Biodegradable screw fixation of the syndesmosis together with metallic osteosynthesis. Preliminary experience of 7 ankles.

Background and aims: In ankle fractures with separation of the tibiofibular mortise a metallic syndesmosis screw is generally used. As a rule, this transfixing screw is removed by a separate operation 6 to 8 weeks later. Usually the fracture fixation implants are removed by a second operation later on. In order to eliminate separate removal of the transfixing screw, we used a biodegradable syndesmosis screw in a pilot clinical study.

Patients and methods: We treated seven consecutive patients with malleolar fractures and separation of the syndesmosis by an ordinary metallic plating and screw fixation of the fractures and biodegradable polyglycolic acid (PGA) screw transfixation of the syndesmosis.

Results and conclusions: All the patients ended up with an acceptable result and stable ankle mortise. One of the ankles, which was the only one fixed by two transfixing PGA screws instead of one screw, had transient sinus formation and intraosseal osteolysis. The final result was good also in this case. The ankle mortise can be fixed safely by biodegradable screws in connection with metallic osteosynthesis of malleolar fractures. Thus a separate removal of the transfixing material is possible to eliminate.