Syndesmotic screw removal after broken ankle?

I recently broke my fibula. After further examination the doctors said I needed two screws to keep my tib/fib stable so the fibers could bond together again. I have 4 more weeks and the screws are set to be taken out. I am contemplating leaving them in so I don't have to have another surgery. The only thing I want to know is if someone else has left them in and had success. I'm not real active (rock climbing etc.) but i play ball with the kids. Im 39 years old and if it's best to do it...well I will. Again if anyone has any input that would be AWESOME!

Well...I had all the plates and screws removed. Ya know what? I pretty much HAD TO. For some reason, my body just wasnt reacting well to all that hardware. My ankle was constantly inflamed and the swelling and inflamation was getting worse. Just to touch the skin on my right ankle was enuff to drive me crazy. BUT....once it was all out.....inflamation subsided....i actually felt the difference IMMEDIATELY. Much happier now and back to work.

I had screws and a plate for a spiral fib fracture with torn ligaments. I had to fight to get insurance to cover the removal two and a half years later, but it made a HUGE positive difference in decreasing pain when doing long runs. I couldn’t say why exactly, and some of it may have been in my mind, but I felt like the real healing didn’t start till the metal was out.

Paul Fleming wrote:Broke my ankle about a 8 weeks ago (being lowered off a climb by a guide, fell about six feet) and had it repaired. Now the question is, do I undergo surgery to remove syndesmotic screws? My doctor says he usually doesn't remove the screws unless they are causing pain or impede range of motion. I'm thinking this may be fine for people who aren't going to really stress their ankle, but not for someone who wants to continue climbing/skiing/kiteboarding etc. Medical articles I've read says that the screws frequently loosen or break. ( olc.metrohealth.org/SubSpec… )The most recent metastudy ( ncbi.nlm.nih.gov/pmc/articl… looks at outcomes from 7 other recent studies) says that removal of screws results in outcomes that are similar to results if the screws become loose or break. Results for the intact screws were the worst. While it would be great to avoid surgery and the additional time I would have to spend on crutches after screw removal, I'd rather not have to deal with it later. Anyone have to make this decision that has an opinion, or a bad experience with leaving the hardware in place?

Paul Fleming wrote:Broke my ankle about a 8 weeks ago (being lowered off a climb by a guide, fell about six feet) and had it repaired. Now the question is, do I undergo surgery to remove syndesmotic screws? My doctor says he usually doesn't remove the screws unless they are causing pain or impede range of motion. I'm thinking this may be fine for people who aren't going to really stress their ankle, but not for someone who wants to continue climbing/skiing/kiteboarding etc. Medical articles I've read says that the screws frequently loosen or break. ( olc.metrohealth.org/SubSpec… )The most recent metastudy ( ncbi.nlm.nih.gov/pmc/articl… looks at outcomes from 7 other recent studies) says that removal of screws results in outcomes that are similar to results if the screws become loose or break. Results for the intact screws were the worst. While it would be great to avoid surgery and the additional time I would have to spend on crutches after screw removal, I'd rather not have to deal with it later. Anyone have to make this decision that has an opinion, or a bad experience with leaving the hardware in place?

Hi I am responding to this post because I have had a plate in my ankle for about 15 years.. The last 6 or 7 years I had 1 screw that stuck out about a quarter inch... I kept bumping it aon things càusing pain ... Doctors agreed it had to come out a little over a year ago. .. Upon taking it out the surgeon told me it was literally only 2 twists and it was out of the bone... I say it was a good move to have it out...and not loose floating about in my ankle...

i had trimallular surgery l6 months ago, 6 screws, 1 lag screw, 1 plate on fibula side. then 2 long lag screws into tibia side...those r the ones that started hurting more then other side
im 69, so i had the 2 tibia screwsremoved 2 days, he did make a 2 inch incision, thot that was overkill, knife happy, lol...but at least they are gone now, ill try to keep the other side in
as the fibula bone is smaller, more holes too left in bone, which might break again. so not doing that, unless have to...but i limp, use a cane, i dont know why i read eveyrone is hiking, biking, etc
i lost all that, i work outside, w hile sitting down, in 3 hrs, i have severe pain, sweelling again...wish it had healed 100% 

I had trimallar surgery October 31st 2018 .   Surgeon said it was the worst he as seen.   Four months later and my ankle is terribly swollen.   I make myself walk on it with a limp but the swelling is a really big deal.  Between that and the scar tissue I feel like there is cement around my ankle.   I do excercises in the pool daily and ROM excercises but the last few days it seems to be worse.   Very frustrated 

takes a long time, my surgery for trimallular fx was back in sept of 2017. over yr and 5 mos ago...i still limp, recently had the 2 lag tibia screws removed because of their pain
im going to ask for an MRI ankle, to check ligaments and tendons, exrays only show, bones, then go see ankle surgeon specialist in dallas tx. for 2nd opinion
i know arthritis etc has set in, lack of ROM. NEVER GONNA BE LIKE GOD MAKE IT, but i'd like to know if some tendon or ligament injury was missed. i really dont wanna limp have unstable ankle rest of life, but may have to

heather ann wrote: Question: What does it feel like when your screws break? How do I know? I had a spiral fracture of my fibula, tibia in 7-8 chunks, and talus "crumbled" (apparently that is a technical term) in 10/12. Got 2 plates and 15 screws. Had 2 syndesmosis screws removed in 1/13 as planned from beginning. Dorsiflexion continued to be severely limited so had bone chips removed from joint in 4/13. Freakish swelling problems started, so had all hardware removed in 11/13 HOWEVER this surgery was with a different doctor (I live in rural upper MI, traveled to Minneapolis for surgery #4) and he put the syndesmosis screws back in. He said they would probably be fine long term. Well, about a month ago I started to develop severe pain with bearing weight AFTER resting. So, particularly bad in the morning. Feels like there are sharp rocks inside my joint. Oddly, the pain eventually goes away with continued weight bearing...then comes back after I've rested for any length of time. I carry crutches around with me and use them any time I get up for the first 1-30 minutes of walking, depending how long I've been resting. Has anybody ever experienced pain that appears to be CAUSED by rest??? Any words of wisdom would be appreciated...I'm getting tired of this. Thanks!

