, 2) recurrent syndesmotic diastasis, and 3) unnecessary removal of a broken screw, not recognized during preoperative planning prior to surgery. Results: A total of 76 patients were included. A wound infection occurred in 9.2% (N=7) of which 2.6% (N=2) were deep infections requiring reoperation. Recurrent syndesmotic diastasis was found in 6.6% (N=5) of patients, and in 6.6% (N=5) screws were broken at the time of implant removal. In the group with recurrent diastasis the screws were removed significantly earlier compared with the group without recurrent diastasis (Mann- Whitney U-test; p= 0.011) and the group with screw breakage had their screws significantly longer in place compared with the group without breakage ( p = 0.038). Conclusion: A total of 22.4% complications occurred upon routine removal of the syndesmotic screw. Removal might therefore be considered only in selected cases with complaints, after a minimum of eight to twelve weeks and using antibiotic prophylaxis during removal. Level of Evidence: IV, Retrospective Case Study

2020 ◽  
Vol 41 (9) ◽  
pp. 1065-1072
Author(s):  
Omar A. Behery ◽  
Jessica Mandel ◽  
Sara J. Solasz ◽  
Sanjit R. Konda ◽  
Kenneth A. Egol

Background: The purpose of this study was to identify characteristic patterns of syndesmotic screw (SS) failure, and any effects on clinical outcome. Methods: A retrospective study was performed using a consecutive series of patients treated with open reduction and internal fixation with trans-syndesmotic screws for unstable ankle fractures with syndesmotic injury between 2015 and 2017. Patient demographics, fracture characteristics and classification, rates and patterns of trans-syndesmotic screw breakage, and backout were analyzed. Functional outcome was assessed using passive range of motion (ROM) and Maryland Foot Score (MFS). Results: A total of 113 patients (67%) had intact screws and 56 patients (33%) demonstrated either screw breakage or backout. Patients with SS failure were younger ( P = .002) and predominantly male ( P = .045). Fracture classification and energy level of injury were not associated with screw failure. Nine screws (11%) demonstrated backout (2 also broke) and 56 other screws broke. There was no association between the number of screws or cortices of purchase and screw failure. There was a trend toward a higher proportion of screw removal (20%) in this failed SS group compared with the intact SS group (12%) ( P = .25), but with similar ankle ROM and MFS ( P > .07). Conclusion: Syndesmotic screw breakage was common in younger, male patients. Despite similarities in ankle range of motion and clinical outcome scores to patients with intact screws, there was a trend towards more frequent screw removal. This information can be used to counsel patients pre- and postoperatively regarding the potential for screw failure and subsequent implant removal. Level of Evidence: Level III, retrospective case-control study.


2019 ◽  
Vol 10 (11) ◽  
pp. 1131-1135
Author(s):  
Tomas Hambili Paulo Sanjuluca ◽  
◽  
Ricardo Correia ◽  
Anabela Antunes de Almeida ◽  
Ana Gloria Diaz Martinez ◽  
...  

Introduction: In order to have a good assessment of the quality of maternal and child health care, it is essential that there is up-to-date and reliable information. Objective: To evaluate the impact of the implementation of a computerized database of clinical processes in the admission, archive and medical statistics section, of Maternity hospital Irene Neto/Lubango-Angola. Methodology: A descriptive study with a quantitative and qualitative approach to carry out a retrospective case study deliveries and newborns, records from 2014 to 2017. Final considerations: The implementation of this project may contribute to the improvement of clinical management support management of the hospital as well as facilitating access to information for research and scientific production.


2018 ◽  
Vol 69 (8) ◽  
Author(s):  
Doina Vesa ◽  
Cristian Martu ◽  
Razvan Leata ◽  
Ludmila Lozneanu ◽  
luminita Radulescu ◽  
...  

Paranasal mucoceles are a type of cysts that evolve slowly and are asymptomatic; this poses a difficulty in diagnosing the patient because the symptoms can go unnoticed. The mucocele evolves unpredictably. On the one hand, it can become infected turning into pyoceles and on the other hand, it can invade important regions such as the orbital, cranial or genian regions, creating facial asymmetry. This is a retrospective case study of 37 patients diagnosed with sinus mucoceles, followed up by clinical examination and paraclinical tests such as CT and MRI scans. The biochemical components of the liquid from within the mucocele were analyzed and the following criteria were recorded: NaCl-, Cl-, Na+ and cholesterine as well as cellular components such as mastocytes, macrophages, hematocytes and leucocytes. In all cases, the treatment option was surgery with favorable post-operative and follow-up evaluation. The mucoceles that appeared post-operatively (maxillary and ethmoid sinuses) evolved more rapidly than the mucoceles that were induced byan external injury. Longer follow-up of operated patients permitted a more timely diagnosis of recurrences.


2021 ◽  
Vol 3 (1) ◽  
pp. 214-223
Author(s):  
Yuke Armika ◽  
Nerseri Barus

Chronic kidney disease (CKD) is a condition in which there is a gradual decline in kidney function. This disease is progressive and usually irreversible. Indications for hospitalized CKD patients with severe complications and do not allow inpatient therapy. This study was aimed to describe the overview and management of chronic kidney disease inpatient in Royal Prima General Hospital Medan. The type of research used is research with a descriptive and retrospective case study design. This study is based on medical record data related to inpatient CKD patients' diagnostic and management features at the Royal Prima General Hospital Medan in 2020. The research subjects were all inpatients diagnosed with CKD, whereas 100 research subjects with complete medical records were included in this study. It was found that the highest age group was 57-65 years, as much as 37.0%, and men as much as 27%. The chief complaint was shortness of breath at 43% and additional complaints, the most of which were fever + low back pain + edema at 38%. On physical examination, most of the inspections were weak, 55%. Most palpation was sociable 57%. There was auscultation of four abdominal regions and normal positive bowel sounds (93%). Complete blood count + blood sugar level + electrolytes + urea + creatinine 70%, the most combination medication is NaCl 0.9% + Furosemide injection 31%. Based on the length of stay, the longest was 13-14 days (20%).


2015 ◽  
Vol 7 (1) ◽  
pp. 22 ◽  
Author(s):  
Young-Min Ye ◽  
Mi Kyeong Kim ◽  
Hye-Ryun Kang ◽  
Tae-Bum Kim ◽  
Seong-Wook Sohn ◽  
...  

2018 ◽  
Vol 12 (1) ◽  
pp. 98-103 ◽  
Author(s):  
Yanyan Jiang ◽  
Zhongying Yuan ◽  
Guoqing Zang ◽  
Dan Li ◽  
Ying Wang ◽  
...  

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