Table 1.

Literature overview on after-treatment of syndesmotic screws

Study	LOE	Patients	Screws retained	Follow-up (months)	Major findings
Hoiness [48]	1 (RCT)	64	32	12	Routine removal of quadricortical screws; no removal of tricortical screws. Tricortical, at 3 months significantly better on OMAS; after 1 year no difference in outcome
Bell [46]	4 (retrospective cohort)	30	7 (2 broken)	15	No significant difference in Baird–Jackson ankle score
Weening [32]	4 (retrospective cohort)	51	21	18	No significant difference in OMAS and SMFA for removed and retained screws
Moore [17]	2 (quasi-RCT)	120	113 (9 broken)	5	No apparent difference in outcome between retained and removed screws
Hamid [47]	4 (retrospective cohort)	52	25 (10 broken)	30	No significant difference in AOFAS and VAS for intact and removed screws. Broken screws, best outcome
Manjoo [49]	4 (retrospective cohort)	76	64 (44 broken or loose)	23	No significant difference in the lower extremity measure and OMAS for broken/loose and removed screws. Intact screws, significantly lower outcome
Egol [28]	4 (retrospective cohort)	79	68 (15 broken)	12	No statistical difference in pain, function or range of ankle motion between removed/broken screws and retained screws

LOE level of evidence; FAOS Foot and Ankle Outcome Score; OMAS Olerud–Molander Ankle Score; AOFAS American Orthopedic Foot Ankle Society hindfoot score; SMFA Short Musculoskeletal Function Assessment Questionnaire