I definitely know that feeling. I thought it was in my head and seemed like when I was in bed at night the pain would be horrible.. my ankle was never comfortable. I'd rock myself to sleep and sometimes hang the ankle out of the bed. walking in Am was like it was when I 1st was allowed to put weight on. broke my tibia & fibula also dislocated the heel which slid backwards.  I had 1 plate and 7screws installed.  
today was a scheduled surgery to remove the long screw attaching the tibia and fibula.  my husband said the surgeon told him the long screw was broken do the had to make a 2nd incision on the inner ankle to remove in 2parts
when he told me I immediately thought this may have been my issue with pain at night and morning maybe it was on a nerve.  long story short surgery was at7am by 6pm I was walking on it and its 9pm I'm in bed and do not feel the pain I felt before surgery.  I still have 6screws and plate.  I also think break was on me I fell on ankle 1wk after 1st surgery 

I wanted to provide my experience in case it helps. I broke my ankle and had ligament damage 5/2018. The doctor installed a plate, 5 small screws, and two longer syndesmosis screws. I was not walking much I think for a month or two. At the three month point I asked to have the two syndesmosis screws out. I didn't like the idea of them eventually breaking and being left in, and I also didn't like the idea of having any metal left in my ankle if I could avoid it. The outpatient surgery went quickly and I was not "put under," but I don't remember anything during their removal. I was asleep. I could walk that day with minimal pain. In May 2019 I had the remaining plate and five screws removed, same experience. It's been 18 months now and my ankle is doing great. I am even back to running with the finger toe shoes. It's been a gradual / periodic process, but I just did it and paid attention to pain to not overdo it by stopping when I felt certain pain. I also did some PT to help strengthen and increase flexibility in the ankle. I think my ankle is close to or near back to normal as before the accident. I thank Jesus for this healing. I hope this helps you in your journey to a complete recovery. God bless you all, Tim

im 70 i had trimallular and very disloated  right ankle  fx, in 2017, plate, 7 screws on outside, 2 lag long screws on tibia, had them removed after 2 yrs. they didnt remove the other plate/screws. nor did they fix the torn ligaments. i still have pain ujpon walking, PT told m e ur flexiblity wont ever be the same, with that place on  your ankle joint
i  dont want to be cut o n again, i may go to springfield mo. dr reed does stemcell injections for 2400. ins wont pay as its your own bodys materials., but my br did it f or rotator cuff issue and it healed it.  glad ur hardware removal went well, im just afraid, if i remove the fibula plate (small bone) and screws with my osteoporosis  and age, it might break again, and  i sure as hell
dont want to go thru that hell surgery again

I broke my ankle in an automobile accident in 2002. Both bones right above the joint. It was also dislocated att that time. First surgery consisted of a plate 6 screws and 2 pins. That was April that year. By September I had my second surgery to remove the 2 pins which were pinching a nerve. As years rolled by a screw started working its way out right at my ankle bone joint. It was sticking out a little more than an 8th of an inch. It caused pain and I would periodically catch it on furniture.. Which hurt. So in 2014 I had that screw removed. Dr. said it was one turn from being out. Now it is 2020. I still have pain in this ankle. I feel as though this plate has shifted. It does cause problems walking from time to time. And some days it can cause my whole leg to hurt and give out and buckle under body weight of just standing. I do have some nerve damage from initial surgery. Just thankful to be alive. Hopes this helps in some of your questions about removal of partial hardware. 

What a difference a few years makes. 2013 when poster Paul Fleming asked it this gets a handful of replies. Today it would be 20 pages with side tracks and flame wars. Wonder how his ankle has fared in the 7 years since he asked this.

And how about a guide dropping you while lowering, that's a rookie move. Did the guide insurance cover the medical?

I broke my ankle on the 19th of August 2020. Got admitted and had the fracture reduced with external fixation. About 10 days later when the swelling came down, I was taken for surgery. Metal plates and screws are now placed and the healing process has begun. Had my stitches removed after 14 days. I’m free to answer any questions about the procedures - vnm230@gmail.com.. 

I broke my ankle back in April at the distal tibiofibular joint and needless to say that wasn’t pretty! I did decide (my Dr agreed) however to have the syndesmotic screw removed which I did 2 weeks ago. I just felt it was possibly hindering movement in my ankle, which is hard to tell because of the initial  reduced flexibility which I expected anyway. I have very small ankles and that screw just ‘looked’ like it would cause problems down the road. Also since I met my deductible with the surgery I figured wth, take it now! Recovery was a breeze. Weight bearing as tolerated for 2 weeks. Went back to Dr. in a boot. Came home in my shoe and walked 3 miles and definitely felt a difference in my flexibility. For me removal was the way to go....